H5N1

Botswana asks for help against H1N1

Via Mmegi Online: Ministry appeals to diplomats to thwart 'swine flu'. Excerpt:

The Ministry of Health has appealed to diplomats in Botswana for assistance in fighting the influenza pandemic, H1N1 2009, should it affect Botswana.  

Briefing the diplomats on the pandemic at an event held this week at the GICC in Gaborone, the permanent secretary in the MoH, Newman Kahiya, revealed that the ministry still has challenges and it is in need of assistance to augment the stock of antivirals, personal protective clothing, funding for the dissemination of information, communication materials and building of laboratory capacity to perform tests within the country. 

He revealed that they are still sending specimens to South Africa for analysis and verification. 

"As an appeal to you, we welcome any assistance you may have in this area,"  he said, adding that the World Health Organisation and USAID has donated medicine and medical supplies towards fighting the pandemic in the event it spills over into the country. 

The permanent secretary said Botswana has not had any confirmed case of this type of influenza. 

"This does not mean that we should be complacent because the pandemic influenza is communicable and spreads from human to human very quickly," he noted. 

Kahiya revealed that last week there were three suspected cases of the influenza and lab results for two of the cases are negative. 

"We are awaiting results of the third case. All cases have fully recovered and none are under observation," he added, while stating that there they do not place the suspected cases on isolation but require them to be home.

Celebrity flu

NewsNow is full of versions of this report from the Watford Observer: Harry Potter star catches swine flu. The story popped up on Saturday and has now, um, gone viral. 

Somewhat less widespread are the reports about French rugby star Maxime Medard. And now someone named Imogen Thomas, in a British reality-TV show called Big Brother, is down with H1N1 also.

It's all pretty trivial, but unless you actually know someone who's come down with swine flu (or you've caught it yourself), it's a hard story to relate to. But millions of people have seen the Harry Potter films, and millions more are rugby fans, and millions no doubt follow Big Brother.

So if H1N1 hits a familiar face, it must become a little more real to many people. That means more people will watch the news (boosting ratings) or buy the paper (boosting circulation). The media will predictably give their audiences what sells.

And if Sarah Palin ever comes down with H1N1, expect a media meltdown on an unheard-of scale.

New Zealand: July 5 update

Via the Ministry of Health: Influenza A (H1N1) Swine Flu - Update Ninety-six. Excerpt:

The cumulative total of confirmed cases in New Zealand is 961, up from 945 yesterday. The number of probable cases is 62. The number of deaths associated with influenza A (H1N1) is three. 

The cumulative total of confirmed cases by region are: Northland (20), Auckland (202), Waikato (45), Bay of Plenty/Lakes (29), Gisborne (2), Hawkes Bay (84), Taranaki (3), Wanganui/Palmerston North (14), Wellington (292), Nelson/Marlborough (22), Canterbury (234), Otago/Southland (14).

Singapore: July 5 update

Via the Ministry of Health: 52 new confirmed cases of Influenza A (H1N1-2009). Excerpt:

Singapore has confirmed 52 new cases (1004th – 1055th case) of Influenza A (H1N1-2009) today, bringing the total tally to 1055 confirmed cases. 

Investigations are on-going for these 52 cases. Of the 69 cases investigated today, there were 50 local cases and 19 imported cases. Of the cumulative number of 1003 cases investigated thus far, 591 were local cases and 412 were imported cases.

New Zealand: Swine flu deaths prompt calls

Via Stuff.co.nz: Swine flu deaths prompt calls. Excerpt:

New Zealand's Healthline received a 40 percent increase in the number of calls after the Ministry of Health announced yesterday three people with swine flu had died. 

Two of the people had underlying medical conditions. They were a young girl who died yesterday morning in Wellington Hospital and a 42-year-old man who died on Thursday in Christchurch. 

The coroner will investigate whether any medical conditions played a part in the death of Zachary Wilson, 19, from Hamilton, who died at home last Sunday without having been diagnosed with swine flu. 

The Ministry said swine flu was more than likely the cause of the three deaths. 

Following the announcement of the deaths yesterday, Healthline received 2000 calls, director of Public Health Mark Jacobs said. 

"There was a definite spike in calls after the news at 6pm, so I encourage people to persevere and keep holding if they call at a busy time and need to wait." 

Healthline, 0800 611 116, has registered nurses answering calls 24/7. 

New Zealand now had 961 confirmed cases, up from 945 yesterday, Dr Jacobs said.

Sydney man dies with H1N1

Via ABC: Sydney man dies with swine flu. Excerpt:

A Sydney man who had been diagnosed with swine flu has died - the 11th death related to the virus in Australia. 

The New South Wales Department of Health says the 57-year-old had significant underlying medical conditions, including diabetes. He died in Westmead hospital on Friday. 

It is the second case of a swine flu-related death in NSW. 

Last Monday a 45-year-old man became the first person with swine flu to die in the state, and the 10th in Australia. Doctors say he also had underlying medical issues.

Manitoba: July 2 update

Via Manitoba Health: Bulletin #29 H1N1 Flu. Excerpt: 

Manitoba Health and Healthy Living is reporting 227 new confirmed cases of H1N1 flu this past week based on positive lab tests reported by Cadham Provincial Laboratory. This brings the Manitoba total to 685 reported laboratory‑confirmed cases. Manitoba has reported four H1N1 flu‑related deaths.

That's a 49.5 percent increase in cases in a week.

Australia: H1N1 cases double in 10 days in New South Wales

Via the Sydney Morning Herald: Swine flu cases double in 10 days in NSW. Excerpt:

Swine flu is spreading faster in NSW with the number of confirmed cases doubling to more than 1,200 in 10 days. 

The steep climb has outstripped the rate of increase in national figures and includes 142 cases admitted to hospital - eight of whom have been placed in intensive care. 

NSW Health confirmed on Saturday that 1267 people in the state have contracted the virus since the worldwide outbreak of H1N1 influenza. 

The numbers represent a 114 per cent increase from June 25, when NSW's total cases reached 592. 

Australia's total is also on the rise from 3000 to 5254 over the same period, which represents a substantial increase but at a rate slower than NSW has experienced.

Argentina: Flu and politics keep mixing

Via the Latin American Herald Tribune: Argentina Denies Manipulating Flu-Virus Figures. Excerpt:

Argentina’s new health minister, Juan Manzur, denied Saturday that officials concealed information about the number of people infected with the AH1N1 flu virus in the lead-up to recent legislative elections. 

“They were working with data on patients confirmed (ill in laboratory tests),” Manzur said in justifying the drastic change in the official infection figures before and after last Sunday’s legislative elections, in which the ruling Peronist party lost its control over both houses of Congress. 

On June 26, two days before the vote, the Health Ministry said 1,587 people were infected with swine flu; but on June 29, Graciela Ocaña resigned as head of that portfolio and was replaced by Manzur, who on Friday acknowledged that the number of people infected nationwide could be as high as 100,000. 

But Manzur said the figures were not manipulated under his predecessor and denied that left-leaning President Cristina Fernandez had reprimanded him for providing an estimate on the number of swine-flu cases. 

Only 2,800 infections have been confirmed in laboratory tests, Manzur said. He also said Saturday that the AH1N1 virus thus far has killed 55 people in Argentina, although non-governmental organizations say the death toll is closer to 90. 

The president of the Argentine NGO Doctors Without Flags, Ariel Umpierrez, said there is “no doubt the government hid figures, both on the number infected and killed,” adding that Ocaña should have resigned once she knew the real number of people infected rather than waiting for the results of the elections.

Branswell: Hong Kong's Tamiflu resistance raises worries

Via Google News, a CP report by Helen Branswell: Tamiflu resistant H1N1 from Hong Kong more worrying than earlier findings. Excerpt:

All cases of Tamiflu resistance are not created equal. So while the first three instances of swine flu infection with Tamiflu-resistant viruses were reported in the past week, it was Number 3, not Number 1 that put influenza experts on edge. 

Public health authorities in Hong Kong announced Friday they have found a case of Tamiflu resistance in a woman who hadn't taken the drug. That means she was infected with swine flu viruses that were already resistant to Tamiflu, the main weapon in most countries' and companies' pandemic drug arsenals. 

The two earlier cases, reported from Denmark and Japan, involved people who had been taking the medication. While always unwelcome, that type of resistance is known to occur with seasonal strains and may be less of a threat to the long-term viability of this key flu drug. 

"It was not at all surprising to see resistance in patients on treatment but seeing it in someone who was not treated, it certainly is more concerning," says Dr. Malik Peiris, a flu expert at the University of Hong Kong. 

There is currently no evidence Tamiflu-resistant viruses are spreading widely. Still, some experts see the Hong Kong case as a warning Tamiflu's role in this pandemic may not be as long-lived as pandemic planners would like. 

"I think it's too early to judge," says Dr. Frederick Hayden, an expert on influenza antivirals who teaches at the University of Virginia. "But I think that possibility has existed from the beginning. 

"And it's something that needs to be certainly considered in making determinations about things like antiviral stockpiling, management of patients with more serious illness in hospital and how the available drugs will be used." 

Some experts say this early sign of resistance should prompt a rethink of how often and in which circumstances Tamiflu is used to battle the novel H1N1 virus. "

It ... probably highlights the importance of not using these antiviral drugs indiscriminately, given that the disease is relatively mild," says Peiris, whose hospital monitored the woman who was found to be carrying the resistant virus. 

"In people who don't have underlying risk factors, it probably should not be treated with Tamiflu, basically."

Indonesia: Bird flu suspect in hospital

Via Bird Flu Information Corner, a translated and edited report from Rakyat Aceh: Aceh ::: Bird flu suspect. Excerpt:

Yudi Anggara (14), a resident of Kampung Alur Nunang, Kecamatan Banda Mulia, Aceh Tamiang, is suspected to contract bird flu virus. 

Victim has contact history with dead chicken, when he disposed dead chickens into a river nearby his house. 

Currently, victim is being treated in Adam Malik hospital, Medan, South Sumatera. Until now, victim has not recovered yet, and he is prohibited to return to his village before test result issued by Jakarta laboratory. 

Health service staff, dr Zuheini said that victim had fever after disposing dead chickens belong to his family. The chickens were found suddenly died with bluish appearance. 

Victim was then rushed to local public health center, and from then was referred to Tamiang regional hospital. Furthermore, Agriculture Service officers have done further test to the dead chickens done, and showed positive bird flu infection.

UK: H1N1 in Parliament

Via the Daily Mail: Swine flu has arrived in Westminster too - but who'll be claiming for the Tamiflu. Excerpt:

Swine flu has found its way to the Houses of Parliament. 

A senior security official there has become the first member of staff to be diagnosed with the virus – sparking fears that it may spread to MPs. 

Simon Pierce, 44, a Metropolitan Police civilian employee who supervises 28 security officers, was taken ill at work last Tuesday. After spending two days in bed, he went to see his GP and tested positive for swine flu. 

 The security chief, who is married with a teenage daughter, told officials in a phone call that he had the virus and had been prescribed a course of Tamiflu anti-viral tablets. 

Mr Pierce, who has worked at Parliament for ten years, walks around most areas of the Lords and the Commons, often chatting with MPs and staff. On Friday, Jill Pay, the Serjeant at Arms, was notified and told the Government of the health scare.

Australia: H1N1 second-wave fears grow around the world

Via the Courier-Mail, a global survey of H1N1 that starts with news from Queensland: Swine flu second wave fears grow around the world. Excerpt:

Queensland has recorded a surge in swine flu cases as concern grows internationally over a second wave of the disease. 

The number of confirmed cases of the H1N1 virus rose by 85 to 831 in the 24 hours to noon yesterday – more than three times the rate for the previous week. 

There are six swine flu patients in hospital, including three in intensive care. 

No deaths have yet been reported in the state. 

Health authorities in New Zealand yesterday confirmed its first three fatalities. The rising number of cases could also impact on Queensland – a popular winter holiday destination for Kiwis. 

All Queensland schools which were closed due to swine flu will re-open after the holidays on Tuesday, July 14. 

Under a new "protect" phase, classrooms or schools will only be closed in special circumstances, such as those in areas which are otherwise free of the virus. 

Restrictions on students returning from Victoria and several overseas countries have also been lifted. Previously, they were not allowed to go back to school for seven days.

Indonesia: Catch a plane, catch H1N1

Via the Jakarta Post: Catch a plane, catch H1N1. Excerpt:

The number of people in Indonesia suspected of having contracted influenza A H1N1 continued to increase on Thursday, with five new hospital admissions in North Sumatra and four in Bali. 

Adam Malik Hospital in Medan, North Sumatra, said the group of five had just returned from a holiday in Malaysia and Thailand. 

"All five patients are still only suspect cases and are being monitored closely," hospital spokesman Atmawijaya said Thursday. 

"We have isolated them in special rooms for swine flu and bird flu patients." 

After returning to Medan on Tuesday, the patients were admitted to hospital on Wednesday afternoon with one of them suffering a high fever. 

During their stay in Malaysia, the group had learned from local authorities that someone with a suspected case of influenza A H1N1 infection had been aboard their flight from Thailand, and they could have been exposed to the virus. 

The five were in a relatively stable condition on Thursday and samples had been sent to the Health Ministry in Jakarta for laboratory tests, Luhur Soeroso, head of hospital's team of doctors handling influenza A H1N1 and H5N1 (bird flu) infections, said. 

"We are treating this very seriously because these are the first *suspected* cases of H1N1 infection in Medan," Luhur said. 

In Denpasar, Sanglah General Hospital announced Monday it had admitted four new patients believed to be infected with influenza A H1N1. The four had recently arrived from Europe, the United States and Australia.

Shanghai: City stops on-board flu checks

Via Shanghai Daily: City stops on-board flu checks.

The Shanghai Health Bureau yesterday eased some swine flu detection and prevention measures in the city. 

It stopped on-board aircraft passenger temperature checks and ceased confinement of people in close contact with suspicious or confirmed swine flu sufferers in designated quarantine quarters. 

Officials said the revised measures were in line with decisions made by the State Council, China's cabinet, and the Ministry of Health in relation to the epidemic. 

Authorities will continue to check passenger's temperatures through scanners at airports and other transport hubs, while medical measures will be tightened to detect people with fever and respiratory conditions. 

Visitors from other countries and regions suffering from flu symptoms will be treated at designated medical facilities, while their close contacts will be confined to home or residence for observation. 

Shanghai reported seven new swine flu cases yesterday, taking the city's total cases to 156. 

Health officials said the new phase of swine flu prevention and control would still focus on reducing second-generation patients, preventing a wider outbreak, enhancing treatment to critical patients and getting ready for a change in the epidemic's status. 

Shanghai will strive to limit the number of critical and fatal cases, tighten supervision in key places such as schools, communities and public venues, enhance flu epidemic monitoring and adequately prepare for a second wave of the disease.

The story also mentions that China confirmed 42 new cases on Friday, for a total on the mainland of 1,002. Hong Kong, with 26 new cases, now has a total of 927.

UK: Fergus Walsh on 40 deaths a day

Via the BBC's Fergus on Flu blog, a reasonable discussion of Health Minister Andy Burnham's prediction of 100,000 H1N1 cases a day in the UK...and the implied 40 deaths a day resulting from such a rate: Predictions should come with a health warning. Excerpt:

Could the 40 deaths a day figure be accurate? The US experience may help us. They are about one month ahead with swine flu and the CDC reckons (here comes another estimate) that at least one million Americans have had swine flu. They made that prediction when there had been 127 deaths in the US. 

So, using the American figures, that would give us a UK death rate of one per 7,800 cases or 12 deaths a day come the end of August. 

Which goes to show that predicting death rates, and even case numbers, is an inexact science, and such predictions should come with a health warning.

Argentina: H1N1 hits Congress

Via the Buenos Aires Herald: H1N1 hits the Congress. Excerpt: 

Senator Gerardo Morales might be infected with H1N1 influenza virus. The House’s press director Román Tambini confirmed to BuenosAiresHerald.com that another employee is infected by the new virus. 

However, rumors inside the Congress say that cases might be much more and sources of the Lower House’s Administrative Office assure that the winter break was brought forward to next Monday in order to shut the House down, although the measure might also reach the Senate. 

Although the Congress authorities have not yet confirmed the information, several employees have already been notified that the winter break was brought forward. 

Gerardo Morales, head of the Radical Party and Senator of the Upper House of Congress, might be infected with the H1N1 influenza virus. He had the deadly illness' symptoms on Tuesday and Malbrán Institute is already analyzing his sample to confirm the case.

In a related story, the health minister of Buenos Aires City says six more persons have died of H1N1 in the city. That means a total of 52 deaths for the country.

Indonesia: 20 confirmed cases

Via Bird Flu Information Corner, an Antara report: Indonesia ::: Total confirmed novel H1N1 flu reaches 20 cases. Excerpt:

Twelve new positive novel H1N1 cases in Indonesia have been confirmed. This has added the total number of laboratory confirmed to 20 patients. 

According to the data of General Directorate of Disease Control and Environmental Health, Ministry of Health, Jakarta, the twelve new cases are AR (23), RA (10 months), HR(40), IG (33),N (34), BE (50), TD (56), F (14), RW (23), BA (22), JO (43) and NN. 

The patients are being treated in several hospitals. Six in Sulianti Saroso Infectious Disease hospital, one in Gatot Subroto hospital, one in Bintaro International hospital and four in Sanglah Denpasar hospital. 

“Their conditions are improving,” said Head of Public Communication Ministry of Health, Lily Sulistyowati.

Canada: Unready for the next wave

An editorial in today's Globe and Mail: Unready for the next wave. Excerpt:

The first wave of H1N1 has been, mostly, mild; and the mildness has bred complacency. Some of it has been nurtured by public health officials, who refer to “underlying health conditions” among those who have become the sickest. 

What are those underlying conditions? Pregnancy, diabetes, asthma and obesity are among them. So is smoking. There may be nearly as many households with an underlying condition in them as not. 

The outbreak is likely to worsen. Most flus hit hardest at the old, sick and weak; H1N1 strikes people between 20 and 50. Most flus disappear in summer; Canada has five times the flu rate this summer because of H1N1. Of the 29 Canadians who died, several had no other health problems. Canada has a high rate of the disease compared with other countries, but that may be a sign it keeps a closer eye out for it. 

What lies ahead? If Britain's plan is an indication, efforts at containment would end. Schools would stay open, no matter how many cases of sick children had been reported, unless staff members fell ill in large numbers. The focus would be on medical treatment, from an overwhelmed system. 

Britain already has a national information campaign on swine flu; nothing in Canada thus far compares. Public authorities here need, as a first step, to communicate the importance of knowing the flu's symptoms, of applying common sense – don't go to work and infect colleagues. 

But more than that, the authorities need to make whatever investments are necessary to ensure that the system is not overwhelmed, and that lifesaving care is available to all.

In the same paper, Dr. David Butler-Jones of the Public Health Agency of Canada has a letter saying, "We have a pandemic plan that is working well across the country."

Hong Kong: Nurse among new human swine flu cases

Via the Hong Kong government website: Nurse among new human swine flu cases.

Twenty-six new cases of human swine flu were confirmed today, including a nurse from Queen Mary Hospital.   

She developed flu symptoms on June 25 and attended the hospital's staff clinic the same day. She is stable and is under isolation with a paracetamol prescription at home.   

The hospital has traced her close contacts including patients and staff working in the ward. So far no patient or other staff has been found to have upper respiratory symptoms.   

According to the Department of Health, the new cases are 13 males and 13 females aged three to 52. Hong Kong's human swine flu tally is now 927.