Posts Tagged ‘H1N1’

2009 H1N1 Influenza Shots and Pregnant Women: Questions and Answers

Sunday, November 8th, 2009
2009 H1N1 Influenza Shots and Pregnant Women

2009 H1N1 Influenza Shots and Pregnant Women

Why does CDC advise pregnant women to receive the 2009 H1N1 influenza (flu) vaccine (shot)?
Getting the flu shot is the single best way to protect against the flu. It is important for a pregnant woman to receive both the 2009 H1N1 flu shot and the seasonal flu shot. A pregnant woman who gets any type of flu has a greater chance for serious health problems. Compared with people in general who get 2009 H1N1 flu (formerly called “swine flu”), pregnant women with 2009 H1N1 flu are more likely to be admitted to hospitals. Pregnant women are also more likely to have serious illness and death from 2009 H1N1 flu. When a pregnant woman gets a flu shot, it can protect both her and her baby. Research has found that pregnant women who had a flu shot get sick less often with the flu than do pregnant women who did not get a flu shot. Babies born to mothers who had a flu shot in pregnancy also get sick with flu less often than do babies whose mothers did not get a flu shot.
Will the seasonal flu shot also protect against the 2009 H1N1 flu?
Seasonal flu and 2009 H1N1 flu are caused by different viruses. The seasonal flu vaccine will not protect against the 2009 H1N1 flu. Also, the 2009 H1N1 flu vaccine will not protect against seasonal flu.

Are there flu vaccines that pregnant women should not get?
The seasonal and 2009 H1N1 flu vaccines can be given by shot or by nasal spray. Pregnant women should get the “flu shot”—a vaccine made with killed flu virus. This one is given with a needle, usually in the arm. The other type of flu vaccine—a nasal spray—is not approved for pregnant women. This vaccine is made with live, weakened flu virus. Nasal spray flu vaccine should be used only in healthy people 2-49 years of age who are not pregnant. The nasal spray vaccine is safe for women after they have delivered, even if they are nursing.

Can the seasonal flu shot and the 2009 H1N1 flu shot be given at the same time?
Seasonal and 2009 H1N1 flu shots can be given on the same day but should be given at different sites (e.g., one shot in the left arm and the other shot in the right arm). If a woman is getting her vaccines after delivery, she can get the nasal spray flu vaccine. However, she should not get the seasonal and 2009 H1N1 nasal spays on the same day; they should be given 4 weeks apart.

Is the 2009 H1N1 flu shot safe for pregnant women?
The seasonal flu shot has been given to millions of pregnant women over many years. Flu shots have not been shown to cause harm to pregnant women or their babies. The 2009 H1N1 flu vaccine is being made in the same way and at the same places where the seasonal flu vaccine is made.

What studies have been done on the 2009 H1N1 flu shots and have any been done in pregnant women?
Studies to test the 2009 H1N1 flu shots in healthy children and adults and pregnant women are being done now. Results are available from some of the studies done in non-pregnant adults and children. These results show that the immune system responded well to the 2009 H1N1 vaccine, and the safety results were very similar to those seen in studies of seasonal flu vaccine. These studies are being conducted by the National Institute of Allergy and Infectious Diseases (NIAID) and the vaccine manufacturers. More information can be found at http://www3.niaid.nih.gov/news/QA/vteuH1N1qa.htm.

Does the 2009 H1N1 flu shot have mercury in it?
There is no evidence that thimerosal (a mercury preservative in vaccine that comes in multi-dose vials) is harmful to a pregnant woman or a fetus. However, because some women are concerned about thimerosal during pregnancy, vaccine companies are making preservative-free seasonal flu vaccine and 2009 H1N1 flu vaccine in single-dose syringes for pregnant women and small children. CDC advises pregnant women to get flu shots either with or without thimerosal.

Does the 2009 H1N1 flu shot have an adjuvant or squalene in it?
Adjuvants are agents that are sometimes added to a vaccine to make it more effective. There are no adjuvants (such as squalene) in either the 2009 H1N1 or seasonal flu shot used in the United States.

Can the 2009 H1N1 flu shot be given at any time during pregnancy?
Both seasonal flu shots and 2009 H1N1 flu shots are recommended for pregnant women at any time during pregnancy.

How many 2009 H1N1 flu shots will a pregnant woman need to get?
The U.S. Food and Drug Administration (FDA) has approved the use of one shot for full protection for persons 10 years and older. Therefore, a pregnant woman is recommended to get one dose of the 2009 H1N1 vaccine.

Should the 2009 H1N1 flu shot be given to a pregnant woman who had flu between April 2009 and now? Do I need a test to know if I need the shot or not?
A pregnant woman who had a flu-like illness at any time in the past should still get the 2009 H1N1 shot because she cannot assume that the illness she had was caused by the 2009 H1N1 virus. Pregnant women who had flu symptoms in the past do not need to be tested now, but should get the vaccine.

What are the possible side effects of the 2009 H1N1 flu shots?
The side effects from 2009 H1N1 flu shots are expected to be like those from seasonal flu shots. The most common side effects after flu shots are mild, such as being sore and tender and/or red and swollen where the shot was given. Some people might have headache, muscle aches, fever, and nausea or feel tired. If these problems happen, they usually begin soon after the shot and may last as long as 1-2 days. Some people may faint after getting any shot. Sometimes, flu shots can cause serious problems like severe allergic reactions. But, life-threatening allergic reactions to vaccines are very rare. A person who has a severe (life-threatening) allergy to eggs or to anything else in the vaccine should not get the shot, even if she is pregnant. Pregnant women should tell the person giving the shots if they have any severe allergies or if they have ever had a severe allergic reaction following a flu shot.

What if a pregnant woman gets the live nasal spray flu vaccine instead of the flu shot?
The nasal spray flu vaccine has not been approved for pregnant women. It differs from the flu shot because it is made with live, weakened virus. However, sometimes a pregnant woman might get the nasal spray flu vaccine—for example, before she knew she was pregnant. If this happened, she would not be expected to have any additional problems. The weakened, live flu virus has never been shown to be passed to the unborn baby. However, if a woman does get the nasal spray vaccine while she is pregnant, she should talk to her healthcare provider.

If a pregnant woman delivers her baby before receiving her seasonal flu shot or her 2009 H1N1 flu shot, should she still receive them?
Yes. Besides protecting her from infection, the shot may also help protect her infant. Flu shots are only given to infants 6 months of age and older. Everyone who lives with or gives care to an infant less than 6 months of age should get both the seasonal flu and 2009 H1N1 vaccines. A woman can get either the shots or the nasal spray after she delivers.

Can a breastfeeding mother receive the flu shot or the nasal spray?
Yes. Both seasonal and 2009 H1N1 flu vaccines should be given to breastfeeding mothers and breastfeeding women can receive either the shot or the nasal spray form of the vaccine. Breastfeeding is fully compatible with flu vaccination, and preventing the flu in mothers can reduce the chance that the infant will get the flu. Also, by breastfeeding, mothers can pass on to the infant the antibodies that their bodies make in response to the flu shots, which can reduce the infant’s chances of getting sick with the flu. This is especially important for infants less than 6 months old, who have no other way of receiving vaccine antibodies, since they are too young to be vaccinated.

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Swine Flu H1N1 Symptoms

Friday, November 6th, 2009

Swine Flu H1N1 Symptoms

Swine Flu H1N1 Symptoms


According to the CDC, like seasonal flu, symptoms of swine flu infections can include:

•fever, which is usually high, but unlike seasonal flu, is sometimes absent
•cough
•runny nose or stuffy nose
•sore throat
•body aches
•headache
•chills
•fatigue or tiredness, which can be extreme
•diarrhea and vomiting, sometimes, but more commonly seen than with seasonal flu
Signs of a more serious swine flu infection might include pneumonia and respiratory failure.

If your child has symptoms of swine flu, you should avoid other people and call your pediatrician who might do a rapid flu test to see if he has an influenza A infection. Further testing can then be done to see if it is a swine flu infection. (Samples can be sent to local and state health departments and the CDC for confirmation of swine flu, especially if a child is in the hospital.)

Swine Flu High Risk Groups
With regular seasonal flu, young children and the elderly are usually thought to be most at risk for serious infections, in addition to people with chronic medical problems. Swine flu high risk groups, people who are thought to be at risk for serious, life-threatening infections, are a little different and can include:

•pregnant women
•children under age two years old
•people with chronic medical problems, such as chronic lung disease, like asthma, cardiovascular disease, diabetes, and immunosuppression
•children and adults with obesity
It is important to keep in mind that unlike seasonal flu, more than half of the hospitalizations and a quarter of the deaths from swine flu are in young people under the age of 25.

Serious Swine Flu Symptoms
More serious symptoms that would indicate that a child with swine flu would need urgent medical attention include:

•Fast breathing or trouble breathing
•Bluish or gray skin color
•Not drinking enough fluids
•Severe or persistent vomiting
•Not waking up or not interacting
•Being so irritable that the child does not want to be held
•Flu-like symptoms improve but then return with fever and worse cough
Swine Flu Symptoms vs. a Cold or Sinus Infection
It is important to keep in mind most children with a runny nose or cough will not have swine flu and will not have to see their pediatrician for swine flu testing.

What You Need To Know
•Swine flu likely spreads by direct contact with respiratory secretions of someone that is sick with swine flu, like if they were coughing and sneezing close to you.

•People with swine flu are likely contagious for one day before and up to seven days after they began to get sick with swine flu symptoms.

•Droplets from a cough or sneeze can also contaminate surfaces, such as a doorknob, drinking glass, or kitchen counter, although these germs likely don’t survive for more than a few hours.

•Anti-flu medications, including Tamiflu (oseltamivir) and Relenza (zanamivir), are available to prevent and treat swine flu in high risk children.

•The latest swine flu news from the CDC includes advice that daycare centers should do daily health checks, separate ill children until they can go home, encourage kids to stay home until they are free of fever for at least 24 hours, encourage proper hand-washing, and teach kids to properly cover their coughs and sneezes to help everyone avoid the flu.

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2009 H1N1 Influenza Vaccine and Pregnant Women

Thursday, September 3rd, 2009

Q: Why does CDC recommend that pregnant women receive the 2009 H1N1 influenza vaccine?

A. It is important for a pregnant woman to receive the 2009 H1N1 influenza vaccine as well as a seasonal influenza vaccine. A pregnant woman who gets any type of flu is at risk for serious complications and hospitalization. Pregnant women who are otherwise healthy have been severely impacted by the 2009 H1N1 influenza virus (formerly called “novel H1N1 flu” or “swine flu”). In comparison to the general population, a greater proportion of pregnant women infected with the 2009 H1N1 influenza virus have been hospitalized. In addition, severe illness and death has occurred in pregnant women. Six percent of confirmed fatal 2009 H1N1 flu cases thus far have been in pregnant women while only about 1% of the general population is pregnant. While hand washing, staying away from ill people, and other steps can help to protect pregnant women from influenza, vaccination is the single best way to protect against the flu.

Q: Is there a particular kind of flu vaccine that pregnant women should get? Are there flu vaccines that pregnant women should not get?

A. There are two type of flu vaccine. Pregnant women should get the “flu shot”— an inactivated vaccine (containing fragments of killed influenza virus) that is given with a needle, usually in the arm. The flu shot is approved for use in pregnant women.

The other type of flu vaccine — nasal-spray flu vaccine (sometimes called LAIV for “live attenuated influenza vaccine)—is not currently approved for use in pregnant women. This vaccine is made with live, weakened flu viruses that do not cause the flu). LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant.

Q. Will the seasonal flu vaccine also protect against the 2009 H1N1 flu?

A. The seasonal flu vaccine is not expected to protect against the 2009 H1N1 flu. Similarly, the 2009 H1N1 influenza vaccine will not protect against seasonal influenza.

Q. Can the seasonal influenza vaccine and the 2009 H1N1 influenza vaccine be given at the same time?

A. It is anticipated that seasonal flu and 2009 H1N1 vaccines may be administered on the same day but given at different sites (e.g. one shot in the left arm and the other shot in the right arm). However, we expect the seasonal vaccine to be available earlier than the 2009 H1N1 influenza vaccine. The usual seasonal influenza viruses are still expected to cause illness this fall and winter. Pregnant women and others at increased risk of complications of influenza are encouraged to get their seasonal flu vaccine as soon as it is available.

Q: Is the 2009 H1N1 influenza vaccine safe for pregnant women?

A: Influenza vaccines have not been shown to cause harm to a pregnant women or her baby. The seasonal flu shot (injection) is proven as safe and already recommended for pregnant women. The 2009 H1N1 influenza vaccine will be made using the same processes and facilities that are used to make seasonal influenza vaccines.

Q: What safety studies have been done on the 2009 H1N1 influenza vaccine and have any been done in pregnant women?

A: A number of clinical trials which test 2009 H1N1 influenza vaccine in healthy children and adults are underway. These studies are being conducted by the National Institutes of Allergies and Infectious Diseases (NIAID). Studies of 2009 H1N1 influenza vaccine in pregnant women are expected to begin in September.

Q: Does the 2009 H1N1 influenza vaccine have preservative in it?

A: There is no evidence that thimerosal (used as a preservative in vaccine packaged in multi-dose vials) is harmful to a pregnant woman or a fetus. However, because some women are concerned about exposure to preservatives during pregnancy, manufacturers will produce preservative-free seasonal and 2009 H1N1 influenza vaccines in single dose syringes for pregnant women and small children. CDC recommends that pregnant women may receive influenza vaccine with or without thimerosal.

Q: Can the 2009 H1N1 influenza vaccine be given at any time during pregnancy?

A: Yes.

Q: How many 2009 H1N1 influenza vaccine shots will be needed?

A: Some people, including pregnant women, may need two doses. We will know more about the number of doses once data from the clinical trials are available.

Q. What will be the recommended interval between the first and second dose if two doses are needed?

A. This will not be known until clinical trial data are available. We anticipate that 21-28 days will be needed between the first and second doses.

Q: Should the 2009 H1N1 influenza vaccine be given to someone who has had an influenza- like illness since between April and now? Do I need a test to know if I need the vaccine or not?

A. There is no test that can show whether a person had 2009 H1N1 influenza in the past. Many different infections, including influenza, can cause influenza-like symptoms such as cough, sore throat and fever. In addition, infection with one strain of influenza virus will not provide protection against other strains. People for whom influenza vaccine is recommended should receive the 2009 H1N1 vaccine, even if they had an influenza-like illness previously. It is not necessary to test a person who previously had an influenza-like illness. People for whom the 2009 H1N1 influenza vaccine is recommended should receive it, even if they have had an influenza-like illness previously, unless they can be certain they had 2009 H1N1 influenza based on a laboratory test that can specifically detect 2009 H1N1 viruses. CDC recommends that persons who were tested for 2009 H1N1 influenza discuss this issue with a healthcare provider to see if the test they had was either an RT-PCR or a viral culture that showed 2009 H1N1 influenza. There is no harm in being vaccinated if you had 2009 H1N1 influenza in the past.

Q: What are the possible side effects of the 2009 H1N1 influenza vaccine?

A. The side effects from 2009 H1N1 influenza vaccine are expected to be similar to those from seasonal flu vaccines. The most common side effects following vaccination are expected to be mild, such as soreness, redness, tenderness or swelling where the shot was given. Some people might experience headache, muscle aches, fever, nausea and fainting. If these problems occur, they usually begin soon after the shot and may last as long as 1-2 days. Like any medicines, vaccines can cause serious problems like severe allergic reactions. However life-threatening allergic reactions to vaccines are very rare. In 1976, an earlier type of swine flu vaccine was associated with cases of a severe paralytic illness called Guillain-Barre Syndrome (GBS) at a rate of approximately 1 case of GBS per 100,000 persons vaccinated. Some studies done since 1976 have shown a small risk of GBS in persons who received the seasonal influenza vaccine. This risk is estimated to be no more than 1 case of GBS per 1 million persons vaccinated. Since then, flu vaccines have not been clearly linked to GBS. GBS has a number of different causes, and GBS can occur in a person who has never received an influenza vaccine. The potential benefits of influenza vaccination in preventing serious illness, hospitalization, and death substantially outweigh these estimates of risk for vaccine-associated GBS.

Anyone who has a severe (life-threatening) allergy to eggs or to any other substance in the vaccine should not get the vaccine. People should always inform their immunization provider if they have any severe allergies, if they’ve ever had a severe allergic reaction following flu vaccination, or if they have ever had GBS.

Q. Can the family members of a pregnant woman receive the nasal spray vaccine?

A. Pregnant women should not receive the live nasal spray influenza vaccine but family and household members and other close contacts of pregnant women (including healthcare personnel) who are 2 through 49 years old, healthy* and not pregnant may receive live nasal spray vaccine.

Q. Can a pregnant healthcare worker administer the live nasal influenza vaccine?

A. Yes. No special precautions are (such as gloves) are necessary. Hands should be washed or cleaned with waterless hand sanitizer before and after administering the vaccine or having any direct contact with patients in a health care setting.

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WHO: Swine flu pandemic has begun, 1st in 41 years

Thursday, June 11th, 2009

GENEVA – The World Health Organization declared a swine flu pandemic Thursday — the first global flu epidemic in 41 years — as infections in the United States, Europe, Australia, South America and elsewhere climbed to nearly 30,000 cases.

The long-awaited pandemic announcement is scientific confirmation that a new flu virus has emerged and is quickly circling the globe. WHO will now ask drugmakers to speed up production of a swine flu vaccine, which it said would available after September. The declaration will also prompt governments to devote more money toward efforts to contain the virus.

WHO chief Dr. Margaret Chan made the announcement Thursday after the U.N. agency held an emergency meeting with flu experts. Chan said she was moving to phase 6 — the agency’s highest alert level — which means a pandemic, or global epidemic, is under way.

“The world is moving into the early days of its first influenza pandemic in the 21st century,” Chan told reporters. “The virus is now unstoppable.”

“However, we do not expect to see a sudden and dramatic jump in the number of severe and fatal infections,” she added.

On Thursday, WHO said 74 countries had reported 28,774 cases of swine flu, including 144 deaths. Chan described the danger posed by the virus as “moderate.”

The agency has stressed that most cases are mild and require no treatment, but the fear is that a rash of new infections could overwhelm hospitals and health authorities — especially in poorer countries.

Still, about half of the people who have died from swine flu were previously young and healthy — people who are not usually susceptible to flu. Swine flu is also crowding out regular flu viruses. Both features are typical of pandemic flu viruses.

The last pandemic — the Hong Kong flu of 1968 — killed about 1 million people. Ordinary flu kills about 250,000 to 500,000 people each year.

Swine flu is also continuing to spread during the start of summer in the northern hemisphere. Normally, flu viruses disappear with warm weather, but swine flu is proving to be resilient.

“What this declaration does do is remind the world that flu viruses like H1N1 need to be taken seriously,” said Kathleen Sebelius, the U.S. Secretary of Health and Human Services, warning that more cases could crop up in the fall.

“We need to start preparing now in order to be ready for a possible H1N1 immunization campaign starting in late September,” she said in a statement from Washington.

Chan said WHO was now recommending that flu vaccine makers start making swine flu vaccine. Drug giant GlaxoSmithKline PLC said they could start large-scale production of pandemic vaccine in July but that it would take several months before large quantities would be available.

Glaxo spokesman Stephen Rea said the company’s first doses of vaccine would be reserved for countries who had ordered it in advance, including Belgium, Britain and France. He said the company would also donate 50 million doses to WHO for poor countries.

Pascal Barollier, a spokesman for Sanofi-Aventis, said they were also working on a pandemic vaccine but WHO had not yet asked them to start producing mass quantities of it.

The pandemic decision might have been made much earlier if WHO had more accurate information about swine flu’s rising sweep through Europe. Chan said she called the emergency meeting with flu experts after concerns were raised that some countries like Britain were not accurately reporting their cases.

Chan said the experts unanimously agreed there was a wider spread of swine flu than what was being reported.

Chan would not say which country tipped the world into the pandemic, but the agency’s top flu expert, Dr. Keiji Fukuda, said the situation from Australia seemed to indicate the virus was spreading rapidly there — up to 1,260 cases late Wednesday.

Many health experts said the world has been in a pandemic for weeks but WHO became bogged down by politics. In May, several countries urged WHO not to declare a pandemic, fearing it would cause social and economic turmoil.

“This is WHO finally catching up with the facts,” said Michael Osterholm, a flu expert at the University of Minnesota.

Despite WHO’s hopes, Thursday’s announcement will almost certainly spark panic about spread of swine flu in some countries.

Fear has already gripped Argentina, where thousands of people worried about swine flu flooded into hospitals this week, bringing emergency health services in the capital of Buenos Aires to the brink of collapse. Last month, a bus arriving in Argentina from Chile was stoned by people who thought a passenger on it had swine flu.

Chile has the most swine flu cases in South America, and the southern hemisphere is moving into its winter flu season.

In Hong Kong on Thursday, the government ordered all kindergartens and primary schools closed for two weeks after a dozen students tested positive for swine flu. The decision affected over half a million students.

In the United States, where there have been more than 13,000 cases and at least 27 deaths from swine flu, officials at the U.S. Centers for Disease Control and Prevention said the move would not change how the U.S. tackled swine flu.

“Our actions in the past month have been as if there was a pandemic in this country,” Glen Nowak, a CDC spokesman, said Thursday.

The U.S. government has already increased the availability of flu-fighting medicines and authorized $1 billion for the development of a new swine flu vaccine. In addition, new cases seem to be declining in many parts of the country, U.S. health officials say, as North America moves out of its traditional winter flu season.

Still, New York City reported three more swine flu deaths Thursday, including one child under 2, one teenager and one person in their 30s.

“Countries where outbreaks appear to have peaked should prepare for a second wave of infection,” Chan warned, adding that the virus could mutate “without rhyme or reason, at any time.”

In Mexico, where the epidemic was first detected, the outbreak peaked in April. Mexico now has less than 30 cases reported a day, down from an average of 300, Health Secretary Jose Angel Cordova told The Associated Press. Mexico has confirmed 6,337 cases, including 108 deaths.

Cordova said he is concerned that other countries were not taking drastic measures to stop its spread like Mexico, which closed schools, restaurants, theaters, and canceled public events. He said the Mexican government has strengthened its detection system to spot cases in most of its 32 states to prepare for a possible second wave of infections in the winter.

“There’s much anxiety over how the virus will act in the Southern Hemisphere, because the zone is currently showing a large number of new cases, in particular Australia, Chile and Argentina,” Cordova said.

Many experts said the declaration of a pandemic did not mean the virus was getting deadlier.

“People might imagine a virus is now going to rush in and kill everyone,” said John Oxford, a professor of virology at St. Bart’s and Royal London Hospital. “That’s not going to happen.”

But Oxford said the swine flu virus might evolve into a more dangerous strain in the future.

“That is always a possibility with influenza viruses,” he said. “We have to watch very carefully to see what this virus does.”
H1N1 Swine Flu Virus is Pandemic Now

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WHO: Swine flu pandemic has begun, 1st in 41 years

Thursday, June 11th, 2009

GENEVA – The World Health Organization declared a swine flu pandemic Thursday — the first global flu epidemic in 41 years — as infections in the United States, Europe, Australia, South America and elsewhere climbed to nearly 30,000 cases.

The long-awaited pandemic announcement is scientific confirmation that a new flu virus has emerged and is quickly circling the globe. WHO will now ask drugmakers to speed up production of a swine flu vaccine, which it said would available after September. The declaration will also prompt governments to devote more money toward efforts to contain the virus.

WHO chief Dr. Margaret Chan made the announcement Thursday after the U.N. agency held an emergency meeting with flu experts. Chan said she was moving to phase 6 — the agency’s highest alert level — which means a pandemic, or global epidemic, is under way.

“The world is moving into the early days of its first influenza pandemic in the 21st century,” Chan told reporters. “The virus is now unstoppable.”

“However, we do not expect to see a sudden and dramatic jump in the number of severe and fatal infections,” she added.

On Thursday, WHO said 74 countries had reported 28,774 cases of swine flu, including 144 deaths. Chan described the danger posed by the virus as “moderate.”

The agency has stressed that most cases are mild and require no treatment, but the fear is that a rash of new infections could overwhelm hospitals and health authorities — especially in poorer countries.

Still, about half of the people who have died from swine flu were previously young and healthy — people who are not usually susceptible to flu. Swine flu is also crowding out regular flu viruses. Both features are typical of pandemic flu viruses.

The last pandemic — the Hong Kong flu of 1968 — killed about 1 million people. Ordinary flu kills about 250,000 to 500,000 people each year.

Swine flu is also continuing to spread during the start of summer in the northern hemisphere. Normally, flu viruses disappear with warm weather, but swine flu is proving to be resilient.

“What this declaration does do is remind the world that flu viruses like H1N1 need to be taken seriously,” said Kathleen Sebelius, the U.S. Secretary of Health and Human Services, warning that more cases could crop up in the fall.

“We need to start preparing now in order to be ready for a possible H1N1 immunization campaign starting in late September,” she said in a statement from Washington.

Chan said WHO was now recommending that flu vaccine makers start making swine flu vaccine. Drug giant GlaxoSmithKline PLC said they could start large-scale production of pandemic vaccine in July but that it would take several months before large quantities would be available.

Glaxo spokesman Stephen Rea said the company’s first doses of vaccine would be reserved for countries who had ordered it in advance, including Belgium, Britain and France. He said the company would also donate 50 million doses to WHO for poor countries.

Pascal Barollier, a spokesman for Sanofi-Aventis, said they were also working on a pandemic vaccine but WHO had not yet asked them to start producing mass quantities of it.

The pandemic decision might have been made much earlier if WHO had more accurate information about swine flu’s rising sweep through Europe. Chan said she called the emergency meeting with flu experts after concerns were raised that some countries like Britain were not accurately reporting their cases.

Chan said the experts unanimously agreed there was a wider spread of swine flu than what was being reported.

Chan would not say which country tipped the world into the pandemic, but the agency’s top flu expert, Dr. Keiji Fukuda, said the situation from Australia seemed to indicate the virus was spreading rapidly there — up to 1,260 cases late Wednesday.

Many health experts said the world has been in a pandemic for weeks but WHO became bogged down by politics. In May, several countries urged WHO not to declare a pandemic, fearing it would cause social and economic turmoil.

“This is WHO finally catching up with the facts,” said Michael Osterholm, a flu expert at the University of Minnesota.

Despite WHO’s hopes, Thursday’s announcement will almost certainly spark panic about spread of swine flu in some countries.

Fear has already gripped Argentina, where thousands of people worried about swine flu flooded into hospitals this week, bringing emergency health services in the capital of Buenos Aires to the brink of collapse. Last month, a bus arriving in Argentina from Chile was stoned by people who thought a passenger on it had swine flu.

Chile has the most swine flu cases in South America, and the southern hemisphere is moving into its winter flu season.

In Hong Kong on Thursday, the government ordered all kindergartens and primary schools closed for two weeks after a dozen students tested positive for swine flu. The decision affected over half a million students.

In the United States, where there have been more than 13,000 cases and at least 27 deaths from swine flu, officials at the U.S. Centers for Disease Control and Prevention said the move would not change how the U.S. tackled swine flu.

“Our actions in the past month have been as if there was a pandemic in this country,” Glen Nowak, a CDC spokesman, said Thursday.

The U.S. government has already increased the availability of flu-fighting medicines and authorized $1 billion for the development of a new swine flu vaccine. In addition, new cases seem to be declining in many parts of the country, U.S. health officials say, as North America moves out of its traditional winter flu season.

Still, New York City reported three more swine flu deaths Thursday, including one child under 2, one teenager and one person in their 30s.

“Countries where outbreaks appear to have peaked should prepare for a second wave of infection,” Chan warned, adding that the virus could mutate “without rhyme or reason, at any time.”

In Mexico, where the epidemic was first detected, the outbreak peaked in April. Mexico now has less than 30 cases reported a day, down from an average of 300, Health Secretary Jose Angel Cordova told The Associated Press. Mexico has confirmed 6,337 cases, including 108 deaths.

Cordova said he is concerned that other countries were not taking drastic measures to stop its spread like Mexico, which closed schools, restaurants, theaters, and canceled public events. He said the Mexican government has strengthened its detection system to spot cases in most of its 32 states to prepare for a possible second wave of infections in the winter.

“There’s much anxiety over how the virus will act in the Southern Hemisphere, because the zone is currently showing a large number of new cases, in particular Australia, Chile and Argentina,” Cordova said.

Many experts said the declaration of a pandemic did not mean the virus was getting deadlier.

“People might imagine a virus is now going to rush in and kill everyone,” said John Oxford, a professor of virology at St. Bart’s and Royal London Hospital. “That’s not going to happen.”

But Oxford said the swine flu virus might evolve into a more dangerous strain in the future.

“That is always a possibility with influenza viruses,” he said. “We have to watch very carefully to see what this virus does.”
H1N1 Swine Flu Virus is Pandemic Now

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