The Lancet Infectious Diseases: Closure of schools during an influenza pandemic

In response to WHO raising the influenza pandemic alert level from phase five to phase six, health officials around the world are carefully reviewing pandemic mitigation protocols.

School closure (also called class dismissal in North America) is a non-pharmaceutical intervention that is commonly suggested for mitigating influenza pandemics.

Health officials taking the decision to close schools must weigh the potential health benefits of reducing transmission and thus case numbers against high economic and social costs, difficult ethical issues, and the possible disruption of key services such as health care.

Also, if schools are expected to close as a deliberate policy option, or just because of high levels of staff absenteeism, it is important to plan to mitigate the negative features of closure. In this context, there is still debate about if, when, and how school closure policy should be used.

The Lancet published a Review, in which a multidisciplinary and holistic perspective and review the multiple aspects of school closure as a public health policy is taken. Implications for the mitigation of the swine-origin influenza A H1N1 pandemic are also discussed.

The Lancet Infectious Diseases: Closure of schools during an influenza pandemic

AFP: Stay away from Mecca over swine flu, pilgrims warned

Egypt has become the latest country to warn vulnerable Muslims against pilgrimage to Mecca, after an Egyptian woman back from Saudi Arabia became the first swine flu death in the Middle East and Africa.

Egypt's health ministry 'has warned the elderly, pregnant women, children and those suffering from chronic illness not to perform the hajj or omra pilgrimages,' the official MENA news agency reported late Monday.

As well as the annual hajj, which all Muslims are required to make once in a lifetime if they have the means, the faithful can also make a lesser pilgrimage to the holy places, known as omra, at any time of the year.

Upwards of two million people are expected in Saudi Arabia over the next five months on pilgrimages to the Muslim holy cities of Mecca and Medina in the west of the kingdom.

The ministry 'has asked them to delay taking part so that they are not exposed to the risks... of swine flu,' MENA quoted health ministry official Amr Qandil as saying.

The warning came ahead of a meeting of Arab health ministers in Cairo on Wednesday to coordinate arrangements and precautions to be taken during the pilgrimage season.

Egypt on Sunday reported its first death linked to swine flu after a 25-year-old woman returning from a pilgrimage in Saudi Arabia died in hospital.

AFP: Stay away from Mecca over swine flu, pilgrims warned

Reuters: UK school children quarantined for H1N1 flu in China

A group of 52 British school children and their teachers have been quarantined in Beijing after four pupils were admitted to hospital infected with the H1N1 flu virus, Britain's Foreign Office said Saturday.

(A hospital worker wearing an isolation suit stands
at the entrance of a flu inspection clinic in
Beijing's Ditan Hospital. REUTERS/Jason Lee)

The group arrived in China earlier this week for a culture and study tour. But shortly after arrival at Beijing airport, four of the students -- all believed to be teenagers -- were admitted to hospital showing symptoms of swine flu infection.

As a precaution, the remainder of the group was quarantined in their four-star hotel in Beijing.

'We can confirm that a group of 52 British school children and teachers are being held in quarantine in their hotel,' a Foreign Office spokeswoman said.

Reuters: UK school children quarantined for H1N1 flu in China

Swine Flu Diary - Melissa Auf der Maur

Photo courtesy of Melissa Auf der Maur

Musician Melissa Auf der Maur, formerly of Hole and the Smashing Pumpkins has Mexican Flu.
She writes in her weblog:

"About two weeks ago, I was reading an article in The Globe and Mail over breakfast, when a question crossed my mind: 'Have I been kissed by the gloom of Swine?'

You might think it’s a shocking or silly question, but I’d been sick on and off for a month. It turns out that, somewhere between a video shoot in Vermont, a heavy metal concert in London, and my own musical showcase in Toronto, I had indeed fallen victim to a world pandemic. I am now officially on the mend – thanks to a combination of naturopathic treatments and heavy-duty antibiotics, among other survival tools – and I’ve gathered enough energy to type out this, my swine flu chronicle."

Swine Flu Diary - Melissa Auf der Maur

Swine flu reports jump by half in a week - Times Online

The number of swine flu cases has jumped by nearly 50 per cent in a week, figures released yesterday indicate.

Data from a sample of GPs’ surgeries, seen by The Times, shows that up to 40,000 people complained to their doctor last week of “flu-like illness” in England and Wales, with a huge rise in the number of young children being affected.

The report shows that the highest rates of reported illness are in children aged five to 14, with 160 of every 100,000 in this age group reporting symptoms, followed by 114 per 100,000 of the 0 to four-year-olds.

Overall, the rate of people complaining of symptoms increased to 73.4 cases for every 100,000 people in the week to Sunday, compared to 50.3 cases per 100,000 the week before.

Times Online: Swine flu reports jump by half in a week

Edmonton Sun: Swine flu on wane, but health officials anticipate comeback

Three months after Canadian scientists first became aware of a mysterious influenza outbreak in Mexico, the rate of new swine flu cases in this country finally seems to be ebbing.

But public health officials warn the virus will be back with a vengeance in the fall.

'We're still seeing new cases (but) it appears there are fewer,' Dr. David Butler-Jones, Canada's chief public health officer, said yesterday. 'We are seeing fewer people admitted to hospital, so it seems to be on the wane.'

But he added, 'It's an amazing, adaptive disease and it's always full of surprises.'

So full of surprises, apparently, that British officials this week projected a worst-case scenario of up to 65,000 deaths in the U.K. from H1N1. Their bleak assessment included an estimate that 30% of the population could become infected, and that half of British children could contract H1N1.

Edmonton Sun: Swine flu on wane, but health officials anticipate comeback

WHO stopped tracking swine flu cases

In a move that caught many public health experts by surprise, the WHO quietly announced Thursday that it would stop tracking swine flu cases and deaths around the world," the New York Times reports.

As the 2009 pandemic evolves, the data needed for risk assessment, both within affected countries and at the global level, are also changing.

At this point, further spread of the pandemic, within affected countries and to new countries, is considered inevitable.

This assumption is fully backed by experience. The 2009 influenza pandemic has spread internationally with unprecedented speed. 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 increasing number of cases in many countries with sustained community transmission is making it extremely difficult, if not impossible, for countries to try and confirm them through laboratory testing. Moreover, the counting of individual cases is now no longer essential in such countries for monitoring either the level or nature of the risk posed by the pandemic virus or to guide implementation of the most appropriate response measures.

WHO | Pandemic (H1N1) 2009 briefing note 3

Ministry of Tourism in Malaysia to brain-storm on fears over A/H1N1

A two-day brain-storming session to tackle the Influenza A (H1N1) issue will be held by the Tourism Ministry of Malaysia today.

The ministry’s officers from 44 locations around the world would be attending the session and come up with strategies to allay fears of the virus and encourage more visitors to the country, said Minister Datuk Seri Dr Ng Yen Yen.

“We need feedback to understand the real situation that we are in now,” Ng said after attending the “Loving Heart Cheongsam Night”, an event organised by the Federation of Hakka Association of Malaysia at the KL & Selangor Chinese Assembly Hall here yesterday.

Ng said the ministry would collaborate with the Federation of Hakka Association to tap the federation’s vast network around the world.

A session with nine selected advertising agencies would also be held to discuss promotional strateties for the country.

“People are afraid to travel these days.

“Each time we lose 10% of our tourists, we will lose an income of RM4.9bil,” she said.

Ministry of Tourism in Malaysia to brain-storm on fears over A/H1N1

The Guardian: Swine flu strikes Downing Street – and almost reaches G8 summit

The first case of swine flu has struck Downing Street and it nearly caused a diplomatic crisis.

Gordon Brown's senior climate change adviser Michael Jacobs was banned from attending the G8 summit in Italy for fear he would pass the contagious disease to Barack Obama and other world leaders.

It is understood that Jacobs contracted the disease while involved in climate change talks in Mexico.

He had travelled to Rome for some preliminary negotiations on the draft of the G8 communique text, and was told by his personal doctor that he was no longer suffering from the disease. He then planned to travel to the conference site in L'Aquila, Italy, but was told by Brown that he could not risk him going.

The Guardian: Swine flu strikes Downing Street – and almost reaches G8 summit

Pandemic Information News: Swine flu vaccine production hits a snag: yield so far is 'less than optimal'

Swine flu vaccine production has hit a snag, with manufacturers reporting a disappointingly low yield when vaccines viruses are grown in eggs.

The World Health Organization says so far the yield for egg-based production is half or less what manufacturers get when they make vaccine to protect against seasonal H1N1 viruses. The lion's share of influenza vaccine is made by companies that grow the viruses in eggs.

New seed strains are being made in the hopes of increasing the vaccine yield, a report by the WHO's vaccine chief, Dr. Marie-Paule Kieny says.

But if the yield cannot be increased, it will slow the rate at which pandemic vaccine comes out of the production pipeline, adding to the time it takes to protect populations in countries like Canada that have purchased vaccine. And countries that haven't pre-ordered pandemic vaccine would face substantial delays before manufacturers have product to sell to them.

'There's nothing to suggest it will take longer to make vaccine, if in fact everything goes as planned. The question is: How much?' says Dr. Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

'There is nothing magical about making this virus. The questions will be: How much? When? and Where will it be available?'

The yield problem is revealed in presentations WHO staff made to last week's special meeting of the expert panel that advises the Geneva-based global health agency on vaccine issues.

Pandemic Information News: Swine flu vaccine production hits a snag: yield so far is 'less than optimal'

U.S. To Spend Another $1 Billion To Fight Swine Flu

The United States is ready to announce another $1 billion in orders for swine flu vaccinations.

Health and Human Services Secretary Kathleen Sebelius says she will announce Monday that Washington has approved another billion dollars to buy components of the vaccine.

Sebelius said on Sunday that research is under way to provide a safe and effective vaccine to fight a flu strain that could be a pandemic.

Sebelius and other top officials are bracing for fall's flu season.

She said leaders are watching the Southern Hemisphere for clues how serious the U.S. flu season might be.

Sebelius appeared on CNN's "State of the Union."

U.S. moves forward with preparations for H1N1 vaccination campaign

The Obama administration on Thursday said a nationwide vaccination program could begin as early as mid-October to protect Americans from the H1N1 (swine flu) virus and pledged $350 million to help prepare communities across the country for this effort.

"I think it's clear that although we were fortunate not to see a more serious situation in the spring when we first got news of this outbreak, the potential for a significant outbreak in the fall is looming," President Obama said, speaking by phone from the G8 summit in Italy to U.S. health officials who gathered in Maryland for a daylong flu summit organized by his Cabinet, AFP/Yahoo! News reports. "We want to make sure that we are not promoting panic, but we are promoting vigilance and preparation," he said.

"The White House has drawn up a battle plan for taking on the virus when influenza season returns to the northern hemisphere in several weeks' time," contingent on the development of a viable H1N1 vaccine. Clinical trials on the first H1N1 vaccine are scheduled to start next month, according to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "We know that a safe and effective vaccine is the best means of both preventing the disease in individuals and stopping the community spread of the virus," HHS Secretary Kathleen Sebelius said.

U.S. moves forward with preparations for H1N1 vaccination campaign

NZ Herald: Be prepared, or face the consequences when the pandemic peaks

In a column in the New Zealand Herald, Gill South wrote:

"For many New Zealand businesses, the swine flu virus has arrived at the worst possible time; when they are already leaning heavily on a depleted staff, with many personnel doing more than one job, the idea of losing even more employees for a period is enough to send many management teams into despair.

The Ministry of Health says businesses can expect absenteeism to be as high as 50 per cent for a two-week period during the peak of the pandemic, and businesses need to be aware the overall pandemic could last around eight weeks.

There has been plenty of news about how to handle the clinical side of things in the workplace, but how should companies respond in a more considered managerial way?

Business continuity specialist David Dunsheath, who runs Business Continuance Planning, says managers should be trying to protect their reputation, operation and finances. Don't think of this as a pandemic, think of it as a business continuity challenge, he says. 'It's about preparedness.'

The consultant recommends larger operations not only have a crisis management team, but a business continuity team and a clinical health team."

NZ Herald: Be prepared, or face the consequences when the pandemic peaks

U.S. scientists discover why A/H1N1 flu virus spreads less effectively

The new A/H1N1 strain of flu has a form of surface protein that binds inefficiently to receptors found in the human respiratory tract, which make it spread from person to person less effectively than other flu viruses, scientists said.

A team from Massachusetts Institute of Technology (MIT) and the U.S. Centers for Disease Control and Prevention (CDC) reported the discovery Thursday in the online edition of Science.

'While the virus is able to bind human receptors, it clearly appears to be restricted,' says Ram Sasisekharan, director of the Harvard-MIT Division of Health Sciences and Technology (HST) and the lead MIT author of the paper. Sasisekharan and his laboratory co-workers have been actively investigating influenza viruses.

That restricted, or weak, binding, along with a genetic variation in an H1N1 polymerase enzyme, which MIT researchers first reported three weeks ago in Nature Biotechnology, explains why the virus has not spread as efficiently as seasonal flu, says Sasisekharan.

Sasisekharan and CDC senior microbiologist Terrence Tumpey have previously shown that a flu virus's ability to infect humans depends on whether its hemagglutinin protein can bind to a specific type of receptor on the surface of human respiratory cells.

U.S. scientists discover why A/H1N1 flu virus spreads less effectively

ABC News: "Babies should wear face masks"

A New South Wales Health Department expert says all children younger than two should wear face masks to prevent the spread of swine flu.

The senior clinical adviser to the department's Chronic Disease Program, Professor Ron Penny, says parents should heed his advice because influenza has a higher mortality rate in babies.

Professor Penny says anyone with flu symptoms or lung disease should also wear face masks.

He says Australians need to accept responsibility to prevent disease spreading.

ABC News: "Babies should wear face masks"

First Chinese A/H1N1 fatality "was electrocuted"

A 34-year-old woman who became the first swine flu victim to die in China may have actually been electrocuted in the hospital toilet, it has emerged.
The unnamed patient was found dead early on Wednesday morning in the Number One People's Hospital in the eastern city of Hangzhou.

The woman had been admitted to the hospital on June 23, but had shown signs of recovery as her fever abated.

Doctors told Xinhua, the state newswire, that her temperature had been normal for a week and that her only remaining symptom was occasional coughing.

Yesterday, relatives of the woman attacked the hospital, smashing the entrance lobby and an ambulance with rocks. They said the woman had died from an electric shock while using the bathroom.

First Chinese A/H1N1 fatality "was electrocuted"

China A/H1N1 flu patient dies "accidentally"

BBC NEWS | Health | Swine flu in UK 'cannot be contained

The rising number of swine flu cases mean trying to contain the virus is no longer an option, the government says.

Ministers said the emergency response would now move to a new 'treatment' phase across the UK as there may soon be 100,000 new cases a day.

It means anti-flu drugs will no longer be given to the close contacts of those infected nor will lab testing be done to confirm cases.

BBC NEWS | Health | Swine flu in UK 'cannot be contained

Reuters: Roche finds 1st case of H1N1 resistance to Tamiflu

(Reuters) - A patient with H1N1 influenza in Denmark showed resistance to Roche Holding AG's Tamiflu, the main antiviral flu drug, a company executive said on Monday.

'While receiving the drug, the patient appeared to develop resistance to it,' David Reddy, Roche's pandemic taskforce leader, told reporters on a conference call on the Danish case. 'This is the first report we have of it in H1N1.'

The World Health Organization has raised its pandemic flu alert on the H1N1 flu virus to phase 6 on a six-point scale, indicating the first influenza pandemic since 1968 is under way.

Reuters: Roche finds 1st case of H1N1 resistance to Tamiflu

Latest Swine Flu Europe News: German authorities warn of swine flu mutation risk

(Reuters) Germany's federal agency for infectious diseases said on Tuesday there were signs the H1N1 swine flu virus had started to mutate and warned it could spread in the coming months in a more aggressive form.

Experts were concerned about how the flu was developing in Australia and South America, said Joerg Hacker, head of the Robert Koch Institute for infectious diseases.

'It's possible the virus has mutated. In autumn the mutated form could spread to the northern hemisphere and back to Germany,' Hacker told a news conference in Berlin.

Latest Swine Flu Europe News: German authorities warn of swine flu mutation risk

Germany's federal agency for infectious diseases said on Tuesday there were signs the H1N1 swine flu virus had started to mutate and warned it could spread in the coming months in a more aggressive form.
Photograph by: Ramzi Haidar, AFP/Getty Images

How to Avoid Getting The H1N1 Flu Virus | eHow.com

It is still flu season and with a new flu strain such as the Swine Flu epidemic makes many of us feel uneasy. There are many different methods of preventing the flu.

Things You'll Need:

• Mask
• Gloves
• Cleaner such as bleach and water
• Herbs such as Garlic and Onions

Read the rest on eHow.com:

How to Avoid Getting The H1N1 Flu Virus