With H1N1 poised to enter history as the least deadly of four global flu pandemics, some experts are calling for an end to Canada's mass vaccination program.
Nature is already achieving what we would hope to achieve by vaccinating, they say.
H1N1's "reproductive number" -- the number of people each infected person passes the virus to -- was above one when the epidemic began, which led to the explosive initial increase in cases.
Now it is less than one, because many people have become immune, and each old case is making less than one new case. When the reproductive number falls below one, the epidemic can't sustain itself, and fades away.
The drop in cases suggests Canada has hit the critical fraction of the population that needs to be vaccinated to control the pandemic, says Dr. David Fisman, a University of Toronto expert in infectious disease dynamics.
Fisman can't understand the rational for continuing mass vaccinations. He said that for a virus as contagious as H1N1, less than 30 per cent of the population needed vaccination to reach a critical level of immunity.
"I'm sure that the vaccine has prevented some deaths. I'm sure that there are people who are alive right now who would not have been alive if we hadn't vaccinated," he says. But the pandemic was already peaking, and then subsiding before the vaccination was rolling out in force.
"That's nobody's fault, that's just how long it took to make a vaccine against a brand new virus. Those were the cards we were dealt," says Fisman, an associate professor of infectious diseases epidemiology at the university.
Despite that view, Canada's top doctor this week pleaded with Canadians to get vaccinated if they have not already done so. Chief public health officer David Butler-Jones said that, while 30 per cent of the population is now immune to H1N1, either because they have been vaccinated or because they have already been infected, "millions" of people are still at risk of infection.
Someone vaccinated today may be protected against infection two weeks from now, "if there is still enough of (H1N1) kicking around," Fisman says. But the benefit diminishes the further into the future we go, and he says other public health programs have suffered as staff and resources were redeployed to the H1N1 campaign. In some jurisdictions, breastfeeding support programs, sexually transmitted disease clinics and other usual activities were cancelled or postponed as public health was forced to bear the brunt of delivering the largest immunization program in Canada's history.
"At this point, in terms of saying everybody must get vaccinated because there is a pandemic abroad, it's kind of done," Fisman says.
H1N1 will likely fade away with a death rate lower than that for regular seasonal flu.
When the World Health Organization declared the pandemic in June, officials warned the rogue virus threatened all of humanity. The reality is so far proving strikingly different from what was expected.
The world agency, and Canada, had done their pandemic planning with a different flu virus in mind. They spent five years watching H5N1, or "bird flu," which kills up to 60 per cent of those it infects.
We got off lucky when the real pandemic hit, WHO says, but the public doesn't always understand that.
"Adjusting public perceptions to suit a far less lethal virus has been problematic," WHO said in a statement Thursday, issued in response to media reports that ties with the drug industry among expert advisers may have influenced WHO's policy decisions related to H1N1.
"Given the discrepancy between what was expected and what has happened, a search for ulterior motives on the part of WHO and its scientific advisers is understandable, though without justification.
"WHO has consistently assessed the impact of the current influenza pandemic as moderate. WHO has consistently reminded the medical community, public and the media that the overwhelming majority of patients experience mild influenza-like illness and recover fully within a week, even without any form of medical treatment." But some critics say WHO set itself up for blame.
"They had been talking for years about the possibility of some kind of reprise of the 1918 pandemic," says Philip Alcabes, author of Dread: How Fear and Fantasy Have Fueled Epidemics from the Black Death to the Avian Flu. "A huge amount of money and person power was devoted to preparing" for the next outbreak, he says.
But, "there was never any evidence, not from Day 1, and not anytime since, that this strain of flu was going to be a particularly dangerous strain, either in terms of its capacity to make people sick or its capacity to kill people," says Alcabes, associate professor in urban public health at Hunter College's School of Health Sciences in the City University of New York.
Showing posts with label H5N1 virus. Show all posts
Showing posts with label H5N1 virus. Show all posts
Saturday, December 5, 2009
Tuesday, November 24, 2009
Baxter Received Approval for avian flu (H5N1) pandemic vaccine CELVAPAN in Europe 11/24/09 8:45am
Baxter Received Approval for avian flu (H5N1) pandemic vaccine CELVAPAN in Europe
Thank you Mary for linking this to us.
Article:
Baxter has received positive recommendations for its avian flu (H5N1) pandemic vaccine CELVAPAN for use in the European Union, it has revealed.
The Committee for Medicinal Products for Human Use of the European Medicines Agency (EMEA) has issued its verdict on the product ahead of the firm submitting its licence for the vaccine - which could authorise its use in the event of the World Health Organization declaring a pandemic.
This recommendation comes after a clinical trial found that vaccines for two different H5N1 virus strains were well-tolerated and generated an immune response in candidates.
Hartmut Ehrlich, vice-president of bioscience global research and development at the firm, commented: "This is another step towards our goal of supplying a safe and effective vaccine to protect the population against a possible influenza pandemic."
In other Baxter news, the firm's board of directors declared a quarterly dividend of $0.29 (17p) per common share last week, marking an increase over the previous quarterly rate of $0.26 per share.
Is it Really SAFE? Or should countries make sure it does NOT have the Live Real Virus in the vaccines, as Baxter has sent out before?!
Article:
Baxter has received positive recommendations for its avian flu (H5N1) pandemic vaccine CELVAPAN for use in the European Union, it has revealed.
The Committee for Medicinal Products for Human Use of the European Medicines Agency (EMEA) has issued its verdict on the product ahead of the firm submitting its licence for the vaccine - which could authorise its use in the event of the World Health Organization declaring a pandemic.
This recommendation comes after a clinical trial found that vaccines for two different H5N1 virus strains were well-tolerated and generated an immune response in candidates.
Hartmut Ehrlich, vice-president of bioscience global research and development at the firm, commented: "This is another step towards our goal of supplying a safe and effective vaccine to protect the population against a possible influenza pandemic."
In other Baxter news, the firm's board of directors declared a quarterly dividend of $0.29 (17p) per common share last week, marking an increase over the previous quarterly rate of $0.26 per share.
Is it Really SAFE? Or should countries make sure it does NOT have the Live Real Virus in the vaccines, as Baxter has sent out before?!
Friday, November 13, 2009
New England Journal of Medicine Article on Changes in Swine Flu" 11/13/09 4:41pm
NEW ENGLAND JOURNAL OF MEDICINE ARTICLE - CHANGES IN SWINE FLU
Thanks to a reader of the blog also named Sherry, we have some interesting information, I have not heard about from the media or any governments.
Sherry, linked this New England Journal of Medicine article that just came out, yesterday, with a very interesting article about the Swine Flu.
It seems the media and governments, when they have talked about the "Swine Flu" and how it started, as we all know in Mexico, and they labeled it H1N1 - well it has had changes.
From autopsies it was found it had already morphed into H5N1 in Mexico - almost right away.
So, from reading this article, if I understood it correctly - this whole Swine Flu pandemic along with the Swine Flu Vaccine - may not even be what is really going around right now. This is yet another added virus to the whole lethal concoction already spreading. As I see it, the vaccine, they want everyone to take might not even be for what is actually going around anyway.
Please correct me, if I am not right in my assumptions.
Article:
To the Editor: Between April 23, 2009, and May 15, 2009, we performed 15 autopsies on deceased patients in whom probable influenza had been diagnosed either clinically or macroscopically. Small samples of lung tissue were obtained and taken for analysis to the Institute of Epidemiological Diagnosis and Reference in Mexico City. Five infections with the 2009 pandemic influenza A (H1N1) virus were confirmed with the use of a real-time reverse-transcriptase–polymerase-chain-reaction assay, after it was determined that these patients were seronegative for influenza B virus, respiratory syncytial virus, parainfluenza virus (types 1, 2, and 3), and adenovirus.1 From these five patients, organ samples were collected, fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin and eosin. In the remaining 10 patients in whom the 2009 H1N1 virus was not detected, histopathological analyses identified bacterial pneumonia.
All five patients with diagnosed 2009 H1N1 influenza had been residents of Mexico City. Four of them were young adults (ages 22, 26, 28, and 37 years) who were hospitalized with the presumptive diagnosis of influenza. These patients were initially treated with antibiotics for bacterial pneumonia. The fifth patient was an 83-year-old woman with a diagnosis of cerebral hemorrhage, who had no clinical signs of influenza but showed characteristics of hemorrhagic pneumonia on macroscopic evaluation. The patients had died 7 to 13 days after the onset of influenza symptoms.
On autopsy for all five patients, the right and left lungs had increased in weight (650 to 1200 g for each lung; normal, 450 g) and had a solid consistency (see Fig. 1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org). In four patients, zones of edema, hemorrhage, or necrosis were observed in the upper respiratory tract on the internal surface of the larynx and trachea, as reported in previous cases of seasonal influenza.2,3 All five patients showed evidence of pulmonary damage and signs of acute interstitial lesions, as noted in patients with avian influenza A (H5N1) virus infection.3,4
In four patients, we observed hyaline membranes, alveolar septal edema, hyperplasia of type II pneumocytes, fibrin thrombus in the vascular lumen, and necrosis of the bronchiolar walls; three patients had inflammatory infiltrate below the endothelium and partial loss and adherence of the endothelium in the medium- and small-caliber intrapulmonary blood vessels (Figure 1). These histologic changes are characteristics of influenza though not pathognomonic. In three patients, we observed pneumonia foci with intraalveolar exudates without evidence of bacterial colonies; however, nearly all the patients had received antibiotic treatment. In two patients, we observed erythrophagocytosis and phagocytosis of inflammatory cells in the liver, spleen, and bone marrow, which is similar to observations in lethal cases of infection with the avian influenza A (H5N1) virus2 (Fig. 2 and 3 in the Supplementary Appendix). One patient had focal centrilobular necrosis of the liver and hemorrhagic necrosis of the adrenal gland cortex, and acute tubular necrosis was observed in another patient.
The cause of death in one patient was parenchymal cerebral hemorrhage. Histologic evaluation of the lungs showed only septal edema and extensive hemorrhage with scarce fibrin thrombi. The interstitial lesion was incipient, and hemorrhage was the predominant characteristic. These observations may represent an early stage of an acute pulmonary lesion that had not yet transitioned from the exudative phase to the proliferative phase.
M. Virgilia Soto-Abraham, M.D.
Juan Soriano-Rosas, M.D.
Hospital General de México
Mexico City, Mexico
virgiliasoto@yahoo.com
Alberto Díaz-Quiñónez, Ph.D.
Instituto de Diagnóstico y Referencia Epidemiológicos
Mexico City, Mexico
Juan Silva-Pereyra, Ph.D.
Universidad Nacional Autónoma de México
Mexico City, Mexico
Patricia Vazquez-Hernandez, M.D.
Oralia Torres-López, M.D.
Hospital General de México
Mexico City, Mexico
Alfonso Roldán, M.D.
Hospital Central Militar
Mexico City, Mexico
Ana Cruz-Gordillo, M.D.
Patricia Alonso-Viveros, M.D.
Francisco Navarro-Reynoso, M.D.
Hospital General de México
Mexico City, Mexico
References
Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009;360:2605-2615. [Erratum, N Engl J Med 2009;361:102.] [Free Full Text]
Taubenberger JK, Morens DM. The pathology of influenza virus infections. Annu Rev Pathol 2008;3:499-522. [CrossRef][Web of Science][Medline]
Korteweg C, Gu J. Pathology, molecular biology, and pathogenesis of avian influenza A (H5N1) infection in humans. Am J Pathol 2008;172:1155-1170. [Free Full Text]
Guarner J, Paddock CD, Shieh WJ, et al. Histopathologic and immunohistochemical features of fatal influenza virus infection in children during the 2003-2004 season. Clin Infect Dis 2006;43:132-140. [CrossRef][Web of Science][Medline]
I am not a doctor, nor do I know medical information, so I may have read this completely wrong. I look forward to hopefully hearing from those who do understand this better, through comments or emails.
Thanks to a reader of the blog also named Sherry, we have some interesting information, I have not heard about from the media or any governments.
Sherry, linked this New England Journal of Medicine article that just came out, yesterday, with a very interesting article about the Swine Flu.
It seems the media and governments, when they have talked about the "Swine Flu" and how it started, as we all know in Mexico, and they labeled it H1N1 - well it has had changes.
From autopsies it was found it had already morphed into H5N1 in Mexico - almost right away.
So, from reading this article, if I understood it correctly - this whole Swine Flu pandemic along with the Swine Flu Vaccine - may not even be what is really going around right now. This is yet another added virus to the whole lethal concoction already spreading. As I see it, the vaccine, they want everyone to take might not even be for what is actually going around anyway.
Please correct me, if I am not right in my assumptions.
Article:
To the Editor: Between April 23, 2009, and May 15, 2009, we performed 15 autopsies on deceased patients in whom probable influenza had been diagnosed either clinically or macroscopically. Small samples of lung tissue were obtained and taken for analysis to the Institute of Epidemiological Diagnosis and Reference in Mexico City. Five infections with the 2009 pandemic influenza A (H1N1) virus were confirmed with the use of a real-time reverse-transcriptase–polymerase-chain-reaction assay, after it was determined that these patients were seronegative for influenza B virus, respiratory syncytial virus, parainfluenza virus (types 1, 2, and 3), and adenovirus.1 From these five patients, organ samples were collected, fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin and eosin. In the remaining 10 patients in whom the 2009 H1N1 virus was not detected, histopathological analyses identified bacterial pneumonia.
All five patients with diagnosed 2009 H1N1 influenza had been residents of Mexico City. Four of them were young adults (ages 22, 26, 28, and 37 years) who were hospitalized with the presumptive diagnosis of influenza. These patients were initially treated with antibiotics for bacterial pneumonia. The fifth patient was an 83-year-old woman with a diagnosis of cerebral hemorrhage, who had no clinical signs of influenza but showed characteristics of hemorrhagic pneumonia on macroscopic evaluation. The patients had died 7 to 13 days after the onset of influenza symptoms.
On autopsy for all five patients, the right and left lungs had increased in weight (650 to 1200 g for each lung; normal, 450 g) and had a solid consistency (see Fig. 1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org). In four patients, zones of edema, hemorrhage, or necrosis were observed in the upper respiratory tract on the internal surface of the larynx and trachea, as reported in previous cases of seasonal influenza.2,3 All five patients showed evidence of pulmonary damage and signs of acute interstitial lesions, as noted in patients with avian influenza A (H5N1) virus infection.3,4
In four patients, we observed hyaline membranes, alveolar septal edema, hyperplasia of type II pneumocytes, fibrin thrombus in the vascular lumen, and necrosis of the bronchiolar walls; three patients had inflammatory infiltrate below the endothelium and partial loss and adherence of the endothelium in the medium- and small-caliber intrapulmonary blood vessels (Figure 1). These histologic changes are characteristics of influenza though not pathognomonic. In three patients, we observed pneumonia foci with intraalveolar exudates without evidence of bacterial colonies; however, nearly all the patients had received antibiotic treatment. In two patients, we observed erythrophagocytosis and phagocytosis of inflammatory cells in the liver, spleen, and bone marrow, which is similar to observations in lethal cases of infection with the avian influenza A (H5N1) virus2 (Fig. 2 and 3 in the Supplementary Appendix). One patient had focal centrilobular necrosis of the liver and hemorrhagic necrosis of the adrenal gland cortex, and acute tubular necrosis was observed in another patient.
The cause of death in one patient was parenchymal cerebral hemorrhage. Histologic evaluation of the lungs showed only septal edema and extensive hemorrhage with scarce fibrin thrombi. The interstitial lesion was incipient, and hemorrhage was the predominant characteristic. These observations may represent an early stage of an acute pulmonary lesion that had not yet transitioned from the exudative phase to the proliferative phase.
M. Virgilia Soto-Abraham, M.D.
Juan Soriano-Rosas, M.D.
Hospital General de México
Mexico City, Mexico
virgiliasoto@yahoo.com
Alberto Díaz-Quiñónez, Ph.D.
Instituto de Diagnóstico y Referencia Epidemiológicos
Mexico City, Mexico
Juan Silva-Pereyra, Ph.D.
Universidad Nacional Autónoma de México
Mexico City, Mexico
Patricia Vazquez-Hernandez, M.D.
Oralia Torres-López, M.D.
Hospital General de México
Mexico City, Mexico
Alfonso Roldán, M.D.
Hospital Central Militar
Mexico City, Mexico
Ana Cruz-Gordillo, M.D.
Patricia Alonso-Viveros, M.D.
Francisco Navarro-Reynoso, M.D.
Hospital General de México
Mexico City, Mexico
References
Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009;360:2605-2615. [Erratum, N Engl J Med 2009;361:102.] [Free Full Text]
Taubenberger JK, Morens DM. The pathology of influenza virus infections. Annu Rev Pathol 2008;3:499-522. [CrossRef][Web of Science][Medline]
Korteweg C, Gu J. Pathology, molecular biology, and pathogenesis of avian influenza A (H5N1) infection in humans. Am J Pathol 2008;172:1155-1170. [Free Full Text]
Guarner J, Paddock CD, Shieh WJ, et al. Histopathologic and immunohistochemical features of fatal influenza virus infection in children during the 2003-2004 season. Clin Infect Dis 2006;43:132-140. [CrossRef][Web of Science][Medline]
I am not a doctor, nor do I know medical information, so I may have read this completely wrong. I look forward to hopefully hearing from those who do understand this better, through comments or emails.
Subscribe to:
Posts (Atom)
