H1N1: Swine Flu Vaccine for Children Withdrawn

Hundreds of thousands of swine flu shots for children manufactured by French drug company Sanofi Pasteur have been recalled because tests indicate the vaccine doses lost some strength, government health officials said Tuesday.

The recall is for about 800,000 pre-filled syringes intended for young children, ages 6 months to nearly 3 years. The shots were distributed across the country last month and most have already been used, according to the federal government's Centers for Disease Control and Prevention.

Doctors were notified of the voluntary recall on Tuesday. Dr. Anne Schuchat, a CDC flu expert, stressed that parents don't need to do anything or to worry. The vaccine is still safe, she said.

The issue is the vaccine's strength. Tests done before the shots were shipped showed that the vaccines were strong enough. But tests done weeks later indicated the strength had fallen slightly below required levels. Why the potency dropped isn't clear.

Children in that age group are supposed to get two doses, spaced about a month apart. Health officials don't think children need to get vaccinated again, even if they got two doses from the same lots, said Schuchat.

Swine flu vaccine has been available since early October, and since then manufacturers have released about 95 million doses for distribution in the United States.

The recalled shots were made by Sanofi Pasteur, the vaccines division of France-based Sanofi-Aventis Group. The company reported the potency findings to the government officials and did a voluntary recall. A Sanofi Pasteur representative could not immediately be reached for comment Tuesday.

H1N1: Swine flu toll in Gaza reaches 10

Two more people died of swine flu in the besieged Gaza Strip on Sunday, bringing to 10 the total number of Gazans who have been killed by the disease, according to the Hamas-run health ministry.

"Two more cases died today, a 25-year-old woman and a 35-year-old man, bringing the total number of deaths from A(H1N1) to 10," said Hassan Khalaf, a ministry spokesman.

He added that another 67 people have been stricken with the disease, including "a number of serious cases."

Gaza, which has been under strict Israeli closure since the Islamist Hamas movement seized power in June 2007, was among the last places in the world to see cases of the virus, the first of which were reported a week ago.

The ministry has demanded 300,000 vaccines for the impoverished territory of 1.5 million people, including some 13,000 vaccines for government and public and private health workers.

Israel has already allowed in 10,000 doses of swine flu vaccine in a bid to prevent the latest outbreak from spreading to the Jewish state, which has lost 67 people to the virus.

Israel said last week it will allow in 30,000 to 40,000 more vaccines supplied by the World Health Organisation, but the transfer has not yet taken place, according to a military spokeswoman.

The Hamas-run government has meanwhile started examining foreigners entering the territory through the Erez crossing with Israel for signs of the disease, including by taking their temperature.

H1N1: Spain reports death from swine flu virus mutation

Spanish health ministry has reported that a Spanish patient, infected by a mutant strain of the swine flu A(H1N1) virus, has died.

"We have registered three cases of this mutation, including one which was fatal. We believe these are three isolated cases, and that there has been no transmission to any other person," a ministry spokesman reports.

It is the sixth officially reported fatal case of this mutation of the A(H1N1) virus in Europe, health minsters have acknowledged one in the Netherlands and two each in France and Norway.

Last month the WHO said that this mutation had been observed in Brazil, China, Japan, Mexico, Ukraine, Italy and the United States as early as April 2009.

Beware H1N1: The Computer Phishing email

Beware the H1N1 phishing e-mail, designed to convince you to put your personal information on a Web page created by a crook so they can steal from you.

Your first clue here may be the address the e-mail purports to be from, cdcmails.gov. According to the domain gurus Whois, this is not a registered domain.

What frightens folks most is its claims that the topic is a real program, and forms part of the official vaccination programs for H1N1. The problem here is that you have to register for the fake H1N1 malware but you don’t have to register for the official program.

Malware and phishing victims are directed to a “personal profile” capture page, run by the scammers.

The US CDC has put out an alert in response to the hoax. They have a special feature on their continuing blog site, called hoaxes_rumors.

It might be interesting if the researchers and analysts compared the spread of this virus with the spread of the real H1N1 strain. I suspect that this one will be more infectious but with a shorter duration.

H1N1: WHO Admit drug resistance in influenza mutation

The World Health Organisation said Friday that a mutation had been found in samples of the swine flu virus taken following the first two deaths from the pandemic in Norway. This is not unusual in itself because viruses, by their nature, will and do, mutate.

However, the WHO denied that the mutation had created a more contagious or more dangerous form of influenza A(H1N1) and they admitted that some similar cases observed elsewhere, had been mild. That was certainly the case for the people who did not die from it.

"The Norwegian Institute of Public Health has informed WHO of a mutation detected in three H1N1 viruses," the WHO said in a briefing note. Realistically, influenza viruses are continually undergoing mutations.

It is important to note that some of these are unsustainable and that some of these will succeed in not only being sustained but also in being drug resistant. It is their nature and follows the normal course of natural variation and selection, that all living things are prone to.

"The viruses were isolated from the first two fatal cases of pandemic influenza in the country (Norway) and one patient with severe illness," the report continued, although it added that no further instances were found in tests.

"Norwegian scientists have analysed samples from more than 70 patients with clinical illness and no further instances of this mutation have been detected (in the lab). This finding suggests that the mutation may not be widespread in the country," the UN health agency assumed, optimistically.

WHO spokesman Gregory Haertl said that the global health watchdog did not believe "that this has any significant impact, for the time being." Presumably, if the mutation proliferates over time, then it will become significant.

However, despite their blind faith and optimism, the agency admitted that a similar mutation had been observed in Brazil, China, Japan, Mexico, Ukraine, and the United States, as early as April 2009. Thus, contradicting themselves, whilst confirming the true nature of influenza viruses.

"The mutations appear to occur sporadically and spontaneously (you think!). To date, no links between the small number of patients infected with the mutated virus have been found and the mutation does not appear to spread," the WHO statement said. Some of those cases also produced mild symptoms, Haertl noted.

The WHO also underlined that there was no evidence of more infections or more deaths as a result, while the antiviral drugs used to treat severe flu, oseltamivir (Tamiflu) and zanamivir (Relenza), were still effective on the mutated virus.

Thus defending their single minded determination to follow this contraversial course of treatment, sponsored by the pharmaceutical agencies involved. Presumably to appear to be doing something in the face of an uncontrollable force of nature.

"Studies show that currently available pandemic vaccines confer(?) protection," it added, as mass vaccine campaigns were slowly gaining ground in the northern hemisphere amid signs of public skepticism in several European nations. (and growing profit margins of pharma companies)

Informed scientists naturally fear that mutations in flu viruses could cause more virulent and deadly pandemic flu. The global health watchdog reiterated a call for close monitoring.

The WHO was still assessing the significance of the latest observation, but it stressed that many such changes in the flu virus do not alter the illness it causes in patients.

"Although further investigation is under way, no evidence currently suggests that these mutations are leading to an unusual increase in the number of H1N1 infections or a greater number of severe or fatal cases," it added.

Norwegian authorities reported the country's first swine flu death on September 3, a 52 year-old Danish truck driver who died just over a week earlier.

On Friday, WHO data showed reported that around 6,750 people had died from swine flu since the virus was first uncovered in Mexico and the United States in April.

That represented an increase of about 500 more than a week ago, as the pandemic took hold in the northern hemisphere during the cold season

The WHO estimates that some 250,000 to 500,000 people die every year from standard seasonal variants of swine flu. Oh well! That's alright then. Sorry we troubled you guys. Let's just let you go back to sleep, whilst the rest of the world sits quietly by, watching people suffer and die.

Npw, the only question left in our minds is whether the WHO's approach to the pandemic is based on blatant incompetence or cynical corruption.

H1N1: Rules of Contact and Engagement

“In Samoa, people do not touch when they greet each other,” the linguistic anthropologist Alessandro Duranti says.

There is, of course, a catch: “When people whom they respect highly come into a house, they sit down across from you, and there is an elaborate ceremonial greeting: mentioning each person’s titles and social connections, one at a time, usually for an extended period.”

For those outside Samoa, the era of swine flu poses the thorny challenge of how to express cordiality, friendship, even love — while staying, as the authorities recommend, at least three to five feet away from anyone who coughs, sneezes or might otherwise show signs of infection with the H1N1 virus. Let's hope good sense prevails.

H5N1 Bird flu virus linked to inflamation of the brain

As if fever, aching muscles and a sore throat were not enough, researchers have found that flu may also lead to chronic neurodegenerative diseases like Parkinson's and Alzheimer's.

Most influenza infections affect the respiratory system, but there have long been suspicions that they are also linked to neurological disorders. The H1N1 flu pandemic in 1918 was followed by an outbreak of encephalitis and later by an unusually high number of cases of Parkinson's disease.

Hard evidence of such a link has been hard to find, however. So Richard Smeyne of the St Jude Children's Research Hospital in Memphis, Tennessee, sprayed a solution containing a highly pathogenic subtype of H5N1 avian flu into the noses of 225 mice. The team found that the virus infected nerves in the gut, then entered the brain stem and finally reached the brain. In the brain, it led to chronic activation of the immune system, even long after the viral infection had been cleared.

This immune system activity later led to protein aggregation and neuron loss in the brain, and to symptoms like tremor and loss of coordination – the hallmarks of Parkinson's and Alzheimer's.

Brain strains

"Infection with influenza virus might leave the brain vulnerable to damage from future infections with new influenza strains," says Smeyne, adding that this is more likely to happen in young children or during an flu pandemic.

Smeyne suspects that all flu viruses, including the current H1N1 swine flu pandemic, could cause symptoms of encephalitis, or inflammation of the brain. But he says that there is currently no proof that flu viruses other than the H5N1 he worked with can enter the central nervous system.

Reports of extra encephalitis during outbreaks of seasonal flu in Japan and the US, and most recently of swine flu-infected children hospitalised with neurological symptoms in Dallas, Texas, hint at a related mechanism, however.

"The link between flu infection and neurological disorders has been the elephant in the room [ever since 1918]," says virologist John Oxford, a virologist at Barts and The London School of Medicine and Dentistry, Queen Mary, University of London.

Journal reference: Proceedings of the National Academy of Sciences, DOI: 10.1073/pnas.0900096106

Confusion over giving antivirals to children with flu

Another pertinent study from the BMJ casts doubt over the UK's strategy to combat H1N1 Swine Flu, is well founded.

Specifically, whether all children suspected of having H1N1 Swine flu, should be given antiviral drugs such as oseltamivir (Tamiflu) or zanamivir (Relenza).

The UK government Health Ministers, insist that everyone suspected of having H1N1 Swine flu should be offered antivirals as part of a "safety first" strategy but the BMJ study, published in their journal, suggests the strategy is misguided, at best.

Small help
It concludes that treating children under 12 with antivirals does very little, shortening the duration of disease by just a day or so, and decreasing by just 8 per cent the likelihood that an infected child will spread it to others.

Also, Tamiflu causes additional vomiting in 5 per cent of children already vomiting because of their illness. Nor does it bring any benefits for asthmatics, as implied by advice from the UK government's Health Protection Agency.

"The results show the beneficial effect is fairly small for most children," says Matthew Thompson of the University of Oxford, who led the research.

His team's advice is for parents to treat mild flu symptoms with the usual medicines and the priority is in controlling the high fever, ensuring the patient gets plenty of rest and their fluid intake is maintained.

Beneficial Value unknown
Even if complications develop, the beneficial value of giving antivirals to children is unknown, the researchers say. "What we need are studies large enough to let us know if antivirals reduce the risks of serious complications such as pneumonia or hospitalisation in children," Thompson says.

Another bonus of limiting treatment in children is that it will reduce the risk of the mutating virus developing resistance to the drugs.

UK Government's response
Responding, the British government's Department of Health said that the BMJ study is based on seasonal flu and so may not apply to swine flu. This is a very weak knee-jerk response with little substance.

"Whilst there is doubt about how swine flu affects children, we believe a safety-first approach of offering antivirals to everyone remains a sensible and responsible way forward," said a spokesperson. "However, we will keep this policy under review as we learn more about the virus and its effects."

The government can see their ass-covering strategy diminishing in the face of evidence based criticism.

Viral Influenza A
Thompson accepts that his review only looked at seasonal flu. "But about two-thirds of the studies were influenza A, which is what the current strain is," he says. "So we would expect our results to be applicable to swine flu."

Sharp shooting
Thompson says that other countries are deploying a more considered and targeted approach, unlike the scattergun approach in the UK. "Canada, Ireland and the US are only recommending antivirals for patients at particularly high risk, or with severe illness," he says.

Good Advice
"It may be worth the UK Department of Health taking the new research on board and consider having a more targeted approach to the use of antivirals, or urgently conducting randomised controlled trials of children and adults to identify whether there are subgroups of children who will benefit from antivirals, and whether they do have an impact on severe complications such as pneumonia or hospitalisation," says Thompson.

Fortunately, the decisions lie not only with the UK Government. "I hope the evidence from such trials will help parents and family doctors make sensible decisions about which children to treat."

Results and Conclusions from BMJ Study: BMJ, DOI: 10.1136/bmj.b3172

Review methods: Eligible studies were randomised controlled trials of neuraminidase inhibitors in children aged 12 in the community (that is, not admitted to hospital) with confirmed or clinically suspected influenza. Primary outcome measures were time to resolution of illness and incidence of influenza in children living in households with index cases of influenza.

Results: We identified four randomised trials of treatment of influenza (two with oseltamivir, two with zanamivir) involving 1766 children (1243 with confirmed influenza, of whom 55-69% had influenza A), and three randomised trials for postexposure prophylaxis (one with oseltamivir, two with zanamivir) involving 863 children; none of these trials tested efficacy with the current pandemic strain. Treatment trials showed reductions in median time to resolution of symptoms or return to normal activities, or both, of 0.5-1.5 days, which were significant in only two trials. A 10 day course of postexposure prophylaxis with zanamivir or oseltamivir resulted in an 8% (95% confidence interval 5% to 12%) decrease in the incidence of symptomatic influenza. Based on only one trial, oseltamivir did not reduce asthma exacerbations or improve peak flow in children with asthma. Treatment was not associated with reduction in overall use of antibiotics (risk difference –0.30, –0.13 to 0.01). Zanamivir was well tolerated, but oseltamivir was associated with an increased risk of vomiting (0.05, 0.02 to 0.09, number needed to harm=20).

Conclusions: Neuraminidase inhibitors provide a small benefit by shortening the duration of illness in children with seasonal influenza and reducing household transmission. They have little effect on asthma exacerbations or the use of antibiotics. Their effects on the incidence of serious complications, and on the current A/H1N1 influenza strain remain to be determined.

Tamiflu not suitable for Children: TV Personality's daughter 'almost died'

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Health Secretary Andy Burnham has defended giving swine flu drug Tamiflu to children as TV presenter Andrew Castle said his daughter "almost died" after taking it.

Mr Burnham was confronted by Castle on GMTV after research cast doubt that the anti-viral drug's benefits outweighed its side-effects.

The presenter said: "I can tell you that my child - who was not diagnosed at all - she had asthma, she took Tamiflu and almost died."

Fatal Consequences

Castle said his daughter, Georgina, had a severe reaction, "respiratory collapse" and "suffered very heavily" after being "just handed" the drug without having been properly diagnosed.

All this is in the light of last week, when a 2 yr old child died of Meningitis, after being wrongly diagnosed as having Swine Flu. She and her parents were dismissed and turned away by off-hand, hospital, medical staff.

Sympathy on Offer

Mr Burnham sympathised with Castle, saying it must have been "very worrying", but maintained that the current advice being given to parents to treat swine flu with Tamiflu, remained unchanged, despite the wave of severe doubts and criticisms coming from consultants and specialists alike.

Given that swine flu had a "disproportionate effect" on children, he maintained that Tamiflu was "our only line of defence" or, the only line of defense being considered. A policy that puts children in as much danger from the cure as from the disease.

Specialists Warn against Tamiflu

On Monday, Oxford University researchers made a serious announcement that children should NOT be given the anti-viral drug to combat swine flu. They urged the Department of Health to urgently rethink its policy on giving the drug to youngsters affected by the current flu pandemic.

The study, published in the British Medical Journal (BMJ), warned that Tamiflu can cause severe vomiting in some children, which can lead to dehydration and the need for emergency hospital treatment.

Cure worse than Disease

The researchers stated strongly that children should NOT be given the drug if they have a mild form of the illness. In such cases the cure is worse than the disease. They urged parents and GPs to remain vigilant for signs of complications and to avoid 'off the shelf' solutions and knee-jerk reactions.

Child dies of Meningitis after Swine Flu wrongfully diagnosed by 16 year old responder

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Health bosses are investigating whether a two-year-old girl who died from suspected Meningitis was wrongly diagnosed with swine flu by medical responders, one of which was under age.

16 Year Old Responders
News of her death comes after it emerged at least one call centre for the Government's National Flu Pandemic Service for England was employing 16-year-olds, sparking concern about the inexperience of staff.

Remote or Off-Hand Diagnosis
The parents of Georgia Keeling from Norwich claim paramedics "diagnosed her before even looking at her" and gave Tamiflu before her condition worsened and she died in hospital.

The parents of Georgia, who died at the Norfolk and Norwich University Hospital on Tuesday, said they were twice told her symptoms sounded like swine flu before she was finally taken to hospital, in a state of emergency and in the last throws of Meningitis.

Didn't Fit the H1N1 Profile

Their local health centre first said, Georgia 'probably' had swine flu and advised them to call the swine flu helpline. They told them that Georgia had only one of the symptoms and suggested that they should call NHS Direct.

NHS Direct; Dangerously poor advice
NHS Direct then advised them to take the little girl to hospital only if her temperature rose above an astounding 40 degrees C, enough to cause hallucinations and fits in a young child. An hour later, Georgia's condition worsened and her distraught mother called an ambulance.

Paramedic Turned Ambulance away
A paramedic who arrived first said it sounded to him like Georgia had swine flu (H1N1). Having decided that it was a 'False Alarm', and nothing but another 'Hysterical Mother', he advised the ambulance despatchers not to send an ambulance.

Calpol and Tamiflu
Georgia's mother Tasha Keeling was given Calpol and Tamiflu and told to put Georgia to bed, the girl's father said.

An hour later, her near hysterical mother again called for an ambulance again, this tie it came but far too late. Georgia was taken to hospital where she died soon after.

Meningitis; Wrongly Diagnosed
A hospital spokesman said the suspected cause of death was meningitis. Sources said the investigation into the little girl's death would look into all aspects of her care - including the possibility that she may have been wrongly diagnosed as having swine flu.

A Tragedy of Errors
A horrendous story of incompetence and lack of support for the public. The NHS panic about Swine Flu has blinded them to the greater risk of more prevalent and more deadly diseases e.g. Meningitis, Clostridium difficile (C Diff), etc. C Diff kills more people every week in hospital than Swine Flu will ever do.

50% of Young Children Suffer Side Effects from Tamiflu

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More than half of children taking Tamiflu suffer side-effects such as nausea, insomnia and nightmares, researchers have said.

Two studies from experts at the Health Protection Agency (HPA) showed a "high proportion" of British schoolchildren reporting problems after taking the anti-viral drug.

Data was gathered from children at three schools in London and one in the South West who were given Tamiflu earlier this year after classmates became infected.

The researchers behind one study said that, although children may have attributed symptoms that were due to other illnesses to the use of Tamiflu, "this is unlikely to account for all the symptoms experienced".

Their research, published in Eurosurveillance, looked at side-effects reported by 11 and 12-year-old pupils in one school year in a secondary school in South West England. The school was closed for 10 days in response to a pupil being confirmed with swine flu on return from a holiday in Cancun, Mexico.

A total of 248 pupils took part in the study and were given Tamiflu prophylactically. Compliance with prophylaxis was high, with 77% of children taking the full course, the researchers said. But they added: "Fifty-one per cent experienced symptoms such as feeling sick (31.2%), headaches (24.3%) and stomach ache (21.1%).

The researchers said "likely side-effects were common" and the "burden of side-effects needs to be considered" when deciding on giving Tamiflu to children prophylactically. The researchers concluded that a "high proportion of school children may experience side-effects of oseltamivir (Tamiflu) medication".

Swine flu - UK absentees from work 'triple in a week'

The number of people calling in sick with swine flu symptoms has tripled in a week, with 130,000 people staying away from work.

Worldwide, 700 people have died!

News of the increase in absenteeism came as the British death toll from the virus rose to 31, with a 51-year-old woman from Wiltshire and the 15-year-old from Glasgow the latest victims.

Greatest Challenge to NHS
Sir Liam Donaldson, the chief medical officer, yesterday warned that swine flu “almost certainly” posed the biggest challenge to the NHS for a generation. Fears of swine flu crisis grow as six-year-old girl and doctor dieAlmost 130,000 people stayed off work with flu, coughs and colds on July 14, up from 45,000 a week before, according to FirstCare, an absence management company.

Absentees triple
While absences tripled, the number of people who have actually contracted the virus is thought to have only doubled over the same period, highlighting how fear of infection is damaging business.

Septic Shock
Meanwhile, it has emerged that Chloe Buckley, the girl thought to have been the first healthy young victim of swine flu, died from septic shock after a bout of tonsillitis, a post mortem examination indicated. The death of Chloe, six, from West Drayton, west London, alarmed parents of young children.

Dr Simon Tanner, London’s regional director of public health, said it was impossible “to say to what degree swine flu contributed to her death”.

Andrew McCombe, a leading surgeon, said it was rare for a child to die from septic shock after contracting tonsillitis. “Normally septic shock affects old people,” he said.

Human Vaccine Trials to Begin
Human trials of a vaccine to protect against the H1N1 swine flu virus have begun in Australia.
Vaxine and CSL have both started injecting human volunteers this week, but it will be at least six weeks before the initial results are known.

Morbidity rate increases
The overall morbidity figure is likely to climb on Thursday when the Department of Health gives its weekly update. Worldwide, more than 700 people have died.

H1N1 Pandemic in UK: Sudden Increase in Cases

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GPs have seen a leap of almost 50% in the numbers of people contacting them with fears they have swine flu in the last week, new figures reveal.

Around 40,000 people a week in England and Wales are now complaining to their doctor of "flu-like illness", with a dramatic rise in the number of young children being affected.

The Royal College

The figures, from the Royal College of GPs' monitoring system, showed 50.3 people per 100,000 were reporting flu-like illness between June 29 and July 5, but this leapt by 46% to 73.4 people per 100,000 between July 6 and 12.

Financial Times

Almost one in eight workers are likely to be kept at home with the virus in the next few weeks, according to Government figures. This could leave many businesses struggling to run as normal, the Financial Times reported.

Sir Liam Donaldson is expected to announce that 30% of the population is likely to be infected during this first wave of the pandemic, the FT newspaper said.

Young at most Risk
Wednesday's weekly report from the Royal College of GPs said: "National incidence of influenza-like illness increased for all regions and is now evident in all age groups but remains highest in five to 14 age groups."

Central England Hotspot
The study said the highest number of cases was being seen in central England but the North had seen "a marked increase compared to previous weeks".

There has been a small decrease in the number of cases being seen in London although the capital remains a major hot spot for the virus.

Statistics
The rate of influenza-like illness is highest among those aged five to 14, at 159.57 per 100,000 population. The next most affected group is youngsters and babies aged up to four, at 114.12 per 100,00 population. This is followed by people aged 15 to 44, those aged 45 to 64 and then people aged 65 and over.

Ant-viral Vaccine
The Government has insisted that the swine flu vaccine should begin arriving at the end of August, amid genuine fears of a delay in this delivery date, and further delay before people receive jabs.

The UK claims, it is in line to get around 60 million doses of the vaccine - enough to cover half the population - by the end of December, with the rest of the doses following next year.

Vaccine Production Delayed
This is a substantial turn around in their earlier claims and the first phase of the virus should have run its course by then. The mutated second phase will take over and the vaccine will be ineffective against it.

Virus Dictates Timeline
It is impossible to determine how the H1N1 virus will mutate, so scientists are unable to prepare in advance for this strain. Only when the new strain is identified will they be able to start on development of a new anti-viral vaccine.

So, the development, testing and distribution of a second antiviral vaccine will need to start after January 2010 and is therefore unlikely to be in production before the Spring 2010.

H1N1: How Swine Flu kills

As the H1N1 swine flu pandemic continues to spread around the world, most cases are still mild but reports are starting to emerge of people who sicken and die very quickly of what appears to be viral pneumonia. Now two independent groups of scientists have now found out why and it's all down to where the virus binds within the body.

H1N1 swine flu comes from pigs, so it binds well to cell-surface molecules in the respiratory tracts of other mammals, including humans but there are slight differences in the way different flu proteins bind to these receptors.

Two separate teams – one led by Ron Fouchier at Erasmus University in Rotterdam, the Netherlands, and the other by Terrence Tumpey at the Centres for Disease Control in Atlanta, Georgia – both report that the pandemic virus binds deeper than ordinary flu in the respiratory tract of ferrets, the animal most like humans when it comes to flu.

A virus of the same H1N1 family as the pandemic flu has been circulating as ordinary seasonal flu since 1977. Both groups found that the seasonal virus binds almost exclusively to cells in the ferrets' noses. But, the pandemic H1N1 binds deeper, in the lung's trachea, bronchi and bronchioles. The pandemic virus also replicated more, and caused more damage, though none of the ferrets were severely ill.

H1N1: The Hidden or Concealed Pandemic

H1N1 swine flu continues to roam the planet. In the US, cases are thought to be in the hundreds of thousands. In Japan, hundreds of teenagers have caught it, despite no obvious connections with Mexico or the US.

Yet in Europe, health authorities are not testing widely for it and are prescribing drugs as though they could still contain it. And in Geneva, health ministers have fought this week to keep the World Health Organization from following its own rules and calling this a pandemic.

There has been a phenomenal mismatch between quite sensible rules about how to declare a flu pandemic, and equally sensible rules about how to respond. The mismatch was wholly predictable, yet somehow no one saw this coming.

The WHO rules for declaring different degrees of flu pandemic threat are based on epidemiology (how the virus is spreading) for good reasons. This is because any new flu virus to which most of the world has little immunity, and which spreads well enough person-to-person to escape its continent of origin, is very likely to go global, and to cause more sickness and death than flu usually does. That is the definition of a flu pandemic.

The virus's ability to spread is what matters. H5N1 bird flu has travelled across Eurasia, mainly in birds, but it hasn't spread readily in people, so it isn't a pandemic.

The Mexican swine flu H1N1, however, has. When it spread across the Americas, the WHO followed its rules and declared it a level 5 situation; one down from a pandemic. When it starts spreading outside the Americas, through "community transmission" - meaning it crops up generally, not just in people who have visited Mexico or New York recently or their contacts - that means it's got a foothold globally.

A flu that can do that is very unlikely to stop there. The WHO rules make that a full-blown level 6 pandemic.

And frankly, that is starting to happen. As I write, the number of confirmed cases in Japan (and that's just people sick enough to see a doctor and get tested) has jumped by 35 in the past 24 hours, to nearly 300, mostly due to that perennial vector of flu, the gregarious teenager. The main cluster started without any known links to the Americas.

In Europe, countries are deliberately not testing cases that could be community acquired, almost as if someone doesn't want to trigger - 'LEVEL 6'

In fact, Britain, Japan and other countries spent this past week pleading with the WHO not to go to level 6 yet, at least while the virus is still causing mostly mild disease. WHO boss Margaret Chan has now agreed to make the call when she sees "more signals coming from the virus itself or the spread of the disease, including severity."

The problem is, countries have pandemic plans that, rightly, prepare for the worst. Until recently we were worried about H5N1 (we still are) and there seemed a good chance that if it went pandemic, it might start off severe, necessitating major controls from the start.

H1N1 Swine Flu pandemic update

Chinese health inspectors and officials prepare to transport quarantined Mexican passengers to Pudong International Airport, ready for repatriation (Image: View China Photo / Rex)

Swine Flu H1N1 Level 4: Can business survive this after severe lay-offs

The business world is growing increasingly concerned about a quickly developing H1N1 swine flu outbreak, with cases now appearing all over the world, and hundreds more in Mexico.

This should ring loud alarm bells for IT managers and spur them on to take a close look at the dusty old influenza pandemic plans, developed several years ago in response to a potential bird flu pandemic.

The additional problem that IT managers are facing today, is that following the recent consolidations, layoffs and restructurings, they will have less staff and reduced capability to deal with events. They will also have disjointed and inadequate response plans to correct because the old ones were drafted in more favourable times. People who once took a pivotal role as part of a critical team, may now be on garden-leave, collecting unemployment money or re-assigned to another location or position.

Clearly, it is very important that managers pay close attention to what's going on; the H1N1 pandemic situation is a dynamic event and is still emerging. It has been developing quickly over a short period of time. This is something that needs to be monitored and taken very seriously.

Now, the World Health Organization has raised its threat level to Level 4 in its six-level scale because the swine flu currently has "a sustained limited human-to-human transmission."

While the business world figures out just what this means, the Contingency managers are already pushing and recommending that the business seriously reviews and updates their call lists and decision-making chains. It is essential that they close any gaps and weaknesses in plans caused by recent organisational restructuring and downsizing, in particular.

If an organisation has not developed a specific pandemic plan, then they should do so quickly. Develop one by concentrating on one key factor; making a continuity plan that is business focused and that considers a "significant absence" of employees. Give serious thought about how your business could support its clients and sustain services by the use of tele-working methods and virtual environments, from your employees homes.

The standard model used in pandemic planning is to consider what would happen to a business if 40% of the workforce was absent, for an extended period of time. In this case it would be pertinent to consider a range of options, taking into consideration absentee levels of between 25 and 40%.

The WHO is in the midst of its initial investigations of the illness, and they currently believe that it may not be anywhere near the threat envisaged, specifically if the bird flu became a human influenza pandemic.

Gartner Inc.'s response in 2006 was to suggest stringent measures to IT departments, such as storing 42 gallons of water per data centre worker, enough for a six-week quarantine. Even at the time this was felt to be excessive.

Asked if Gartner was offering any advice in response to the Mexican outbreak, analyst Ken McGee, the author of that Gartner report, said today that it will go into "full-force advisory mode" not when the virus jumps from birds or swine to people, but when it jumps from people to people. So, that will be quite soon then. Worryingly, it does show a slight lack of foresight and planning on Gartner's side, as well as a reactive rather than proactive response.

If nothing else, the Mexican situation will acts as a wake-up call for businesses and clients that need to develop meaningful infectious virus disease-related influenza plans. If you consider this as a meaningful step for you, then the next sensible thing to do would be to have your plans checked and reviewed by a risk and contingency expert. These simple measures are by far preferably to having a 'live' and potentially destructive test being inflicted upon your business by the virus itself, in whatever form it takes. Your choice or no choice.