A researcher in Taiwan sorts through eggs used to cultivate swine flu vaccine. Canada is currently developing guidelines for its use.


http://www.cbc.ca/health/story/2009/07/20/aboriginal-flu.html

Swine flu hits young aboriginal residents hard, expert says
Last Updated: Monday, July 20, 2009 | 11:13 AM ET Comments21Recommend14
CBC NewsAboriginal communities have been harder hit by swine flu than others, and that may be because of the high percentage of young people, according to Audrey Lawrence, the director of the Aboriginal Nurses Association.
Lawrence said more than half the aboriginal population in Canada is under the age of 25.
"And this is what's so different about this H1N1 flu is that it's disproportionately targeting or seems to be affecting younger people, much more so than traditional flus where the severity of impact is more on the very, very young and the very old," she said.
Her organization wants to make sure aboriginal people are a top priority to receive the regular flu vaccine in September, and the specialized H1N1 vaccine when it's available later this fall.
So far, only one case of H1N1 has been confirmed in Yukon but there have been more than 10,000 cases confirmed across Canada, including 390 from Nunavut.
Recent statistics from Manitoba peg the infection level among First Nations at 135 per 100,000 people versus 6.1 cases per 100,000 for the province, the Assembly of First Nations said Friday.
Cape Breton communities wary of outbreak
In Nova Scotia, health officials in Cape Breton's five First Nations communities are meeting to bring their pandemic plans up to date.
Though there have been no reported cases of the virus among Mi'kmaq people on the island, officials say conditions appear ripe for an outbreak.
Sharon Rudderham, director of the Eskasoni Health Centre, said aboriginal communities may be especially vulnerable because of overcrowded living conditions and disease.
"Within our First Nations communities we have a high number of chronic diseases such as diabetes and heart disease, and stuff like that that can compromise the health of individuals, so I think that can be the case as well for Cape Breton," she said.
Rudderham said an education program about swine flu will be presented in Cape Breton schools this fall to teach children the importance of hand-washing.
"We do have a high percentage of young people in our community and so it's important that kids have an understanding as well of what they can do to keep healthy and to stay safe," she said.
Nurse shortage
Lawrence is also concerned about swine flu's effects on the health-care system during a nursing shortage.
"Their workload is quite heavy as it stands, without the H1N1, and in some communities we're hearing, for example, one nurse might be having to cover 15 H1N1 cases in addition to the person's normal workload as well," she said.
So the Aboriginal Nurses Association is calling on retired nurses to contact them, if they can return to work and lend a hand during the fall flu season

http://www.theage.com.au/national/free-flu-vaccine-for-pregnant-women-aborigines-20090719-dp7x.html
.Free flu vaccine for pregnant women, Aborigines
July 19, 2009
The Federal Government is expanding its free seasonal flu vaccine program to pregnant women and Aborigines.
Health Minister Nicola Roxon says the program for older Australians is being extended on medical advice to another two million people .. as swine flu continues to spread.
She's told the Nine Network respiratory diseases associated with swine flu can have complications for pregnant women .. particularly in the last trimester.
To date 31 Australians with swine flu have died and 194 remain in hospital .. more than a third of them in intensive care.
Meanwhile, Ms Roxon said the respiratory diseases associated with swine flu could have complications for pregnant women, particularly in the last trimester when there was significant pressure on their lungs.
However, she did not recommend pregnant women wear masks, instead she urged them to practise good hygiene, stay clear of those who are sick and seek early help if they develop flu symptoms.
Ms Roxon said Tamiflu was generally effective and safe for pregnant women, but there was "isolated evidence" the swine flu was becoming resistant to the drug overseas.
"I do agree with doctors that we have to be careful not to over prescribe this medication. It's why we're urging people, the vast majority who have mild symptoms, not to take Tamiflu unless they are in a vulnerable category and unless their doctor recommends that it's necessary."
To date, 31 Australians with swine flu have died. Ms Roxon said 194 people remained in hospital with the disease, more than a third of whom were in intensive care.
She said she expected the outbreak to persist for months to come but believed the worst was almost over.
Victoria was past the peak and other states were reaching theirs.
Ms Roxon said swine flu had put "extreme pressure" on hospitals and elective surgery may be delayed as a result.
However, the disease was tracking the same as the 2007 seasonal flu, which was the worst for several years.
"So, I think what we're seeing increasingly is a substitution of the swine flu instead of the seasonal flu, rather than an additional burden."

http://www.theaustralian.news.com.au/story/0,25197,25806651-23289,00.html
High-risk to get free flu shots
Natasha Bita | July 20, 2009
Article from: The Australian
FREE flu shots will be offered to pregnant women, Aborigines and the chronically ill as the federal government sweats on the production of 21million doses of vaccine for the swine flu sweeping the nation.
The government will spend $44million over four years to cover an extra 2.2 million people with vaccinations for seasonal flu -- usually reserved for the elderly -- from January 1 next year.
Health Minister Nicola Roxon said yesterday the swine flu outbreak -- which has infected 12,000 Australians, killed 31 and put 81 in intensive care -- showed how severely influenza could affect vulnerable people.
Scientists were "working madly" to see if a swine flu vaccine could be incorporated with the seasonal flu shot next year, Ms Roxon said.
The government might not wait for the completion of clinical trials to roll out a swine flu vaccine before October, she said.
Pharmaceutical company CSL will start clinical trials with 240 adults in Adelaide next week.
"If the intensity of the disease changes, if we get early results that make it very clear this vaccine is safe, I certainly would take advice to bring it online more quickly if that was appropriate," Ms Roxon told the Nine Network.
The World Health Organisation criticised Britain last week over its plans to bring in a vaccine without clinical trials.
A CSL spokeswoman said Britain would probably rely on the results of the clinical tests under way in Australia. Ms Roxon said doctors should not over-prescribe the antiviral drug Tamiflu, after reports that three cases of swine flu had grown resistant to the drug overseas.
"We're urging people, the vast majority of whom have mild symptoms, not to take Tamiflu unless they are in a vulnerable category and unless their doctor recommends it's necessary," she said.
"We always have to be aware there is a risk of resistance developing."
Ms Roxon urged pregnant women to stay away from anyone who is sick. Swine flu has triggered the premature birth of several babies and put expectant mothers in intensive care wards.
"If you're late in your pregnancy when there's already significant pressure on a mother's lungs, this is a disease that can have complications," she said.
From January next year, all pregnant women and Aboriginal and Torres Strait Islanders aged 15 to 50 will be able to access the seasonal flu vaccine free from their GPs.
Those aged six months to 64 who are medically at risk, including the chronically ill, will also qualify for free flu shots. Currently, the vaccine is only available free to seniors aged 65 and over.
Pregnant women and the chronically ill have been excluded from the clinical trials of the CSL vaccine.
Half the volunteers will be given two shots of vaccine equal to the standard dose of seasonal flu vaccine, three weeks apart.
The rest will be given two double doses.
Ms Roxon said the spread of swine flu appeared to have reached its peak, but no one should pretend the situation would not be difficult for months to come.
"I think it does put our health services under extreme pressure," she said.
"There is the potential that some elective surgery might have to be delayed."
Queensland will open a flu clinic today in the Aboriginal community of Cherbourg, 280km northwest of Brisbane, after the flu spread there. Indigenous people often suffer chronic diseases that make them more susceptible to flu complications.



Kids, natives most in need of vaccine
Canadian health officials developing a priority list for giving out H1N1 flu shots, expected to be in short supply
By Sharon Kirkey, Canwest News Service
http://www.calgaryherald.com/health/Kids+natives+most+need+vaccine/1720472/story.html
Five-to-40-year-olds and Canada's aboriginal communities should be the first to get vaccinated against human swine flu, experts say as Canadian officials decide who gets priority for the flu shots.
Under Canada's official pandemic plan, the entire population would ultimately be immunized against the H1N1 swine flu.
But the vaccine will become available in batches, meaning the entire population can't be vaccinated at once. It might take four or five months to get all the vaccine we're going to get, during which time a second wave of swine flu may well be underway.
The Public Health Agency of Canada is working on a priority list, deciding where the first batches should go, and who should get the injections first. All provinces and territories would be expected to follow the national prioritization scheme.
Unlike normal seasonal flu, the H1N1 virus appears to be disproportionately infecting older children and young adults. So far the largest number of confirmed cases have occurred in people between the ages of five and 24.
"It doesn't mean they're all getting sick and need to be hospitalized, but they're getting significant illness," said Dr. Noni MacDonald, a leader in pediatric infectious diseases and a professor of pediatrics at Dalhousie University in Halifax.
British researchers reported last week that targeting children first would protect not only them, but also unvaccinated adults.
"Even if you are concerned about the elderly, who are often mentioned as another risk group, their main connection to the big pool of infection is often their grandchildren," said Dr. Thomas House of the University of Warwick.
But adults older than 64 don't appear to be at increased risk of H1N1-related complications so far in the outbreak. It's possible they have some antibodies against the virus.
As well, children "are known to be really important for transmitting flu," said Earl Brown, executive director of the Emerging Pathogens Research Centre at the University of Ottawa.
"They're important for the cycle of infection. They tend to be naive as far as not having flu antibodies in their system before. And really young kids, their immune systems aren't fully mature.
"Children tend to be hit, and they can be hit harder," Brown said. By immunizing children first, "you get to try to block spread, and protect a vulnerable group."
Gymnasiums would be used for mass school-based vaccination programs but experts say the harder to reach group will be the 18-to-30-year-olds.
"Some of them are in school, a lot of them are not," MacDonald said. "They're very much living in the moment and don't necessarily see themselves as being at risk. We need some fast thinking about how to reach those people."
She suggested booths could be set up outside bars for information and immunization.
"You've got to be creative about this and really think out of the box."
Canada's aboriginal communities also appear to be getting more serious infections. Crowded, poorly ventilated housing and poor access to high-quality running water and sanitization are some of the factors being blamed. Aboriginals also have higher rates of asthma, chronic lung disease, obesity and diabetes -- the very diseases early data suggests puts people at higher risk of life-threatening complications from swine flu.
The H1N1 vaccine will be a separate vaccine from the regular, annual flu shot. People will require two jabs, and possibly three, depending on how effective the vaccine is in producing immunity. The Public Health Agency of Canada says no decisions have yet been made about who would get priority first.
One of the challenges will be getting people to agree to the shots. There will be limited information about any vaccine's safety before immunization campaigns are rolled out across the country.
"We usually do research in healthy adults before we do it in children, because this is a new vaccine, and you want to be sure that it's safe and effective before you give it to vulnerable populations, or populations who don't have full capacity to make an informed decision about getting it or not," said Dr. Joanne Langley, of Health Canada's National Advisory Committee on Immunization.
"There are pros and cons to putting [children] first."
© Copyright (c) The Vancouver Sun

First case of Tamiflu-resistant H1N1 reported in Quebec
By Drew Halfnight, The GazetteJuly 22, 2009 10:01 AM
A Quebec man became the first person in Canada to contract the H1N1 virus after taking the Tamiflu vaccine, raising concerns about the drug’s reliability.
The man, 60, was given Tamiflu after his son fell ill with H1N1, but contracted the deadly flu anyway. He recovered quickly without going to hospital.
Five instances of immunity to Tamiflu have been reported since a Danish man became the first patient to resist the drug at the end of last month.
Doctors have said taking Tamiflu as a prophylactic or preventative against infection can give rise to resistant strains of the virus. In four of the five reported cases, patients had been taking Tamiflu to prevent infection.
A spokesperson for the Public Health Agency of Canada told The Canadian Press it “appears to be an isolated case” and said the agency is watching closely for similar cases.
The agency recommends using Tamiflu for treatment only, not for prophylaxis.
© Copyright (c) The Montreal Gazette
http://www.montrealgazette.com/health/First+Tamiflu+resistant+H1N1+reported+Quebec/1815888/story.html