January 1, 1970 (Vol. , No. )

Rod Raynovich

The CDC provided a situation update regarding key flu indicators for the Week of Sep 20-26 and said that influenza activity remained elevated in virtually all states.

Visits to doctors and hospitals are higher than can be expected this time of the year and almost all cases were similar to the H1N1 strain which was chosen for the 2009 H1N1 vaccine. This virus remains susceptible to the antiviral drugs oseltamivir and zanamivir. Most of the swine flu cases are mild to moderate but millions of people with rather common problems such as diabetes, asthma or cardiovascular problems.

On Sep 25 the CDC put out a Q&A on Use of Antiviral Medicines for Treatment and Prevention of Flu Among Pregnant Women for the 2009-201 Flu season. http://www.cdc.gov/H1N1flu/pregnancy/antiviral_pregnant_qa.html

Dr. Anne Schuchat the CDC’s Director of immunization and respiratory disease urged pregnant women to swine flu shots as soon as they are available, as they may be at greater risk.

For this reason the CDC (www.cdc.gov) advises doctors to give antiviral medicines to pregnant women who have symptoms of Flu. Between April and August 100 pregnant women have been admitted to intensive care and twenty eight have died from swine flu as of the end of August. Visit flu.gov.

On October 2 the EU (EMEA) drug regulators granted a positive opinion for Baxter’s Celvapan H1N1 flu vaccine and BAX said that it expected to get a license shortly. The Celvapan vaccine is the first cell culture based,non-adjuvanted vaccine to receive a positive opinion in the European Union. Presently Baxter (www.baxter.com) is confirming the safety and immunogenicity of the vaccine in clinical trials and looking at a one dose regimen.

EMEA gave a green light last week to the first H1N1 swine flu vaccines from Glaxo and Novartis both of which use adjuvants. U.S. drug authorities have approved five vaccines for the U.S. market none of which use adjuvants. More details will be coming on availability and clinical trials over the next few weeks but it is expected that only 3B doses a year will be available which could be inadequate to cover a WW population of 6.8 B people. Pandemic vaccines for H1N1 are currently licensed in Australia, China and the U.S.

The first doses of H1N1 vaccine will arrive next week beginning with 600,00 tubes of Astra Zeneca’s (Medimmune) intranasal spray vaccine that was approved on Sep 15,2009. Within two weeks 40-50 million vaccines will be available with initial priority given to healthcare workers, hospitals, children,pregnant women and people who have chronic diseases such as asthma.

On Sep 30 Australia has rolled out a nationwide vaccination program for H1N1 with 5.5M doses sufficient to vaccinate 30% of the population. The cost is expected to be over $100M.

As the flu season officially gets underway next week and vaccines become available it is expected that the response from the general population will be guarded. A recent poll from Harvard School of Public Health found that only 40% of adults were sure to receive the vaccine.There is lot of misinformation and political blogging regarding the flu vaccine so it is important that sources of information come from reliable scientific and medical authorities.

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