Healthy Me - At Home and Away: Influenza pandemic

Showing posts with label Influenza pandemic. Show all posts

Tuesday, October 20, 2009

H1N1 has not mutated into deadlier form

HONG KONG - The head of the World Health Organization said yesterday the Influenza A (H1N1) virus had apparently not yet mutated into a more serious disease and that the development of vaccines was proceeding on track.

The vaccines for H1N1 produced so far have been very effective, WHO director-general Margaret Chan said at the opening ceremony for the organisation's annual Western Pacific meeting in Hong Kong.

"The virus can mutate any time. But from April to now, we can see from the data given to us by laboratories worldwide that the virus is still very similar (to the previous state)," Dr Chan told reporters.

Dr Chan said the biggest challenge in combating the pandemic would be ensuring enough vaccine got to the world's poorest countries.

Ideally, 3 billion doses could be produced worldwide annually, she told the meeting, noting that China had already begun to vaccinate people.

"Results of early clinical trials suggest that a single dose of pandemic vaccine will be sufficient. If confirmed, this finding will literally double the amount of vaccine available," she said. "Here's the big question: Will this result in more equitable distribution of vaccines? Let me assure you: I am pursuing this opportunity from several angles."

Dr Chan warned that the death of pregnant women in the developing world during a pandemic would be "especially tragic" because the number could be much higher than elsewhere.

Her comments came after the WHO's warning last week that the annual production of H1N1 vaccines is expected to fall well short of the 4.9 billion doses that it had earlier forecast. AFP

From TODAY, World – Tuesday, 22-Sep-2009

Wednesday, July 1, 2009

Legislators push for health emergency as A(H1N1) cases climb to 1,709

ANNIE RUTH C. SABANGAN, GMANews.tv
07/01/2009 | 06:12 PM

MANILA, Philippines - Two legislators have urged the government to declare a state of national health emergency and ensure that poor people will have access to affordable medicine, even as the Department of Health (DOH) relaxed its guidelines despite a spike in the number of Influenza A(H1N1) cases in the Philippines.

The declaration would allow the government to re-align funds for the containment of the disease, impose price control over essential medicines, and require compulsory licensing of patented drugs through the Cheaper and Quality Medicines Act of 2008, according to Iloilo Representatives Ferjinel Biron and Janette Garin, who are both physicians.

"Nothing is preventing the DOH from declaring an epidemic. The phenomenon is global, it was declared a pandemic. It is timely for the DOH to declare a state of national health crisis," said Biron, principal author of the House version of R.A. 9502.

As of June 29, the DOH had reported 1,709 cases from various parts of the country. The Philippines has the 10th highest number of patients in the list of 101 countries that have reported A(H1N1) cases, based on the June 29 report of the World Health Organization.

Given its rapid spread, one-fourth of the country's population of 90 million could be hit with the infection, according to recent estimates made by Dr. Lyndon Lee Suy, head of the DOH's Emerging and Re-Emerging Infectious Disease Program.

The virus claimed its first fatality in the country and in Asia last June 19 with the death of a 49-year-old female employee of the House of Representatives who had been suffering from a heart ailment. Thailand, another Southeast Asian country, reported three A(H1N1)-related deaths in the past week of people who had been stricken with pneumonia.

Measures relaxed

However, DOH Secretary Francisco Duque III stood pat on the department's decision to shift its anti-A(H1N1) strategy from containment to mitigation. He said there was nothing to fear in the increase in number of cases, as more than 80 per cent of infected patients have recovered.

He also opposed the suggestion for a declaration of a state of national health emergency. "No, we're far from doing that," Duque said. He refused to answer further questions on the issue, saying the department's legal experts would have to study the matter.

Dr. Robert So, program officer of the DOH's pharmaceutical management unit, said the "criteria for declaring a national health emergency is not fixed" in the Cheaper Medicines Act. He maintained that there is no need for such a declaration because the government has enough stock of 1.2 million Tamiflu capsules, and the drug is not patented by its manufacturer Roche in the Philippines.

Instead, the DOH began relaxing control measures against the new flu strain through Interim Guideline No. 16 issued last June 24. The directive no longer requires travelers arriving from countries with A(H1N1) cases to observe home quarantine before they return to their work places or schools, advising "responsible self-monitoring" instead.

It also lifted mandatory hospital confinement of patients with suspected or confirmed infection. Instead, patients were advised to place themselves under home care.

The DOH limited hospital confinement to patients "manifesting respiratory difficulty, progressively acute illness and debility belonging to risk groups."

Free distribution of the anti-flu drug Oseltamivir has also been limited to individuals who had "close contact" with people having "existing medical conditions that may be aggravated by viral infection."

In previous weeks, the DOH had given Oseltamivir to all healthcare workers, household members, and individuals who had close contact with suspected or confirmed cases.

The new directive has also restricted treatment to A(H1N1) patients "with severe or progressive illness or pre-existing illness that compromises the immune and pulmonary system." Prior to the new guideline, the DOH had been providing treatment to all individuals confirmed to have been infected by the virus.

Also on June 24, the department issued another directive, Interim Guideline No. 18, disallowing the suspension of classes in areas with community level A(H1N1) transmission. The DOH said classes could only be suspended if the schools have patients with "unusually severe illness" or if there is a "large number of simultaneously ill" students or staff.

Secretary Duque said the DOH came out with the guidelines "in conjunction with WHO recommendation."

Duque said that according to the WHO, which declared a flu pandemic last month after receiving reports of A(H1N1) cases across the globe, the virus "is stable and is not undergoing changes so far."

Reactive approach?

But Garin said that even without a pandemic, the government could make the declaration and use it as a tool to lower the prices of essential medicines. She said the move could benefit thousands of chronically ill people who are the most vulnerable to the flu virus.

"As long as you include the medicines in the list of essential drugs, these could already be subject to price regulation that will be approved by the President through the recommendation of the DOH secretary," she said. According to Section 23 of the Cheaper Medicines Act, all medication for the treatment of chronic illnesses, life-threatening conditions and infectious diseases and prevention of diseases are subject to price regulation.

Garin said even paracetamol, Vitamin C supplements and other drugs used to prevent the spread of A(H1N1) should be subject to price control.

Biron and Garin have criticized the DOH's "reactive" approach to combating the new flu strain, saying the agency should have long taken preventive measures to arrest the fast spread of the virus.

"The DOH's approach is always curative, and not preventive. It only acts when the problem is already getting worse. Downplaying the illness could make the public lenient," said Garin.

Biron said the DOH should not underestimate the mild effects of the virus, as this could be just the tip of the iceberg.

"I'm sure there are thousands already affected (by the disease), but we do not have enough testing kits. We are not fully equipped to have people checked. Besides, we don't know whether the virus would stay in its mild state or become virulent," he said. - GMANews.TV

From GMANews.tv; see the source article here.

H1N1 flu spreads as Spain, Uruguay report first deaths

Posted: 01 July 2009 0420 hrs

A guard dons a mask at a hospital in Bangalore, India.

MADRID: Spain and Uruguay on Tuesday reported their first deaths from H1N1 flu, as Canada expressed fears that young people were particularly vulnerable to the virus.

In Spain, a 20-year-Moroccan woman died at a Madrid hospital on Tuesday, becoming the country's first fatality from the A(H1N1) infection.

The woman, who was seven months pregnant and suffered from asthma, died at dawn of a respiratory illness provoked by the infection, said a health ministry statement.

She had been receiving treatment for several days, but her condition deteriorated on Monday, prompting doctors to carry out a Caesarean delivery of the baby, who was fragile but unaffected by the virus, the ministry said.

Three other patients were be in a serious condition in Spanish hospitals, health officials said.

Her death was the fourth from H1N1 flu in Europe.

Late on Monday, Britain reported its third H1N1 flu death - a schoolgirl whom officials said had underlying health problems.

In the Uruguayan capital Montevideo health ministry officials reported the country's first victim, a 60-year-old woman.

"Late today a woman died in Montevideo with multiple organ failure and tests confirmed the presence of the A(H1N1) virus," the ministry said in a statement.
Uruguay has 195 confirmed cases of H1N1 flu, including 12 requiring hospitalisation, according to the ministry.

Health authorities in Canada meanwhile expressed alarm that young people were being hit hardest by the infection.

Preliminary data showed the virus had mostly infected people under the age of 20 in Canada, and relatively few people over 65.

During seasonal influenza outbreaks, it is usually the elderly who account for 25 percent of infections, and most deaths.

"So this is quite different," Chief Public Health Officer David Butler-Jones said.
"Although we do expect some cases to be severe in any influenza outbreak, especially when there is underlying factors such as chronic lung disease or diabetes, there are some cases (now) where the individual was previously healthy before catching this virus and rapidly has progressed to severe illness and required a ventilator," he said.

Figures released by the World Health Organisation on Monday, meanwhile, put the death toll from the pandemic at 311 and the number of total infections at 70,893 - up more than 10,000 on the figures released the previous Friday.

US researchers said in a new study published on Tuesday that the virus responsible for the Spanish flu in 1918 had created a viral dynasty that persists today.

The research, published in the New England Journal of Medicine, said the H1N1 virus, which caused tens of millions of deaths, was also transmitted from humans to pigs during the pandemic and continues to evolve today.

"The 1918-1919 influenza pandemic was a defining event in the history of public health," said Anthony Fauci, the director of the National Institutes of Allergy and Infectious Diseases and a co-author of the study.

Jeffrey Taubenberger, the senior investigator at NIAID's Laboratory of Infectious Diseases, said all human-adapted influenza A viruses were descendants, direct or indirect, of that founding virus.

"Thus we can be said to be living in a pandemic era that began in 1918," he added. - AFP/de

From ChannelNewsAsia.com; see the source article here.

Wednesday, June 24, 2009

Prices of flu drugs, vaccine triple amid A(H1N1) crisis

Image via Wikipedia

MARK D. MERUEÑAS, GMANews.TV
06/24/2009 07:30 PM

MANILA, Philippines – Prices of flu drugs and vaccine have surged up to three times their normal prices, aggravating the Philippines’ Influenza A(H1N1) crisis as demand from health-conscious buyers is making the product so expensive.

The Philippines, which is lagging behind other countries in the race for securing ample supplies of anti-swine flu vaccine, has listed 604 confirmed cases and one A(H1N1)-related fatality so far. It is now under pressure to take decisive steps in reducing mortality related to the novel virus.

Tamiflu – a popular brand of the anti-viral drug oseltamivir used to treat symptoms of the A(H1N1) virus – now sells at P150.50 per capsule at a popular drugstore.

The Department of Health (DOH) was able to purchase the anti-viral drug at much lower price before the A(H1N1) virus started spreading across the globe. Dr. Yolanda Oliveros, director of the DOH National Center for Disease Protection and Control, said the government bought its first batch of 750,000 capsules of Tamiflu at P40 each.

Another batch of 500,000 Tamiflu capsules was sold to the government through bidding at P48 a capsule after the Philippines started reporting A(H1N1) cases in the country, Oliveros said.

Since April, the DOH has distributed 600,000 Tamiflu capsules for free to patients who were infected by the new flu strain. All the medical expenses of A(H1N1) cases – from testing to hospitalization – have been shouldered by the DOH since the virus came out.

A source from the DOH told GMANews.TV that consumers have been calling the agency to inquire about the “high prices" of anti-flu medicine and vaccines.

From P500 to P1,800

The exorbitant prices imposed by medical practitioners and drug firms may be considered “profiteering," and the government should find a way “to regulate" the prices of the flu products, said the source, who spoke on condition of anonymity.

A health advocacy group has called for the filing of charges against doctors and drug firms suspected of jacking up drug prices for Tamiflu and flu vaccines.

In an interview with GMANews.TV, Health Alliance for Democracy (HEAD) vice chairperson Gene Nisperos said the group has received reports about some doctors charging their patients as high as P1,800 for a flu shot, in addition to their professional fee (PF).

“Nakikinabang ang malalaking companies at sinasamantala nila ang takot ng mga tao [Big companies are benefiting from the scare and are taking advantage of the situation]," he said.

“Baka plus PF ay umabot na ng almost P3,000. Overpricing na iyan," (If the PF is included, the price would reach almost P3,000. That’s overpricing) he said.

A doctor who operates her own clinic in Makati City admitted in an interview with GMANews.TV that she sells anti-flu vaccines – with brand names Agrippal, Fluarix, and Vaxigrip – at P1,000 to P1,500 per dosage.

At a popular retail drug store, GMANews.TV learned that a single dose of flu vaccine is sold at P695. Most doctors recommend one to two doses per person as protection from the seasonal flu virus.

According to Oliveros, the regular price of flu vaccine is only P500. The DOH is not undertaking free vaccination for the public, but has purchased vaccine for their employees, she said.

The DOH had earlier requested P93.5 million from the national government for “anti-A(H1N1) preparation," Oliveros said. The DOH has shelled out P60 million of the funds and intends to use the remaining amount to buy personal protective equipment such as masks.

Responsible pricing

Flu vaccine manufacturers and distributors are selling their products to drug retailers at “reasonable" prices, according to Dr. Sally Gatchalian, medical director for vaccines at the GlaxoSmithKline (GSK). The company is a leading flu vaccine distributor in the Philippines, carrying the brand Fluarix.

Gatchalian told GMANews.TV that some patients probably get a steep bill for a flu shot because it includes expenses for medical examination, professional fee, and other miscellaneous fees.

GSK and other manufacturers of flu vaccine are members of the Pharmaceutical Health Care Association of the Philippines, which said it has no control and influence on the pricing policies of member firms.

“Pricing is an individual business decision of our member companies. We however encourage members to practice responsible pricing," the PHAP said in an official statement sent to GMANews.TV.

Vaccine supply running out

GSK and Sanofi Pasteur have ran out of flu vaccine stocks amid the global health scare triggered by the spread of the A(H1N1) virus.

Sanofi Pasteur said its annual stock of flu vaccines usually lasts until September, but demand has doubled in recent months and the firm’s supply had dried up as early as June. GSK said its flu vaccine stocks had sold out much earlier in mid-May.

Dr. Remegio Olveda, director of the Regional Institute for Tropical Medicine, said the flu vaccines in the market only protect people from the regular seasonal flu viruses.

“Pero maganda na rin na protected ka sa seasonal flu para maiwasan na mag-mutate pa ang A(H1N1) virus," said Olveda. He stressed the possibility that the A(H1N1) virus, when introduced to another type of flu virus, could form a new strain.

A day after the World Health Organization declared the onset of a global flu pandemic last June 11, the Swiss drugs giant Novartis announced that it had developed an A(H1N1) vaccine. However, clinical trials will only start in July, and the vaccine will not be available in the market until September, at the earliest. - GMANews.TV

From GMANews.tv; see the source article here for the list of items and their recommended retail price.

US company makes first batch of swine flu vaccine

AFP - Wednesday, June 24

Photo illustration of a woman receiving a flu vaccine. A US company that was awarded a 35-million-dollar contract to develop an influenza vaccine using insect cell technology has produced a first batch against (A)H1N1 flu, company boss Dan Adams said.

WASHINGTON (AFP) - - A US company that was awarded a 35-million-dollar contract to develop an influenza vaccine using insect cell technology has produced a first batch against (A)H1N1 flu, company boss Dan Adams said.

"We turned out our first batch of doses -- about 100,000 -- against (A)H1N1 flu last week and we're continuing to manufacture it," Adams, chief executive officer of Connecticut-based Protein Sciences Corporation, told AFP.

The US Department of Health and Human Services on Tuesday announced that it has awarded a 35-million-dollar contract to Protein Sciences, which could be extended for another five years to reach 147 million dollars.

The insect cell technology "has advanced in recent years to a point that we believe it could help meet a surge in demand for US-based vaccine for seasonal and pandemic flu," Health Secretary Kathleen Sebelius said in a statement.

A(H1N1), or swine flu, which emerged in Mexico in April, has been declared a pandemic by the World Health Organization, killing 231 people worldwide and infecting more than 52,000 people in 100 countries.

As the novel strain of swine flu spread, scientists around the world scrambled to develop a seed strain, a necessary first step in developing a vaccine using either chicken eggs or mammalian cells -- the way most vaccines are produced.

They warned that the virus could mutate during the southern hemisphere's flu season before returning north in a more lethal form in autumn, in a pattern similar to that seen in the deadly 1918 flu pandemic, which claimed an estimated 20 to 50 million lives around the globe.

Protein Sciences makes flu vaccine by infecting caterpillar cells with a baculovirus carrying the gene for hemagluttinin, a molecule that sticks out of the surface of the influenza virus.

"Using this method, vaccine candidates, clinical investigational lots, and commercial-scale vaccine production may be available faster than by using traditional vaccine production methods," the health department said in a statement.

The method does not need a seed strain to develop a vaccine, Adams said.
"While everyone else was waiting to get a seed strain, we worked with the genetic code from the virus," said Adams.

"The CDC (Centers for Disease Control and Prevention) sent us a dead virus, which is perfectly safe, and then we extracted genetic information from that virus.

"We can be in manufacturing a lot, lot quicker than people who have to wait for a seed strain," he said.

Protein Sciences' technology is also safer "because these caterpillars don't have any association with man or other animals, so there's no chance for their cells to learn how to propagate human viruses," Adams told AFP.

Under the terms of the grant made to Protein Sciences, if the company's new insect-cell technology proves to be safe and effective, the pharmaceutical minnow, which has just 50 employees, must boost its US manufacturing capability "to provide a finished vaccine within 12 weeks of pandemic onset."

It would also have to produce at least 50 million doses of flu vaccine "within six months of pandemic onset."

That should not be a problem, said Adams, because manufacturing a vaccine using insect cells can be easily and rapidly scaled up because it does not require the same specialized factories required to produce vaccine using egg or mammalian cells.

"We can manufacture our product facilities that make monoclonal antibodies, which is a huge class of products with a huge manufacturing capacity around the world," said Adams.

Protein Sciences' new vaccine against swine flu "could be available right away" if the Food and Drug Administration (FDA) issues an emergency use authorization for it, as it did for the bird flu vaccine developed by Adams's company.

Swiss drugs giant Novartis, which the US government gave 289 million dollars to help develop a vaccine against (A)H1N1 flu, said around two weeks ago that it was poised to begin pre-clinical trials -- tests in vitro and on animals -- on its first batch of novel swine flu vaccine.

Sanofi-Pasteur of France has said it hopes to have doses of swine flu vaccine ready for clinical trials within weeks, while Taiwan's Adimmune Corporation said it expects to complete clinical trials on its A(H1N1) influenza vaccine around September.

From Yahoo! News; see the source article here.