2. Study has shown virus to be different from the normally circulating North American pig virus. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia , avian genes and human genes. "quadruple reassortant" virus How is it then that it made its first appearance in Mexico and the US?
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10. He says ice-cream made him feel better, and Thank God has now recovered full health. But the rest of the planet has a quick –paced pandemic marching on…. 'Patient Zero' in Swine Flu Outbreak Identified as 5-Year-Old Mexican Boy: Edgar Hernandez
14. WHO Report 95 AFFECTED COUNTRIES Nothing’s holding this virus back…….!!!
15. keyword A pandemic means an epidemic of an infectious disease, that spreads throughout a large number of people and can spread worldwide. A pandemic begins when : there is person-to-person sustained transmission on multiple continents.
16. The World Health Organization uses a six stage phase for alerting the general public to an outbreak
17. Phase 1 – animal to animal transmission. Phase 2 – an animal influenza virus is capable of human infection. Phase 3 - small outbreaks among close populations but not through human to human contact. Phase 4 - Human to human transmission Phase 5 - spread across two countries or more in one of the WHO regions (continents). Phase 6 – spread across two countries or more in one of the WHO regions plus spread to another WHO region.
18. W.H.O. identifies the following six epidemiological sub-regions. - African Region - Eastern Mediterranean Region - European Region - Region of the Americas - South-East Asian Region - Western Pacific Region
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22. Even an island in the middle of the ocean isn’t out of its reach….
30. In one week , the United Nations agency raised the alert level twice, from phase 3 to phase 5, in response to the sustained transmission of H1N1 in Mexico and the United States. ( 1976 swine flu Hsw1N1 outbreak never passed phase 3. The vaccine developed caused 10 per million Guillain Barre syndrome as compared to the 1-2 per million with the seasonal flu vaccine and was banned.) Graveness of the situation
31. 19/6/2009 WHO report 19/6/2009 WHO report Country Cumulative total Newly confirmed since the last reporting period Cases Deaths Cases Deaths Country Cumulative total Newly confirmed since the last reporting period Cases Deaths Cases Deaths Country Cumulative total Newly confirmed since the last reporting period Cases Deaths Cases Deaths Argentina 918 4 185 3 Australia 2199 0 87 0 Austria 8 0 1 0 Bahamas 2 0 0 0 Bahrain 12 0 0 0 Barbados 4 0 1 0 Belgium 19 0 0 0 Bermuda, UKOT 1 0 0 0 Bolivia 11 0 0 0 Brazil 96 0 17 0 British Virgin Islands, UKOT 1 0 0 0 Bulgaria 2 0 0 0 Canada 4905 12 856 5 Cayman Islands, UKOT 4 0 0 0 Chile 3125 2 790 0 China 519 0 137 0 Colombia 60 1 7 0 Costa Rica 149 1 0 0 Cuba 15 0 8 0 Cyprus 1 0 0 0 Czech Republic 5 0 1 0 Denmark 22 0 7 0 Dominica 1 0 0 0 Dominican Republic 93 1 0 0 Ecuador 86 0 0 0 Egypt 29 0 3 0 El Salvador 160 0 35 0 Estonia 5 0 1 0 Finland 13 0 1 0 France 131 0 13 0 French Polynesia, FOC 1 0 0 0 Martinique, FOC 1 0 0 0 Germany 238 0 43 0 Greece 31 0 8 0 Guatemala 153 1 25 0 Honduras 108 0 8 0 Hungary 7 0 3 0 Iceland 4 0 0 0 India 30 0 0 0 Ireland 16 0 4 0 Israel 219 0 67 0 Italy 88 0 16 0 Jamaica 14 0 2 0 Japan 690 0 24 0 Jordan 2 0 0 0 Korea, Republic of 84 0 19 0 Kuwait 18 0 0 0 Laos 1 0 1 0 Lebanon 12 0 1 0 Luxembourg 2 0 0 0 Malaysia 23 0 6 0 Mexico 7624 113 1383 5 Morocco 8 0 5 0 Netherlands 87 0 19 0 Netherlands Antilles, Curaçao * 3 0 2 0 Netherlands Antilles, Sint Maarten 1 0 1 0 New Zealand 216 0 89 0 Nicaragua 144 0 26 0 Norway 17 0 4 0 Oman 3 0 3 0 Panama 272 0 0 0 Papua New Guinea 1 0 1 0 Paraguay 27 0 2 0 Peru 141 0 29 0 Philippines 311 0 118 0 Poland 7 0 0 0 Portugal 5 0 2 0 Qatar 3 0 0 0 Romania 18 0 2 0 Russia 3 0 0 0 Samoa 1 0 0 0 Saudi Arabia 22 0 5 0 Singapore 77 0 28 0 Slovakia 3 0 0 0 South Africa 1 0 1 0 Spain 512 0 13 0 Sri Lanka 1 0 0 0 Suriname 11 0 11 0 Sweden 43 0 6 0 Switzerland 27 0 0 0 Thailand 518 0 208 0 Trinidad and Tobago 18 0 13 0 Turkey 20 0 4 0 Ukraine 1 0 0 0 United Arab Emirates 2 0 1 0 United Kingdom 1752 1 291 0 Isle of Man, Crown Dependency 1 0 0 0 Jersey, Crown Dependency 1 0 0 0 United States of America 17855 44 0 0 Uruguay 36 0 0 0 Venezuela 60 0 15 0 Viet Nam 27 0 0 0 West Bank and Gaza Strip 5 0 3 0 Yemen 4 0 3 0 Grand Total 44287 180 4667 13
32. Countries of origin. Mixing of NH1N1 with seasonal flu virus could result in a strain resistant to tamiflu(NH1N1 is already resistant to other antivirals Mixing with H5N1 could produce strains capable of human to human transmission(Death toll of H5N1 is app. 66%) Australia 2199 0 87 0 Chile 3125 2 790 0 Egypt 29 0 3 0 Mexico 7624 113 1383 5 United States of America 17855 44 0 0 Grand Total 44287 180 4667 13 Country 19/6/2009 Cumulative total Newly confirmed since the last reporting period (17/6) Cases Deaths Cases Deaths
37. 1918 - Spanish Flu (originated in birds). First hit soldiers in Europe during World War I, as their immune systems were weakened by war. The mortality rate was highest between 20 to 50 year olds. There was never any vaccine developed, after about 18 months, the virus seemed to just disappear . The final death toll was written as 40 million people worldwide . Soldiers whose immunity was weakened by war. Many of the victims who have died in Mexico have been young and otherwise healthy. society's healthiest demographic
38. 1957 - Asian Flu This flu started in birds in Asia. In September schools and public places started closing in an effort to contain the virus. In December the virus started to subside , but reappeared in January. over two million people died Reappeared
39. 1968 - The Hong Kong Flu This is the mildest pandemic It was first found in the early months of 1968 in Hong Kong, and was declared a global pandemic by December. Children were out of school and were therefore not able to spread it as much. It made a mild reappearance in 1970 and 1972 . it claimed about a million lives Seasonal influenza normally claims app. ¼ to ½ a million lives yearly. Reappeared…!!!
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41. Disease spectrum ranges from very mild self-limited disease to Death. Novel H1N1 virus tends to affect younger people just like the seasonal H1N1. (Older adults were shown to possess serum neutralizing antibodies to the new virus, most likely due to cross‐immunity with human H1N1 viruses. ) Novel H1N1 spreads just as easily as regular winter flu . Novel H1N1 virus tends to affect younger people just like the seasonal H1N1. (Older adults were shown to possess serum neutralizing antibodies to the new virus, most likely due to cross‐immunity with human H1N1 viruses. )
45. Characteristics of reported cases of influenza A(H1N1) by country Of note , the prevailing clinical picture in other countries has been GIT related.
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47. WHO currently recommends shifting surveillance efforts to following trends in illness cases rather than testing all ill patients which can severely stress national resources. Top priority is to determine which groups of people are at highest risk of serious disease. WHO is now relying on information obtained from special research and clinical studies and other data provided by countries directly through frequent expert teleconferences on clinical, virological and epidemiological aspects of the pandemic. WHO Pandemic (H1N1) 2009 briefing note 4 July 24/2009
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54. (iv) Manufacturers are urged to develop clinical trial batches and accelerate initiation of clinical trials of influenza A (H1N1) vaccines and to start preparing for a potential future recommendation to move to commercial‐scale production. (v) The above activities should not interfere with the present production of the Northern hemisphere seasonal vaccines (vi) The number of needed doses of A (H1N1) vaccine will depend on the spread of influenza A (H1N1) virus in the next few weeks and on a better definition of the groups to be targeted (vii) An evidence‐based recommendation for the groups to be targeted for vaccination still requires more data
55. Medpage 7/24/2009 from an article written by Dr. Zalman S. Agus: The FDA is likely to approve 2009 H1N1 (swine flu) vaccines before trial data can prove their safety and effectiveness against the virus. Having a licensed vaccine doesn't mean that an immunization program will kick-off immediately -- that call has to come from the Secretary of Health and Human Services (HHS).
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57. If the vaccine is ineffective at stimulating an immune response, the FDA might have to issue an "emergency use authorization" for an oil-in-water adjuvant that sparks a stronger reaction in the immune system, but causes more side effects. Two companies, GlaxoSmithKline and Novartis, are applying for approval for vaccines that contain oil-in-water adjuvants. The NIH is also conducting a trial of an adjuvant-enhanced vaccine. Adjuvanted flu vaccines have been used for a decade in Europe and have not been shown to harm vulnerable populations, such as children.(Theodore Eickhoff). The government has already purchased a supply of 120 million adjuvant doses that it will add to its antigen supply if it there is a shortage of the vaccine, or if the standard versions are shown to be ineffective.
58. Human infection with 2009 H1N1virus: clinical observations from Mexico and other affected countries, May 2009
