March 9, 2010 | Mark Paradies

Pandemic Flu Update from Dennis Osmer

Dear Friends –

While influenza outbreaks appear to be slowing, neither the WHO, nor CDC has declared an end to this pandemic. There are still some areas with widespread influenza activity.

  

NOVEL H1N1

In an overview of flu activity during the 2009-10 flu season that started Aug 30, the US Centers for Disease Control and Prevention (CDC) said pediatric deaths from the pandemic virus are three times higher than the average for the past three seasons. Flu activity peaked on Oct 24, much earlier than the February peaks of the most recent flu seasons. The CDC pointed out that multiple waves were seen during the three most recent pandemics, emphasizing the importance of vaccination. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5902a3.htm?s_cid=mm5902a3_x

Though older people appear to have some immunity to the pandemic virus, the US Centers for Disease Control and Prevention learned of several outbreaks at nursing homes, detailing three in Morbidity and Mortality Weekly Report (MMWR). They occurred during the fall before the vaccine was widely available, and infections in healthcare workers were documented at two of the facilities. Infection control steps and antiviral prophylaxis seemed to slow flu spread. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5903a3.htm?s_cid=mm5903a3_x

            A new study is shedding light on the immune response of the elderly to H1N1. This study demonstrates that in Finland, individuals born between 1909 and 1924 and to a lesser extent those born between 1925 and 1944 have pre-existing humeral immunity against the 2009 pandemic H1N1 influenza A virus.

·   Ninety-six per cent of individuals born between 1909 and 1919 had antibodies against the 2009 pandemic influenza virus.

· Those born between 1920 and 1944, the prevalence varied from 77% to 14%.

· Most individuals born after 1944 lacked antibodies to the pandemic virus.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19478

H5N1

During 2009, 73 laboratory-confirmed cases of human infection with highly pathogenic avian influenza A (H5N1) virus were reported to WHO from 5 countries. The 73 laboratory-confirmed cases of H5N1 virus infection were reported from Cambodia (1 case), China (7), Egypt (39), Indonesia (21) and Viet Nam (5); all of these countries reported human cases of H5N1 previously. Circulation of highly pathogenic H5N1 virus in poultry is considered to be endemic in these countries.

With almost double the number of human cases of H5N1 reported in 2009 compared with 2008, and with continuing circulation of the virus among certain poultry populations, it is clear that H5N1 remains a concern for both animal health and public health. http://www.who.int/wer/2010/wer8507.pdf


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VACCINE

            Given signs that the pandemic H1N1 virus will continue its dominance over other flu strains, the World Health Organization (WHO), CDC, FDA, etc. have recommended adding the pandemic strain as the H1N1 component of the seasonal flu vaccine for the Northern Hemisphere’s next flu season. Additionally, they have also changed the other influenza A strain, replacing the Brisbane H3N2 component with a Perth H3N2 strain. The influenza B component (changed last year) remains the same.The recommendation for next season’s vaccine:

·   A/California/7/2009 (H1N1)-like virus

· A/Perth/16/2009 (H3N2)-like virus

· B/Brisbane/60/2008-like virus.

The Advisory Committee on Immunization Practices (ACIP) voted to expand the recommendation for annual influenza vaccination to include all people aged 6 months and older. The expanded recommendation is to take effect in the 2010 – 2011 influenza season. The new recommendation seeks to remove barriers to influenza immunization and signals the importance of preventing influenza across the entire population. The vote took place against a backdrop of incremental increases in the numbers and groups of people recommended for influenza vaccination in years past, and lessons learned from the world’s still ongoing first flu pandemic in 40 years.

http://www.cdc.gov/vaccines/recs/acip/

OTHER

            In an effort to maintain the nation’s supply of drugs and other medical products in the event of a pandemic or other emergency, the US Food and Drug Administration (FDA) recently issued guidance to help pharmaceutical companies plan for high absenteeism rates. It focuses on “medically necessary products” such as antivirals and details what the FDA could do to help protect the supply. The guidance is also aimed at companies that make the raw materials and components used in the products. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM196497.pdf

College students living in dorms reduced their risk of influenza-like illness (ILI) at the peak of the flu season by wearing surgical masks a few hours a day and practicing good hand hygiene, say researchers from the University of Michigan. There have been many studies that point out the effectiveness of masks, hand hygiene & social distancing as very effective tools. http://www.cidrap.umn.edu/cidrap/content/influenza/general/news/jan2210masks.html

     

COMMENTARY

                        As the H1N1 pandemic vaccine becomes available in your area, I urge you to get it – for yourself, your family & your community. In the meantime, continue to practice good hygiene and social distancing.

Stay safe

Best regards

               Dennis

Dennis Osmer
Environment, Health, Safety,
& Emergency Management
www.LinkedIn.com/in/dennisosmer
HSE-exec@charter.net
678-421-4452

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