People at High Risk of Developing Flu-Related Complications

October 8, 2009, 12:45 AM ET

Most people who get the flu (either seasonal or 2009 H1N1) will have mild illness, will not need medical care or antiviral drugs, and will recover in less than two weeks. Some people, however, are more likely to get flu complications that result in being hospitalized and occasionally result in death. Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications. The flu can also make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic congestive heart failure may have worsening of this condition that is triggered by the flu. The list below includes the groups of people more likely to get flu-related complications if they get sick from influenza.

People at High Risk for Flu Complications:

• Children younger than 5, but especially children younger than 2 years old
• Adults 65 years of age and older
• Pregnant women
• People who have:
  • Cancer
  • Blood disorders (including sickle cell disease)
  • Chronic lung disease [such as asthma or chronic obstructive pulmonary disease (COPD)]
  • Diabetes
  • Heart disease
  • Kidney disorders
  • Liver disorders
  • Neurological disorders (such as epilepsy, cerebral palsy, brain or spinal cord injuries, moderate to profound intellectual disability [mental retardation] or developmental delay)
  • Neuromuscular disorders (such as muscular dystrophy and multiple sclerosis)
  • Weakened immune systems (such as people with HIV or AIDS or who are on medications that weaken the immune system )

Antigenic Diversity Increases with 7 Novel H1 SNPs from Chengdu and Jiangyin

On 2009-10-06 China deposited 22 Hemagglutinin sequences and 23 matching partial Neuraminidase sequences from the areas of Chengdu and Jiangyin sampled respectively on 2009-07-26 and 2009-08-16. The Neuraminidase segments are far too limited in data for evaluation. The HA segments are remarkable due to the fact that 100% of the distinguishable SNPs are, on first inspection, novel introductions to ΣPF11. Changes directly upstream and downstream of the Receptor Binding Domain may affect Antigen match.

HA Protein Codings to 7 Novel Polymorphisms and 1 Mixed Signal
-snip-

Japan: Drug-resistant flu can spread

Oct 8, 2009

TOKYO - A GENETIC mutation of H1N1 swine flu that is resistant to the antiviral drug Tamiflu has been detected in a Japanese teenager who had not previously been treated with the drug, a Japanese health official said.
The case could mark Japan's first instance of person-to-person transmission of a Tamiflu-resistant strain of the H1N1 flu but Health Ministry official Takeshi Enami said there was still insufficient evidence to confirm that.



'We cannot deny that this could be person-to-person transmission, but we are not able to reach that conclusion,' Mr Enami said. Japan has had eight cases of new H1N1 patients who were resistant to Tamiflu, he added.
The mutation was detected by health officials in Sapporo, northern Japan, in a teenage girl who had developed a fever on Aug 22. She was given GlaxoSmithkline's Relenza and recovered a day later, the ministry said in a statement.



The detected mutation did not worsen the virus, nor were there signs of an unusual rise in new H1N1 cases nearby, it said.
The risk of resistance is higher in patients who suffer from weak immune systems and have already been treated with Tamiflu, manufactured by Roche Holding under license from Gilead Sciences. -- REUTERS

Seasonal Flu Vaccine & Pandemic H1N1A Vaccine Shots Taken Together

Additional Information, previous post:

Thursday, October 1, 2009

Seasonal Vaccine "FluMist" and Swine Flu "FluMist" Do Not take together

Excerpt:

Can seasonal vaccine and novel H1N1 vaccine be administered at the same time?

October 6, 2009, 6:30 PM ET

Can seasonal influenza vaccine and 2009 H1N1 vaccine be given at the same visit?

Both seasonal and 2009 H1N1 vaccines are available as inactivated and live attenuated (LAIV) formulations. The simultaneous and sequential administration of seasonal and 2009 H1N1 inactivated vaccines is currently being studied. However, existing recommendations are that two inactivated vaccines can be administered at any time before, after, or at the same visit as each other (General Recommendations on Immunization, MMWR 2006;55[RR-15]). Existing recommendations also state that an inactivated and live vaccine may be administered at any time before, after or at the same visit as each other. Consequently, providers can administer seasonal and 2009 H1N1 inactivated vaccines, seasonal inactivated vaccine and 2009 H1N1 LAIV, or seasonal LAIV and inactivated 2009 H1N1 at the same visit, or at any time before or after each other. Live attenuated seasonal and live 2009 H1N1 vaccines should NOT be administered at the same visit until further studies are done. If a person is eligible and prefers the LAIV formulation of seasonal and 2009 H1N1 vaccine, these vaccines should be separated by a minimum of four weeks.


Can 2009 H1N1 vaccine be administered at the same visit as other vaccines?

Inactivated 2009 H1N1 vaccine can be administered at the same visit as any other vaccine, including pneumococcal polysaccharide vaccine. Live 2009 H1N1 vaccine can be administered at the same visit as any other live or inactivated vaccine EXCEPT seasonal live attenuated influenza vaccine.

Japan: Sapporo's new flu-infected patients or people with resistant virus

2009/10/08 01:29

Ministry of Health and Sapporo on June 7, and seek medical attention for the city's 10 new flu virus was detected in patients with the woman announced that a gene mutation was found resistant to Tamiflu treatment.

厚労省によると、タミフル耐性ウイルスの確認は国内８例目だが、今回の患者はタミフルを使用しておらず、初 めてほかの人から感染した可能性があるという。

According to the ministry, confirmed Tamiflu-resistant virus, but eight of the domestic cases, this patient was not using Tamiflu, that there is a possibility of infection from other people first.

タミフル耐性が確認されたこれまでの例では、服用した患者の体内でウイルスが変異し、耐性を持ったとみられ ていた。

This was confirmed in cases of resistance to Tamiflu, the virus mutated in patients taking the body, with a resistance was expected.

厚労省などによると、女性は８月２２日に発熱し、医療機関で別の治療薬リレンザを投与されて翌日に解熱した 。

According to the ministry, the woman developed fever on August 22 and Sun, the day after antipyretic drug Relenza is administered by medical institutions.

９月２５日になって札幌市衛生研究所での遺伝子検査でタミフルへの耐性が判明。

September 25 found that genetic testing of resistance to Tamiflu in Sapporo City Institute of Public Health is in the Sun.

今月６日に国立感染症研究所で確定した。

This month the final six days at the National Institute of Infectious Diseases.

札幌市は女性の家族や周辺地域でタミフルの服用後に症状が改善しなかったりしたケースは確認していないとし ている。

Sapporo is the case or does not improve after taking Tamiflu symptoms in women family and the surrounding area has not been confirmed.

厚労省は「タミフル耐性を持つウイルスの女性からの感染拡大は確認されていない。女性が人から感染した可能 性は否定できない」としている。

The ministry is "the spread of Tamiflu-resistant virus from women has not been confirmed. The possibility of infection from a woman who can not be denied" and that.

Jqpan: New Tamiflu-resistant flu, Sapporo or first person infected

2009年10月7日23時12分

October 7, 2009 23:12


Ministry of Health and Sapporo on June 7 from patients infected with swine flu in the new city, announced the discovery of resistant virus could be resistant to the antiviral drug Tamiflu.

新型インフルのタミフル耐性例は国内８例目だが、今回の患者自身はタミフルを使っておらず、初めて人から感 染した事例の可能性もある。

Tamiflu-resistant flu cases in the new country, but of eight cases, the patient's own Tamiflu does not use this, possibly the first cases of infected people.

これまでの例は、タミフルを服用するうちに患者の体内で変異して耐性を持ったと見られていた。

Previous cases had been seen as the resistant mutant in the body of the patient taking Tamiflu.

厚労省などによると、患者は１０代女性。

According to the ministry, the patient is 10 year-old women.

８月２２日、発熱して受診した札幌市内の医療機関で簡易検査が陽性で別の抗ウイルス薬のリレンザを投与、翌 日には熱が下がった。

August 22, administered the antiviral drug Relenza is another simple test positive at the Sapporo Medical examination in the heat, the heat went down the next day.

９月下旬になって、同市衛生研究所の遺伝子検査でタミフル耐性の結果が出た。

Is in late September, showed Tamiflu-resistant genetic testing laboratory in the city's health.

このため、改めて国立感染症研究所で調査、今月６日に耐性だと確定した。

Therefore, the National Research Institute of Infectious Diseases in again, this month confirmed it resistant to six days.

女性の家族は発症しておらず、周辺でタミフルを服用して症状が改善しない患者は増えていない。

Family of women has not developed symptoms, the symptoms do not improve patient taking Tamiflu has not increased around.

これまでの報告例では、耐性ウイルスは感染力が弱かった。

The cases reported so far, the weak force resistant virus infection.

今回、人から感染していた場合、感染力を持った可能性もあるが、厚労省は、感染拡大は起きていないとしてい る。

This time, when people were infected, could be infected with the power ministry, the spread has not happened.

同省は、「人から感染したのか、ウイルスが体内で変異したのかわからない」としている。

Ministry, "or from an infected person does not know how the virus mutated in the body" and that.

（野瀬輝彦、小林舞子）

(Nose Teruhiko, Maiko Kobayashi)

Indiana: Elkhart County doctors see swine flu spike (500% @ Elkhard General Hospital)

We only have 2 hosptials in Elkhart County. The bigger one is Elkhart General and the other one is Goshen General.
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Last Updated: 10/6/2009 12:00:58 AM

ELKHART -- Despite occasional cases and one death attributed to swine flu, the virus hadn't fully hit Elkhart County yet, said a local hospital official.

At least that's what he thought until a week ago, when H1N1 flu cases jumped, by Dr. David VanRyn's estimates, 500 percent at Elkhart General Hospital's emergency department, where he is medical director.

"Doctors' offices are being inundated with people who think they're sick with the virus," he said.

VanRyn said a meeting scheduled for 7 p.m. Wednesday at Jimtown High School should help answer the public's questions about how the virus is transmitted, what to expect from it this fall and concerns about the vaccine.

"One of our big concerns is as the wave of these infections hits, as people inundate doctors' offices and emergency departments, the whole system would be bogged down," VanRyn said.

"The volume of people you would be talking about would shut down these offices" if everyone who suspects they have H1N1go to doctors' offices and emergency rooms to be checked, he said.

Statewide, the virus is responsible for four deaths. The virus has attacked younger patients than the seasonal flu vaccine traditionally does.

VanRyn attributes the sharp jump in H1N1 flu cases to the change in weather and people passing the virus to others.

Dan Nafziger, Elkhart County Health Officer and infectious disease physician at Goshen General Hospital, said anecdotally he's seen swine flu activity increase in the last two weeks.

"We do seem to have more influenza in the area than we've had earlier in the fall and certainly a lot more than we normally see at this time of the year for influenza," he said.

A group of Indianapolis health care workers were among the first to receive doses of the nasal mist swine flu vaccine Monday, the Associated Press reported. The mist is recommended for healthy people ages 2-49 who are not pregnant.

The injectible vaccine will be available in a few weeks and will be distributed first to targed groups: pregnant women, children, adolescents and young people ages 6 months to 24 and those who care for them, and older people who have chronic medical conditions.

Nafziger said he expects Elkhart County to have some doses of the nasal spray later this week.

INFORMATIONAL MEETING ON SWINE FLU WEDNESDAY
Where: Jimtown High School Auditorium, 59021 C.R. 3, Elkhart
When: 7 p.m. Wednesday
Who: Elkhart General Hospital, Elkhart County Health Department, Elkhart Emergency Physicians
Why: To inform Elkhart County residents what to expect from the H1N1 flu this fall, vaccine recommendations and how H1N1 is transmitted. The meeting will include a question and answer period.
hat-tip mixin

India: 25 swine flu ‘suspects’ of same family kept in isolation

Punjab Newsline Network

Monday, 05 October 2009

LUDHIANA: Twenty-five persons of a joint family that resides in Sarabha Nagar have been identified as the suspects of swine flu, Rapid Response Team (RRT) formed to deal with the Swine Flu cases act rapidly and put each of the family members on preventive medication followed by complete isolation. The family members were constantly in touch with their NRI relative, who was tested positive for H1N1 virus on September 3 at the PGI in Chandigarh. The relative of the family had come from Canada for attending his cousin’s wedding but got sick soon after landing in the city. The NRI had attended a wedding at Kothari resorts on September 30, which had a gathering of almost 1,000 people. Going by the incubation period of Swine Flu, which is five to 10 days, those showing symptoms should go in for swab sample test. However, district epidemiologist, Dr GP Mangla, stated that they had made the lists of persons who came in direct contact with the person infected by H1N1 virus and added that things were under control. The file of all above details has been prepared and sent to the state nodal official for Integrated Disease Surveillance Programme Dr Deepak Bhatia in Chandigarh. The swab samples of two servants and three members of the family have been sent to the PGI for test. District epidemiologist Dr GP Mangla said: “Having identified the cluster of suspects, we in order to take precautionary measures have sent five samples for testing. The reports will be available by tomorrow evening,” Dr Mangla added.