A/H1N1 pandemic spreads at unprecedented speed, says WHO

GENEVA, July 16 (Xinhua) -- The A/H1N1 influenza pandemic has been spreading at an unprecedented speed, much faster than other pandemics in history, the World Health Organization (WHO) said on Thursday.

"In past pandemics, influenza viruses have needed more than six months to spread as widely as the new H1N1 virus has spread in less than six weeks," the UN agency said in a briefing posted on its website.

The new flu virus has caused more than 94,500 laboratory-confirmed infections in more than 130 countries and regions, with more than 400 deaths, according to figures released by the WHO on July 6. Since that date no updated figures have been released.

The agency will no longer issue the global tables showing the numbers of confirmed cases for all countries, because the number of infections is increasing so fast in many countries that it has become almost impossible for them to follow through laboratory tests, said the WHO briefing.

A strategy that concentrates on laboratory confirmation and investigation of all cases is extremely resource-intensive. And in some countries, this strategy is absorbing most national laboratory and response capacity, leaving little capacity for the monitoring and investigation of severe cases and other exceptional events, it said.

However, there is still an ongoing need in all countries to closely monitor unusual events, such as clusters of cases of severe or fatal virus infection, clusters of respiratory illness requiring hospitalization, or unexplained or unusual clinical patterns associated with serious or fatal cases, the WHO said.

As part of continued efforts to document the global spread of the A/H1N1 pandemic, the WHO will still provide regular updates describing the situation in newly-affected countries, according to the briefing.

The WHO will continue to request that newly-affected countries report the first confirmed cases and, as far as feasible, provide weekly aggregated case numbers and descriptive epidemiology of the early cases, it said.

From...

Time Online
http://www.timesonline.co.uk/tol/life_and_style/health/article6716477.ece

Britain could face up to 65,000 swine flu deaths
July 16, 2009
Sam Lister, Health Editor

“The number of swine flu cases has jumped by nearly 50 per cent in a week”

Up to 65,000 people could die as a result of swine flu as the pandemic takes hold of the country, according to latest planning calculations by the Department of Health.

Sir Liam Donaldson, the Chief Medical Officer, said that the estimate of 65,000 deaths was based on 30 per cent of the population becoming ill. But the actual figure could be anywhere between 3,000 and 750,000 fatalities, he added.

He said that statistics showed “exceptional influenza activity” in terms of the number of people visiting their GP across most of the country, except Yorkshire and the Humber.

Study Suggests H1N1 Virus More Dangerous Than Suspected
Article Date: 15 Jul 2009 - 1:00 PDT

A new, highly detailed study of the H1N1 flu virus shows that the pathogen is more virulent than previously thought.

Writing in a fast-tracked report published in the journal Nature, an international team of researchers led by University of Wisconsin-Madison virologist Yoshihiro Kawaoka provides a detailed portrait of the pandemic virus and its pathogenic qualities.

In contrast with run-of-the-mill seasonal flu viruses, the H1N1 virus exhibits an ability to infect cells deep in the lungs, where it can cause pneumonia and, in severe cases, death. Seasonal viruses typically infect only cells in the upper respiratory system.

“There is a misunderstanding about this virus,” says Kawaoka, a professor of pathobiological sciences at the UW-Madison School of Veterinary Medicine and a leading authority on influenza. “People think this pathogen may be similar to seasonal influenza. This study shows that is not the case. There is clear evidence the virus is different than seasonal influenza.”

The ability to infect the lungs, notes Kawaoka, is a quality frighteningly similar to those of other pandemic viruses, notably the 1918 virus, which killed tens of millions of people at the tail end of World War I. There are likely other similarities to the 1918 virus, says Kawaoka, as the study also showed that people born before 1918 harbor antibodies that protect against the new H1N1 virus.

And it is possible, he adds, that the virus could become even more pathogenic as the current pandemic runs its course and the virus evolves to acquire new features. It is now flu season in the world’s southern hemisphere, and the virus is expected to return in force to the northern hemisphere during the fall and winter flu season.

To assess the pathogenic nature of the H1N1 virus, Kawaoka and his colleagues infected different groups of mice, ferrets and non-human primates - all widely accepted models for studies of influenza - with the pandemic virus and a seasonal flu virus. They found that the H1N1 virus replicates much more efficiently in the respiratory system than seasonal flu and causes severe lesions in the lungs similar to those caused by other more virulent types of pandemic flu.

“When we conducted the experiments in ferrets and monkeys, the seasonal virus did not replicate in the lungs,” Kawaoka explains. “The H1N1 virus replicates significantly better in the lungs.”

The new study was conducted with samples of the virus obtained from patients in California, Wisconsin, the Netherlands and Japan.

The new Nature report also assessed the immune response of different groups to the new virus. The most intriguing finding, according to Kawaoka, is that those people exposed to the 1918 virus, all of whom are now in advanced old age, have antibodies that neutralize the H1N1 virus. “The people who have high antibody titers are the people born before 1918,” he notes.

Kawaoka says that while finding the H1N1 virus to be a more serious pathogen than previously reported is worrisome, the new study also indicates that existing and experimental antiviral drugs can form an effective first line of defense against the virus and slow its spread.

There are currently three approved antiviral compounds, according to Kawaoka, whose team tested the efficacy of two of those compounds and the two experimental antiviral drugs in mice. “The existing and experimental drugs work well in animal models, suggesting they will work in humans,” Kawaoka says.

Antiviral drugs are viewed as a first line of defense, as the development and production of mass quantities of vaccines take months at best.

In addition to his appointment at UW-Madison, Kawaoka also is a professor at the University of Tokyo. The new study was funded by grants from the U.S. National Institutes of Health, and the Japanese Ministry of Education, Culture, Sports, Science and Technology.

Source
University of Wisconsin-Madison

http://www.medicalnewstoday.com/articles/157485.php

This is closely related to the 1918 deadly strain of flu...

1918 Flu Pandemic
http://en.wikipedia.org/wiki/1918_flu_pandemic

Mortality

The global mortality rate from the 1918/1919 pandemic is not known, but it is estimated that 10% to 20% of those who were infected died. With about a third of the world population infected, this case-fatality ratio means that 3% to 6% of the entire global population died.[11] Influenza may have killed as many as 25 million in its first 25 weeks. Older estimates say it killed 40–50 million people[4] while current estimates say 50 million to 100 million people worldwide were killed.[12] This pandemic has been described as “the greatest medical holocaust in history” and may have killed more people than the Black Death.[13]

As many as 17 million died in India, about 5% of India’s population at the time.[14] In Japan, 23 million persons were affected, and 390,000 died.[15] In the U.S., about 28% of the population suffered, and 500,000 to 675,000 died.[16] In Britain as many as 250,000 died; in France more than 400,000.[17] In Canada approximately 50,000 died.[18] Entire villages perished in Alaska[19] and southern Africa.[which?] Ras Tafari (the future Haile Selassie) was one of the first Ethiopians who contracted influenza but survived,[20] although many of his subjects did not; estimates for the fatalities in the capital city, Addis Ababa, range from 5,000 to 10,000, with some experts opining that the number was even higher,[21] while in British Somaliland one official there estimated that 7% of the native population died from influenza.[22] In Australia an estimated 12,000 people died and in the Fiji Islands, 14% of the population died during only two weeks, and in Western Samoa 22%.

This huge death toll was caused by an extremely high infection rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms.[4] Indeed, symptoms in 1918 were so unusual that initially influenza was misdiagnosed as dengue, cholera, or typhoid. One observer wrote, “One of the most striking of the complications was hemorrhage from mucous membranes, especially from the nose, stomach, and intestine. Bleeding from the ears and petechial hemorrhages in the skin also occurred.”[12] The majority of deaths were from bacterial pneumonia, a secondary infection caused by influenza, but the virus also killed people directly, causing massive hemorrhages and edema in the lung.[9]

The unusually severe disease killed between 2 and 20% of those infected, as opposed to the more usual flu epidemic mortality rate of 0.1%.[9][12] Another unusual feature of this pandemic was that it mostly killed young adults, with 99% of pandemic influenza deaths occurring in people under 65, and more than half in young adults 20 to 40 years old.[23] This is unusual since influenza is normally most deadly to the very young (under age 2) and the very old (over age 70), and may have been due to partial protection caused by exposure to a previous Russian flu pandemic of 1889.[24]

—

Bears repeating...

The global mortality rate from the 1918/1919 pandemic is not known, but it is estimated that 10% to 20% of those who were infected died.

With about a third of the world population infected, this case-fatality ratio means that 3% to 6% of the entire global population died.[11]

Influenza may have killed as many as 25 million in its first 25 weeks. Older estimates say it killed 40–50 million people[4] while current estimates say 50 million to 100 million people worldwide were killed.[12]

This pandemic has been described as “the greatest medical holocaust in history” and may have killed more people than the Black Death.[13]

I’m isolating and highlighting these paragraphs from above...

And then you can note post #11...

NEW FLU “UNSTOPPABLE”, WHO SAYS, CALLS FOR VACCINE

Mon Jul 13, 2009 7:48pm EDT
By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - Saying the new H1N1 virus is “unstoppable”, the World Health Organization gave drug makers a full go-ahead to manufacture vaccines against the pandemic influenza strain on Monday and said healthcare workers should be the first to get one.

Every country will need to vaccinate citizens against the swine flu virus and must choose who else would get priority after nurses, doctors and technicians, said Dr. Marie-Paule Kieny, WHO director of the Initiative for Vaccine Research.

Several reports showed the new virus attacks people differently than seasonal flu — affecting younger people, the severely obese and seemingly healthy adults, and causing disease deep in the lungs.

Kieny briefed reporters on the findings of the WHO’s Strategic Advisory Group of Experts on Immunization, or SAGE. “The committee recognized that the H1N1 pandemic ... is unstoppable and therefore that all countries need access to vaccine,” Kieney said.

http://www.reuters.com/article/newsOne/idUSTRE56C60820090713

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.