From the news: Roundup and analysis.

[Giuseppe]

Re: From the news: Roundup and analysis.

Reuters AlertNet - SOUTHERN AFRICA: Not enough drugs to handle a pandemic

SOUTHERN AFRICA: Not enough drugs to handle a pandemic

29 Apr 2009 16:21:04 GMT
Source: IRIN
Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author's alone.
JOHANNESBURG, 29 April 2009 (IRIN) -

South Africa, the country with the most resources in Africa, has two suspected cases of swine flu, but does not have adequate supplies of the antiviral drugs known to be effective in treating the rapidly spreading disease that has so far claimed more than 150 lives in Mexico, according to an expert.


"I know for a fact we haven't stockpiled. If you don't have a national stockpile, that's it ? you're not going to get the drugs in time," said Ed Rybicki, a virologist who teaches at the University of Cape Town.

In the absence of a vaccine for swine flu, antiviral medicines such as oseltamivir (Tamiflu) and zanamivir (Relenza) have been used to treat the disease.

Dr Lucille Blumberg, of the South African National Institute for Communicable Diseases, confirmed on 29 April that two suspected cases of swine flu were being investigated. South Africa is a major transit hub for the continent and a destination of migrants.

The World Health Organization (WHO) has allocated a Phase 4 alert level to the flu, which is two steps away from the pandemic phase but signals the need for response and mitigation efforts.

Dorothy Mwangu, a spokeswoman for Roche, the global pharmaceutical company that manufactures Tamiflu, confirmed that the South African government had a stockpile of the drug and said the company also kept its own reserve of drugs to handle seasonal flu outbreaks at country level, but could not comment on the specific quantities on hand in South Africa.

The company had set aside key ingredients of the drug, but it would take time to respond to any sudden major upsurges in demand. She said the country's best bet was to maintain an adequate stockpile.

Neighbours such as Namibia have pinned their hopes on South Africa to meet their drug requirements, should there be an outbreak. Mozambique's national deputy director of health, Leonardo Antonio Chavane, said his country did not have the antiviral drugs. "We use what we have."

Tamiflu is sold at a discounted price to developing countries, and a box of 75 pills retails for about US$24 in South Africa. The government had not responded to queries on the quantity of antiviral drugs stockpiled at the time this story went online.

Rybicki, who is working on a flu vaccine, said if swine flu hit Africa it might be nearly unstoppable because the continent's poor surveillance capacity, higher disease burden than more developed regions, and lack of drugs were a deadly combination.

"I think picking it up - outside of sophisticated centres - all over the world is going to be difficult," he said. "Surveillance at airports is almost nil - I reckon you can count the number of thermal scanners in South Africa on one hand."

Screening a problem
Screening for the disease in Africa would mean locating it in a population that already suffered from many fever-producing ailments, like malaria, and could result in higher mortality rates, Rybicki said.

Developed countries often have standing orders with pharmaceutical companies for vital drugs, so developing countries like those in southern Africa may be out of luck when placing emergency orders for medicines in high demand.Swine flu is a respiratory disease in pigs, caused by type A influenza viruses. According to the US Centers for Disease Control and Prevention, people do not normally get swine flu, however, "swine flu viruses have been reported to spread from person-to-person, but in the past this transmission was limited and not sustained beyond three people."

Here is how some southern African countries have responded so far:

- Zimbabwean economist Innocent Makwiramiti said there was "zero preparedness" for an outbreak. The country is still recovering from one of the biggest ever cholera outbreaks, which claimed thousands of lives. "There is no money to stock hospitals with drugs and it would be a miracle for the government to mobilize funds needed to combat swine flu that, as it were, seems far away."

- Frank Mwenifumbo, Malawi's deputy minister of agriculture and food security, told IRIN that medical teams, including veterinary officials, had been deployed at all entry points to ensure that the human strain of the virus associated with pigs did not spread into the country.

- Zambia is placing a renewed emphasis on epidemiological surveillance throughout the country, while working with the WHO and other organizations to obtain drugs and set up the logistics to cope with a swine flu epidemic, according to local media reports.

- There is concern whether Angola, which has a fragile health infrastructure and a poor track record of responding to recent outbreaks of cholera, rabies and polio, would be able to handle an outbreak. The government has announced that it was "taking measures".

- Botswana's Ministry of Health has advised people who travelled to any of the affected countries or have had contact with any person affected by swine flu and developed a combination of symptoms to report to the nearest health facility.

- Swaziland, which lacks capacity, will be assisted by the WHO country office to help the country monitor flu cases.

llg/ff/jk/vs/jh/gn/jk/he
? IRIN. All rights reserved.
More humanitarian news and analysis: http://www.IRINnews.org
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<cite cite="http://www.alertnet.org/thenews/newsdesk/IRIN/5d35ebd8cc39d3922ac72fa763bd7860.htm">Reuters AlertNet - SOUTHERN AFRICA: Not enough drugs to handle a pandemic</cite>

 

[Giuseppe]

Re: From the news: Roundup and analysis.

Reuters AlertNet - Texas Govption to close US-Mexico border, but premature

Texas Govption to close US-Mexico border, but premature

29 Apr 2009 16:36:49 GMT
Source: Reuters
HOUSTON, April 29 (Reuters) -

Closing the U.S. border with Mexico to prevent the spread of swine flu is an option, but action now would be premature, Texas Gov. Rick Perry said on Wednesday.


"That obviously would be an option, but again, I think playing the what-if game of escalation without good indicators ... is a little premature," Perry said at a news conference in Austin.

(Reporting by Chris Baltimore)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/N29422451.htm">Reuters AlertNet - Texas Govption to close US-Mexico border, but premature</cite>

 

[Giuseppe]

Re: From the news: Roundup and analysis.

Reuters AlertNet - Spanish swine flu patient had not been to Mexico

Spanish swine flu patient had not been to Mexico

29 Apr 2009 17:01:24 GMT
Source: Reuters
(Adds details)
MADRID, April 29 (Reuters) -

​

Spain has detected its first case of swine flu in someone who has not recently visited Mexico, although the patient had been in contact with a visitor to that country, Health Ministry officials said on Wednesday.

Spanish authorities have confirmed 10 cases of the disease and 53 others are under investigation.

Up to now, all had been people who had recently returned from Mexico.

"The patients are stable and they are all responding very well to treatment," Health Minister Trinidad Jimenez told Congress.

A Health Ministry official said the case of transmission in Spain had been a result of contact with a person who had recently been to Mexico.

(Reporting by Raquel Castillo; writing by Jason Webb; editing by Andrew Dobbie)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/LT908055.htm">Reuters AlertNet - Spanish swine flu patient had not been to Mexico</cite>

 

[Giuseppe]

Re: From the news: Roundup and analysis.

Reuters AlertNet - WHO says no sign flu outbreak slowing

WHO says no sign flu outbreak slowing

29 Apr 2009 16:59:02 GMT
Source: Reuters
(For full coverage of the flu outbreak, click [nFLU])

* United States confirms first flu death outside Mexico
* Flu in 9 countries as Germany and Austria confirm cases
* WHO says no sign virus is slowing down
* Markets wary, but impact thus far very limited
(Adds more details on U.S. death)

By Maggie Fox, Health and Science Editor
WASHINGTON, April 29 (Reuters) -

A Mexican toddler in Texas has died of the new swine flu virus, the first confirmed death outside Mexico, as the World Health Organization said the outbreak showed clear signs of spreading around the world.


Nearly a week after the threat first emerged in Mexico, Spain reported the first case in Europe of swine flu in a person who had not been to Mexico, underscoring the threat of person-to-person transmission.

"It is clear that the virus is spreading and we don't see evidence of it slowing down at this point," Dr. Keiji Fukuda, WHO acting assistant director-general, told a news briefing.

With Germany and Austria reporting cases, bringing the number of affected countries to 9, Fukuda said the WHO was moving loser to raising its pandemic alert to phase five, the second highest level possible. [nLT908042]

U.S. officials said that a 22-month-old boy had died in Texas -- the first confirmed U.S. swine flu death -- but they added that he was on a family visit from Mexico, where up to 159 flu fatalities have been recorded.

Dr. Richard Besser, acting head of the U.S. Centers for Disease Control and Prevention, said the country now had 91 confirmed cases in 10 states from New York to California.

"We're going to find more cases. We're going to find more severe cases and I expect that we'll continue to see additional deaths," Besser said. [nN29385038]

President Barack Obama, who on Tuesday asked for $1.5 billion in emergency funding to fight the disease, said the death showed it was time to take "utmost precautions" against the virus.[nLT884447]

Wall Street opened higher on Wednesday even as data showed the U.S. economy shrank at a steeper pace than expected and traders looked beyond flu fears for hopeful signs that the recession may be abating. [ID:nN29399582].

Financial markets are keeping an eye on the spread of the virus, but so far the economic impact has largely been confined to the tourism and pharmaceutical industries.

Unless a significant number of deaths start to be reportedfrom a number of countries, raising the possibility of an even slower recovery from recession, analysts predict the impact on stock, bond and currency prices is likely to be limited.


TOURISM HIT

France said it would seek a European Union ban on Thursday on flights to Mexico [nLT437502]. Argentina and Cuba have already stopped flights from Mexico.

The EU, the United States and Canada have advised against non-essential travel to the popular tourist destination, as nearly all the cases so far, in Canada, New Zealand, Israel and Spain, have been linked to travel from Mexico.

The WHO said there was no plan now to call an emergency committee meeting to raise the pandemic alert level, which could take place if it were confirmed that infected people in at least two countries were spreading the disease to other people in a sustained way.

The WHO's Fukuda, who earlier said the outbreak may end up as a "very mild pandemic", said the report of the Spanish case involving a person who had not been to Mexico suggests the virus is spreading more easily among people.

"There are cases which are occurring in people who have not traveled," Fukuda told a news briefing. "What we are looking for overall is whether we see many kinds of those infections occurring that suggest transmission is occurring independent of travel."

Spain's El Mundo newspaper said the Spanish patient had recent contact with someone who had visited Mexico.

H1N1 swine flu poses the biggest risk of a large-scale pandemic since avian flu re-emerged in 2003, killing 257 people of 421 infected in 15 countries. In 1968 a "Hong Kong" flu pandemic killed about 1 million people globally, and a 1957 pandemic killed about 2 million.

The new strain contains genetic material from avian, swine and human viruses and appears to have evolved the ability to pass easily from one person to another.

It cannot be caught from eating pork products but Egypt ordered all its pigs to be slaughtered and some countries, led by Russia and China, have banned U.S. pork imports.

The World Trade Organization said on Wednesday it had not been told officially of any such bans, and the EU and Japan said they would not follow suit.

In the United States, where pork producers have voiced outrage over the trade bans, officials began referring to the outbreak as the 2009 H1N1 flu.

Obama's newly confirmed Health and Human Services Secretary Kathleen Sebelius held her first news conference on Wednesday seeking again to reassure the public

"We are determined to fight this outbreak and do everything we can to protect the health of every American," she said.


SCHOOLS, PYRAMIDS CLOSED

The outbreak has deeply affected life in Mexico and ravaged tourism, a key earner. Mexico City was unusually quiet, with schools closed. Many parents took their children in to work.

All Mayan and Aztec pyramid ruins, dotted through central and southern Mexico, were closed until further notice.

Mexican Health Minister Jose Angel Cordova said more than 1,300 people were in hospitals, some of them seriously ill, out of a total of about 2,500 suspected cases.

"In the last few days there has been a decline (in cases)," he said. "The death figures have remained more or less stable."

Seasonal flu kills 250,000 to 500,000 people in a normal year, including healthy children in rich countries.

Health agencies advise frequent hand-washing and covering sneezes and coughs to help stop the spread. Experts generally agree that face masks, especially the surgical masks seen on the streets of Mexico City, offer little protection.

(Reporting by Maggie Fox, Doina Chiacu and Will Dunham in Washington, Jason Lange, Catherine Bremer Alistair Bell and Helen Popper in Mexico City, Eric Burroughs and Tan Ee Lyn in Hong Kong; Writing by Andrew Quinn, editing by Anthony Boadle)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/N29472619.htm">Reuters AlertNet - WHO says no sign flu outbreak slowing</cite>

 

[Giuseppe]

Re: From the news: Roundup and analysis.

Reuters AlertNet - US state Maine confirms three swine flu cases

US state Maine confirms three swine flu cases

29 Apr 2009 16:58:00 GMT
Source: Reuters
BOSTON, April 29 (Reuters) -

Three adults in the northeastern U.S. state of Maine were diagnosed on Wednesday with H1N1 swine flu and are recovering in their homes, the governor's office said.


"It is important for the citizens of Maine to prepare for this as they would any other emergency situation," Governor John Baldacci said in a statement.

(Reporting by Jason Szep)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/N29490063.htm">Reuters AlertNet - US state Maine confirms three swine flu cases</cite>

 

[Giuseppe]

Re: From the news: Roundup and analysis.

Reuters AlertNet - ANALYSIS-US vaccine supply could be limited in flu pandemic

ANALYSIS-US vaccine supply could be limited in flu pandemic

29 Apr 2009 17:25:51 GMT
Source: Reuters

* Experts worry US would lose flu vaccine in pandemic
* Production has improved

By Lisa Richwine
WASHINGTON, April 29 (Reuters) -

Most influenza vaccines for Americans are manufactured in other countries -- a scenario that could limit U.S. supplies should a swine flu vaccine be needed in the coming months.


U.S. government officials have taken steps in recent years to promote more production on U.S. soil by a diverse group of companies, but those efforts are far from complete.

If the current strain of swine flu turned into a pandemic, some health experts worry countries might try to reserve flu vaccine for their own citizens.

"If this thing goes global, our lack of capacity makes it very hard," said former U.S. Health and Human Services Deputy Secretary Tevi Troy, who worked on flu preparedness efforts in the George W. Bush administration.

"One of the things we were worried about is what if European governments say 'Hey, I know you've got a contract with the U.S. government, but we're going to nationalize our capacity.' That is a concern," said Troy, now a visiting senior fellow at the Hudson Institute.

But other experts say U.S. capacity has greatly improved in recent years.

Global health officials are debating whether to ask manufacturers to mass-produce a vaccine to fight the H1N1 strain of swine flu that has killed dozens of people in Mexico plus a Mexican boy who was brought to the United States for treatment.

Infections have been found in the United States, New Zealand, Israel, Canada and Spain.


MONTHS TO MAKE

Manufacturers have taken initial steps, but it would require months to make a vaccine to fight the new strain.

An immunization against a pandemic virus "will probably be the most highly sought-after product on the face of the earth," said Mike Osterholm, director of the Minnesota-based Center for Infectious Disease Research and Policy.

"In the face of a pandemic, it's hard to imagine any country willingly letting vaccine leave from within its border to another country just because there's a contract" with the U.S. government, he said.

The precarious situation was highlighted in 2004 when a British flu vaccine plant was contaminated, wiping out half the U.S. supply for that year.

The Bush administration in 2006 gave $1 billion to five companies to modernize production of vaccines and make them in the United States. The goal was to establish enough domestic capacity to supply vaccine within six months of the start of a pandemic to the entire U.S. population of about 300 million.

Building up U.S. production is still ongoing.

Sanofi-Aventis SA <sasy.pa> is the major supplier for the U.S. market, making about 50 million doses annually at a plant in Swiftwater, Pennsylvania.

A second Swiftwater plant could produce another 50 million doses of seasonal vaccine this year if cleared by U.S. regulators, Sanofi spokeswoman Donna Cary said. When fully operational, that plant could churn out 100 million doses of the three-strain seasonal vaccine, said Cary, but she declined to say when that would be.

Other companies including GlaxoSmithKline Plc <gsk.l> and Novartis AG <novn.vx> make at least part of the vaccine outside the


U.S.PHENOMENAL EXPANSION

The funding for vaccine manufacturing has produced "phenomenal expansion in manufacturing capacity," Dr. Anne Schuchat, an interim deputy director at the Centers for Disease Control and Prevention, told a Senate hearing.

Asked if the United States could produce 300 million doses domestically now, Schuchat said officials were "very optimistic," but added: "This virus can surprise us, and even with all those investments it may just technically be difficult."

Other experts agreed preparedness efforts had helped, particularly with Sanofi boosting its U.S.-based production."We are in a good position right now in the United States," said Dr. Kathleen Neuzil, who serves on the pandemic flu task force of the Infectious Diseases Society of America as well as a U.S. government advisory committee on vaccines.

Companies limit production each year based on how much officials think they can sell, and they could make more, she added.

Also, the seasonal vaccine contains three flu strains, but a pandemic vaccine might need only one. "You can make three times as much if only one strain is in the vaccine," Neuzil said.

Osterholm said it was too soon to predict the U.S. capacity, as it would depend in part on what dose would be needed and whether it could be stretched with an ingredient known as an adjuvant. "There clearly has been some increase (in capacity), but it's not clear what the increase is," he said.

Neuzil said antiviral drugs could help address any shortfall by treating or preventing the flu, although the medicines do not offer long-term protection.

She said she worried more about vaccine availability for poor countries than for the United States.

"Ninety-five percent of influenza vaccine is made in the U.S. and Europe. As a global community, we also need to consider supply for the low-resource countries," she said.

(Reporting by Lisa Richwine; Editing by Maggie Fox and Gerald E. McCormick)
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</novn.vx></gsk.l></sasy.pa>​

<cite cite="http://www.alertnet.org/thenews/newsdesk/N28309616.htm">Reuters AlertNet - ANALYSIS-US vaccine supply could be limited in flu pandemic</cite>

 

[Giuseppe]

Re: From the news: Roundup and analysis.

Reuters AlertNet - FACTBOX-Chronology of 1st US swine flu death in Texas

FACTBOX-Chronology of 1st US swine flu death in Texas

29 Apr 2009 17:35:13 GMT
Source: Reuters
April 29 (Reuters) -

A Mexican toddler in Texas has died of the new swine flu virus, the first confirmed death outside Mexico, as the World Health Organization said the outbreak showed clear signs of spreading around the world.


Following is a chronology of key dates in the case, as provided by Texas state health officials:

• April 4 - A 22-month-old boy travels with his family to Matamoros, Mexico, from Mexico City on a commercial flight, to visit relatives in Brownsville, Texas, just across the border.
• April 8 - boy develops fever and influenza-like symptoms.
• April 13 - boy admitted to Brownsville area hospital.
• April 14 - medical transport service transfers boy to Texas Children's Hospital in Houston, which has a world-class medical center.
• April 27 - boy dies of underlying problems associated with pneumonia.
• April 29 - U.S. Centers for Disease Control and Prevention confirm that boy had swine flu, making him the first confirmed U.S. death of the disease.

(Sources: Texas Department of State Health Services, Houston Department of Health and Human Services, Texas Children's Hospital)
(Reporting by Chris Baltimore, editing by Jackie Frank)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/N29494594.htm">Reuters AlertNet - FACTBOX-Chronology of 1st US swine flu death in Texas</cite>

 

[Giuseppe]

Re: From the news: Roundup and analysis.

WHO | Swine influenza - update 5

Swine influenza - update 5

29 April 2009 --

The situation continues to evolve rapidly.

As of 16:15 GMT, 29 April 2009, eight countries have officially reported cases of swine influenza A/H1N1 infection.


The United States Government has reported 91 laboratory confirmed human cases, with one death.

Mexico has reported 26 confirmed human cases of infection including seven deaths.

The following countries have reported laboratory confirmed cases with no deaths

- Canada (13), Germany (3), Israel (2), New Zealand (3), Spain (4) and the United Kingdom (5).

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders.


It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products.

Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.
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<cite cite="http://www.who.int/csr/don/2009_04_29/en/index.html">WHO | Swine influenza - update 5</cite>

 

[Lurker]

Re: From the news: Roundup and analysis.

WHO moves closer to raising flu pandemic alert
29 Apr 2009 18:05:19 GMT
Source: Reuters
* Flu infecting people who have not been to Mexico

* Virus spreading between humans, not from contact with pigs

* New strain causing everything from mild to fatal illness

(Recasts with details of infection patterns, virus risks)

By Laura MacInnis

GENEVA, April 29 (Reuters) - Swine flu is infecting people who have not been to Mexico and the outbreak shows no sign of slowing down, the World Health Organization said on Wednesday.

The WHO's emergency committee had not scheduled a meeting to increase its pandemic alert level but was likely to do so soon, acting Assistant Director-General Keiji Fukuda said.

"It appears we are moving closer to that, but we are not there yet," he told a news conference. "At this point there is very intense analysis of all available information going on."

WHO experts are scrutinizing the transmission patterns of swine flu to see if it is spreading among people who have never been to Mexico -- the epicenter of the outbreak -- or had close contact with those who had.

Fukuda said people who have not travelled were among those falling ill, although many of those had contact with people who had recently traveled to Mexico.

Once the disease showed signs of spreading in a sustained way within communities in the United States, Europe or elsewhere, Fukuda said the WHO would look to again raise the alert level, as it did on Monday from 3 to 4.

The U.N. agency's official guidance indicates: "the declaration of Phase 5 is a strong signal that a pandemic is imminent."

WHO Director-General Margaret Chan could call an emergency committee meeting at short notice, Fukuda said, saying this could happen "whenever the evidence suggests".

In its own laboratories, the WHO has confirmed only eight deaths from swine flu, including seven in Mexico and one in the United States, a case that U.S. authorities have said was a Mexican toddler. Mexico has reported as many as 159 deaths from the virus.

Fukuda also cited 114 confirmed swine flu infections in Mexico, the United States, Canada, Israel, Spain, Britain and New Zealand, with mild symptoms reported outside Mexico. "It is clear that the virus is spreading and we don't see any evidence of this slowing down at this point," he said.

There is no link between contact with pigs or eating pork and infection with the virus, which is spreading from person to person and appears to cause more diarrhea than seasonal flu.

Infection with swine flu could cause symptoms from very mild to fatal illness, according to Fukuda, who stressed more analysis was needed before the virus risks could be understood.

"It is possibly premature to think of this as a mild pandemic or as a severe pandemic," he said.



http://www.alertnet.org/thenews/newsdesk/LT910095.htm

 

[Lizw]

Re: From the news: Roundup and analysis.

Haven't posted here before, so I'm not sure I'm putting this in the right place--moderators please move if needed.

WiredScience is reporting that the swine flu is composed of two swine variants only, not a combination of swine, human and avian. CDC has allegedly confirmed this in a notice to scientists. I'm not sure what that means in terms of diagnosis and treatment (or transmissibility) but perhaps, if confirmed to the public, it will stop some of the speculation about deliberate tampering with viruses, or things missing from laboratories, etc.

http://www.wired.com/wiredscience/2009/04/swinefluupdate/