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Early use of antivirals key in H1N1 flu: WHO

in.reuters.com

Early use of antivirals key in H1N1 flu: WHO

Early use of antivirals is effective in treating H1N1 flu and health authorities must be vigilant for signs of drug resistance, the World Health Organisation said on Friday.

Drug-resistant pandemic flu viruses have appeared infrequently so far and there is no evidence they are spreading, but further cases are likely, the WHO said on its website.

Growing international experience showed the importance of the early use of oseltamivir, manufactured as Tamiflu by Roche Holding and Gilead Sciences, or zanamivir, an inhaled medicine produced as Relenza by GlaxoSmithKline in swine flu cases,” the WHO said.

“The experience of clinicians, including those who have treated severe cases of pandemic influenza, and national authorities, suggests that prompt administration of these drugs following symptom onset reduces the risk of complications and can also improve clinical outcome in patients with severe disease,” the Geneva-based U.N. agency said.

“This experience further underscores the need to protect the effectiveness of these drugs by minimizing the occurrence and impact of drug resistance,” it said.

Most people who contract pandemic influenza suffer only mild symptoms before recovery without treatment, but children, pregnant women and those with some existing health conditions are vulnerable to a more severe attack or even death.

The WHO, which declared H1N1 a global pandemic in June, says one third of the world’s population of nearly seven billion people could catch it.

The risk of resistance is higher in patients who suffer from weak immune systems and have already been treated with oseltamivir, it said.

It is also high in people who are treated with the antivirals as a prophylactic — as a precaution after exposure to someone with influenza, but nevertheless develop the disease.

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Swine flu vaccine due next week in Pa., N.J.

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Swine flu vaccine due next week in Pa., N.J.

After months of anticipation, the first doses of swine flu vaccine are expected to arrive next week, public health officials said yesterday as the federal government began accepting orders from the states.

In Pennsylvania, they will go to healthy children ages 5 to 9 in just three regions of the state, including the southeast. New Jersey will direct a smaller number of doses to ages 2 through 24 statewide.

The priority lists are likely to change weekly, if not daily, as the federal government ramps up the biggest vaccination campaign it has ever attempted.

Pregnant women, for example, are among those at highest risk from the disease – but the first doses, in a nasal spray, will be a form of live virus that isn’t safe for them. Shots made with an inactivated or “dead” virus should arrive a week or so later.

The live virus is safe for children without underlying medical conditions. Children are the most likely of all age groups to catch and spread the new flu. While most people will require one dose, children under 10 will need two, nearly a month apart, to trigger a robust immune response. (The same applies to children getting seasonal flu vaccine for the first time.) So children will get first dibs.

“Targeting the healthy and the young is a good way to get this vaccine out quickly to a significant population,” said Susan Walsh, a deputy state health commissioner in New Jersey.

Where to get the vaccine?

Officials in both states urged parents to call their pediatricians, although they are not likely to know that they will have the vaccine until it actually arrives. Many schools, including those in Philadelphia, will hold vaccination clinics; letters and permission forms will go out to parents beforehand.

Health department Web sites for New Jersey, Pennsylvania, and Philadelphia – the three local overseers for swine flu vaccination – will list locations when more doses become available, officials said. All vaccinations are voluntary.

Because the swine flu vaccine was purchased entirely by the federal government, providers can charge only an administration fee, and many will offer it free. It generally will not be available from supermarkets and pharmacies that run clinics for seasonal vaccine.

Swine flu was more common than the seasonal strains in the southern hemisphere, which experienced a full influenza season after the novel H1N1 first appeared in Mexico and the United States in April.

That has led to scattered reports in the north that the seasonal vaccine would be unnecessary. Public health officials strongly disagreed.

“We have no idea what the interplay is going to be between [swine] flu and the seasonal flu,” said Stephen Ostroff, Pennsylvania’s acting physician general.

Those seeking to cover all their bases might also want to consider a report from the U.S. Centers for Disease Control and Prevention yesterday saying that, as in previous flu pandemics, bacterial pneumonia contributed to some swine flu deaths in spring and summer.

Pneumococcal vaccine is in plentiful supply, as is seasonal flu vaccine.

But no one knows how many people will want them, let alone the new swine flu vaccine. Just 35 percent of adults in New Jersey and 38 percent in Pennsylvania said they got the seasonal flu vaccine last year, according to the most recent federal survey.

And a Consumer Reports poll released yesterday found that just 35 percent of parents said they definitely would have their children vaccinated for swine flu.

“Who wants it? Who knows?” said Caroline Johnson, director of the division of disease control for the Philadelphia Department of Public Health.

Despite the newness of the vaccine, public health officials say they have no safety concerns. It is essentially the “seasonal vaccine with a different strain contained in it,” said Ostroff.

The first-to-arrive spray form of the vaccine contains no thimerosal – a preservative that some people believe is linked to other diseases – and later versions will be available both with or without it, officials said.

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Canada outranks U.S. in healthcare report card

in.reuters.com

Canada outranks U.S. in healthcare report card

Canada outperforms the United States in health outcomes but is well behind global leaders like Japan in overall health of its population, a Canadian report released on Monday showed.

The annual report card by the Conference Board of Canada ranked Canada 10th out of 16 developed countries, with a “B” grade. The United States was the worst performer, placing 16th and earning a “D” grade.

“Canada has been at the center of much of the debate on U.S. health care reform. Since Canada ranks ahead of the United States on all but one indicator of health status … it is clear that we are getting better results,” Gabriela Prada, director of health policy at the Conference Board, said in a statement.

“But when we look beyond the narrow Canada-U.S. comparison to the rest of the world, Canadians rank in the middle of the pack in terms of their health status,” Prada said.

Most of the data on which the report card was based is from 2006, the group said.

President Barack Obama has pledged to reform the country’s healthcare system, which is expensive and leaves millions of Americans without coverage. Canada, with its single-payer government-run system, is often held out as an example to be praised or derided by U.S. critics.

The Conference Board, which has been issuing the report card since 1996, ranked the 16 countries according to 11 criteria, including life expectancy, mortality due to cancer, circulatory diseases, respiratory diseases, metal disorders, as well as infant mortality and self-reported health status.

Japan was once again the top-ranking country. Switzerland, Italy, and Norway also earned “A” grades.

“B” grades were given to Sweden, France, Finland, Germany, Australia and Canada, while Netherlands, Austria and Ireland earned a “C” grade, the report showed.

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