Swine Flu Could Hit Up To 40 Percent In US

By MIKE STOBBE - Ap Medical Writer
Associated Press– Fri Jul 24, 5:48 pm ET

ATLANTA – In a disturbing new projection, health officials say up to 40 percent of Americans could get swine flu this year and next and several hundred thousand could die without a successful vaccine campaign and other measures.
The estimates by the Centers for Disease Control and Prevention are roughly twice the number of those who catch flu in a normal season and add greater weight to hurried efforts to get a new vaccine ready for the fall flu season.
Swine flu has already hit the United States harder than any other nation, but it has struck something of a glancing blow that's more surprising than devastating. The virus has killed about 300 Americans and experts believe it has sickened more than 1 million, comparable to a seasonal flu with the weird ability to keep spreading in the summer.
Health officials say flu cases may explode in the fall, when schools open and become germ factories, and the new estimates dramatize the need to have vaccines and other measures in place.
A world health official said the first vaccines are expected in September and October. The United States expects to begin testing on some volunteers in August, with 160 million doses ready in October.
The CDC came up with the new projections for the virus' spread last month, but it was first disclosed in an interview this week with The Associated Press.
The estimates are based on a flu pandemic from 1957, which killed nearly 70,000 in the United States but was not as severe as the infamous Spanish flu pandemic of 1918-19. The number of deaths and illnesses from the new swine flu virus would drop if the pandemic peters out or if efforts to slow its spread are successful, said CDC spokesman Tom Skinner.
"Hopefully, mitigation efforts will have a big impact on future cases," he said. Besides pushing flu shots , health officials might urge measures such as avoiding crowded places, handwashing, cough covering and timely use of medicines like Tamiflu.
Because so many more people are expected to catch the new flu, the number of deaths over two years could range from 90,000 to several hundred thousand, the CDC calculated. Again, that is if a new vaccine and other efforts fail.
In a normal flu season, about 36,000 people die from flu and its complications, according to the American Medical Association. That too is an estimate, because death certificates don't typically list flu as a cause of death. Instead, they attribute a fatality to pneumonia or other complications.
Influenza is notoriously hard to predict, and some experts have shied away from a forecast. At a CDC swine flu briefing Friday, one official declined to answer repeated questions about her agency's own estimate.
"I don't think that influenza and its behavior in the population lends itself very well to these kinds of models," said the official, Dr. Anne Schuchat, who oversees the CDC's flu vaccination programs.
The World Health Organization says as many as 2 billion people could become infected in the next two years — nearly a third of the world population. The estimates look at potential impacts in a two-year period because past flu pandemics have occurred in waves over more than one year.
Swine flu has been an escalating concern in Britain and some other European nations, where the virus' late arrival has grabbed attention and some officials at times have sounded alarmed.
In an interview Friday, the WHO's flu chief told the AP the global epidemic is still in its early stages.
"Even if we have hundreds of thousands of cases or a few millions of cases ... we're relatively early in the pandemic," Keiji Fukuda said at WHO headquarters in Geneva.
The first vaccines are expected in September and October, Fukuda said. Other vaccines won't be ready until well into the flu season when a further dramatic rise in swine flu cases is expected.
First identified in April, swine flu has likely infected more than 1 million Americans, the CDC believes, with many of those suffering mild cases never reported. There have been 302 deaths and nearly 44,000 laboratory-identified cases, according to numbers released Friday morning.
Because the swine flu virus is new, most people haven't developed an immunity to it. So far, most of those who have died from it in the United States have had other health problems, such as asthma.
The virus has caused an unusual number of serious illnesses in teens and young adults; seasonal flu usually is toughest on the elderly and very young children.

Swine Flu: Why You Should Still Be Worried

Friday, July 17, 2009

By Marrecca Fiore

Swine flu is spreading faster than ever — so much so that the World Health Organization has decided to stop tracking cases.
In the U.S., the H1N1 virus has sickened tens of thousands and closed summer camps at a time when there should be little or no flu activity.
Even as the WHO and the U.S. Centers for Disease Control and Prevention continue to raise awareness of this potentially deadly disease, which appears to be killing both sick and healthy individuals, the topic has virtually disappeared from the headlines.
“Complacency is a major concern,” said Dr. Anne Schuchat, director for National Center for Immunization and Respiratory Diseases at the CDC.
“This virus is a new one, and on top of that, we really still don’t know how it’s going to behave,” Schuchat said during a media conference call Friday. “There are special efforts that have been undertaken by health agencies, but individuals also need to be ready, to be thinking ahead and have steps in place should a family member get sick or a workplace close down or a situation arise that requires working from home.”

Over the next six to 12 weeks, there are several concerns that national health officials are preparing for:
1. Figuring out how the virus will react and spread once students return to schools, especially inner city schools, which typically struggle with overcrowding issues.
2. Overseeing the completion of a vaccine and getting it to the individuals who need it most.
3. Determining how the virus will behave as it spreads and mutates.

*Schools

School districts across the U.S. struggle every fall with outbreaks of typically non-flu respiratory viruses, which are easily spread through germs on surfaces and doorknobs, as well as passed from student to student through sneezing, coughing, and sharing drinks and food.
Seasonal influenza usually begins to spread through schools in the late fall and early winter, but this probably will not be the case with swine flu, which behaves differently than seasonal influenza – by oddly thriving in warm and humid conditions.
“This year we’re seeing the H1N1 virus circulating through summer camps and military units, so I’m expecting we may see an increase in cases once school starts, but we don’t definitely know that,” Schuchat said. “We are concerned that there will be challenges in the fall. It is the kind of thing we want to be ready for and not surprised by.”
Schuchat said national and state health officials are working closely together on updating their guidance for schools and similar institutions with regard to swine flu outbreaks.
“We still believe that the best place for kids is in schools, where they can be nourished receiving a healthy breakfast and lunch and learning,” she said. “But we also believe the best place for a sick kid is at home being cared for. So we’re working on putting strong plans in place on communication and preparedness on the local and state levels.”
*Vaccine
Companies such as Baxter, GlaxoSmithKline and Novartis are working to ready a swine flu vaccine for October. Earlier this week, concerns were raised that the U.S. may not receive all the vaccine it needs because it only manufactures about 20 percent of its own supply. The other 80 percent is produced in foreign countries, which will also need ample supplies of the vaccine.
But Schuchat downplayed those concerns, saying the U.S. has contracts in place with manufacturers around the world that guarantee it will receive adequate vaccine.
But, will the vaccine be effective?
In a typical year, the seasonal flu vaccine is about 70 to 90 percent effective, depending on how closely the vaccine matches the strains circulating and on the population the vaccine is used in. In other words, a vaccine is not going to be as effective in a person with a compromised immune system or someone who is considered at high risk for the virus.
Scientists typically spend months researching the strains of seasonal flu virus that are circulating the globe in order to pick out the three strains that it puts into the annual vaccine.
Because swine flu is new and mutating – for example, in Argentina the virus appears to have mutated to where it can now easily spread from humans to pigs – scientists have their work cut out for them when it comes to determining what strains of the H1N1 swine flu virus to include in the vaccine.
“Unfortunately, right now, we do not know how effective it will be in different populations,” Schuchat said. “We will be looking back at how well it worked, taking into account whether it worked as well as expected, better than expected or worse than expected. Unfortunately, that’s something we’re not able to do until after the fact.”
*Virus Behavior
World and U.S. health officials have already determined that swine flu behaves differently than seasonal flu in a number of ways. First, it’s able to spread in hot and humid weather, which is not usually the case for the seasonal flu virus.
Second, the infection appears to be more severe in young people and less severe in the elderly than the typical seasonal flu. Schuchat said in some countries, elderly people, usually at high-risk for influenza, appear to be immune to swine flu – possibly because of the similarities between swine flu and the 1918 flu pandemic, which some of the world’s elderly survived and may be resistant to.
“We are particularly concerned about pregnant women; we’re seeing fatalities and life-threatening illnesses that have occurred in pregnant women in the Southern Hemisphere,” Schuchat said. “We are expecting pregnant women to get a recommendation to get the H1N1 vaccine to reduce the risk of complications from influenza. We know many pregnant women don’t like to take any drugs, but this is one instance where you need to be much more concerned about your health than the baby’s health.”
“We’re in a very active stage of preparing for the [coming months],” she continued. “We’re working with the private sector. We want individuals and families to be preparing. Influenza in general is unpredictable, and we don’t know what to expect in the weeks and months ahead.”

Advice for Parents on Talking to Children About Novel H1N1 Flu (Formerly Swine Flu) Concerns

Center For Disease Control And Prevention CDC
May 6, 2009, 10:30 PM ET
As a parent you know how hard it can be for children to understand stressful situations, such as the current situation of novel H1N1 flu. Stressful situations often cause children to worry and have many questions as to why it is happening and how it can be fixed. It is important to remember to take care of your health and well-being as well as the health of your children. If you cope with a stressful situation well, your children will also cope better. Your confidence and calm attitude will help your children ease their worries and feel safe and secure.

Here are some helpful tips on what you can do for your children:

• Keep activities as consistent and normal as possible even if your normal routine changes (due to daycare or school closures).
• Ask your children what they have heard about novel H1N1 flu. Answer questions openly and honestly, at a level they can understand. Be concrete and do not avoid difficult questions. (See Talking With Children About Flu for more information on talking tips).
• Allow your children to express their feelings and concerns. Let them know it is okay to be afraid or mad. Ask questions so you can help them identify and cope with their feelings.
• Children always need to feel safe and loved. When they are uncertain about situations and afraid they may need even more affection and attention.
• Limit exposure to media and adult conversations about novel H1N1 flu . If your children are watching T.V. try to watch with them or make sure you are available to answer questions about what they have heard.
• As appropriate, encourage healthy behaviors: eating well, sleeping well, playing outside.
• Use their questions as an opportunity to let them know what they can do to avoid getting novel H1N1 flu.

Focus on what your child can do to avoid getting novel H1N1 flu:

• Wash hands frequently with soap and water for 20 seconds (long enough for children to sing the “Happy Birthday” song twice). Be sure to set a good example by doing this yourself.
• Cough and sneeze into a tissue. (If a tissue is used, throw the tissue away immediately).
• Be sure to set a good example by doing this yourself.
• Stay at least six feet away from people who are sick.
• Stay home from school if sick, and stay away from sick people until they are better.