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The USA government has a website dedicated to Pandemic Flu. It is promoted as "One-stop access to U.S. Government H1N1, avian and pandemic flu information."

WHO on verge of declaring H1N1 flu pandemic
Tuesday Jun 9, 2009

Stephanie Nebehay

GENEVA (Reuters) - The World Health Organization (WHO) is on the verge of declaring the first influenza pandemic in more than 40 years, but wants to ensure countries are well prepared to prevent a panic, its top flu expert said on Tuesday.

Keiji Fukuda, acting WHO assistant director-general, voiced concern at the sustained spread of the new H1N1 strain -- including more than 1,000 cases in Australia -- following major outbreaks in North America, where it emerged in April.

Confirmed community spread in a second region beyond North America would trigger moving to phase 6 -- signifying a full-blown pandemic -- from the current phase 5 on the WHO's 6-level pandemic alert scale.

"The situation has really evolved a lot over the past several days. We are getting really very close to knowing that we are in a pandemic situation, or I think, declaring that we are in a pandemic situation," Fukuda told a teleconference.

Fukuda said a move to phase 6 would reflect the geographic spread of the new disease.

Sodas a Tempting Tax Target
David Leonhardt
The New York Times, May 20, 2009
"So one of the nation’s top public health officials is now a fierce proponent of a soda tax. Meanwhile, other Obama advisers and some Senate staff members have been talking about such a tax -- which wouldn’t apply to diet soda or real juice -- as a way to help pay for expanded health insurance. Among 15 options for paying for health care reform, a new Senate Finance Committee analysis lists a 'sugar-sweetened beverage excise tax'…Most public health scourges have a brutal way of holding down the associated medical cost: they kill people. That’s why preventive medicine doesn’t provide nearly the cost savings that some advocates claim...Obesity is different. It has only a modest effect on life span, but it causes costly chronic illnesses, like diabetes. For some people, obesity is a matter of genetic predisposition, and it can’t be prevented. But most of today’s obesity problem is about behavior."

May 9, 2009
Other Illness May Precede Worst Cases of Swine Flu
By DONALD G. McNEIL Jr. New York Times

Underlying conditions like asthma, diabetes, heart disease or tuberculosis appear to put swine flu victims at greater risk of hospitalization or death, doctors from the World Health Organization and the Centers for Disease Control and Prevention said Friday.

Health officials emphasized that the observations were preliminary and based on discussion of only about 40 deaths in Mexico and half of the 57 hospitalizations in the United States. But a few trends have begun to emerge.

Some of the serious cases involve healthy young people, and the reasons for that are still unexplained. Many of the patients went into rapid decline and died of viral pneumonia, not bacterial pneumonia, said Dr. Sylvie Briand, a W.H.O. flu expert. Viral pneumonia may be a result of the “cytokine storm,” in which the body’s own immune reaction to a new virus floods the lungs with fluid. It can progress faster and be harder to treat than bacterial pneumonia.

Dr. Richard E. Besser, the acting director of the C.D.C., said most of the hospitalized Americans had an additional health problem. In seven cases it was asthma, which is worrying because asthma has become quite common in the United States. So has diabetes, which is linked to America’s epidemic of obesity, he said. Seasonal flu has always been dangerous for those with cardiovascular problems, which are unusual among the young.

Many States Do Not Meet Readiness Standards
Kimberly Kindy
(The Washington Post, Friday, May 1, 2009)
"More than two dozen states…have not stocked enough of the emergency supplies of antiviral medications considered necessary to treat victims of swine flu should the outbreak become a full-blown crisis, according to federal records. The medications are part of a national effort to be prepared for a pandemic, and the stockpiling program is being tested for the first time by the rapid spread of the H1N1 strain of the influenza virus. If a health crisis wiped out drug supplies in pharmacies and hospitals, or if families were unable to get to their doctors, local and state officials could quickly distribute stockpiled medications. The Strategic National Stockpile, created during the Clinton administration a decade ago to provide a federally coordinated response to disasters, maintains a massive collection of antibiotics, vaccines, gas masks and other supplies in a dozen secret locations. The program was expanded in 2004 to include drugs needed in a pandemic and is designed to link with stockpiles kept by state governments, pharmaceutical companies and federal agencies."

Shortage of Doctors Proves Obstacle to Obama Goals
Robert Pear
(The New York Times, April 26, 2009)
"Obama administration officials, alarmed at doctor shortages, are looking for ways to increase the supply of physicians to meet the needs of an aging population and millions of uninsured people who would gain coverage under legislation championed by the president. The officials said they were particularly concerned about shortages of primary care providers who are the main source of health care for most Americans. One proposal -- to increase Medicare payments to general practitioners, at the expense of high-paid specialists -- has touched off a lobbying fight. Family doctors and internists are pressing Congress for an increase in their Medicare payments. But medical specialists are lobbying against any change that would cut their reimbursements. Congress, the specialists say, should find additional money to pay for primary care and should not redistribute dollars among doctors -- a difficult argument at a time of huge budget deficits."

The Lessons from SARS
Kayla Webley
(TIME, Online, April 28, 2009)
"The same Hong Kong scientists who followed SARS from the moment it emerged as a mystery disease until they had identified its cause warned on Monday that swine flu poses an even greater challenge. While scientists have studied influenza for many years, the nature of the disease makes it a tough enemy to combat. With Severe Acute Respiratory Syndrome, or SARS, patients developed symptoms around the same time they became contagious. But with the flu, a person can spread the infection days before they feel sick enough to go to a doctor. ‘The flu is a known devil,’ says Malik Peiris, one of the scientists at Hong Kong University who helped trace the 2003 outbreak of SARS to the civet cat. 'This is a different ballgame.'"

Tests for New H.I.V. Infection Not Widely Adopted
David Tuller
(The New York Times, April 30, 2009)
"Although the antibody test [for HIV] can deliver immediate results, it is not likely to identify an infection that has occurred in the past month. The genetic test, which looks for bits of the virus’s ribonucleic acid, or RNA, can identify infections in a week to 10 days. Chris, who asked that his full name not be used, was told that his antibody test was negative. But his RNA test was positive, making him one of the few whose diagnosis came in the acute, or primary, phase of infection, when the virus is replicating aggressively but the body has not yet mounted an effective immune response. Many public health officials and AIDS experts increasingly see identification of the newly infected as an important next step in controlling the spread of H.I.V., the virus that causes AIDS. Yet the RNA test, the only one capable of detecting the newest infections, has not been widely adopted for this purpose. 'People with acute infection have more virus in the blood, and if they’re unaware they’re infected, they’re more likely to engage in risky behavior,' said Dr. Kenneth Mayer, a professor of medicine at Brown University and a leading AIDS researcher. Finding those with new infections sooner and providing counseling will help prevent them from infecting others, Dr. Mayer said. As it stands, studies suggest that the recently infected could be the source of 10 percent to 50 percent of all new H.I.V. transmissions."

 

Nebraska Public Health

Copyright. 2009. Byron L.Barksdale, M.D.