Sneezing Piggies

CDC: 3.4 million inhalable H1N1 vaccine doses available soon

2009-09-19T15:53:00.001+01:00

ATLANTA, Georgia (CNN) -- Health officials expect more than 3 million doses of H1N1 flu vaccine to be available in the first week of October.

"3.4 million doses of vaccines will be available," said Dr. Jay Butler, who heads the 2009 H1N1 Vaccine Task Force at the Centers for Disease Control and Prevention.
"All of that vaccine is the inhalable vaccine," he said Friday.
That form of vaccine is marketed in the United States as FluMist and is approved only for healthy individuals between the ages of 2 and 49. Pregnant women are not allowed to get this type of vaccine because it contains a live virus.
Butler added that he thinks there some flu shots may be available in early October as well, but he had a hard number only for the inhalable vaccine. Flu shots contain an "inactivated," or dead, virus.
The 3.4 million doses of vaccine that will be shipped at the beginning of October are the first of 195 million doses the U.S. government has purchased from five vaccine manufacturers, Butler said.
Last week, the Food and Drug Administration licensed the vaccine from four of those companies. Sanofi Pasteur, Novartis and CSL Limited all manufacture flu shots, and MedImmune manufactures the inhalable vaccine. GlaxoSmithkline, which also is producing injectable flu vaccine, still needs to have its vaccine approved by the agency.
Health officials report that the new H1N1 flu virus has not changed from what was seen earlier this year, so they are expecting the vaccine to be very effective.
In some parts of the country, the vaccine can't some soon enough. The deputy director of the CDC's Influenza Division, Dr. Daniel Jernigan, said 21 states are now reporting widespread flu activity.
"It's a very strange thing for us to see that amount of influenza at this time of year" rather than much later in the flu season.
Jernigan said there's been only a small an increase in hospitalizations, mainly among young children and adults. But there has been a lot of activity in outpatient settings.
More at link ~ http://edition.cnn.com/2009/HEALTH/09/18/swine.flu.vaccine/index.html

As far as i know the inhaled versions contain live virus (at least the regular flu ones do).

So just be careful guys - if you must have one, make sure you know what you're getting.

Unlicensed Intravenous Form Of Relenza Helped Save Life Of Swine-Flu Infected Woman Who Had Just Had Chemotherapy

2009-09-16T20:05:00.001+01:00

Unlicensed Intravenous Form Of Relenza Helped Save Life Of Swine-Flu Infected Woman Who Had Just Had Chemotherapy
06 Sep 2009

http://www.medicalnewstoday.com/articles/163056.php

A 22-year-old woman, whose immune system was impaired due to recent chemotherapy, has survived a serious case of swine-flu after being treated with the unlicensed intravenous form of relenza, in combination with high-dose corticosteroids. The Case Report is published Online First and in an upcoming edition of The Lancet, and is written by Dr Michael Kidd and Dr Mervyn Singer, University College London Hospitals NHS Foundation Trust, London, UK, and colleagues.

The woman had received chemotherapy as part of treatment for Hodgkin's disease, and on July 8 this year was referred to the Intensive Care Unit (ICU) at University College Hospital. She had laboratory-confirmed H1N1 infection, increasing shortness of breath, build-up of fluid in both lungs-and her condition was not responding either to tamiflu 75mg twice daily or broad-spectrum antimicrobials. Progressive deterioration meant she needed artificial ventilation from day 3 of her ICU admission. Since she did not appear to be absorbing the tamiflu, this was switched to nebulised relenza for ICU days 6-13. However this had no obvious clinical benefit, and high levels of H1N1 RNA were detected on day ICU 10. Increasing the relenza dose for ICU days 13-16 did not improve her clinical state.

As she remained critically ill with severe respiratory failure, doctors decided on day 16 to begin treatment using unlicensed intravenous relenza (provided by GlaxoSmithKline). Agreement for this was granted by the hospital and next-of-kin. Treatment with the corticosteroid methylprednisolone was also started to treat the lung inflammation. The patient's condition improved within 48 hours-H1N1 viral load had decreased over 100-fold by ICU day 21. She was extubated the same day, and discharged back to the ward after 24 days in ICU. Inhaled relenza was continued as a precaution due to her immunocompromised state.

The authors say: "Since her inflamed, atelectatic* lungs were probably impeding adequate drug absorption, and clinical improvement was not forthcoming, we decided to use intravenous (unlicensed) zanamivir. High dosing achieves effective respiratory epithelial concentrations and is well-tolerated. Our patient progressively recovered with no drug related side-effects."

Deaths due to pandemic H1N1 influenza are mainly related to severe respiratory failure, or acute respiratory distress syndrome (ARDS). The authors suggest that persistent high level H1N1 replication may drive ongoing lung inflammation, and that the intravenous relenza and high-dose corticosteroids could have worked together in this case, although this may be considered controversial and high-dose corticosteroids are not recommended in swine influenza treatment guidelines. The authors say: "However, controlled trials are lacking and a rationale does exist for the use of corticosteroids in ARDS."

They conclude: "Although this is a single case report and direct cause and effect cannot be confirmed, the improvement in clinical status following intravenous relenza encourages prompt further investigation, both alone and in combination with high-dose methylprednisolone."

Source
The Lancet
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961528-2/fulltext

http://www.medicalnewstoday.com/articles/163056.php

Swine flu deaths show this flu is different: experts

2009-09-16T19:09:00.000+01:00

Tue Sep 15, 2009 3:17pm EDT

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - Autopsies on people who have died from the new pandemic H1N1 flu show this virus is different from seasonal influenza, even if it has not yet caused more deaths, experts told a meeting on Tuesday.

Americans who died from swine flu had infections deep in their lungs, Dr. Sherif Zaki of the U.S. Centers for Disease Control and Prevention told a meeting of flu experts, including damage to the alveoli -- the structures in the lung that deliver oxygen to the blood.

This in turn caused what is known as acute respiratory distress syndrome -- an often fatal development that leaves patients gasping for breath.

The World Health Organization has confirmed 3,205 deaths globally from swine flu but experts agree all estimates of the extent of the pandemic are grossly understated because so few patients are ever actually tested.

Seasonal flu kills, too -- about 250,000 to 500,000 cases a year globally, according to the WHO. But not in the same way as swine flu, which unlike seasonal flu frequently causes severe disease in young adults and children.

"It is very rarely you see what we call diffuse alveolar damage in fatal seasonal influenza," Zaki told a meeting sponsored by the U.S. Institute of Medicine, which advises government on health matters.

Seasonal flu causes bronchitis and other upper respiratory disease. But Zaki, the chief infectious disease pathologist at CDC, said the new virus had burrowed into the lungs of the 90 or so people he examined after they died, and they had huge amounts of the virus in their blood.

"This is almost exactly what we see with avian flu," Zaki said. "This looks like avian flu on steroids."

EXPERIMENTAL DRUGS

Dr. Yoshi Kawaoka of the University of Wisconsin said tests in monkeys showed the virus lives and replicates 1,000-fold better in the lungs than does seasonal flu.

He said the No. 1 drug of choice against H1N1 -- Roche AG's and Gilead Sciences Inc's Tamiflu -- lowered the so-called viral load of virus in the lungs just enough to help the body fight back.

Experimental flu drugs lower it even more, notably Daiichi Sankyo Co Ltd's CS 8958 and another drug called T-705 or favipiravir, made by Fujifilm Holdings Corp unit Toyama Chemical Co, Kawaoka said.

Zaki said 90 percent of the fatalities he looked at had some condition that would predispose them to serious disease. They had a median age of 38 and one victim was a two-month-old infant who died within a day of getting sick.

Nearly half -- 46 percent -- were obese, many had fatty liver disease, 27 percent had heart disease and 22 percent had asthma, he said.

Dr. Guillermo Ruiz-Palacios of Mexico's National Institute of Medical Sciences and Nutrition said many Mexican patients with severe disease were also obese. In addition, patients came in late for treatment and many were infected with a second common virus, called parainfluenza virus. Continued...

Fewer than a third of the U.S. deaths, 29 percent, had a so-called secondary bacterial infection, usually Streptococcus pneumoniae, Zaki said.

Ruiz-Palacios also said the new virus can be found in the urine and feces of patients, something that may affect how it spreads.

(Editing by Cynthia Osterman)

http://www.reuters.com/article/healthNews/idUSTRE58E6NZ20090915?pageNumber=1&virtualBrandChannel=0

What H1N1 Can Do To You

2009-09-16T19:04:00.000+01:00

This is a couple of weeks old but worth posting.

September 2, 2009 7:45 AM

Dr. Jennifer Ashton offers a detailed explanation to Harry Smith of acute respiratory distress syndrome in the most extreme H1N1 cases where patients are already immune compromised.

(CBS) Federal officials said a vaccine to help prevent the new flu is expected to be ready by mid to late October. But still some people are wondering how you can actually die from the H1N1 virus.

CBS News medical correspondent Dr. Jennifer Ashton sat down with Early Show co-anchor Harry Smith and took a closer look at what happens to the body.

Germs are everywhere - in our homes, offices, and schools. While some are harmless, others can be deadly, like the H1N1 virus or swine flu.

It spreads when a carrier coughs or sneezes; another person touches the object or surface with the flu virus on it and then touches his own nose or mouth.

The virus is inhaled by the body and goes straight to the lungs. The virus attaches to the lung cells, infecting the body. Over the course of days, the blood vessels in the lungs or the air sacs are damaged. Fluid leaks from the blood vessels into the air sacs of the lungs. While some air sacs fill with fluid, others collapse altogether. When the air sacs collapse, the lungs can no longer inflate as they normally would with oxygen. The lungs become stiff.

Without air entering the lungs, the amount of oxygen in the blood drops. If diagnosed early, some patients will get extra oxygen supplied by a breathing machine; others may fall into a coma. Patients die from H1N1 because their lungs give out via lack of oxygen or drowned by fluids.

At this time, 50 percent of H1N1 deaths are due to viral pneumonia and half the fatalities have been in people with pre-existing medical conditions like obesity, diabetes, and pregnancy.

An animation was shown that demonstrated the affects of ARDS (acute respiratory distress syndrome).

"Is that flu or is that pneumonia?" Smith asked after viewing the animation.

"Well, what that described is a situation we referred to as ARDS where the lungs literally become like sponges and can't exchange oxygen. That can happen with the viral pneumonia, a bacterial pneumonia, but half of the deaths due to H1N1 have been due to this viral pneumonia leading to that kind of pulmonary failure," Ashton explained.

Last week, the Centers for Disease Control and Prevention (CDC) reported to Ashton that it has studied the autopsy results of the people who have succumbed to the H1N1 virus, and found that about half of the cases are in people who were either obese, had diabetes, or were pregnant and suppressed their immune system.

"So they were at a higher risk going into this virus, which, again, we have to emphasize in most cases have been mild, but they were at higher risk going into severe complications that then led to their death," she added.

According to Ashton, there's a "variable time course," where sometimes it happens over hours, days, or weeks. But Ashton stressed that once ARDS sets into the lungs and the patient is put on a ventilator, multiple organ systems then begin to fail and the mortality rate can be as high as 30 percent to 50 percent.

CBS Early Show Video of above:

http://www.cbsnews.com/video/watch/?...ted;photovideo

GPs to be paid £5.25 per jab for swine flu vaccine

2009-09-16T09:19:00.000+01:00

Family doctors have secured a deal with the government over their payments for giving patients a swine flu jab, it was announced , allowing the final arrangements for vaccination to be put in place.
GPs will be paid £5.25 for each jab they give. The wrangle over payments has been going on all summer. Doctors represented by the British Medical Association appear to have reduced their demands from an initial level of almost £7 a shot. They are paid £7.50 a patient to give the seasonal flu vaccine.
Although the government has ordered enough vaccine for the entire population, the vaccination programme expected to begin in the autumn – once the vaccine receives a licence – will target the 9 million people most at risk from swine flu, the government said today.
Whether the rest of the population is then offered a jab will depend on the evolution of the pandemic, it said. If it continues to be mild, vaccination will not be introduced universally.
GPs stand to gain more than £42m, which they say will be spent on contacting patients, administering the vaccine and if necessary taking on extra staff. A statement from the Department of Health noted that "the vaccine will reduce the number of people needing hospital and intensive care treatment and save the NHS money in the long run".
The health secretary, Andy Burnham, said the deal was "great news for patients". He added: "I am glad that we have reached a fair deal with the GPC [general practitioners' committee of the BMA] and I am pleased that GPs will continue to play a key role in the fight against swine flu. They have already worked incredibly hard in what have been very difficult circumstances to help their patients."
Dr Laurence Buckman, chairman of the GPs' committee, said it believed family doctors were the best people to administer the vaccine. "This will be a lot of additional work for practices, but general practice is used to running large vaccination programmes. We are confident that GPs and their teams will have the resources they need in order to run the swine flu vaccination programme smoothly and efficiently." Four groups of people were identified as the first who will be summoned for a flu jab in England:
• People aged over six months and under 65 who are currently considered to be at risk from normal winter flu because of health conditions such as asthma or heart conditions ‑ about 5 million people.
• All pregnant women, unless the regulatory authorities impose restrictions on the stage of pregnancy in which it is safe to vaccinate ‑ about 500,000.
• Household contacts of people with compromised immune systems, such as people in regular close contact with patients on treatment for cancer ‑ about 500,000.
• People aged 65 and over in the current seasonal flu vaccine clinical at-risk groups ‑ about 3.5 million. This does not include otherwise healthy over-65s, since they appear to have some natural immunity to the virus.

http://www.guardian.co.uk/society/2009/sep/14/swine-flu-vaccine-gps-pay

FDA approves H1N1 vaccine applications

2009-09-16T09:17:00.001+01:00

ATLANTA, Georgia (CNN) -- The Food and Drug Administration has approved applications from four manufacturers to make H1N1 flu vaccine, the secretary of the Department of Health and Human Services said Tuesday.

"We will have enough vaccine available for everyone," Kathleen Sebelius told the House Energy and Commerce Committee.
The plan is to begin the large-scale vaccination program in mid-October in as many as 90,000 sites, though limited amounts of the vaccine are expected to be available a week to 10 days earlier, she said.
Monday, the director of the nation's top disease agency told CNN the vaccine will be available earlier than had been expected.
"We think the first doses of some of the vaccine forms should be available in about three weeks," said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.
Previously, the CDC had been predicting the vaccine would not be available before middle or late October.
Frieden said that the vaccines appear to confer protection from the virus eight to 10 days after they are administered.
The news about the vaccine against H1N1, also called swine flu, comes a week after researchers concluded that a single injection would suffice to protect against the virus.
Health officials are urging that pregnant women, school-age children and anyone with underlying health conditions, like diabetes, heart disease or lung disease, get the swine flu shot. See which states are showing the greatest swine flu activity »
Frieden said it appears that health workers will be able to administer the H1N1 vaccine at the same time that they administer the shot against seasonal flu.
The symptoms of seasonal flu are similar to those of swine flu, and patients and their caregivers need not know which one they have, he said.
"The key messages are the same in either case: If you're sick, stay home," he said. "If you're severely ill -- and that means you have trouble breathing, you have severe illness, your fever comes back or you have one of those underlying conditions like diabetes or people with special health care problems, like children with disabilities, that make it difficult for them to breathe -- then see your doctor right away."
The timing is important because 11 states already are reporting widespread flu activity. "We wish we had the vaccine today," Frieden said.
He said flu vaccines have a good safety record. "Literally, hundreds of millions of people have gotten the flu vaccine, and certainly my kids will be getting the H1N1 vaccine when it becomes available for everybody."
Frieden's two children are ages 5 and 15.

http://edition.cnn.com/2009/HEALTH/09/15/h1n1.flu.vaccine/index.html

FDA NEWS RELEASE
For Immediate Release: Sept. 15, 2009
Media Inquiries: Pat El-Hinnawy, 301-796-4763, patricia.el-hinnawy@fda.hhs.gov; Peper Long, 301-796-4671, mary.long@fda.hhs.gov
Consumer Inquiries: 1-888-INFO-FDA
FDA Approves Vaccines for 2009 H1N1 Influenza Virus
Approval Provides Important Tool to Fight Pandemic
The U.S. Food and Drug Administration announced today that it has approved four vaccines against the 2009 H1N1 influenza virus. The vaccines will be distributed nationally after the initial lots become available, which is expected within the next four weeks.
“Today's approval is good news for our nation's response to the 2009 H1N1 influenza virus,” said Commissioner of Food and Drugs Margaret A. Hamburg, M.D. “This vaccine will help protect individuals from serious illness and death from influenza.”
The vaccines are made by CSL Limited, MedImmune LLC, Novartis Vaccines and Diagnostics Limited, and sanofi pasteur Inc. All four firms manufacture the H1N1 vaccines using the same processes, which have a long record of producing safe seasonal influenza vaccines.
”The H1N1 vaccines approved today undergo the same rigorous FDA manufacturing oversight, product quality testing and lot release procedures that apply to seasonal influenza vaccines,” said Jesse Goodman, M.D., FDA acting chief scientist.
Based on preliminary data from adults participating in multiple clinical studies, the 2009 H1N1 vaccines induce a robust immune response in most healthy adults eight to 10 days after a single dose, as occurs with the seasonal influenza vaccine.
Clinical studies under way will provide additional information about the optimal dose in children. The recommendations for dosing will be updated if indicated by findings from those studies. The findings are expected in the near future.
As with the seasonal influenza vaccines, the 2009 H1N1 vaccines are being produced in formulations that contain thimerosal, a mercury-containing preservative, and in formulations that do not contain thimerosal.
People with severe or life-threatening allergies to chicken eggs, or to any other substance in the vaccine, should not be vaccinated.
In the ongoing clinical studies, the vaccines have been well tolerated. Potential side effects of the H1N1 vaccines are expected to be similar to those of seasonal flu vaccines.
For the injected vaccine, the most common side effect is soreness at the injection site. Other side effects may include mild fever, body aches, and fatigue for a few days after the inoculation. For the nasal spray vaccine, the most common side effects include runny nose or nasal congestion for all ages, sore throats in adults, and -- in children 2 to 6 years old -- fever.
As with any medical product, unexpected or rare serious adverse events may occur. The FDA is working closely with governmental and nongovernmental organizations to enhance the capacity for adverse event monitoring, information sharing and analysis during and after the 2009 H1N1 vaccination program. In the U.S. Department of Health and Human Services, these agencies include the Centers for Disease Control and Prevention.
Vaccines against three seasonal virus strains are already available and should be used (see information on the seasonal flu). However, they do not protect against the 2009 H1N1 virus (see information on H1N1 flu).
#
Additional Information
Influenza A (H1N1) 2009 Monovalent

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm182399.htm

Docs say NO to vaccine in pregnancy

2009-09-15T22:19:00.001+01:00

Influenza Vaccination During Pregnancy:

A Critical Assessment of the Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Influenza vaccination during all trimesters of pregnancy is now universally recommended in the United States. We critically reviewed the influenza vaccination policy of the CDCs Advisory Committee on Immunization Practice (ACIP) and the citations that were used to support their recommendations. The ACIPs citations and the current literature indicate that
influenza infection is rarely a threat to a normal pregnancy. There is no convincing evidence of the effectiveness of influenza vaccination during this critical period. No studies have adequately assessed the risk of influenza vaccination during pregnancy, and animal safety testing is lacking.

Thimerosal, a mercury-based preservative present in most inactivated formulations of the vaccine, has been implicated in human neurodevelopment disorders, including autism, and a
broad range of animal and experimental reproductive toxicities including teratogenicity, mutagenicity, and fetal death. Thimerosal is classified as a human teratogen.
The ACIP policy recommendation of routinely administering influenza vaccine during pregnancy is ill-advised and unsupported by current scientific literature, and it should be withdrawn.
Use of thimerosal during pregnancy should be contraindicated.

On May 28, 2004, the Advisory Committee on Immunization Practice (ACIP) of the Centers for Disease Control and Prevention (CDC) published its annual report on its current policy for prevention of influenza. The recommendation to vaccinate all pregnant women regardless of trimester was the most aggressive in a series of policy changes that began in 1995. Previously, influenza vaccine was advised only for women with preexisting medical conditions. The latest ACIP recommendation was promptly endorsed by the
American College of Obstetricians and Gynecologists (ACOG) and theAmericanAcademy of Pediatrics (AAP).

This investigation critically assesses the current ACIP recommendations, reviews the clinical research that supported them, and evaluates the risk-benefit analysis of administering
inactivated influenza vaccine during pregnancy.

http://www.jpands.org/vol11no2/ayoub.pdf

German Swine Flu Vaccine Trial Participant Coughs Up Blood

2009-09-15T17:12:00.000+01:00

A participant in German swine flu vaccine trials has come forward with startling allegations that he experienced serious adverse side effects after taking the swine flu vaccine - including coughing up blood. The 40 year old German businessman named Axel described to a German publication exactly what happened after he was vaccinated on August 10th: "I felt totally beat. On the third day, my kidneys and head were aching and I got a fever. I then had a coughing fit - and the wash basin was suddenly red - it was blood!"
You can find the original German article containing Axel's story here (it is in German though):
http://www.merkur-online.de/nachrichten/muenchen/schweinegrippe-impfung-testpatient-packt-meta-451084.html
German medical researcher Frank von Sonnenburg, who is in charge of the swine flu vaccine trials there does not believe that Axel's account is credible. He told the German publication doing the story that Axel's symptoms could not possibly be related to the vaccine.
Axel, however, insists that what happened to him was most definitely a result of taking the vaccine: "Surely it is no coincidence that they occurred directly after the vaccination."
Considering what happened in 1976, one would think that reports such as these would give health authorities reason to do more testing at least.
But that is not going to happen. In fact, in the United States the swine flu vaccine is going to be rolled out even earlier.
U.S. Health and Human Services Secretary Kathleen Sebelius recently told ABC's George Stephanopoulos that the swine flu vaccine will be available in the United States by the first week of October, 2 weeks earlier than has been previously expected.
So instead of delaying the swine flu vaccine in order to do proper testing, U.S. authorities have decided to rush it out as fast as they can possibly get their hands on it.
Just listen to how reckless Sebelius sounds in the following quote....
"We are on track to have an ample supply rolling out by mid October, but we may have some early vaccine as early as the first full week in October. And we plan to get the vaccine rolling out the door as fast as it hits the production line."
Should Americans be thanking Sebelius and the Obama administration for rushing out the door an untested, potentially dangerous vaccine "as fast as it hits the production line"?
How negligent can the U.S. government possibly be?
At least some health authorities are trying to warn the public about this potential disaster. Dr. Marc Girard, a very highly respected authority on the side effects of drugs and a medical expert commissioned by French courts, has actually said on French television that the swine flu vaccine could cause as many as 60,000 deaths in France - especially among young children and pregnant women.
A YouTube video of Dr. Girard being interviewed on French television about this is below, but unless you know French you will not be able to understand it. For those that don't speak French, the following is a translation of the most pertinent portion of his remarks:
A vaccine is being developed in conditions of amateurism such as I have never seen. Lets take the pessimistic hypothesis: one death among every 1000 patients. There are plans to vaccinate 60 million people, and you so you already have 60,000 deaths, and this time, young people, children, pregnant women.

All of this news is very, very disturbing. A swine flu vaccine is being rushed out to the public that some health experts are warning could kill tens of thousands of people and that is causing very serious side effects in some patients during trials.
What if 60,000 people do die from the swine flu vaccine as the French doctor is suggesting?
Will the reckless health authorities that have rushed out this vaccine be held accountable?
If you know of any additional swine flu news that should be brought to our attention, please post a message in the comments field below. We could be heading for a complete and total worldwide health disaster if an unsafe, untested vaccine is rushed out to millions of people around the globe. It will be important for all of us to pay attention and to get important swine flu news items out to our family and friends as quickly as possible in the days ahead. Their lives may depend upon it.

Doctor says FLU VACCINE will cause 60,000 deaths in France alone ( SEE INFO BOX )

http://thebirdflupandemic.com/archives/german-swine-flu-vaccine-trial-participant-coughs-up-blood

Also check this out ~
3 People In Egypt Suspected Of Being Infected With H1N1 Swine Flu And H5N1 Bird Flu

http://thebirdflupandemic.com/archives/3-people-in-egypt-suspected-of-being-infected-with-h1n1-swine-flu-and-h5n1-bird-flu

H1N1 Vaccines Safe, Immunogenic in Single Dose

2009-09-15T16:55:00.001+01:00

By Michael Smith, North American Correspondent, MedPage Today
Published: September 10, 2009

Two investigational vaccines against the pandemic H1N1 flu appear to be safe and to yield a robust immune response with a single dose.

Those findings -- contained in two preliminary reports published online today in the New England Journal of Medicine -- are reassuring, experts said.

Among other things, vaccines that can produce an immune response with a single dose will stretch what is predicted to be a short supply of the drugs, according to Kathleen Neuzil, MD, of the University of Washington in Seattle.

Also, she wrote in an editorial accompanying the papers, immunity will appear more quickly -- soon after vaccination rather than after two doses at least three weeks apart.

The reports are "welcome and reassuring," Neuzil said, especially since a third online paper reported that few people currently have any immunity to the new H1N1 strain.

The first of the preliminary reports published today is from a continuing study in Australia, where researchers are testing an inactivated H1N1 vaccine in a cohort of 240 volunteers, randomized to get either 15 or 30 micrograms of the drug.

Three weeks after vaccination more than 90% of volunteers had a robust immune response, according to Michael Greenberg, MD, of CSL, the vaccine's manufacturer.
Volunteers -- 175 adults, ages 18 to 50 -- were randomly assigned to receive:
Two intramuscular injections of adjuvanted vaccine containing 7.5 micrograms of hemagglutinin on day zero in each arm
Or one injection on day zero and the other on either day seven, 14, or 21
Or two 3.75-microgram doses of adjuvanted vaccine 21 days apart
Or 7.5 micrograms or 15 micrograms of non-adjuvanted vaccine, again given 21 days apart

The researchers are reporting data from 100 volunteers -- those who got the 7.5-microgram dose of the adjuvanted vaccine. (The manufacturer earlier gave some details of the findings. See Novartis Says Swine Flu Vaccine Works Quickly)
In that cohort, Stephenson and colleagues found, 86% of the volunteers reported adverse reactions after one or both doses -- primarily injection site pain and muscle aches. The reactions were generally mild or moderate and resolved after 72 hours, the researchers said.

For those who got two doses, the researchers said, more than 90% achieved "seroprotection" by day 21 -- defined as an antibody titer of 1:40 or more -- regardless of the dosing schedule.
"Generally, I think the results are good news," said John Treanor, MD, a vaccine expert at the University of Rochester in Rochester, N.Y.

He noted that the vaccine recently approved in China reportedly had good results with a single dose and other studies are still under way that should have data available soon.

"The overall impression I think, is that for adults, a single dose of vaccine will be sufficient," Treanor said.

One thing to consider, he said, is that the Australian study took place during the epidemic in that country, so that prevaccination antibody levels were higher than expected.

But the level of protection the researchers found is high enough that it seems likely the conclusion will stand up, he added.

The vaccines thus far have been given to healthy adults, so immunization of other groups may produce different antibody responses.

Richard E. Besser, MD, a former CDC deputy director who is now senior health and medical editor at ABC News, was also enthusiastic -- especially about the possibility that a single dose could produce immunity.

"This is very exciting news. It has many implications. It could double the number of adults who could be vaccinated. It will greatly simplify vaccination programs by no longer needing to track people between the first and second dose. It will greatly reduce the costs of vaccination programs," Besser said.

The results of the British study are also encouraging, Treanor said, although it's still too early to say what role the oil-in-water adjuvant is playing.

John Bartlett, MD, of Johns Hopkins Medical Institution, in Baltimore, agrees that the findings are encouraging. "The good news is that it suggests a single dose may be adequate," he said.

That's important for logistical reasons, as well as to stretch an available vaccine as far as it will go, said Robert Field, JD, PhD, of Drexel University in Philadelphia.

"It is dramatically easier to administer one shot than two," he said. "With a two-dose regimen, many people will neglect to get the second shot" -- sometimes for the simple reason that they don't know where to get the second shot.

"For instance," Field said, "if someone gets the first one at a supermarket, do they have to return there, can they get it at another supermarket, can they go to their physician's office, or can they go elsewhere?"

The Australian study was supported by CSL and the Department of Health and Aging of the Australian government. All authors report being employees of CSL and several report having an equity interest in the company.
The British study was supported by University Hospitals Leicester and Novartis. Stephenson reported financial links with Novartis Vaccines, Sanofi Pasteur, Baxter Vaccines, Hoffmann–La Roche, and GlaxoSmithKline.
The CDC study was supported by the CDC. Katz reported research support from GlaxoSmithKline.
The editorial author reported no conflicts.

Seeing who paid for the trials i wouldnt be putting too much faith in them - they have all been known to falsify reports in the past :/

Possible link between El Nino & Flu Pandemics

2009-09-15T16:36:00.001+01:00
Texas A&M researcher shows possible link between 1918 El Niño and flu pandemic

Research conducted at Texas A&M University casts doubts on the notion that El Niño has been getting stronger because of global warming and raises interesting questions about the relationship between El Niño and a severe flu pandemic 91 years ago. The findings are based on analysis of the 1918 El Niño, which the new research shows to be one of the strongest of the 20th century.

El Niño occurs when unusually warm surface waters form over vast stretches of the eastern Pacific Ocean and can affect weather systems worldwide. Using advanced computer models, Benjamin Giese, a professor of oceanography who specializes in ocean modeling, and his co-authors conducted a simulation of the global oceans for the first half of the 20th century and they find that, in contrast with prior descriptions, the 1918-19 El Niño was one of the strongest of the century.

Giese says there were few measurements of the tropical Pacific Ocean in 1918, the last year of World War I, and the few observations that are available from 1918 are mostly along the coast of South America. “But the model results show that the El Niño of 1918 was stronger in the central Pacific, with a weaker signature near the coast,” Giese explains. “Thus the limited measurements likely missed detecting the 1918 El Niño.”

Giese adds, “The most commonly used indicator of El Niño is the ocean temperature anomaly in the central Pacific Ocean. By that standard, the 1918-19 El Niño is as strong as the events in 1982-83 and 1997-98, considered to be two of the strongest events on record, causing some researchers to conclude that El Niño has been getting stronger because of global warming. Since the 1918-19 El Niño occurred before significant warming from greenhouse gasses, it makes it difficult to argue that El Niño s have been getting stronger.”

The El Niño of 1918 coincided with one of the worst droughts in India, he adds. “It is well known that there is a connection between El Niño and the failure of the Indian monsoon, just as there is a well-established connection between El Niño and Atlantic hurricane intensity,” Giese says. In addition to drought in India and Australia, 1918 was also a year in which there were few Atlantic hurricanes.

The research also raises questions about El Niño and mortality from the influenza pandemic of 1918. By mid-1918, a flu outbreak – which we now know was the H1N1 strain that is of great concern today – was sweeping the world, and the resulting fatalities were catastrophic: At least 25 million people died worldwide, with some estimates as high as 100 million deaths. India was particularly hard hit by the influenza.

“We know that there is a connection between El Niño and drought in India,” Giese notes.

“It seems probable that mortality from influenza was high in India because of famine associated with drought, so it is likely that El Niño contributed to the high mortality from influenza in India.”

The flu epidemic of 1918, commonly called the “Spanish Flu,” is believed to be the greatest medical holocaust in history. It lasted from March of 1918 to June of 1920, and about 500 million people worldwide became infected, with the disease killing between 25 million to 100 million, most of them young adults. An estimated 17 million died in India, between 500,000 to 675,000 died in the U.S. and another 400,000 died in Japan.

Could the events of 1918 be a harbinger of what might occur in 2009?

Giese says there are some interesting parallels. The winter and spring in 1918 were unusually cold throughout North America, just at the time influenza started to spread in the central U.S. That was followed by a strengthening El Niño and subsequent drought in India. As the El Niño matured in the fall of 1918, the influenza became a pandemic.

With a moderate to strong El Niño now forming in the Pacific and the H1N1 flu strain apparently making a vigorous comeback, the concerns today are obvious, Giese adds.

Giese’s work will be published in the current “Bulletin of the American Meteorological Society,” and the research project was funded by NOAA (National Oceanic and Atmospheric Administration) and the National Science Foundation.

http://www.youtube.com/watch?v=Mp1yR2NL1v4

A(H1N1) gets more virulent

2009-09-15T16:24:00.001+01:00

HYDERABAD, September 15, 2009

The A(H1N1) virus is showing signs of getting ‘mutated’ into a more virulent form.
Clinical observation of experts in the State capital indicate that the genetic make up of A(H1N1) virus has ‘changed’ and is now more ‘potent’ after coming into contact with the local existing viral forms.
‘Second wave’
This is the ‘second wave’ of swine flu virus, coinciding with the rainy season, which is still active. There is a possibility of onset of a third and more virulent form in the upcoming winter season. The virus is getting more ‘time’ to stay in the atmosphere because of low temperatures, experts opine.
A pattern, among the swine flu fatalities in twin cities, has been detected. “Patients are dying within 24 to 48 hours after getting infected with A(H1N1). The virus is not giving any chance to the doctors to treat the patient. The virus has become virulent and that’s why we are losing patients who have good immunity,” said Gandhi Hospital Superintendent E.A. Ashok Kumar.
Between May and August, when A(H1N1) virus was imported from other countries, it did not cause severe illness to patients. “These days, the patient’s condition is deteriorating within 24 hours. There is a definite shift in the genetic make up of the virus. It might have genetically changed after coming into contact with local influenza virus,” Superintendent of Chest Hospital S.V. Prasad.

Taken from the Hindu Times

Wow!

2009-09-10T19:20:00.002+01:00
I've been gone for almost a month.

Ironically i had the flu lol. Wasnt too bad, just a high temp for 5 days & felt nauseous - no more pain than usual.

The tiredness was the worst bit - slept for 3 days.

GP offered me tamiflu which i didnt take. Didnt take paracetamol either - just let nature take its course. Wise or unwise, who knows but i survived to tell the tale.

I did stop my methotrexate for a week though as i figured my immune system was having a hard enough time without the mtx making it worse.

Only other excuse for not posting is that i got busy getting kids back to school etc. Its like most things with me - if i dont do something for a while then i lose interest.

I've got approx 850 articles stacking up to read but there's no way i'm doing all that so i'll just scan em for anything interesting.

I work as a nurse & got word today that i have to go get fitted for a face mask next week - ugh. Plus here in N. Ireland they're planning to start vaccinations at the end of October - imagine my joy...........not.

Neurologists concerned over safety of swine flu vaccine

2009-08-16T01:26:00.001+01:00

A warning that the new swine flu jab is linked to a deadly nerve disease has been sent by the Government to senior neurologists in a confidential letter.
The letter from the Health Protection Agency, the official body that oversees public health, has been leaked to The Mail on Sunday, leading to demands to know why the information has not been given to the public before the vaccination of millions of people, including children, begins.

It tells the neurologists that they must be alert for an increase in a brain disorder called Guillain-Barre Syndrome (GBS), which could be triggered by the vaccine.
GBS attacks the lining of the nerves, causing paralysis and inability to breathe, and can be fatal.

The letter, sent to about 600 neurologists on July 29, is the first sign that there is concern at the highest levels that the vaccine itself could cause serious complications.

Read more at link: http://www.dailymail.co.uk/news/article-1206807/Swine-flu-jab-link-killer-nerve-disease-Leaked-letter-reveals-concern-neurologists-25-deaths-America.html

More of the same

2009-08-10T17:42:00.002+01:00

Children with seasonal flu should not be given antivirals such as Tamiflu because harmful side effects outweigh relatively meager benefits, according to a study released Monday.

In some children Tamiflu caused nausea and vomiting, which can lead to dehydration and other complications, researchers reported.

The study did not cover the current outbreak of swine flu, but its conclusions suggest that antivirals may not significantly reduce the length of illness or prevent complications in children infected with the new A(H1N1) virus, the researchers said.

Carl Henegan, a doctor at John Radcliffe Hospital in Oxford and co-author of the study, said the current British practice of giving Tamiflu for mild illness was "an inappropriate strategy."

"The downside of the harms outweigh the one-day reduction in symptomatic benefits," he said.

The research showed that antivirals oseltamivir and zanamivir shortened the duration of seasonal flu by up to a day and a half.

But the drugs had little or no effect on asthma flare-ups, increased ear infections or the need for antibiotics.

Tamiflu, the brand name for oseltamivir, was also linked to an increased risk of vomiting. Zanamivir is marketed under the name Relenza.

The study, published in the British Medical Journal (BMJ), comes 10 days after Britain's Health Protection Agency (HPA) reported that more than half of 248 students given Tamiflu after a classmate fell ill with swine flu suffered side-effects such as nausea, insomnia and nightmares.

Most of the students did not have the flu when they were given the drug.

In the BMJ study, led by David Mant of Oxford University, researchers reviewed four earlier clinical trials -- two with Relenza and two with Tamiflu -- for influenza treatment covering 1,766 children 12 or younger. More half had confirmed cases of type A flu.

They also reviewed three other trials in which the drugs were given to children who had been exposed to the virus but showed no symptoms.

Such "proactive" use resulted in only an eight percent reduction in the incidence of influenza.

None of the trials tested the efficacy of anti-virals against the new strain of swine flu that has swept across the globe since April, infecting hundreds of thousands and claiming more than 1,100 lives.

Swiss pharmaceutical company Roche, the patent holder of Tamiflu, suggested that the symptoms described in the study might been due in part to the flu itself and not the medication.

"According the WHO, 50 percent of patients with the flu (swine or seasonal) have nausea symptoms or digestive problems caused by the illness," a Roche spokesman told AFP.

"Clinical studies on children treated with Tamiflu have shown secondary effects such as nausea, but these have been moderate and it is extremely rare that treatment must be halted as a consequence," the spokesman said.

Tamiflu can be prescribed from the age of one year old.

http://www.physorg.com/news169111819.html

Tamiflu "harmful to children"

2009-08-10T15:40:00.000+01:00

Tamiflu 'harmful to children'
http://itn.co.uk/b728f6439934ee482493dce11cb1ad6b.html

Experts say children should not be given the swine flu drug Tamiflu because the negative effects could outweigh the benefits.

The Department of Health is under pressure to hold an urgent rethink of its current policy.

The study found that Tamiflu caused vomiting in some children, which can lead to dehydration and complications.

The drug also had little or no effect on asthma flare-ups, ear infections or the likelihood of a youngster needing antibiotics.

Dr Carl Henegan, a GP and expert from the John Radcliffe Hospital in Oxford, said the current policy of giving Tamiflu for mild illness was an "inappropriate strategy".

He added: "The downside of the harms outweigh the one-day reduction in symptomatic benefits."

The study comes little over a week after other research found that children given Tamiflu preventatively reported side-effects including nausea and nightmares.

Here's a link to the article in the Telegraph
http://www.telegraph.co.uk/health/swine-flu/6004313/Children-should-not-be-given-Tamiflu-Oxford-researchers.html

Popular flu drugs have modest effect.
http://www.medpagetoday.com/Pulmonary/URIstheFlu/15439

Looks like i'm not alone on the vaccine issue :)

2009-08-09T21:19:00.000+01:00

Children could be given untested swine flu vaccine
http://www.dailymail.co.uk/health/article-1205267/Children-given-untested-swine-flu-vaccine.html

The swine flu vaccine which will be offered to 12 million children in the UK may not have been tested on infants by the time the first batches arrive.
Pharmaceutical companies manufacturing the jabs do not have any paediatric safety data for the drugs, which could be distributed to children in the autumn.
The first consignment of the vaccine is due to arrive at the end of this month but drugs firms have only just begun trials on adults.
Trials on children may not start for a few weeks.
Children are thought to be most at risk of developing a serious form of the H1N1 virus and also help to spread swine flu. It is expected they will be among the first to be vaccinated, along with health professionals, pregnant women and people with underlying health conditions.
However, the European Medicines Agency (EMEA), which will license the vaccines, said approval could be granted before the results of these trials are known.
Dr Tom Jefferson, of the vaccines section of the Cochrane Collaboration, an independent group that reviews research, said he feared there would be safety issues with the jab and had doubts it would work. He added: ‘Governments have a duty of care, and therefore a duty to provide vaccines which are proven to be safe and effective.’
During the last swine flu outbreak in the US in 1976, a vaccine caused 25 deaths – more than the virus itself. Dr Jefferson said a repeat of that ‘was possible’.
GP Dr Richard Halvorsen, author of The Truth About Vaccines, said that there was a ‘worrying trend’ to introduce jabs for children without good data. He said that in this case there was no pressing need for one.
However, microbiologist Professor Hugh Pennington said flu vaccines in general had an excellent safety record.
The EMEA admitted it could authorise the vaccine before the results of trials are known but if it did it would issue a warning it had not been tested on a specific group.
GlaxoSmithKline said it had conducted paediatric trials on the bird flu vaccine, on which the swine flu jab is based. A trial for children is planned within the next month.
The Department of Health said it would not be using the vaccine until ‘we are satisfied it is safe.’

Fever is our friend

2009-08-09T01:27:00.005+01:00

"Give me a fever, and I can cure any illness" -- Hippocrates

Fever is an unusually high body temperature, a thermometer is used to measure the body temperature, temperatures varies when taken in different part of the body, if it is taken in the rectum/anus the temperature is generally one degree higher than if the temperature is taken under the arm, on a degree lower. Pyrogen is a substance that induces fever or rise in the body temperature. Fever is not a disease but symptoms of another sickness. During a fever, the body requires extra energy, which it generates by muscular activity in the form of shivering and by metabolizing (chemically breaking down) proteins, carbohydrates, vitamins, and minerals at a faster rate than normal.

Body Temperature if there is fever:

100°Fahrenheit (37.8° C), taken orally, indicates a mild fever.

100° to 103°F (37.8° to 39.4°C) taken orally, indicates a moderate fever.

104°F (40°C) taken orally, indicates a high fever.

110°F. (43.3°C), this is the uppermost limit of the human body, this kind of fever is extremely rare.

Types of Fever

Continued Fever - the temperature remains above normal for long period of time.

Intermittent Fever - type of fever wherein body temperature periodically rises and falls.

Relapsing Fever - type that recurs sometimes a number of times, several days after the temperature has returned to normal.

Stages of Fever:

In the first stage of fever also known as the invasion period the patient will experience chill, loss of appetite, and headache. Chill occurs, occurs because of the tightening of blood vessels near the skin.

In the next stage, the body is hot and flushed, the skin dry, and the pulse and respiration are rapid. The patient will experience thirst and he/she will feel restless. In high fever, delirium and convulsions may occur.

In the final stage before returning to normal, the temperature falls, breathing and pulse slow down, and the skin becomes moist. The patient often sweats.

Other than fever, other factors that can affect the body temperature are:

Time of the day - body temperature normally fluctuates over the day, with the lowest levels at 4a.m and the highest at 6 p.m. That's why a normal body temperature of 37.5°C (99.5°F) is considered a fever in the morning, but just normal body temperature in the afternoon.

Menstrual cycle is another factor that can affect body temperature. When the woman is ovulating her body temperature is higher that when she is not ovulating.

Psychological factors - when a person is experiencing tension, his/her body temperature rises.

Body temperature also rises even after few hours after a heavy workout (muscle are working to burn fats) and after eating.

Fever is not a disease in itself -- it's an important part of the healing process.

A study published in the February 2004 Journal of Allergy and Clinical Immunology found that children who ran a fever during their first year were less likely to develop allergies later in childhood than children who did not have fever.

More importantly, according to the AAP, a fever can help your child's body fight off infection. Many illness-causing microbes do best at the body's normal temperature. A fever raises the temperature beyond which certain microbes need to reproduce. A fever also kicks your immune system into high gear, spurring the rapid production of bug-clobbering white blood cells. A small but growing body of research shows that letting a fever run its course may reduce the length and severity of such illnesses as colds and flu.

As for the concern among parents that fevers can have harmful effects, these instances are very rare. The brain has an internal regulatory mechanism that prevents fevers caused by infections from getting higher than 105 or 106 degrees. Body temperature must get above 108 degrees to cause damage. Temperatures this high are caused only by exceptional circumstances, such as central nervous system disorders or heatstroke.

Additional Facts About Fevers

Fevers need to be treated only if they are causing discomfort (and usually a fever has to be above 102 or 103 degrees before making a child uncomfortable).

Treating a fever usually doesn't bring the body temperature back to normal -- just down 2 or 3 degrees.

Only 4 percent of children have fever seizures -- marked by a momentary loss of consciousness, eyes rolling back, shaking, twitching, or stiffening -- and when seizures do occur they cause no permanent harm.

How your child looks is more important than the exact reading on the thermometer.

The body has several ways to maintain normal body temperature. The organs involved in helping with temperature regulation include the brain, skin, muscle, and blood vessels. The body responds to changes in temperature by:

increasing or decreasing sweat production.

moving blood away from, or closer to, the surface of the skin.

getting rid of, or holding on to, water in the body.

naturally wanting to seek a cooler or warmer environment.

When you have a fever, the body works the same way to control the temperature, but it resets its thermostat at a higher temperature. The temperature increases for a number of reasons:

Chemicals, called cytokines and mediators, are produced in the body in response to an invasion from a microorganism, malignancy, or other intruder.

The body is making more macrophages, which are cells that go to combat when intruders are present in the body. These cells actually "eat-up" the invading organism.

The body is busily trying to produce natural antibodies, which fight infection. These antibodies will recognize the infection next time it tries to invade.

Many bacteria are enclosed in an overcoat-like membrane. When this membrane is disrupted or broken, the contents that escape can be toxic to the body and stimulate the brain to raise the temperature.

How did fever come to be seen as so dangerous a condition that we put our child's well being at risk in order to suppress the temperature?

Let's first consider the functions of fever and how it works. The two functions of fever are:

To stimulate the immune system.

To create an inhospitable environment for invading organisms. That is, to turn up the heat high enough that the invading microbes cannot live.

The Benefits of Fever

More antibodies -- cells trained to specifically attack the exact type of invader that your body is presently suffering from -- produced more specific to that bug than any pharmaceutical.

More white blood cells (the good guys) produced, circulating, mobilizing and armed to fight off the invading bugs specific to the general category of invader.

More interferon produced (another immune system good guy, which blocks spread of viruses to healthy cells).

Walling off of iron, which bacteria feed on.

Increased temperature, which directly kills microbes. (Most bacteria and viruses actually grow better at temperatures lower than the human body, which is why they like our cool noses in the winter.) Parents, it's not your kids begging for fever-reducing drugs; it's the germs.

Treating Fever the Naturopathic Way

Naturopathic treatment is to support a fever, unless it rises too high or too quickly. A fever of 102 degrees F to 103 degrees F is considered the optimal defense against microbes. Temperatures like these also heal the body most effectively. Supporting a fever means to work with it. For example, one effect of fever is to slow down peristalsis, which is movement of food through the gut.

To support a fever, naturopathic physicians recommend either fasting or eating foods such as broths and water till the fever breaks. Fever is also best supported with rest. Even when the child appears sleepy on the outside, the body is working quite hard to carry out all the functions described above.

Exercise and activity both distract body energy from these vitally important immune system processes. Naturopaths look at acute disease as the body's attempt to cure. Therefore, it is best to support the body's defenses; not suppress them by exercising or working at these times.

Naturopathic physicians compare the fear of fever symptoms to the fear of your car's engine light. To suppress a fever is like asking your mechanic to disconnect the engine light, rather than asking him or her to identify and fix the problem that caused the light to come on in the first place. Parents should ask themselves how they can approach their children's symptoms as logically as they approach their cars: do we really want to suppress our warning signals?

In the case of fever, the warning signal is much more of an aid to conquering illness, rather than as a source of damage in itself.

Also, there's a concern that breaking the fever is the wrong move in some circumstances. That's how the body fights off viruses, the telomeres don't function above 101 degrees, and the immune system clears the infection. By improperly reducing his fever too much, you can potentially allow the virus to propagate to deadly levels. Even high levels can be a problem, as the body will deposit the viral remains into the lungs, causing pneumonia.

That's why aspirin is typically counterindicated, because it's so effective in fighting fever that it can be deadly to an ill person. A fair number of people link the 1918 Flu to the newly prolific use of aspirin teas and similar medications. That's why it was so deadly, because folks were drinking aspiring teas as a preventative measure, so when they did get an infection, by the time they noticed the symptoms, they were packed to the gills with the virus.

How the immune system works:
http://health.howstuffworks.com/immune-system1.htm

HPA advice on anti-pyretics contradicts NICE guidelines
http://www.bmj.com/cgi/content/extract/339/jul28_3/b3050
Julius Wagner-Jauregg won the Nobel prize in 1927 for developingan effective treatment for syphilis which entailed deliberatelyinfecting patients with malaria. This research suggests thatfever may be a beneficial response to infection. The 2007 guidelinefrom the National Institute for Health and Clinical Excellence(NICE) on feverish illness in children under 5 reviewed thesparse evidence on using antipyretic medicines, which seemsto indicate that artificially lowering a fever may reduce theimmune response and prolong illness. NICE therefore recommended,"Do not routinely give antipyretic drugs to a child with feverwith the sole aim of reducing body temperature."¹
A small trial on the use of antipyretics in an intensive careunit was stopped because mortality was 16% in the treated groupand 1% in the untreated group.²
The existing evidence suggests that antipyretics should be avoidedin patients with pandemic flu,³ yet the Health Protection Agency(HPA) . . . [Full text of this article]

Same goes for NSAIDS
http://www.bmj.com/cgi/content/extract/338/jun15_1/b2345

The potentially harmful effects of non-steroidal anti-inflammatorydrugs (NSAIDs) are rarely discussed in the treatment of A/H1N1flu, which has caused high death rates in Mexico.¹ ²
Severe and fatal cases, including sudden death, are characterisedby severe sepsis with multi-organ failure with findings suchas fever, leucocytosis, leucopenia, acute respiratory distresssyndrome (ARDS), liver impairment, renal failure, rhabdomyolysis,and hypotension.² NSAIDs may aggravate these syndromes, leadingto multi-organ failure.³
Since the flu pandemics of the 20th century salicylates havebeen linked to Reye’s syndrome and their use restrictedin children. But NSAIDs such as diclofenac, mefenamic acid,and ibuprofen are still used as antipyretics in many countries,albeit less often than aspirin. Since the use of diclofenacand mefenamic acid was restricted in children in Japan in 2000,the case fatality of so called flu associated encephalopathyhas fallen dramatically.⁴
Reanalysing the World Health Organization’s data on A/H1N1flu,² I . . . [Full text of this article]

Also this from the British Medical Journal
ttp://www.bmj.com/cgi/eletters/338/jun15_1/b2345#216974
In 2000, Plaisance et al proved that the use of paracetamol increased viral shedding and significantly prolonged the duration of influenza. (1)
In 1992, (2)Shalabi et al, showed that acetaminophen seriously inhibits polymorphonuclear leukocytes, and scavenges available HOCl... paralysing the MPT-H2)2-Cl- antimicrobial system of PMNs and inhibited superoxide anion generation as well as degranulation of PMNs. Given, as Shalabi says, that PMN's play a crucial role in fighting bacterial, viral and parasitic infections, why is paracetamol used during infectious fevers?
Four years later, Shalabi et al again pointed out that the higher the temperature, the more severely acetaminophen inhibited bacterial activity of PMNs. (3)
The medical literature since 1975 is replete with articles showing that reducing fever during many different infections increases both complications and mortality.
Even WHO admits this. (4)
So why does every single country recommend paracetamol (acetaminophen) for routine treatment of any influenza, or indeed, any infection at all?
Meanwhile back in the UK in 2004 (5), Eccles et al state that: "Despite the lack of clinical data on the safety and efficacy of analgesics for the treatment of colds and flu symptoms a case can be made that these medicines are safe and effective for treatment of these common illnesses."
Perhaps the question should also be asked as to why any deaths, potentially augmented, or even caused by the use of antipyretics inhibitting parts of the immune system... are then used to justify the roll-out of a vaccine?

Another one from same page
Dear Sir,
The silence following previous queries, is resounding.
Yet, we continue to read stories like this, daily, from all around the world:
"The Ministry of Health says expectant mums who get symptoms should stay home and limit contact with others especially if they are ill, drink plenty of fluids, call their GP or healthline for advice and treat fever straight away with paracetamol." (1)
so it's natural to then read:
"... the mother-of-two Alma Palmer had been sent home from hospital with paracetamol, a day before collapsing and being airlifted to the mainland.
"I am angry with the hospital," her grandfather Roderick Geesu was quoted as saying. "She went to the hospital and instead of giving her a thorough check-up they gave her a packet of Panadol (paracetamol)." (2)
No doubt the experts will say that OF COURSE all deaths had been taking paracetamol. Standard protocol. "So of course paracetamol has NOTHING to do with the deaths."
Right????
Like Dr Johnson says, when will large scale randomised trials begin?
Why is it, that standard advice flies in the face of both medical literature, principles of immunology, and common sense?
Where is the evidence based science to justify such routine pronouncements? And "coincidental" dismissals?

When Medical Attention is Warranted

Infants less than 1-month-old, with a temperature greater than 100.4 degrees F. Seek care right away for fever in this age group. While waiting for care, breastfeed as often as the baby desires. The mother's milk has antibodies made right at the breast as it encounters pathogens in the baby's mouth.

Infants from 1-month to 3-months-old, with a temperature greater than 100.4 degrees F, if they appear ill. Again, breastfeed on demand while waiting for care.

Children between 3 months and 36 months, with a temperature above 102.2 degrees F, if they appear ill.

Anyone with a temperature over 104.5 degrees F.

For children not in the above three categories, bed rest and fluids will support the fever and allow it to do the job that your child needs it to do.

Story Time :)

2009-08-09T00:34:00.009+01:00

MURDER IN THE MEDICINE CABINET

The Deadliest Killer of the 20th Century, With More Deaths Than All the World Wars, Lurks Right Inside Your House, and Threatens to Take You and Your Family. The Story No One Told You.

In 1918, a virulent, never seen before, form of influenza seemed to suddenly appear. It seemed to kill within hours,

and spread around the world within days. It seemed to appear simultaneously all around the world. Its spread was faster than any then known means of human travel.
In 2004, the Centers for Disease Control and the World Health Organization warned of repeats of such a rapid and deadly pandemic, through such variants of influenza as SARS and Bird Flu. But without knowing what caused the 1918 pandemic or how it spread, how can the CDC or WHO make such a claim? Unless they already know something they are not telling.
As yet no one has been able to identify the actual medical cause of the 1918 Flu, with only a few samples of a "bird-like" virus taken from only several cadaver tissue samples. But no sample is complete. And those are only one or two samples from among the estimated 20 to 40 million people who seemed to die mysteriously almost overnight. The 1918 Flu spread faster and was more deadly, killing more people than even the Plague and Black Death of the middle ages. Why does no one talk about it?
And even if the viral cause were identified, no one can explain the lightning fast spread of the disease. Maybe it wasn't a disease after all. Many researchers have even looked at some world-wide phenomena, such as extra-terrestrial biology filtering into the atmosphere from outer space. Or maybe, the jet stream spreading disease-laden dust from Asia all around the world in a matter of days. In an area of investigation where there seems to be no real facts and less logic, any "fringe theory" or "outre logic" is just as valid as any other. Maybe something about the 1918 Flu is being covered up. Something that we are not supposed to know.
Actually, there is another rather simple mundane solution to the medical mystery. There did exist in 1918 a then new technical invention by which the "disease" was spread almost at the speed of light. The "1918 Flu" was spread around the world almost instantaneously by telephone. Of course, that claim needs an explanation, and proof.
In the 1890's an American chemist made an improvement on an old home folk remedy called Willow or Aspen Tea. It seemed to relieve the pains of old-age gout, arthritis and other assorted pains. But the evil tasting tea containing acetylsalicylic acid was so strong that it caused many people to have nausea and vomiting, along with the pain relief if they could tolerate drinking the tea. This potion was later neutralized, synthesized and buffered, and then sold to the German Bayer company as a pain reliever.
I have researched the source and history of the name Aspirin and found no reasonable explanation has ever been found. I have found, instead, that the German Bayer company, in order to sell to both the American and European markets, used a name familiar in both markets. In America the common folk remedy form was called "Aspen Tea" made from boiling willow bark from the Aspen tree family. In Europe, the same home remedy was called "Spirain Tea" made from boiling the leaves of the common European shrub Spirae.
Both preparations were found to contain large amounts of natural acetylsalicylic acid, but unbuffered. Combining the common home-remedy folklore names Aspen and Spirain comes up with the Euro-American brand name Aspirin. My research is the sole source for the information about that unique derivation of the brand name.
The reason for the deep confusion and lack of any clear history about the trade name is that for almost a decade from 1905 to about 1915, the use of the trade name, and the source of the name Aspirin, was tied up in international courts. In the late 1890's when Aspirin became available as an easy to use "pop a pill" replacement to the sour tasting Aspen or Spirain Teas, many people used it to relieve the pain of joint arthritis. Many users also discovered, quite by accident, a unique side effect. If you had a fever when you took the Aspirin, it also made the fever suddenly go away. What a discovery! It appeared to be a cure for the the common cold and flu.
By 1905 many other drug companies were making acetylsalicylic acid preparations and calling it Aspirin, but they were selling it as a common cold remedy. Bayer took these other companies to court and sued over illegal use of their trademark. Many people believe that Bayer lost the decision and lost control of the name Aspirin. Most believe that Aspirin is now a generic name such as Kleenex, Scotch Tape or Xerox. Not so. It was an odd court decision and a confusing compromise. By 1915 it was decided in court that Bayer had the exclusive use of the tradename Aspirin, if it were sold as a pain-relieving analgesic.
The court also found that the other companies could also use the name Aspirin, if in their ads and packaging, they claimed that their product was an anti-febril agent or a fever reducer. This odd court decision is still in use today. You can still buy Bayer aspirin to relieve pain, and on the store shelf right next to it is Nyquil, Aleve, Tylenol, Motrin, Bufferin, Anacin and a whole long list of others, all containing aspirin or aspirin-like compounds and claiming to be treatments for Colds, Flu and Fever. Reducing fever was not in Bayer's original patent claim. Bayer didn't know in 1895 of the use of aspirin as a fever reducer and had not put that in their original trademark application.
And how does that strange court decision fit into the rapid spread of the 1918 Flu? The primary defense which the human body has, to stop the spread of viral infections is to produce a fever. The fever is not a symptom of disease, but is actually the body's primary anti-viral immune system. The fever stops the telomeres on the ends of viral RNA from making copies of itself.
The telomeres are like a zipper which unzips and separates the new RNA copy within miliseconds, but the telomeres are temperature sensitive and won't unzip at temperatures above 101F. Thus the high temperature of the fever, stops the flu virus from dividing and spreading. It is an immune system response which only mammals have developed to prevent the spread of viral flu infections, which mostly 99% come from the more ancient dinosaur-like earth life forms called birds. Almost all influenza is a form of "Avian Flu." A few influenza forms come from other dinosaur-like life forms, the modern reptiles, but these are usually classified as very rare tropical diseases, since that is where most reptiles live.
The doctors in the early 1900's didn't know about that, and even today few if any doctors are aware that fever is not a symptom of disease, but is the primary and only way for the human body to stop viral infections. If you stop or reduce the fever, viruses are allowed to divide and spread uncontrolled throughout the body. I have already described this process in detail in my articles posted in the Brother Jonathan Gazette in 2003, so I won't go into detail here. Do a search on "SARS" on the Gazette and you'll find the articles.
Normally the progress of a flu is that a virus enters the mucous membrane lining of the lungs, enters cells, then makes many copies of itself, which causes the cell to expand to such an degree that it bursts open. The new viruses then cloak themselves with a coating taken from the old damaged cell wall, thus hiding themselves from the human body's own T-cell antibody immune defense system. To the body's immune system the new viruses simply appear to be pieces of the body's own lung tissue.
By creating a fever, the viral infection is slowed down sufficiently so that the body's T cells can find the swollen infected lung cells, surround them and metabolize (literally eat) the damaged cell with strong acids which also breaks down the RNA viruses into basic amino acids. This effectively "kills" the viruses so that they can't reproduce. But viruses are not living things, and you can't kill something that's not alive. All the body can do is destroy or dissolve the RNA amino acid chain which makes up the virus.
Not knowing this, most doctors treat the flu with aspirin or fever reducers, as a palliative treatment to ease the aches, pains, and delerium fever effects. The result is that within hours, the fever goes down and the patient feels much better. What neither the patient nor the doctor knows is that with only a normal 98.6F body temperature, the viruses are allowed to reproduce unchecked. Within 72 hours, the viruses have grown from one or two virus bodies to millions or billions. The body is now completely overwhelmed. But while taking aspirin or cold medications, there are no symptoms or warnings of what is yet to come.
As a last resort the body tries to quickly flush the infection of billions of viruses from the lungs with massive amounts of T-cells, and fluid in the lungs to "cough out" the virus. This is called viral pneumonia. Soon within hours the patient is in the hospital. The doctors try to treat the now 105 degree fever with more anti-febril aspirins, or related medications to "treat the fever." Then within another 24 hours the patient, suffocating and gasping for breath, is dead.
You should note that the original infection did cause a mild fever, aches and pains, which the patient "self-medicated" with over-the-counter products. For the next several days, the patient seemed to have no symptoms, but was actually growing billions of copies of influenza virus in his lungs. Then days later, the patient and doctor seem to see a sudden rapid case of viral flu infection that is now overwhelming the body. Is that what really happened?
What caused the patient's death? Was it the original flu virus, or was it the use of Aspirin to lower the flu fever which then shutdown the patient's own immune system response? Obviously, the latter. So how did this cause the massive rapid spread of the 1918 Flu?
The Bayer court case had just been settled, and many companies other than Bayer, could now legally market aspirin to treat colds and fever. But then "The Great War to End all War" was on, and most aspirin products were going directly to the front lines in France to treat the soldiers in the diseased hell hole trenches of WWI.
The World War I medics knew that aspirin could quickly reduce a fever. If a soldier had a fever, the docs gave aspirin. Magically the fever went down, the soldier felt better and quickly went back to the fighting. Then three days later, the same soldier was back, now with severe pneumonia and died almost overnight.
No doctors then made the connection between aspirin and pneumonia death, since the trenches were filled with many other seemingly related diseases such as diphtheria or tuberculosis. Death and dying on the front line was common, so no investigation was done. Aspirin seemed to be a god-send since it allowed sick soldiers to swiftly get right back into the fighting.
After the Armistice of November 11, 1918 the fighting stopped and the soldiers went home. The soldiers around the world announced the good news to their families back home. Most of the low-ranked doughboys had to wait till they got back to their homebase in Kansas, or wherever, to call home. They couldn't afford the costly trans-Atlantic deep sea cable phone rates. But when the troop arrived in Kansas, the call from sergeant Tom was something like:
"Hey mom, I'm coming home. I'll see yu and dad next Tuesday in Chattanooga. How's everybody? Oh, Aunt Esther has a fever? Hey tell her to take some aspirin. Yeah, that stuff in the medicine cabinet for treatin' the aches and pains. Tell Esther, we used it in France. Works right away and the fever is gone. OK see yu Tuesday...."
So what does Esther do? She tries the aspirin, but the old Bayer label only says its for "aches and pains" and says nothing about fevers. She takes it and magically the fever is gone, and she feels much better, almost cured. She's so much better, she gets out the horse and buggy to go see her sister, Lucy in Mt Carmel, where Lucy and the kids are down with the fever. Mt. Carmel has no telephones and even no roads, only the buggy path to reach the outside world. But within hours of sergeant Tom's phone call home, by word of mouth, everybody in rural Mt. Carmel is now taking aspirin to treat fevers. Since the new information came from a soldier, from the US Army and the government, it must be true!
Within a week of the 1918 Armistice, by newfangled telephone, trans-oceanic telephone cables, and even the experimental ship-to-shore shortwave radios using Morse code, the message was flashed around the world -- "Have a fever? Take Aspirin. It worked in France, it'll work for you." That message spread at nearly the speed of light over millions of telephone lines all around the world. The news of the "miracle cure" even spread by word of mouth within a day or so, even to places with no phones nor roads.
Mysteriously, a week later, doctors round the world now had hundreds of sick and dying patients. Nobody could figure out why. The patients themselves never reported that just the week before they did have a mild fever. But it was so mild that when they took some aspirin, it simply went away. Nobody made the connection. The doctors only saw, by November 24, 1918 thousands of very sick patients with high fevers, lungs filled with fluid, and swift overnight death.
The medical profession had never seen anything like it before, nor since. It seemed to occur simultaneously all around the world and even reaching into such out of the way places like Mt. Carmel with no telephones nor roads. How could such a massive fast-spreading killer disease exist? It didn't. It wasn't a disease. It was a new use for an old home folk remedy which everybody already had in their medicine cabinet, Bayer Aspirin to reduce fever.
The medical profession, at a complete loss to explain it, simply called it the "Spanish Flu" or the "1918 Flu" or many similar names. It was a mystery with no known source, so it was assigned many place names. So far, nobody has been able to prove any single pathogen was responsible. And even if they did, they still can't explain how it seemed to spread world-wide at almost the speed of light, clear around the world within a week.
To this day there is no explanation. But, now you know. The "disease" was not a single pathogen, but many of the hundreds of similar types of flu which are always existing at any time around the world. What was different in November 1918 was the many hundreds of thousands of almost simultaneous phone calls from the millions of returning sergeant Toms saying, "...tell Aunt Esther to take the aspirin. It worked in France. It'll work for her..." Nobody traced the spread of the 1918 Flu to sergeant Tom. Nobody made the connection.
That very same source of disease still exists today. What is different today is that cold and flu products are sold and used all year long. This results in an estimated one million deaths from mysterious viral pneumonia reported every year, but also all around the year. In 1918, the new use of aspirin for treating colds and flu all started at the same time in November, thus creating the false impression of a sudden massive onset of a new disease. Even today SARS is not a disease. It is the improper use of a brand new high-tech flu fighter called Tamiflu. The FDA approved the use of Tamiflu several years ago. In 2003 it began to be used world-wide. But how is it used?
Many millions of people around the world still self-treat their own colds and flu with over-the-counter meds containing aspirin. Those are the most commonly sold medications in the world. The patient's mild fever quickly goes away. They forget about ever having felt sick. Then several days later the patient sees the doctor and now has a high fever, bad cough and fluid-filled lungs. The doctor, using the new CDC and WHO guidelines, treats the hospitalized "flu" patient with the new high-tech Tamiflu. But how often and at what dosage?
The doctors do what they've always done for the past 100 years. Tell the nurse to stick a thermometer in the patient's mouth, increase the Tamiflu dosage by 10cc's every hour until the fever starts to drop. Then maintain that dosage level until the patient dies. Then blame the death on some new highly contagious lethal virus. Nothing new here. It's the same old story, since 1918.
The only thing different is that they give it a new name like SARS, or Bird Flu or whatever sounds nifty and high-tech. Even today, each year about one million people world-wide die from the very same "disease" which first appeared in the fall of 1918. Has medicine, in the last 100 years, turned this "contagion" from Pandemic by Phone, into Illness by Internet? Is it the rapid and continuous spread of misinformation that is still killing millions?
Marshall Smith
Editor, BroJon Gazette
http://www.brojon.org/frontpage/murdermedicine1.html

I dont doubt that asprin contributed to a lot of the deaths but i dont think all of them - surely a lot of the poor wouldnt have been able to afford it?

House - gotta love that man :D

2009-08-08T23:48:00.003+01:00

Couldnt resist this lol :D

Methotrexate & Tamiflu

2009-08-08T23:28:00.002+01:00
We should be aware of potential interactions with methotrexate and tamiflu, which may increase the bioavailability of methotrexate.

Click here to view guidance from UK Medicines Information.

Summary
The SmPC for oseltamivir (Tamiflu^®) states that care should be taken when using oseltamivir in patients who are taking methotrexate, because of a theoretical risk of increased methotrexate plasma levels leading to toxicity.

Oseltamivir, a pro-drug, is metabolised by hepatic esterases to active oseltamivir carboxylate which is then excreted via the kidney by glomerular filtration and active tubular secretion.

Methotrexate, a drug with a narrow therapeutic margin, is excreted via the same active tubular secretion pathway and competition for this pathway is the basis of the proposed interaction.

There are no published reports of an interaction occurring in clinical practice.

The proposed interaction is unlikely to be of clinical significance and the US prescribing information for oseltamivir does not specifically mention the possibility of an interaction with methotrexate.

Patients taking high dose methotrexate as part of a chemotherapy regimen or low dose methotrexate for the treatment of inflammatory conditions, such as arthritis or psoriasis should be given oseltamivir, if required. Patients on high dose methotrexate will be routinely monitored for toxicity.

The above means that both mtx & oseltamivir (tamiflu) are excreted by the kidneys. If taking both drugs, the tamiflu will be excreted first possibly leading to increased mtx in the blood leading to toxicity.

There is no clinical evidence in the literature of an interaction between oseltamivir (tamiflu) and methotrexate. The only place that mentions a possible interaction is the SmPC (Summary of Product Characteristics) and i dare say thats just to cover themselves.

Royal College of Physicians Guidance

Guidance for hospital medical specialties on adaptations during a pandemic influenza outbreak

Summary

Preparations for pandemic influenza has been developed by the Royal College of Physicians to help hospitals and staff coordinate care during an influenza outbreak.

The document is designed to indicate how specialties could adjust their patterns of work in order to cope during an influenza pandemic when staff and facilities available to care for patients may be reduced. The intended audience for this guidance is those involved in managing and strategic planning of clinical services, and clinical staff working in hospital specialties. Each specialty section has been written by an expert in the field. The document is not designed to provide detailed operational guidance for responding to an influenza pandemic.

The suggested blue and yellow card system (Appendix) of identifying patients who may or may not need to be seen urgently is a way of organising outpatient referrals in a pandemic, which could be used by consultants in consultation with Trust management.

http://www.rcplondon.ac.uk/pubs/contents/ce8398cc-a20b-4f41-bea6-f32f7a320835.pdf

British Society of Rheumatology Advice Re: Swine Flu

2009-08-08T23:03:00.001+01:00

Patients should follow general government advice regarding swine flu

Online - http://www.nhs.uk/Conditions/Pandemic-flu

By Telephone - Swine Flu Information Line 0800 1 513 513

What are the symptoms of swine flu?
Typical symptoms are sudden fever (38^oC / 100.4^oF) and sudden cough.
Other symptoms are headache, chills, aching muscles and joints, diarrhoea or stomach upset, sore throat, runny nose, loss of appetite
Please note that some cases do not present with fever ~ Moog's edit
http://www.nytimes.com/2009/05/13/health/13fever.html

Can I avoid catching swine flu?
In general you should not change your daily activities to avoid exposure to swine flu. If you know that someone has symptoms of swine flu then it would be sensible to avoid this person, if possible, for the duration they have symptoms.

What should I do if I am exposed to someone who has symptoms of swine flu?
If you have caught swine flu you can expect symptoms to develop within 2-7 days of exposure.

If you develop symptoms of swine flu you should follow national swine flu guidance e.g. contact your GP or National Pandemic Flu Service (check for latest guidance on website / information line given at top of page).

Patients taking Steroids

Symptoms may be less marked in patients taking steroids (e.g. prednisolone) therefore if you feel unwell and think you may have swine flu please contact your GP even if your symptoms are not as severe as other peoples.

- Steroids should NOT be stopped

Patients taking Biologic therapies (e.g. adalimumab, etanercept, infliximab, rituximab, tocilizumab, anakinra) or cyclophosphamide.

Symptoms may be less marked in patients taking these treatments Therefore if you feel unwell and think you may have swine flu please contact your GP even if your symptoms are not as severe as other peoples.

- If you have been in direct contact with someone who has definite swine (at a time when they had symptoms) you should stop your treatment for 7 days.
If you have not developed symptoms of swine flu after 7 days you can restart treatment.
Patients taking azathioprine, ciclosporin, gold, hydroxychloroquine, leflunomide, methotrexate, mycophenolate, penicillamine, sulphasalazine

- If you have been in direct contact with someone who has definite swine flu (at a time when they had symptoms) you should stop your treatment for 7 days. If you have not developed symptoms of swine flu after 7 days you can restart treatment.

-The exception to this information is if your consultant rheumatologist has recommended that you do not stop treatment.

What should I do if I develop symptoms of swine 'flu?

If you develop symptoms of swine flu you should contact your GP / national swine flu advice line and consider treatment with tamiflu in the usual way. (see website and telephone information at top of page)

Patients taking Biologic therapies (e.g. adalimumab, etanercept, infliximab, rituximab, tocilizumab, anakinra) or cyclophosphamide.

Patients taking methotrexate, azathioprine, ciclosporin, hydroxychloroquine, mycophenolate, gold, leflunomide, sulphasalazine

- Stop your treatment until the symptoms of swine flu have gone away completely. You can then restart your treatment.

- Steroids (e.g. prednisolone) MUST NOT be stopped. If you are unwell the dose may need to be increased. Please discuss with your GP.

- If your 'flu symptoms are very severe or deteriorating and you feel very unwell it is important to seek advice from your GP. This is because you may be at higher risk than most people of developing a secondary bacterial infection that may require antibiotics.

Should I have a 'flu jab?

When the swine flu vaccination is available (later in the Summer or Autumn) it is likely that your GP surgery will run a programme of vaccination in the same way as the usual annual 'flu jab.

You should also have the usual annual 'flu jab in the normal way.

Version 1.0 22 July 2009

Tamiflu reduces symptoms by just half a day.

2009-08-08T12:55:00.005+01:00
Swine flu: Tamiflu 'reduces flu symptoms by just half a day'

By Kate Devlin, Medical Correspondent
Published: 8:00AM BST 08 Aug 2009

Tamiflu reduces the length of flu symptoms by an average of only half a day, according to a new study.
Patients diagnosed with the swine flu virus are being given the drug, an anti-viral, to reduce the severity of their symptoms and the length of time they feel ill.
But researchers who led a review into tamiflu and a similar medication, relenza, said that the clinical importance of their effect was "debatable".

A total of 36 deaths in Britain have now been linked to the H1N1 virus, although the number of new cases has fallen dramatically in the past week.
There were an estimated 30,000 new cases last week, down from around 110,000 the week before, although expects predict that cases will rise again in the autumn and winter.
In healthy adults, tamiflu reduced the average length of time that symptoms lasted by 0.55 days, while relenza, cut it by an average of 0.57 days.
People at risk of complications, such as those with heart or lung problems, saw slightly more benefit - tamiflu cut the length of time they felt ill by 0.74 days and relenza by 0.98 days.
Although the review was based on seasonal flu, the authors said that the findings could be relevant to the current H1N1 pandemic.
Dr Jane Burch and Prof Lesley Stewart, from the Centre for Reviews and Dissemination at the University of York, who led the review, suggest that other approaches, such as vaccination, might be more effective at combating the disease.
The clinical importance of the effect that Tamiflu and Relenza had on the length that symptoms persisted was "debatable", they added.
"Extension of the vaccination policy might be a more appropriate choice for healthy adults, and an assessment of cost-effectiveness that includes societal costs of extending the UK vaccination policy to all working-age adults seems desirable," they said.
The findings were published in the Lancet Infectious Diseases journal.
http://www.telegraph.co.uk/health/swine-flu/5989184/Swine-flu-Tamiflu-reduces-flu-symptoms-by-just-half-a-day.html

Tamiflu Side Effects
nausea
vomiting
diarrhea
bronchitis
stomach pain
dizziness
headache
nosebleed
eye redness/discomfort
sleep problems/insomnia
More serious side effects have also sometimes been reported. According to the FDA, 'there have been reports (mostly from Japan) since Tamiflu became available of patients causing self-injury or experiencing delirium (confusion, hallucinations, speech problems) while using Tamiflu.' While these 'reports were mostly in children,' it is still not known if they were actually caused by taking Tamiflu. However, anyone using this medicine should be watched closely for signs of confusion or unusual behavior. Call a doctor at once if you or the child using Tamiflu has any of these symptoms.
Stop using Tamiflu and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat; a red and blistering or peeling skin rash. Some people using oseltamivir have had rare side effects of sudden confusion, delirium, hallucinations, unusual behavior, or self-injury. These symptoms have occurred most often in children. It is not known whether Tamiflu was the exact cause of these symptoms.

UK Vaccine Trial Starts

2009-08-08T01:07:00.001+01:00

The UK's first swine flu vaccine trial is under way in Leicester.

Leicester Royal Infirmary (LRI) has enrolled 175 people for the tests, which involves giving two doses of the vaccine, then checking immunity levels.

The results of the trial, which will also establish how far apart the doses of vaccine must be given, should be ready in four to six weeks.

The government is currently considering plans to immunise every schoolchild in the UK against swine flu.

The trial, led by Dr Iain Stephenson, a consultant in infectious diseases at the LRI and a clinical senior lecturer at Leicester University, started two weeks ago and involves Leicester residents.

“We can't be complacent about this, we have to continue planning, we have to be ready for what happens in the autumn ”
Sir Liam Donaldson Chief Medical Officer

The first swine flu vaccines are expected to be licensed for use in the general population in September.

Ministers have repeatedly said they expect to have enough doses for half the UK population by the end of the year, but advisors were still finalising plans on who would be first to get the injection.

New government figures released on Thursday show the numbers of people being diagnosed with swine flu dropped from 110,000 to 30,000 over the last seven days, but there have been nine new virus-related deaths in the past week.

'Second wave'

The total swine flu-related deaths in England now stands at 36.

Infection rates were expected to drop in the summer before a large leap in the autumn to coincide with the annual flu season.

England's chief medical officer Professor Sir Liam Donaldson said it was very difficult to predict when a second wave would hit.

"It's guesswork really - we would anticipate that when the schools go back, at some point after that it would rise.

"We can't be complacent about this, we have to continue planning, we have to be ready for what happens in the autumn."

The Health Protection Agency said there was no sign that the virus was mutating into a more lethal form, or developing resistance to drugs.

RA & The Menstrual Cycle

2009-08-07T18:59:00.001+01:00

Clinical:Rheumatoid Arthritis and The Menstrual Cycle
http://wiki.medpedia.com/Clinical:Rheumatoid_Arthritis_and_The_Menstrual_Cycle

Not flu related but interesting nonetheless.

First time i've ever heard of this tbh.

Swine Flu & Immunosuppression

2009-08-07T18:06:00.001+01:00

Swine flu and immunosuppression
http://www.nhs.uk/news/2009/07July/Pages/Swinefluandimmunosuppression.aspx

A review of research on how flu affects immunosuppressed people and the effects of vaccination on them has been published in The Lancet Infectious Diseases. The authors specifically looked at susceptibility in people with HIV/AIDS, cancer, those who have had a solid organ transplant or bone-marrow transplant and patients on haemodialysis or steroids.

Such groups are thought to be at higher risk of serious influenza-associated complications and as such are priority groups for immunisation.
However, treatments for immune dysfunction may also limit the effectiveness of vaccination and there may be complications from the vaccination itself in these groups. The evidence behind these issues is discussed in this review.

Key points from the review

There is little research on using vaccination to prevent influenza in immunosuppressed people. This review found just one randomised clinical trial. This trial of HIV-infected patients found high vaccine effectiveness.
The same immune dysfunction that can increase the risk and consequences of influenza infection might also compromise vaccine responses and effectiveness.
Most immunosuppressed populations are at higher risk of influenza-associated complications, have a general trend toward impaired antibody responses but can be safely vaccinated.
The priority for control of influenza is focused on generating effective antibody responses with vaccines. Progress is being made at increasing the scale, duration, and breadth of vaccine responses to the two main surface proteins H and N (haemagglutinin and neuraminidase) in both healthy and immuno-compromised populations.
There are two main types of influenza vaccine and both are being developed for the new H1N1 swine flu virus. One involves inactivated vaccines that contain viruses grown in eggs (mostly) and then killed. The other involves live weakened H1N1 vaccines. The researchers say that previous concerns that these live attenuated vaccine would pose a risk to people that are immunocompromised have not been demonstrated by the studies in their review. Research into this area and into and other novel approaches to flu vaccine development are important. They ask that efficacy studies of attenuated vaccines in adults that are immunocompromised are also considered
Systemic corticosteroids

The authors also looked at people taking oral or inhaled steroids, saying that the evidence shows flu vaccination is both safe and often stimulates an immune response. However, the vaccine’s clinical effectiveness in reducing episodes of flu in people taking the drugs has not been well tested.

What were the researchers’ conclusions?

The researchers say that most immunosuppressed populations are at higher risk of influenza-associated complications. These people have impaired antibody responses to the vaccine (although data for this conclusion is mixed. For example, in some trials, HIV patients with low CD4+ counts developed only 30% of the antibody response of healthy controls, and in one trial of patients on chemotherapy, there was even less of a response. However, other studies have shown that patients who have had haemodialysis and transplant managed up to 80% protective titres.

They say that most immunosuppressed people can be safely vaccinated (although longitudinal data that follows up patients over time are largely lacking).

They also say that the small number of studies of cellular responses to influenza vaccination, in relatively small numbers of immunosuppressed individuals, showed impaired cellular responses among a few patients.

The researchers call for better trial data to inform vaccination recommendations based on the effectiveness and cost in these at-risk populations.

Flu jabs not tested on children

2009-08-07T17:14:00.001+01:00

Flu jabs not tested on children

By Simon Cox
Radio 4's The Report

http://news.bbc.co.uk/2/hi/health/8185897.stm

A new vaccine for swine flu is most likely to be targeted at vulnerable groups such as young children and pregnant women. But a Radio 4 documentary has discovered that little or no data exists on the safety or effectiveness of flu vaccines on these groups.

Holly Pyke, left, receives a swine flu vaccination by nurse Luiza Duszynski at the Royal Adelaide Hospital in Adelaide, Australia
There have been no trials of swine flu vaccines on pregnant women

In 1976 the US Government vaccinated 45 million people for a swine flu outbreak that never materialised.

But 500 people developed a rare neurological condition called Guillame Barre syndrome which left people in a coma and 25 died.

The reaction still mystifies health officials, including Peter Smith, Professor of tropical epidemiology at the London School of Hygiene and Tropical Medicine.

'Adverse reaction'

"Why that happened has never really been understood - it's not really been observed with subsequent influenza vaccines," said Professor Smith, chairman of the global advisory committee on vaccine safety at the World Health Organisation.

"There's been a lot of seasonal flu vaccines and they've not seen this same adverse effect at all and so that is a sort of lurking shadow in the US experience which I suspect influences the way in which they treat all new vaccines," he added.

Health officials and academics think it is highly unlikely that such an adverse reaction would happen again.

But it is a concern as authorities around the globe stand on the verge of a mass vaccination programme against the current pandemic.

Pregnant women and children are expected to be among the groups targeted for vaccination, especially in countries likely to ration their vaccines.

Yet paradoxically the hard scientific evidence about the efficacy or dangers of these vaccines on pregnant women and young children does not exist.

"There is no study of the vaccines on pregnant women - no randomised clinical trials," said epidemiologist Tom Jefferson, who reviews influenza prevention and treatment for The Cochrane Collaboration, the voluntary global database provided by healthcare professionals which monitors the effects of healthcare worldwide.

No trials

He added: "Under the age of two there is only one trial and it shows inactivate vaccines [vaccines based on killed organisms] don't actually work."

Dr Jefferson said the best effect of influenza vaccines was on healthy adults.

A further problem, he explained, was that flu vaccines are unique in that they are registered and approved before full scale clinical trials have taken place.

Neither will the possible side effects be known on pregnant women or young children as Dr Marie Paul Kieny, director of vaccine research at the WHO explained. "It's not to say they would not be safe, they may be very safe but there is no data for the time being to demonstrate safety."

Adam Finn, professor of paediatrics at Bristol University is waiting for the go-ahead to commence a study the UK"

"We urgently need to get some evidence from children because young children, particularly under five, do seem to be at risk of serious illness," says Professor Finn.

"And secondly there is clear evidence that flu epidemics and pandemics are spread very efficiently by children. Children simply infect each other and their parents very efficiently and for that reason a hugely effective strategy to controlling epidemics of this kind is to immunise children."

Priority patients

Professor Finn predicted that the vaccines would probably be more effective in older children although he said that is not to say deploying the vaccines in younger children has no value.

"A vaccine that works, albeit not so well, is still better than no vaccine at all," he added.

The results of these trials will not be ready for a few months, probably mid-October.

This poses a potential dilemma for the Dept of Health - whether to start vaccination before the trial's results are known. Officials declined to tell The Report whether they will wait for the end of the trial.

The US has already issued its priorities: adults under 24, pregnant women, healthcare workers and people with underlying conditions like asthma. The over 65s are at the end of the queue.

Does the H1N1 vaccine increase the risk of cancer?

2009-08-07T14:58:00.000+01:00

Does virus vaccine increase the risk of cancer?
07.08.2009 - 15:29 UHR

The swine flu vaccine has been hit by new cancer fears after a German health expert gave a shock warning about its safety.

Wolfgang Wodarg

Dr. Wolfgang Wodarg is a politician and a specialist in lungs, hygiene and environmental medicine. He is the chairman of the health committee in the German parliament and European Council.

Lung specialist Wolfgang Wodarg has said that there are many risks associated with the vaccine for the H1N1 virus.

He has grave reservations about the firm Novartis who are developing the vaccine and testing it in Germany. The vaccination is injected “with a very hot needle”, Wodarg said.

The nutrient solution for the vaccine consists of cancerous cells from animals and "we do not know if there could be an allergic reaction".

But more importantly, some people fear that the risk of cancer could be increased by injecting the cells.

The vaccine - as Johannes Löwer, president of the Paul Ehrlich Institute, has pointed out - can also cause worse side effects than the actual swine flu virus.

Wodrag also described people’s fear of the pandemic as an "orchestration": “It is great business for the pharmaceutical industry,” he told the ‘Neuen Presse’.

Swine flu is not very different from normal flu. “On the contrary if you look at the number of cases it is nothing compared to a normal flu outbreak,” he added.

The chairman of the health committee in the European Council has urged for a careful and calm reaction to the virus.

Up until now, the producers of the vaccine did not know how many orders they would have by the autumn, but the German Government is now a guaranteed customer.

Even the pharmaceutical companies are trying to exploit the fear of the swine flu pandemic.

[link to www.bild.de]

Playtime

2009-08-07T14:04:00.001+01:00

Playing with scribefire atm :)

Swine Flu Song

A person without a sense of humor is like a wagon without springs. It's jolted by every pebble on the road.

Interview with a retired vaccine researcher

2009-08-07T04:03:00.005+01:00
Nothing to do with swine flu per se but interesting nonetheless.

Retired Vaccine Researcher to Jon Rappoport:
"If I had a child now, the last thing I would allow is vaccination."

http://educate-yourself.org/cn/rappoportinterviewvaccineresearcherjan2002.shtml

CDC says some claims against vaccines cannot be disproved.

http://www.ageofautism.com/2009/08/cdc-media-plan-shocker-we-dont-have-the-science-some-claims-against-vaccine-cannot-be-disproved-.html

Vaccine for swine flu may be unsafe warns WHO

Mark Prigg, Science and Technology Correspondent
27.07.09

Plans to fast-track the swine flu vaccine in Britain came under fire from World Health Organisation chiefs today.

The Department of Health plans to make the vaccine available at least two months earlier than in America.

More than 132million doses have been ordered with the first batch due to arrive next month.

However, Dr Keiji Fukuda, the WHO's flu chief, today warned about the potential dangers of the untested vaccine: "There are certain areas where you simply do not try to make any economies. One of the things which cannot be compromised is the safety of vaccines."

The European Medicines Agency, the drug regulatory body for the EU, is accelerating the approval process for the vaccine, allowing firms to bypass large-scale human trials and instead test a vaccine based on bird flu.

Countries including Britain, Greece, France and Sweden plan to start using it as soon as it is cleared.

The Department of Health said it was "extremely irresponsible" to suggest Britain would use an unsafe vaccine. A spokesman said: "Over 40,000 doses of the vaccine which the swine flu vaccines are based on have been given without any safety concerns."

The plan comes amid growing public concern over the outbreak.

A cruise ship packed with 160 British tourists and hit by swine flu was briefly "impounded" by Italian authorities.The Ruby Princess, carrying 3,393 passengers and 1,196 crew, docked in Venice and was surrounded by coastguards yesterday. After a medical examination passengers, except seven confirmed cases of H1N1, were allowed off the boat.
http://www.thisislondon.co.uk/standa...o?ito=newsnow&

Swine Flu Vaccine - Beware of Squalene Adjuvants

2009-08-06T22:34:00.002+01:00
The first vaccines to combat H1N1 swine flu should be approved and ready for use in some countries from September, the World Health Organisation said on Thursday.

Marie-Paule Kieny, WHO director of the Initiative for Vaccine Research, said manufacturers had initially reported poor yields in making vaccine, leading to worries about supplies, but this was now improving.

"We are on track in development," Kieny told reporters.

First results from clinical trials are expected early next month and these tests will show whether one or two doses are needed to provide immunity -- another big swing factor in determining how many people can be vaccinated.

Once initial clinical trial results are in, regulators will be able to approve the vaccines from next month, Kieny added.

The H1N1 flu outbreak, declared a pandemic on June 11, has spread around the world and could eventually affect 2 billion people, according to WHO estimates.

Fears the strain could become resistant to the anti-viral drug Tamiflu have underscored the need to get vaccines to market quickly. The H1N1 vaccines would be given separately from regular seasonal flu shots.

Leading flu vaccine makers include Sanofi-Aventis, GlaxoSmithKline, Novartis, Baxter, CSL and Solvay.

WHO Director-General Margaret Chan has said the H1N1 virus is stable and there were no signs of it mixing with other more dangerous types of influenza such as the deadly H5N1 bird flu strain.

At present, patients with mild symptoms generally do not need any medicines to recover, and Chan has stressed hospital visits are not necessary unless those infected with flu have certain warning signs.

These include long-lasting high fever in adults and a lack of alertness in children. Pregnant women and people with health problems including diabetes are also vulnerable to more severe effects from the new flu strain.

(Reporting by Jonathan Lynn and Laura MacInnis; writing by Ben Hirschler)

A U.S. plan to rely on swine flu vaccines without ingredients to stretch the supply would reduce the number of available shots just when other countries need them most, the British journal Lancet said in an editorial.

The ingredients, called adjuvants, have never been approved for flu vaccines in the U.S. and are controversial because some studies show they cause immune disorders in mice. The World Health Organization recommended on July 7 that adjuvants be used to boost global amounts of vaccine, and the Lancet criticized the U.S. for plans to rely exclusively on standard formulations.

The desired immune response to vaccines is the production of antibodies, and this is enhanced by adding certain substances to the vaccines. These are called adjuvants (from the Latin adjuvare, meaning "to help").

The chemical nature of adjuvants, their mode of action and their reactions (side effect) are highly variable. According to Gupta et al. (1993), some of the side effects can be ascribed to an unintentional stimulation of different mechanisms of the immune system.

Chemically, the adjuvants are a highly heterogenous group of compounds with only one thing in common: their ability to enhance the immune response—their adjuvanticity. They are highly variable in terms of how they affect the immune system and how serious their adverse effects are due to the resultant hyperactivation of the immune system.

The choice of any of adjuvant reflects a compromise between a requirement for adjuvanticity and an acceptable low level of adverse reactions.

The use of adjuvants enables the use of less antigen to achieve the desired immune response, and this reduces vaccine production costs. With a few exceptions, adjuvants are foreign to the body and cause adverse reactions.

The U.S. government has contracts with several drug companies to develop and produce swine flu vaccines. At least two of those companies, Novartis and GlaxoSmithKline, are using an adjuvant in their H1N1 vaccines.

The adjuvant? Squalene.

According to Meryl Nass, M.D., an authority on the anthrax vaccine,

“A novel feature of the two H1N1 vaccines being developed by companies Novartis and GlaxoSmithKline is the addition of squalene-containing adjuvants to boost immunogenicity and dramatically reduce the amount of viral antigen needed. This translates to much faster production of desired vaccine quantities.”

Novartis’s proprietary squalene adjuvant for their H1N1 vaccine is MF59. Glaxo’s is ASO3. MF59 has yet to be approved by the FDA for use in any U.S. vaccine, despite its history of use in other countries.

Per Dr. Nass, there are only three vaccines in existence using an approved squalene adjuvant. None of the three are approved for use in the U.S.

What Squalene Does to Rats

Oil-based vaccination adjuvants like squalene have been proved to generate concentrated, unremitting immune responses over long periods of time.

A 2000 study published in the American Journal of Pathology demonstrated a single injection of the adjuvant squalene into rats triggered “chronic, immune-mediated joint-specific inflammation,” also known as rheumatoid arthritis.

The researchers concluded the study raised questions about the role of adjuvants in chronic inflammatory diseases.

What Squalene Does to Humans

Your immune system recognizes squalene as an oil molecule native to your body. It is found throughout your nervous system and brain. In fact, you can consume squalene in olive oil and not only will your immune system recognize it, you will also reap the benefits of its antioxidant properties.

The difference between “good” and “bad” squalene is the route by which it enters your body. Injection is an abnormal route of entry which incites your immune system to attack all the squalene in your body, not just the vaccine adjuvant.

Your immune system will attempt to destroy the molecule wherever it finds it, including in places where it occurs naturally, and where it is vital to the health of your nervous system.

Gulf War veterans with Gulf War Syndrome (GWS) received anthrax vaccines which contained squalene. MF59 (the Novartis squalene adjuvant) was an unapproved ingredient in experimental anthrax vaccines and has since been linked to the devastating autoimmune diseases suffered by countless Gulf War vets.

The Department of Defense made every attempt to deny that squalene was indeed an added contaminant in the anthrax vaccine administered to Persian Gulf war military personnel – deployed and non-deployed – as well as participants in the more recent Anthrax Vaccine Immunization Program (AVIP).

However, the FDA discovered the presence of squalene in certain lots of AVIP product. A test was developed to detect anti-squalene antibodies in GWS patients, and a clear link was established between the contaminated product and all the GWS sufferers who had been injected with the vaccine containing squalene.

The symptoms of gulf war syndrome included arthritis, fibromyalgia, lymphadenopathy, rashes, photosensitive rashes, malar rashes, chronic fatigue, chronic headaches, abnormal body hair loss, non-healing skin lesions, aphthous ulcers, dizziness, weakness, memory loss, seizures, mood changes, neuropsychiatric problems, anti-thyroid effects, anaemia, elevated ESR (erythrocyte sedimentation rate), systemic lupus erythematosus, multiple sclerosis, ALS (amyotrophic lateral sclerosis), Raynaud’s phenomenon, Sjorgren’s syndrome, chronic diarrhoea, night sweats and low-grade fevers.”

There is also limited or no data on the safety and effectiveness of vaccines with adjuvants in children under 3 and pregnant women - two of the most vulnerable groups in a pandemic.

http://www.whale.to/v/squalene.html

http://en.wikipedia.org/wiki/Squalene

Studies of seasonal flu vaccine efficacy

2009-08-06T20:54:00.003+01:00

Studies of seasonal flu vaccine efficacy

http://en.wikipedia.org/wiki/Influenza_vaccine#Efficacy_of_vaccine

Studies demonstrate that vaccination can be a cost-effective counter-measure to seasonal outbreaks of influenza; but not perfect. A study led by Dr. David K. Shay in February, 2008 reported that

"full immunization against flu provided about a 75 percent effectiveness rate in preventing hospitalizations from influenza complications in the 2005-6 and 2006-7 influenza seasons."

The group most vulnerable to flu, the elderly, is also the least affected by the vaccine, with an average efficacy rate ranging from 40-50% at age 65, and 15-30% past age 70.

There are multiple reasons behind this steep decline in vaccine efficacy, the most common of which are the declining immunological function and frailty associated with advanced age.

Us RA Warriors have a reduced immune function due to meds etc which explains why vaccines do not work so well for us.

Makes me real mad though - i work in a nursing home where the vast majority of residents are over 80. These studies prove that the vaccines are next to uselesss for them but they continue to pressurize them into having it done leaving them open to needless side effects.

Can you say money making exercise........?

Do Flu Shots Work?
http://articles.mercola.com/sites/articles/archive/2008/11/18/do-flu-shots-work-ask-a-vaccine-manufacturer.aspx

Vaccinating older people against pneumonia is a waste of time
http://www.dailymail.co.uk/health/article-1106237/Vaccinating-older-people-pneumonia-waste-time.html

Children who get flu vacc have 3 times risk of hospitalization
http://dprogram.net/2009/05/27/study-children-who-get-flu-vaccine-have-3-times-risk-of-hospitalization-for-flu/

Where did it go?

2009-08-06T20:09:00.002+01:00
My facebook page seems to have disappeared -- very weird.

Will have to get Scooby Doo on the case ;)

Is the upcoming swine flu vaccine safe?

2009-08-06T14:49:00.003+01:00

In 1976, a failed swine flu vaccine caused irreparable damage to the nervous systems of hundreds of people, paralyzing many. Medical doctors gave the problem a name, of course, to make it sound like they knew what they were talking about: Guillain-Barre syndrome. (Notably, they never called it "Toxic Vaccine Syndrome" because that would be too informative.)

But the fact remains that doctors never knew how the vaccines caused these severe problems, and if the same event played out today, all the doctors and vaccine pushers would undoubtedly deny any link between the vaccines and paralysis altogether. (That's what's happening today with the debate over vaccines and autism: Complete denial.)

Added to that, some swine flu vaccines contain dangerous adjuvants that cause an inflammatory response in the body.

They could actually increase your risk of death from swine flu by altering (or suppressing) your immune system response. There is zero evidence that even seasonal flu shots offer any meaningful protection for people who take the jabs.
More on adjuvants in a later post...

Doctors still don't know why the 1976 swine flu vaccines paralyzed so many people. And that means they really have no clue whether the upcoming vaccine might cause the same devastating side effects. (And they're not testing it, either...)
Even if the swine flu vaccine kills you, the drug companies aren't responsible. The U.S. government has granted drug companies complete immunity against vaccine product liability. Thanks to that blanket immunity, drug companies have no incentive to make safe vaccines, because they only get paid based on quantity, not safety (zero liability).
The World Health Organization is obviously getting concerned about all the questions surrounding the safety of the vaccine & today they issued the following report.
Dont know about you but i'm not sure that reassures me - if there was nothing in the rumours or whatever, would they even bother responding?
Just because you're paranoid doesn't mean they're not out to get you ;)

If the vaccine turns out to have dangerous side effects, it could generate a public backlash, particularly in a country like Britain, where many people remain suspicious of vaccines because of unsubstantiated allegations linking the measles, mumps and rubella vaccine to autism. That could lead to millions of people refusing vaccination.

WHO. Safety of pandemic vaccines (August 6, 2009, edited)
Safety of pandemic vaccines - Pandemic (H1N1) 2009 briefing note 6

6 AUGUST 2009 | GENEVA

WHO is aware of some media reports that have expressed concern about the safety of vaccines for pandemic influenza.

The public needs to be reassured that regulatory procedures in place for the licensing of pandemic vaccines, including procedures for expediting regulatory approval, are rigorous and do not compromise safety or quality controls.Vaccines are among the most important medical interventions for reducing illness and deaths during a pandemic. However, to have the greatest impact, pandemic vaccines need to be available quickly and in large quantities.

During the 1957 and 1968 pandemics, vaccines arrived too late to be used as an effective mitigation tool during the more severe phases of the pandemics. Influenza vaccines had not yet been developed when the 1918 pandemic swept around the world, eventually killing an estimated 50 million people.

In 2007, as part of preparedness for an influenza pandemic, WHO worked together with health officials, regulatory authorities, and vaccine manufacturers to explore a broad range of issues surrounding the regulatory approval of pandemic vaccines. [1]

Ways were sought to shorten the time between the emergence of a pandemic virus and the availability of safe and effective vaccines. Different regulatory pathways were assessed, and precautions needed to ensure quality, safety, and effectiveness were set out in detail.

Fast-track procedures for approval

Regulatory authorities have shown great flexibility in developing procedures for fast-tracking the approval and licensing of pandemic vaccines.In some cases, pandemic vaccines are not regarded by regulatory authorities as entirely “new” vaccines, as they build on the technology used to produce vaccines for seasonal influenza, established procedures for testing and regulatory control, and an extensive body of safety data.

In such cases, approval procedures are similar to those applied to “strain changes” made each year when seasonal vaccines are modified to match circulating viruses in the Northern and Southern Hemispheres.

Specific regulatory procedures have been devised to expedite the approval of pandemic vaccines. In the USA, for example, fewer data are required when the manufacturer already has a licensed influenza vaccine and intends to use the same manufacturing process for its pandemic vaccine.

In the European Union, the European Medicines Agency uses a rolling review procedure whereby manufacturers can submit sets of data for regulatory review as they become available, without having to wait until all data can be submitted together in a single formal application.

Also in Europe, some manufacturers have conducted advance studies using a so-called “mock-up” vaccine. Mock-up vaccines contain an active ingredient for an influenza virus that has not circulated recently in human populations and thus mimics the novelty of a pandemic virus. Such advance studies can greatly expedite regulatory approval.

Special safety concerns

Influenza vaccines have been used for more than 60 years and have an established record of safety in all age groups. While some serious adverse events have been reported, these have been rare.

Nonetheless, special safety issues will inevitably arise during a pandemic when vaccine is administered on a massive scale. For example, adverse events too rare to show up even in a large clinical trial may become apparent when very large numbers of people receive a pandemic vaccine.

Some adverse events will be coincidental – that is, associated in time with vaccine administration, yet not directly caused by the vaccine. Genuine adverse events directly caused by the vaccine may also occur, but cannot be predicted in advance. Given the safety record of seasonal vaccines, such events are expected to be rare.

Time constraints mean that clinical data at the time when pandemic vaccines are first administered will inevitably be limited. Further testing of safety and effectiveness will need to take place after administration of the vaccine has begun.

For these reasons, WHO advises all countries administering pandemic vaccines to conduct intensive monitoring for safety and efficacy, and many countries have plans in place for doing so. On the positive side, mass vaccination campaigns can generate significant safety data within a few weeks.

International sharing of data from such post-marketing surveillance will be vital in guiding risk-benefit assessments and determining whether changes in vaccination policies are needed. WHO has developed standardized protocols for data collection and reporting in real-time, and will communicate findings to the international community via its web site.

Info on flu vaccines here:
http://www.vaclib.org/basic/fluindex.htm

I'm not completely anti-vaccine - i just like to do a bit of research first. Something i have learned is that you can not trust studies done by drug companies.

Catch me on Facebook

2009-08-06T12:54:00.002+01:00
Also have a facebook page, just havent figured out how to link it all yet lol.

Bit of a learning curve all this but i love a challenge :)

http://www.facebook.com/pages/Sneezing-Piggies/112519396591?v=wall&viewas=100000001593549

Check it out & ask any questions or whatever on there.

Rheumatoid Arthritis Drug Might Fight Swine Flu

2009-08-06T02:19:00.002+01:00

It helps regulate the immune system's response, study with mice shows

Posted May 29, 2009

http://health.usnews.com/articles/health/healthday/2009/05/29/rheumatoid-arthritis-drug-might-fight-swine-flu.html

A Cytokine Storm?

2009-08-06T02:02:00.002+01:00
So many deaths among the young and seemingly healthy, who usually fend off flu far better than infants or the elderly, has experts speculating that H1N1's lethal mechanism may be the so-called "cytokine storm."

Usually seen in ICU patients battling severe sepsis, the cytokine storm occurs when the body mounts a hyper-reactive immune response so massive it harms itself, sometimes fatally.

It's the biological equivalent of friendly fire.

Immune System Overdrive

Because they have stronger immune systems than the elderly or infants, young adults "could be most poised to produce a cytokine storm," said Kathleen Sullivan, MD, PhD, chief of the Division of Allergy and Immunology at The Children's Hospital of Philadelphia.

The cytokine storm "refers to a state where all guns are firing in a non-organ-specific fashion," she said. "Instead of appropriately directing the immune system to a given target, the process goes into overdrive. When the immune system is attacking on all fronts, it is deleterious."

Cytokines "are chemical messengers produced by white blood cells and tissue cells that regulate the inflammatory response and immunity," said Kenneley, who is an assistant professor at Case Western Reserve University Frances Payne Bolton School of Nursing in Cleveland.

"A cytokine storm occurs when the body's immune system overreacts to an intruder, such as a virus, by producing high levels of cytokines," Kenneley explained. "When too many cytokines are produced, they can stimulate an inflammatory response in which the accumulation of immune cells and fluid at the site of infection may prevent affected tissues and organs such as the lungs from functioning properly and may even cause death due to severe damage and fluid buildup in the lungs themselves."

The relative youth of swine flu casualties bears a disquieting similarity to deaths from the infamous 1918 influenza A H1N1 pandemic. Nearly half of those approximately 50 million casualties were young adults 20 to 40 years old, Kenneley said; although we still don't know what factors may have fueled the 1918 pandemic's engine of death.

Depressed Response

In an article published online March 10 in the Journal of Leukocyte Biology, Sullivan and colleagues demonstrated swine flu patients may indeed be at risk of a paralyzed immune system, leading to potentially fatal secondary infections - but for a different reason than the cytokine storm.

Sullivan et al. recruited pediatric patients with severe influenza and compared their pathology with that of five patients with moderate influenza, six with respiratory syncytial virus, and 24 with no health problems who served as controls.

They found elevated levels of cytokines in the severe influenza group, but also a depressed response to toll-like receptor (TLR) ligands, which activate the body's immune cell responses so it attacks invading microbes. Aberrant responses to TLR ligands "may underlie the known susceptibility of influenza-infected patients to secondary bacterial infections," the researchers concluded.

Reactions to her finding so far "have ranged from pleased to surprised," Sullivan told ADVANCE.

The study by Sullivan et al. "brings us a step closer to understanding exactly what goes wrong in some people who get swine flu, so, ultimately, physicians can develop more effective treatment strategies," John Wherry, PhD, deputy editor of the Journal of Leukocyte Biology, told Reuters.

SYMPTOMS OF THE CYTOKINE STORM:

The end stage, or final result, of cytokine storm (SIRS) or sepsis is multiple organ dysfunction syndrome (MODS). The end-stage symptoms of the bird flu, or other infection precipitating the cytokine storm may include:
hypotension
tachycardia
dyspnea
fever (temperature of >38°C or >100.4°F)
Ischemia, or insufficient tissue perfusion (especially involving the major organs)
uncontrollable hemorrhage
and multisystem organ failure (caused primarily by hypoxia, tissue acidosis, and severe metabolism dysregulation
http://www.cytokinestorm.com/

Flu Shots Not As Effective In Lupus

2009-08-06T00:55:00.002+01:00
Flu Shots Not As Effective In Lupus
By John Gever, Senior Editor, MedPage Today
Published: July 31, 2009
WHEELING, W.Va., July 31 -- Patients with systemic lupus erythematosus showed impaired cell-mediated and antibody responses to a subunit flu vaccine, compared with healthy controls, researchers in the Netherlands found.

Following a trivalent subunit vaccination including A/H1N1, A/H3N2, and B/Hong Kong, lupus patients displayed less than half the level of gamma-interferon spot-forming cells of healthy controls, reported Albert Holvast, MD, of the University of Groningen, and colleagues in the August Arthritis & Rheumatism.

Cytokine-producing CD4-positive T cells were also less numerous in the lupus patients after vaccination, and hemagglutinin-specific antibody titers were lower, the researchers said.

The diminished cell-mediated responses appeared to be associated with prednisone and azathioprine, immunosuppressants commonly used to treat lupus.

These agents, Dr. Holvast and colleagues said, may make lupus patients less able to mount the desired antibody and cell-mediated responses to vaccination, leaving them more susceptible to infection.

"Clinicians should be aware that this combined defect might increase the morbidity and mortality due to influenza virus infection, in particular in patients receiving prednisone and/or azathioprine," they wrote.

They suggested that more effective vaccines or better vaccination strategies may be warranted for patients with lupus.

The findings were based on a prospective study of 78 lupus patients and 54 healthy age- and sex-matched controls. Fifty-four of the lupus patients were randomized to receive the flu vaccines, leaving 24 unvaccinated.

Antibody titers and cell-mediated responses to the flu strains were measured at baseline (just prior to vaccination for those receiving the vaccines) and again after four weeks.

Dr. Holvast and colleagues found that cell-mediated responses were substantially lower at baseline in lupus patients relative to controls.

Similar proportions of vaccinated participants in both groups showed increases in cell-mediated responses after vaccination. The magnitude of increase was also similar.

However, the mean absolute level of cell-mediated responses in lupus patients -- as indicated by gamma-interferon spot-producing cells in peripheral blood and the number of CD4-positive cells secreting tumor necrosis factor and interleukin-2 -- was less than half that of controls, both at baseline and after vaccination (P<0.001>

The researchers confirmed that the lupus patients' T cells were functional. Exposing them in vitro to staphylococcal enterotoxin led to strong cytokine responses similar to those seen in T cells from healthy control participants.

Earlier studies had found that antibody responses were impaired in lupus patients, and the current study confirmed those results. Antibody titers for A/H1N1 were reduced by nearly 25% (P<0.001)>P<0.01).>

But Dr. Holvast and colleagues said this was the first study to address cell-mediated immunity in lupus patients in response to flu vaccination.

Although these laboratory results suggesting impaired vaccine response weren't confirmed with live-virus challenge testing, the researchers said it was likely that patients were more susceptible to infection.

Still, the authors conceded that "there are no well-defined correlates between cell-mediated responses to influenza and the risk of influenza infection, which limits translation of our results to clinical implications."

Vaccination did not appear to worsen lupus disease activity, but the patients were more likely to report such adverse effects as itching (18% versus 2% of controls, P=0.006), erythema (24% versus 4%, P=0.003), induration at the injection site (30% versus 11%, P=0.026), and joint pain (16% versus 4%, P=0.046).

Limitations of the study included the absence of a placebo-vaccinated control group, leaving open the possibility that the findings resulted from a different type of placebo response in lupus patients versus the controls.

Other limitations included a small sample size, heterogeneous treatments among vaccinated lupus patients, and a greater number of patients in the vaccinated group who received the prior year's seasonal flu vaccine compared to controls.

Also, participants were not challenged with live flu viruses after vaccination to test their ability to resist clinical infection.

I am assuming that the above will apply to all of us on immunosuppressants.

1. We will have impaired vaccine response as we do to all vaccines including the normal flu one.
2. We are more likely to have adverse side effects to the vaccine.
3. We already know that we're not allowed live vaccines (i learnt last night that we should have finished treatment for 6 months before having a live vaccine) The nasal spray flu vaccine (for ordinary flu) contains a live virus & should be avoided.

It is adviseble to check with your doctor for recommended guidelines. In the UK anyone taking steroids are told strictly not to stop taking the tablets.

Anyone on Biologic Therapies and DMARDs are asked to stop treatment for 7 days if they come in contact with anyone suffering from Swine Flu. If they have not developed symptoms themselves after 7 days they can then restart their medication.

If anyone develops symptoms of Swine Flu they are asked to contact their doctor or helpline and consider treatment with Tamiflu. All other meds should be stopped until symptoms have gone away completely.

The swine Flu vaccination is expected to be available in the UK around September time.

CDC Directors Update Brief

2009-08-05T23:51:00.004+01:00
CDC Director's Update Brief
novel 2009-H1N1
7/31/09

http://cryptome.org/h1n1/cdc-073109.pdf

Very interesting this as it shows what the CDC classify underlying conditions as. Also shows the % of deaths in each age group.
See pg. 42 & 43 for list of underlying conditions contributing to deaths.

Most interesting to me is the fact that smoking seems to be beneficial - i know i should but no way i'm giving up til this pandemic is over. I've even threatened slap a nicotine patch on my lot at the first sign of a sniffle lol.
Nicotine, Anti-inflammatory H1N1 Cure - Vagus Nerve Stimulation Blocks Cytokine Storm of Swine Flu
http://diseases-viruses.suite101.com/article.cfm/nicotine_antiinflammatory_h1n1_cure.

Stimulation of the vagus nerve prevents the damaging effects of cytokine release in experimental sepsis, endotoxemia, ischemia/reperfusion injury, hemorrhagic shock, arthritis, and other inflammatory syndromes. Herein is a review of this physiological, functional anatomical mechanism for neurological regulation of cytokine-dependent disease"...

.."Obesity, on the other hand, is characterized by diminished vagus nerve output and elevated cytokine levels, which have been implicated in mediating insulin resistance and atherosclerosis

This is a possible reason for obesity to be listed as a risk factor or at least it was for a while. My gut feeling is that there are so many obese people these days that the authorities cant list them as a priority group because there are simply too many.

Since weight loss and exercise are each associated with increasing vagus nerve activity, one can consider whether enhanced activity in the cholinergic antiinflammatory pathway might decrease cytokine production and reduce the damage and metabolic derangements mediated by chronic, low-grade systemic inflammation that is characteristic of the metabolic syndrome. "...

My take on pregnancy - we know that a lot of pregnant women get hit hard by this. Is this because their immune systems are dampened to accommodate the baby (foreign body)?

Welcome to Sneezing Piggies

2009-08-05T20:42:00.000+01:00
Hi folks,

I've never done anything like this before so bear with me :-)

My name is Elaine though i'll prob post under Moog cos i like the anonymity.

A bit of background - i'm a 40 year old nurse from N. Ireland & have had rheumatoid arthritis for approx 3 years now. Am currently taking methotrexate 14mg/week & meloxicam 15mg daily.

I've been keeping a fairly close eye on swine flu since it reared its head way back in April & from what i've read, a lot of people are suggesting that the deaths (at least some of them) are being caused by a cytokine storm where the immune system overreacts to the virus causing the lungs to fill with fluid leading to death.

My questions is this? - would we not therefore be better off with a compromised immune system? My theory being that it wont overreact if it isnt working properly in the first place. Of course i could be completely wrong here but worth thinking about.

Then there is the question of vaccines & tamiflu. Being a nurse i was recommended to have the hep b vaccine which to my eternal regret i did for i'm pretty much convinced that this is what brought on my RA.in the first place. Needless to say, i'm not the biggest fan of vaccines due to that.

We know this swine flu vaccine is being rushed through with no or very little safety trials - lets just say i wont be having one - nurse or no nurse. And some of them will contain adjuvants which are pretty harmful to the body & have been shown to cause crippling arthritis etc in ferrets/mice.

Earlier today i was reading that mtx can increase the side effects of tamiflu & from what i've read they're not too pleasant to start with. (Cant remember where i read that now).

http://www.rheumatology.org.uk/media/pressreleases/swineflu

The above link is to the NRAS guidelines for rheumatology patients. Apparently we're supposed to stop our meds if we come into contact with swine flu.
Two probs with this:
1) i would never have known if i hadnt gone looking - how many RA sufferers wont know this?
2) if i were to go off mtx for 1 or 2 weeks, how much of a setback is that going to cause - i have no wish to go back to where i was prior to treatment.

One bit of good news - looks like symptoms of swine flu are less marked for those people taking biologics :) - i will post the relevant link when i come across it again.

What i'm planning to do here is to post any relevant info that migh help answer the above questions. There does not seem to be a definitive answer out there.

That'll do for now - more later :)

Sneezing Piggies

CDC: 3.4 million inhalable H1N1 vaccine doses available soon

Unlicensed Intravenous Form Of Relenza Helped Save Life Of Swine-Flu Infected Woman Who Had Just Had Chemotherapy

Swine flu deaths show this flu is different: experts

What H1N1 Can Do To You

GPs to be paid £5.25 per jab for swine flu vaccine

FDA approves H1N1 vaccine applications

FDA NEWS RELEASE

FDA Approves Vaccines for 2009 H1N1 Influenza Virus Approval Provides Important Tool to Fight Pandemic

Docs say NO to vaccine in pregnancy

German Swine Flu Vaccine Trial Participant Coughs Up Blood

3 People In Egypt Suspected Of Being Infected With H1N1 Swine Flu And H5N1 Bird Flu

H1N1 Vaccines Safe, Immunogenic in Single Dose

Possible link between El Nino & Flu Pandemics

A(H1N1) gets more virulent

‘Second wave’

Wow!

Neurologists concerned over safety of swine flu vaccine

More of the same

Tamiflu "harmful to children"

Tamiflu 'harmful to children'

Looks like i'm not alone on the vaccine issue :)

Children could be given untested swine flu vaccine

Fever is our friend

Story Time :)

House - gotta love that man :D

Methotrexate & Tamiflu

Guidance for hospital medical specialties on adaptations during a pandemic influenza outbreak

Summary

British Society of Rheumatology Advice Re: Swine Flu

Tamiflu reduces symptoms by just half a day.

UK Vaccine Trial Starts

RA & The Menstrual Cycle

Clinical:Rheumatoid Arthritis and The Menstrual Cycle

Swine Flu & Immunosuppression

Swine flu and immunosuppression

Key points from the review

What were the researchers’ conclusions?

Flu jabs not tested on children

Does the H1N1 vaccine increase the risk of cancer?

Playtime

Interview with a retired vaccine researcher

Swine Flu Vaccine - Beware of Squalene Adjuvants

Studies of seasonal flu vaccine efficacy

Where did it go?

Is the upcoming swine flu vaccine safe?

Catch me on Facebook

Rheumatoid Arthritis Drug Might Fight Swine Flu

It helps regulate the immune system's response, study with mice shows

A Cytokine Storm?

Flu Shots Not As Effective In Lupus

CDC Directors Update Brief

Nicotine, Anti-inflammatory H1N1 Cure - Vagus Nerve Stimulation Blocks Cytokine Storm of Swine Flu

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FDA Approves Vaccines for 2009 H1N1 Influenza Virus
Approval Provides Important Tool to Fight Pandemic