1. WHO data continue to show that certain medical conditions increase the risk of severe H1N1 and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression.
2. WHO estimates that more than 230 million people globally have asthma, and more than 220 million have diabetes. Obesity may also worsen the risk of severe infection, WHO said.
WHO Warns of Severe Form of H1N1 Virus
Saturday, August 29, 2009/Reuters/Times
Doctors are reporting a severe form of H1N1 that goes straight to the lungs, causing severe illness in otherwise healthy young people and requiring expensive hospital treatment, the World Health Organization said Friday.
Some countries are reporting that as many as 15 percent of patients hospitalized with the new H1N1 pandemic virus need intensive care, further straining already overburdened healthcare systems, WHO said in an update on the pandemic.
"During the winter season in the southern hemisphere, several countries have viewed the need for intensive care as the greatest burden on health services," it said.
"Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases."
Earlier, WHO reported that H1N1 had reached epidemic levels in Japan, signaling an early start to what may be a long influenza season this year, and that it was also worsening in tropical regions.
"Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections," WHO said.
"In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays."
MINORITIES AT RISK
Minority groups and indigenous populations may also have a higher risk of being severely ill with H1N1.
"In some studies, the risk in these groups is four to five times higher than in the general population," WHO said.
"Although the reasons are not fully understood, possible explanations include lower standards of living and poor overall health status, including a high prevalence of conditions such as asthma, diabetes and hypertension."
WHO said it was advising countries in the Northern Hemisphere to prepare for a second wave of pandemic spread. "Countries with tropical climates, where the pandemic virus arrived later than elsewhere, also need to prepare for an increasing number of cases," it said.
Every year, seasonal flu infects between 5 percent and 20 percent of a given population and kills between 250,000 and 500,000 people globally. Because hardly anyone has immunity to the new H1N1 virus, experts believe it will infect far more people than usual, as much as a third of the population.
It also disproportionately affects younger people, unlike seasonal flu which mainly burdens the elderly, and thus may cause more severe illness and deaths among young adults and children than seasonal flu does.
"Data continue to show that certain medical conditions increase the risk of severe and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression," WHO said.
"When anticipating the impact of the pandemic as more people become infected, health officials need to be aware that many of these predisposing conditions have become much more widespread in recent decades, thus increasing the pool of vulnerable people."
WHO estimates that more than 230 million people globally have asthma, and more than 220 million have diabetes. Obesity may also worsen the risk of severe infection, WHO said.
The good news — people infected with AIDS virus do not seem to be at special risk from H1N1, WHO said.
ALARMING WHO STATISTIC ABOUT FLU AH1N1
CENTRE FOR DISEASE CONTROL RECOMMENDS 2 GROUPS FOR H1N1 VACCINE
2 recommendations by CDC exist that target 5 groups to receive the vaccine:
First
* Pregnant women,
* household contacts of children who are younger than 6 months of age,
* healthcare workers and emergency medical services personnel
* children and young people between the ages of 6 months and 24 years of age, and
* nonelderly adults with underlying risk conditions or medical conditions that increase their risk for complications from influenza.
Second:
* Pregnant women,
* household contacts of children who are younger than 6 months of age,
* healthcare workers and emergency services personnel who have direct patient contact or direct contact with infectious substances,
* children between the ages of 6 months and 4 years of age, and
* children 5 to18 years of age who have underlying risk factors that put them at greater risk for complications of influenza.
CDC Issues H1N1 Vaccination Recommendations
Emma Hitt, PhD
July 30, 2009 (Atlanta, Georgia) — New H1N1 influenza vaccine recommendations from the Centers for Disease Control and Prevention (CDC) suggest priority distribution among 5 groups.
The CDC announced the recommendations in a press conference held after an "urgent" meeting of the Advisory Committee of Immunization Practices yesterday.
Recommended Target Groups
Anne Schuchat, MD, director of the National Center for Immunization and Respiratory Diseases with the CDC, announced that the Advisory Committee of Immunization Practices recommends that 5 target groups receive the vaccine:
* Pregnant women,
* household contacts of children who are younger than 6 months of age,
* healthcare workers and emergency medical services personnel,
* children and young people between the ages of 6 months and 24 years of age, and
* nonelderly adults with underlying risk conditions or medical conditions that increase their risk for complications from influenza.
The committee also addressed the issue of what to do in the event of a vaccine shortage and how to prioritize those groups who should receive the vaccine.
"In general, under most circumstances, we really ought to promote vaccine in all of these 5 focus groups, and...picking them or prioritizing some before others would not benefit the public," Dr. Schuchat said. The CDC's estimate of the target groups totals 159 million individuals, but "there's a lot of overlap in some of the groups...[it is] probably a lower number than that," she said.
"Just in Case" Prioritization Group
However, the Advisory Committee of Immunization Practices also proposed a priority group consisting of a much smaller group, about 41 million individuals, that should be vaccinated in the event of a shortage. These include
* Pregnant women,
* household contacts of children who are younger than 6 months of age,
* healthcare workers and emergency services personnel who have direct patient contact or direct contact with infectious substances,
* children between the ages of 6 months and 4 years of age, and
* children 5 to18 years of age who have underlying risk factors that put them at greater risk for complications of influenza.
According to Dr. Schuchat, the real operating assumption is that they will "go forward with the broader group," she said.
Seasonal Influenza Vaccine Remains Important
According to the CDC, the seasonal influenza vaccine remains very important. "Our assumption is that it is very likely [that seasonal influenza and H1N1 vaccines] can be given together," Dr. Schuchat told Medscape Infectious Diseases during the briefing. "There will be more data coming out...but it is likely they can be given at the same visit," she said. According to Dr. Schuchat, 2 doses of the vaccine will probably be needed, with 15 μg antigen/dose.
"The recommendations make sense on the basis of what we know about this virus," said John Bartlett, MD, chief of the Johns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, Maryland.
"Of interest is the observation that persons over 64 years, a high priority for seasonal flu vaccine, are not included here," he told Medscape Infectious Diseases. "That decision is based on the curious observation that the people born before 1957 appear to be relatively well protected from infection or serious disease with this strain of H1N1 virus." According to Dr. Bartlett, it appears that a similar strain circulated before 1957, accounting for this protection; other comparable viruses also have circulated more recently.
"Pregnant women and young people seem to be especially susceptible to [the H1N1] influenza strain and also to bad outcomes when infected," he said. "But the elderly should get [the] seasonal flu vaccine, since they account for the vast majority of the 36,000 deaths attributed to seasonal influenza in the average season" he added. "In fact, most people should get seasonal flu vaccine. The current indications for that vaccine apply to about 80% of the US population."
Production a Concern
Dr. Schuchat noted that the production of the H1N1 vaccine could be unpredictable. "Right now, we are to on track, expecting vaccine doses in the fall," she said, adding that "exactly how many [doses will be available] exactly when will be tough to pinpoint."
"Production is a concern, since the novel H1N1 virus does not grow well in eggs, and 2 doses are likely to be necessary," said Dr. Bartlett. If the virus thrives in the fall in the Northern hemisphere, "it will be a challenge to be ready," he said.
Medscape
W.H.O GENERAL ADVICE ON H1N1 PERSONAL PREVENTIVE MEASURES
INFLUENZA A (H1N1) MEREBAK KE 74 NEGARA
*Pandemik Influenza A (H1N1): Aktiviti Pemantauan Ditingkat
*W.H.O. Raises Alert Level as Flu Spreads to 74 Countries
Statistics
(Photo:The government of Hong Kong on Thursday ordered all primary schools in the city to be closed for two weeks after the first cluster of local swine flu cases was found. Above, kindergarten students at a local school on Thursday.)
Pandemik Influenza A (H1N1): Aktiviti Pemantauan Ditingkat
Kementerian Kesihatan akan meningkatkan aktiviti pemantauan, pencegahan dan kawalan seiring dengan langkah Pertubuhan Kesihatan Sedunia (WHO) meningkatkan paras amaran wabak itu ke tahap tertinggi Rabu.
Ketua Pengarah Kesihatan Tan Sri Dr Mohd Ismail Merican berkata dalam tempoh lima tahun yang lalu, kementerian telahpun membuat persiapan yang baik termasuk latihan dan menyimpan ubat dan alat perlindungan diri.
Selain meneruskan langkah kawalan sedia ada, kementerian akan turut memaklumkan kepada klinik dan hospital kerajaan dan swasta agar mengenal pasti mereka yang mempunyai tanda-tanda influenza dan sama ada pesakit baru balik dari luar negara atau mempunyai hubungan dengan mereka yang baru pulang dari luar negara, katanya kepada pemberita di sini Jumaat.
Dr Mohd Ismail berkata tindakan seperti penutupan sekolah dan institusi serta pembatalan majlis perhimpunan atau perjumpaan awam akan diambil hanya jika terdapat penularan tempatan wabak Influenza A (H1N1) di negara ini.
"Setakat ini belum terdapat sebarang kes penularan tempatan kerana 11 kes yang dilaporkan sebelum ini kesemuanya merupakan kes import," katanya.
Dr Mohd Ismail berkata kementerian juga akan meminta kerjasama pihak berkuasa tempatan agar lebih kerap memeriksa tandas di tempat-tempat awam seperti dewan masyarakat dan pusat beli belah bagi memastikan kebersihan tandas-tandas itu dijaga kerana jangkitan penyakit dapat dielakkan dengan amalan kebersihan yang baik.
Beliau berkata kerjasama daripada Kementerian Penerangan, Komunikasi dan Kebudayaan juga diperlukan bagi menyiarkan langkah-langkah pencegahan wabak itu dengan lebih kerap manakala orang ramai perlu sentiasa mengamalkan amalan kebersihan yang baik, termasuk memakai topeng muka di tempat awam sekiranya mereka mempunyai tanda-tanda influenza dan sentiasa membasuh tangan dengan sabun.
Dr Mohd Ismail berkata bagi membolehkan mereka yang masuk ke negara ini dijejaki sekiranya terdapat sebarang kes Influenza A (H1N1), kementerian akan meminta kerjasama syarikat penerbangan untuk memastikan borang perisytiharan kesihatan diisi sepenuhnya.
Mengenai situasi semasa, beliau berkata tiada kes baru dilaporkan, manakala tujuh daripada kes yang dilaporkan sebelum ini telahpun tamat rawatan dan dibenarkan pulang, meninggalkan hanya empat kes yang masih dirawat.
Beliau berkata sejumlah 32 notifikasi kes yang mempunyai gejala jangkitan influenza setelah kembali dari negara yang terlibat diterima semalam, dan daripada jumlah itu 23 didapati negatif Influenza A (H1N1) manakala sembilan lagi masih menunggu keputusan.
Sehingga pagi ini, WHO memaklumkan terdapat 28,820 kes dengan 144 kematian dilaporkan semalam, pertambahan 996 kes dan tiga kematian berbanding hari sebelumnya.
Di ALOR SETAR, Menteri Kesihatan Datuk Seri Liow Tiong Lai menasihatkan rakyat agar tidak cemas kerana penyakit itu belum mencapai tahap menular di Malaysia.
Beliau berkata pemeriksaan di semua pintu masuk negara diperketatkan bagi mengesan semua penghidap yang memasuki negara ini.
-- BERNAMA
=====================================================================================
W.H.O. Raises Alert Level as Flu Spreads to 74 Countries
GENEVA — The World Health Organization has told its member nations it is declaring a swine flu pandemic — the first global flu epidemic in 41 years, news services reported.
The move came after an emergency meeting with flu experts here that was convened after a sharp rise in cases in Australia, which reported 1,263 cases on Thursday, and rising numbers in Britain, Japan, Chile and elsewhere.
In a statement sent to member countries, the W.H.O. said it decided to raise the pandemic alert level from phase 5 to 6, indicating a global pandemic outbreak, The Associated Press said, attributing the information to health officials from Scotland, Indonesia and Thailand. An official announcement of the change was due at 6 p.m. Geneva time on Thursday (noon in New York).
In an effort to avoid triggering panic with such an announcement, W.H.O. officials are expected to include a caveat that the flu, which has resulted in mostly mild cases, is not more deadly now that it has been declared a pandemic. Rather, the announcement reflects the global spread of the disease, not an increase in its severity.
According to W.H.O. rules, the organization should declare a pandemic once it finds evidence of widespread “community transmission” — meaning beyond travelers, schools and immediate contacts — on two continents.
In its latest report, the W.H.O. said Wednesday that 74 countries had reported 27,737 cases of the disease, and 141 deaths since the outbreak started in April. Those cases had been heavily concentrated in the Americas, but the rise in cases in Australia and elsewhere appeared to indicate communitywide spread in other world regions.
The declaration of a pandemic will trigger drug makers to speed up production of a swine flu vaccine and prompt governments to devote more money to containing the virus. While international health officials have said the flu appears to be less deadly than the annual bouts of seasonal flu that sweep the globe each year, they have warned that the virus could mutate into a more lethal strain during the Southern Hemisphere’s coming winter flu season. They are also worried that poorer countries could be overwhelmed with cases they do not have the capacity to treat.
The experts gathered at the request of the W.H.O. director-general, Margaret Chan, who held a teleconference on Wednesday with worst affected countries to try to determine if there was “indisputable” evidence that the spread of the disease met the organization’s criteria for declaring a pandemic.
The last pandemic, the Hong Kong flu of 1968, killed about 700,000 people worldwide. Ordinary flu kills 250,000 to 500,000 people each year, international health officials have said.
Meanwhile, efforts to limit the spread of the flu around the world continue. In Hong Kong, which is especially skittish about the flu after its experience with a lethal SARS outbreak in 2003, authorities have ordered all kindergartens, primary schools and day care centers to close after an outbreak of swine flu was reported at a local secondary school. The order, effective Friday, will last at least two weeks and affect about a half million students.
Fifty cases of the H1N1 flu have been reported in Hong Kong, but health officials said the 12 infected students at St. Paul’s Convent School were the first cluster of cases. The students are being quarantined at a hospital while officials try to determine the source of the infections.
On Wednesday, a 55-year-old man became the first person to contract the case locally in Hong Kong, according to health officials. So far, the city has had no fatalities from the disease.
Hong Kong’s Health Department says it will order 5 million doses of flu vaccine and open eight flu clinics. “The government is well prepared,” Donald Tsang, the city’s chief executive, said at a news conference on Thursday announcing the school closings. “There’s no need to panic.”
China confirmed 10 new flu cases on Thursday, bringing the total number of infections on the mainland to 111. Health officials say all of the country’s flu cases have involved people returning from abroad. According to the Health Ministry, the 10 new cases included a Canadian-Chinese teenager who had just been in Toronto and two children in Shanghai who had been in the United States. There have been no deaths, and more than half of those infected have been discharged from the hospital, the ministry said.
A Health Ministry official boasted Thursday that the government’s stringent prevention measures had kept swine flu from spreading in China. Every passenger arriving from overseas is checked for fever, and those suspected of having had contact with an infected person are placed in quarantine for a week.
“We think the method we are using has been pretty successful,” said Mao Qun’an, a ministry spokesman.
Chinese officials released Mayor C. Ray Nagin of New Orleans from three days of quarantine in Shanghai on Wednesday. Mr. Nagin and his wife had been placed in isolation after a passenger who sat one row ahead of them on a flight from the United States came down with a fever.
Mr. Nagin, who had been set to attend a series of economic development meetings, described the experience as “surreal” and said he and his wife had their temperatures taken every three to four hours. “When you see people coming toward you with full hazmat gear on, it’s pretty interesting,” he told The Associated Press after his release, referring to hazardous material protection.
In New York City, health officials said Thursday that three more people had died from the H1N1 virus, bringing the city’s total to 15, The A.P. reported. One victim was a child under the age of 5, one was a person between 5 to 24 years old, and another was between 30 to 39 years old.
The deaths came one day after health officials announcedthat in a telephone poll of New Yorkers, 6.9 percent of the 1,006 surveyed reported having flulike illness, like fever and cough or a sore throat, between May 1 and May 20, that may or may not have been swine flu.
Extrapolated to the general population, that would mean that about 550,000 people could have become sick with the virus. The 530 citywide who have been hospitalized make up a tiny proportion — about one-tenth of 1 percent — of those who became ill, an indication of how mild the virus generally has been, officials said.
The total number of swine flu cases reported to the nation’s Centers for Disease Control and Prevention and other national, state, and city health authorities worldwide likely do not account for hundreds of thousands of cases which were not tested by doctors because of their mildness, flu experts have said.
“The findings don’t tell us exactly how many New Yorkers have had H1N1 influenza,” Dr. Thomas A. Farley, the city’s new health commissioner, said in a statement. “But they suggest it has been widespread and mild in most people.”
Nick Cumming-Bruce reported from Geneva and Andrew Jacobs from Beijing. Sharon Otterman contributed reporting from New York.
HUSBAND SUES PIG FARM USD 1 BILLION OVER WIFE'S H1N1 RELATED DEATH
Trunnell and his lawyer, Marc Rosenthal, do not claim that Smithfield purposely bred the virus, but rather that its Perote operation, which raises some 1 million pigs annually in close quarters, established the necessary conditions for the virus to arise. If Smithfield had taken better care of its farm, the petition claims, H1N1 might never have been introduced to the world.
"We think that the conditions down there are a recipe for disaster," says Rosenthal. "This type of virus is more likely to evolve and mutate in this much filth and putrescence. It's more than a mere coincidence that the first cases emerged right there in La Gloria, Mexico."
H1N1 Virus: The First Legal Action Targets a Pig Farm
In an initial step toward what could be the first wrongful-death suit of its kind, Texas resident Steven Trunnell has filed a petition against Smithfield Foods, the world's largest pork producer, based in Virginia, and the owner of a massive pig farm in Perote, Mexico, near the village of La Gloria, where the earliest cases of the new H1N1 flu were detected.
Trunnell filed the petition in his home state on behalf of his late wife, Judy Dominguez Trunnell, the 33-year-old special-education teacher who on May 4 became the first U.S. resident to die of H1N1 flu.
In late April, Dominguez Trunnell, who was eight months pregnant, became ill with what would eventually be confirmed as H1N1 flu. While the vast majority of victims of the virus — there have been more than 4,700 probable and confirmed cases in the U.S. — have recovered without complications, Dominguez Trunnell grew sicker, eventually being placed on a ventilator. Early this month Dominguez Trunnell passed away, weeks after her baby daughter was delivered via cesarean section. "She was a fun and caring person," Trunnell tells TIME. "She didn't deserve this."
Trunnell's petition seeks to investigate claims that the H1N1 outbreak began in Smithfield's massive pork operation in La Gloria and that the virus may have been caused in part by the conditions under which the farm operates, which the petition terms "horrifically unsanitary."
"This affected my family," says Trunnell, a paramedic who will now be raising two children on his own. "I need someone to be held accountable for this."
If Trunnell ends up following through with a wrongful-death suit against Smithfield Foods, it will most likely make legal history. No one has ever tried to hold a corporation responsible for the inadvertent creation of an infectious disease. Trunnell and his lawyer, Marc Rosenthal, do not claim that Smithfield purposely bred the virus, but rather that its Perote operation, which raises some 1 million pigs annually in close quarters, established the necessary conditions for the virus to arise. If Smithfield had taken better care of its farm, the petition claims, H1N1 might never have been introduced to the world.
"We think that the conditions down there are a recipe for disaster," says Rosenthal. "This type of virus is more likely to evolve and mutate in this much filth and putrescence. It's more than a mere coincidence that the first cases emerged right there in La Gloria."
The suit will hinge on the fact that the first confirmed case of H1N1 appears to be a 5-year-old Mexican boy from La Gloria who lived not far from the Smithfield pork-farming operation. Local villagers had been complaining about the smell and the vast amounts of manure created by the Smithfield pig farms for some time, and H1N1 infection rates in the community were high. The idea that factory farming — where pigs are packed together closely — could provide a breeding ground for new viruses also has some scientific backing. A recent study by the Pew Charitable Trusts and the Johns Hopkins Bloomberg School of Public Health found that such operations could increase the risk for transmission of new viruses, including swine and avian flu.
To date, 34 countries have reported 7,520 confirmed cases of H1N1 infection, including 60 deaths in Mexico. In the U.S., the death toll reached four on Friday, and scientists studying the virus say the novel flu virus appears to be about twice as contagious as the regular seasonal flu. Although the "H1N1 virus tends to cause very mild illness in otherwise healthy people," according to a World Health Organization statement on Monday, "the youth of patients with severe or lethal infections is a striking feature of these early outbreaks."
The outbreaks have been a minor catastrophe for pork producers. Though international health officials were quick to assure the public that the disease initially known as swine flu could not be contracted by eating pork, consumption of pig products dropped rapidly in the wake of the virus's spread. "That is our biggest concern — the economic impact of people shying away from eating our product over fear," C. Larry Pope, CEO of Smithfield Foods, told the Richmond Times-Dispatch on May 5. The National Pork Producers Council estimated that between April 24 and May 1 — the most frenzied days of the H1N1 outbreak so far — the disease cost the pork industry $7.2 million a day.
If Trunnell's claim goes forward, Smithfield will face more serious problems. But that's a big if. Scientists are still far from certain where the H1N1 virus originated or how long it may have been circulating in pigs or people (the first human outbreak is thought to have occurred in February). So far, no pigs have been found to be infected with the virus, other than at one farm in Canada on May 2, where the swine were actually infected by a human worker. And on May 14, Smithfield announced that Mexican authorities had completed tests of the company's pigs in Perote and found no evidence of the virus in the swine. (It's not clear what test Mexican authorities used; only blood tests for antibodies can confirm the virus.)
Rosenthal says he doubts the Mexican tests and wants to have the Perote pigs examined by his own experts. Having Smithfield report on the tests "is like the fox guarding the henhouse," he says. If the case goes forward, Trunnell will be suing Smithfield for up to $1 billion, which would include punitive damages, and Rosenthal indicates that he would be open to launching a class action on behalf of other H1N1 victims.
Reached for comment, Smithfield declined to discuss Trunnell's petition.
New viruses have emerged from animals to infect and kill humans for thousands of years, and while today's factory-farming conditions may raise that risk, it will be tough to hold any one corporation responsible. But Steven Trunnell wants to fight. He says that, contrary to early media reports, his wife Judy had no underlying medical complications and was healthy before she contracted H1N1. "She accomplished so many goals, and she was the mother to a 4-year-old," he says. "It was a gross injustice." Viruses, however, have no sense of justice — and no court in the world will be able to change that.
GARIS PANDUAN DARI WHO
5 garis panduan untuk makanan yang selamat bagi anda seisi keluarga dan masyarakat agar penyakit berjangkit bawaan air serta makanan dapat dicegah.
COMMON SENSE SURVIVAL TIPS DURING FLU PANDEMICS
This CDC (right) photograph captured a sneeze in progress, revealing the plume of salivary droplets as they are expelled in a large cone-shaped array from this man's open mouth. The flu virus can spread in this manner and survive long enough on a doorknob or countertop to infect another person.
It dramatically illustrating the reason you should cover your mouth when sneezing or coughing to protect others from germ exposure, health officials say.
It’s also why you need to wash your hands a lot, on the assumptions others don’t always cover their sneezes. Credit: CDC/James Gathany
5 Essential Swine Flu Survival Tips (From Livescience)
Meanwhile, there are a slew of suggestions out there for what you should do. Often the tips don't include enough detail for you to do it right. For example, you probably don't wash your hands effectively or often enough. And did you know you could be infected and spreading the flu up to a full day before you feel symptoms and up to seven days after you get sick?
So while waiting for a vaccine and the next bout of bad news, here are the top five essential things you can do to avoid getting sick and, importantly, avoid infecting others. These critical tips are widely agreed upon by the World Health Organization, the U.S. Centers for Disease Control and Prevention, and other health experts.
1. Wash your hands.
The best thing anyone could do right now to avoid swine flu, experts say, is to wash their hands. It sounds like a stupidly simple response to an overwhelming situation, but nearly compulsive hand-washing helps prevent the spread of this airborne respiratory disease. It's the droplets from coughing and sneezing that spread the disease. These get on our hands. And then everything we touch is infectious.
How you do it is important:
- Use warm or hot water if you can.
- Lather up and rub not just your fingers and palms but also under the fingernails, around the wrists and between the fingers for as long as it takes to sing "Happy Birthday" twice.
- Rinse well.
It is important to wash your hands before eating and after using the bathroom, but also after using a tissue or covering your mouth when you sneeze or cough, sick or not. So yes, that's a lot of hand-washing. Basically, think of how often you would wash your hands if you worked in an emergency room or operating room. Wash your hands that often and that thoroughly.
2. Cover your mouth when you cough or sneeze.
"The way you spread influenza is with droplets that come out of your mouth or nose," said Dr. George T. DiFerdinando Jr., a physician, epidemiologist and professor at the University of Medicine and Dentistry of New Jersey-School of Public Health. He recommends the classic shoulder or crook-of-the elbow sneeze.
"It's a whole lot better for those [droplets] to be on blouse or sleeve than spraying onto surfaces or other people," he said. Then ... you guessed it ... wash your hands.
Surgical face masks are an option for keeping your droplets to yourself, but they don't keep your hands clean and there is no consensus in the health care community on whether face masks are advisable for everyday use.
"If [the swine flu virus] is spreading throughout the community, it would not surprise me if people use [face masks] to good effect," DiFerdinando said.
3. Stay home.
If you're sick, stay home, DiFerdinando said. Try to muster the energy to wash your hands after you use tissues so you don't reinfect everything you touch afterward. This helps you recover, and protects your loved ones.
4. Don't touch your face.
Try, try, to keep your hands out of your mucous membranes — your eyes, nose and mouth — direct routes to the bloodstream that allow a virus to bypass the protective barrier of the skin. Few of us succeed at this fully.
"That's just human nature," DiFerdinando told LiveScience. "It's not something to moan about. In this circumstance you've got a very strong motivator to keep your hands clean. If you keep washing your hands, you decrease the dose [of flu virus] that you get when you put your hands in your mouth."
5. Avoid sick people
It's a good idea to avoid close contact with other people who are sick, DiFerdinando said, adding: "We won't even see air kisses." The flu virus tends not to float in the air. Instead, once dispersed, the liquid droplets tend to settle on objects that doctors call fomites — things that people touch that can pick up a virus. Examples include coins, hand rails, door knobs, common household and office objects. Smooth objects transmit microbes more than rough or porous ones. So, for instance, coins would allow one to pick up more virus than paper money.
Many of the US's cases currently are concentrated in New York City at two schools, which is not surprising to Dr. James Koopman, professor of epidemiology at the University of Michigan's School of Public Health.
"There is a lot of direct contact and touching of common things when children are in school," Koopman said. "They are in general more susceptible to these things."
FOR NAME SAKE............. SWINE, PORCINE, PIG,....SAME DNA/RNA PROFILES
For economic reasons, swine flu has to get a new name namely just flu.
Swine flu name change? Flu genes spell pig
By SETH BORENSTEIN, AP Science Writer Thu Apr 30, 9:44 pm ET
WASHINGTON – No matter what you call it, leading experts say the virus that is scaring the world is pretty much all pig. So while the U.S. government and now the World Health Organization are taking the swine out of "swine flu," the experts who track the genetic heritage of the virus say this: If it is genetically mostly porcine and its parents are pig viruses, it smells like swine flu to them.
Six of the eight genetic segments of this virus strain are purely swine flu and the other two segments are bird and human, but have lived in swine for the past decade, says Dr. Raul Rabadan, a professor of computational biology at Columbia University.
A preliminary analysis shows that the closest genetic parents are swine flu strains from North America and Eurasia, Rabadan wrote in a scientific posting in a European surveillance network.
"Scientifically this is a swine virus," said top virologist Dr. Richard Webby, a researcher at St. Jude Children's Research Hospital in Memphis. Webby is director of the WHO Collaborating Center for Studies on the Ecology of Influenza Viruses in Lower Animals and Birds. He documented the spread a decade ago of one of the parent viruses of this strain in scientific papers.
"It's clearly swine," said Henry Niman, president of Recombinomics, a Pittsburgh company that tracks how viruses evolve. "It's a flu virus from a swine, there's no other name to call it."
Dr. Edwin D. Kilbourne, the father of the 1976 swine flu vaccine and a retired professor at New York Medical College in Valhalla, called the idea of changing the name an "absurd position."
The name swine flu has specific meaning when it comes to stimulating antibodies in the body and shouldn't be tinkered with, said Kilbourne, 88.
That's not what government health officials say.
"We have no idea where it came from," said Michael Shaw, associate director for laboratory science for the Centers for Disease Control and Prevention. "Everybody's calling it swine flu, but the better term is 'swine-like.' It's like viruses we have seen in pigs, it's not something we know was in pigs."
On Wednesday, U.S. officials not only started calling the virus 2009 H1N1 after two of its genetic markers, but Dr. Anthony Fauci the National Institutes of Health corrected reporters for calling it swine flu. Then on Thursday, the WHO said it would stop using the name swine flu because it was misleading and triggering the slaughter of pigs in some countries.
Another reason the U.S. government wants to ditch the swine label is that many people are afraid to eat pork, hurting the $97 billion U.S. pork industry. Even the experts who point to the swine genetic origins of the virus agree that people can't get the disease from food or handling pork, even raw.
"Calling this swine flu, when to date there has been no connection between animals and humans, has the potential to cause confusion," Chris Novak, chief executive officer of the National Pork Board, said in a news release.
One top flu expert, doesn't like the swine flu name either, but for a different reason. Traditional swine flu doesn't spread easily among people, although this one does now, said Dr. Paul Glezen, a flu epidemiologist at Baylor University.
Columbia's Rabadan said sometimes when he talks to other scientists, he uses the name "swine" or the name "Mexican flu." And that name only adds another case of political incorrectness.
Mexico Health Secretary Jose Angel Cordova said it's wrong to call it "North American flu" and flatly rejects the idea of calling it "Mexican flu." He pointed to WHO information that the swine genes in the virus are from Europe and Asia. Rabadan and others say four of the six pure swine genetic markers are North American.
"I don't think it's fair for someone to blame Mexico for this. You can't blame any country; you can't blame a person or an institution. The recombination of genes in the virus is something that happens naturally," Mexico's chief epidemiologist, Miguel Angel Lezana said Wednesday.
And while the U.S. government and WHO are dropping "swine flu" as the name, someone hasn't told their Webmasters.
On Thursday afternoon, the phrase "swine flu" was still in the Internet addresses for the WHO, Homeland Security and CDC pages on the disease and the question-and-answer page on the U.S. government's pandemic flu Web site.
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Medical Writers Lauran Neergaard in Washington and Mike Stobbe in Atlanta and reporters Rita Beamish in San Mateo, Calif., and E. Eduardo Castillo in Mexico City contributed to this report.
RABADAN DNA STUDY ON H1N1
MAKLUMAT TERKINI BERKENAAN SELESEMA KHINZIR
Untuk maklumat terkini berkenaan selesema khinzir sila layari 3 laman web di bawah. Terima kasih
1.Center For Disease Control (CDC) & Prevention website HERE
2.WHO website HERE
3.Medscape website HERE
ELETRONIC CIGARETTES: WHO SAID AN ALTERNATIVE TO SMOKING?
Ruyan V8, marketed as a healthier alternative to smoking and a potential way to kick the habit, the smokeless smokes have been distributed in swag bags at the British film awards and hawked at an international trade show, attracting attention in China, the U.S. and elsewhere — and the scrutiny of world health officials.
The W.H.O issued a statement in September warning there was no evidence to back up contentions that e-cigarettes are a safe substitute for smoking or a way to help smokers quit.
Furthermore, WHO said that the product may undermine smoking prevention efforts because they look like the real thing and may lure nonsmokers, including children.list of WHO's concerns
Other concerns include the lack of conclusive studies and information about e-cigarette contents and their long-term health effects.
Find out more about e-cig in slide show section below.
Electronic Cigarettes
With its slim white body and glowing amber tip, it can easily pass as a regular cigarette. It even emits what look like curlicues of white smoke.
The Ruyan V8, which produces a nicotine-infused mist absorbed directly into the lungs, is just one of a rapidly growing array of electronic cigarettes attracting attention in China, the U.S. and elsewhere — and the scrutiny of world health officials.
Marketed as a healthier alternative to smoking and a potential way to kick the habit, the smokeless smokes have been distributed in swag bags at the British film awards and hawked at an international trade show.
Because no burning is involved, makers say there's no hazardous cocktail of cancer-causing chemicals and gases like those produced by a regular cigarette. There's no secondhand smoke, so they can be used in places where cigarettes are banned, the makers say.
Health authorities are questioning those claims.
The World Health Organization issued a statement in September warning there was no evidence to back up contentions that e-cigarettes are a safe substitute for smoking or a way to help smokers quit.
It also said companies should stop marketing them that way, especially since the product may undermine smoking prevention efforts because they look like the real thing and may lure nonsmokers, including children.
"There is not sufficient evidence that (they) are safe products for human consumption," Timothy O'Leary, a communications officer at the WHO's Tobacco Free Initiative in Geneva, said this week.
The laundry list of WHO's concerns includes the lack of conclusive studies and information about e-cigarette contents and their long-term health effects, he said.
Unlike other nicotine-replacement therapies such as patches for slow delivery through the skin and some inhalers and nasal sprays, e-cigarettes have not gone through rigorous testing, O'Leary said.
Nicotine is highly addictive and causes the release of the "feel good" chemical dopamine when it goes to the brain. It also increases heart rate and blood pressure and restricts blood to the heart muscle.
Ruyan — which means "like smoking" — introduced the world's first electronic cigarette in 2004. It has patented its ultrasonic atomizing technology, in which nicotine is dissolved in a cartridge containing propylene glycol, the liquid that is vaporized in smoke machines in nightclubs or theaters and is commonly used as a solvent in food.
When a person takes a drag on the battery-powered cigarette, the solution is pumped through the atomizer and comes out as an ultrafine spray that resembles smoke.
Hong Kong-based Ruyan contends the technology has been illegally copied by Chinese and foreign companies and is embroiled in several lawsuits. It's also battling questions about the safety of its products.
Most sales take place over the Internet, where hundreds of retailers tout their products. Their easy availability, O'Leary warns, "has elevated this to a pressing issue given its unknown safety and efficacy."
Prices range from about $60 to $240. Kits include battery chargers and cartridges that range in flavors (from fruit to menthol) and nicotine levels (from zero — basically a flavored mist — to 16 milligrams, higher than a regular cigarette.) The National Institutes of Health says regular cigarettes contain about 10 milligrams of nicotine.
On its Web site, Gamucci, a London-based manufacturer, features a woman provocatively displaying one of its e-cigs. "They look like, feel like and taste like traditional tobacco, yet they aren't," the blurb reads. "They are a truly healthier and satisfying alternative. Join the revolution today!"
Smoking Everywhere, a Florida-based company, proclaims it "a much better way to smoke!" while a clip on YouTube features an employee of the NJoy brand promoting its e-cigarettes at CES, the international consumer technology trade show.
Online sales make it even more difficult to regulate the industry, which still falls in a gray area in many countries.
In the U.S., the Food and Drug Administration has "detained and refused" several brands of electronic cigarettes because they were considered unapproved new drugs and could not be legally marketed in the country, said press officer Christopher Kelly.
He did not give more details, but said the determination of whether an e-cig is a drug is made on a case-by-case basis after the agency considers its intended use, labeling and advertising.
In Australia, the sale of electronic cigarettes containing nicotine is banned. In Britain, the products appear to be unregulated and are sold in pubs.
Smoking is tightly woven into the fabric of daily life in Ruyan's home turf of China, the world's largest tobacco market where about 2 trillion cigarettes are sold every year.
Tobacco sales, the biggest source of government revenue, brought in $61 billion in the first 11 months of last year, up 18 percent from 2007, the Communist Party's People's Daily newspaper said.
In a country where the cheapest brands of cigarettes cost about 20 cents a pack, the e-cig is far pricier. Ruyan's V8 costs $240 and includes batteries and 20 cartridges of nicotine solution, roughly the same number of puffs as 20 packs of tobacco cigarettes. The line has expanded to include cigars and pipes crafted from agate and rosewood.
Ruyan is suing a Beijing newspaper for questioning its safety and for claiming in 2006 that its products have more nicotine than regular cigarettes.
Miu Nam, Ruyan's executive director, blames the newspaper for a hit in sales and profits but declined to give details.
"We have to restore consumers' confidence, we have to clean up people's doubts," Miu said.
An operator at the Beijing Times refused to transfer calls seeking comment Friday to managers at the newspaper. A reporter said she had heard of the case but would not give any details.
Some international experts back Ruyan's claims its product is safe.
David Sweanor, an adjunct law professor at Ottawa University and former legal counsel of the Non Smokers Rights Association in Canada, said e-cigs have the potential to save lives.
With smoking, "it's the delivery system that's killing people," Sweanor said. "Anytime you suck smoke into your lungs you're going to do yourself a great deal of damage. Nicotine has some slight risks but they are minor compared to the risk of smoke in cigarettes."
Dr. Murray Laugesen, a New Zealand physician involved in tobacco control for 25 years who was commissioned by Ruyan to test its e-cigs, said he found "very little wrong" with them.
"It looks more like a cigarette and feels more like a cigarette than any other device so far and yet it does not cause the harm," he said. "It's the best substitute so far invented for tobacco cigarettes."
In the U.S, both Philip Morris USA and RJ Reynolds have introduced cigarettes that did not burn tobacco, but the technologies were very different from the e-cigarette. Neither has been successful.
In 2006, Philip Morris USA, test-marketed the Accord, which used a heating unit activated by puffing. RJ Reynolds introduced its cigarette, the Premier, in 1987 and still sells the Eclipse, which heats the tobacco rather than burning it. Sales are "not great," said spokesman David Howard.
Li Honglei, a fast-talking 28-year-old public relations manager in Beijing, has been smoking since he was in his teens and desperately wants to quit. He thinks he may have found his answer in Ruyan.
"I was intrigued by this new technology," said the pudgy, bespectacled Li as he surveyed products displayed in glass cases at Ruyan's brightly-lit shop in the capital. "I heard acupuncture is effective as well, but this method sounds more painless."
By Associated Press writers Chi-Chi Zhang in Beijing, Vinnee Tong and Carley Petesch in New York and AP researcher Yu Bing in Beijing
