Schuchat said she thinks the unusually high rate of transmission during the heat and humidity of summer, which normally sharply reduce transmission, may be because many Americans have no resistance to the virus from prior exposure. But there are "no data" to suggest why transmission is continuing, she said.
As of Friday, the CDC reported more than 40,000 laboratory-confirmed cases of the virus (commonly known as swine flu), 4,800 hospitalizations and 263 deaths. Experts believe more than a million Americans have been infected, however. Schuchat said the CDC would probably stop reporting cases soon because most people who are infected don’t get tested.
The World Health Organization, which has reported nearly 100,000 confirmed cases worldwide, said Thursday that it would stop counting cases because that required too much unnecessary work by health authorities. The agency had said a week earlier that it recommends local agencies no longer test for the virus unless they have not previously had cases or there is an unusual outbreak.

The WHO said earlier this week that healthcare workers should be the first to be immunized with a pandemic influenza vaccine, both because they are at highest risk due to their exposure to patients and because infected workers could spread the virus to hospitalized patients and others at high risk. Beyond that, the agency said, individual countries should set their own priorities for other groups, vaccinating schoolchildren if their goal is to limit transmission or vaccinating high-risk groups if their goal is to limit illness and deaths.
Schuchat said the CDC’s vaccine advisory committee will meet next week to set this country’s priorities. The Obama administration, however, has already said that it will make the vaccine available to schoolchildren at no charge, budgeting as much as $7.5 billion for the effort beyond the $2 billion already committed for vaccine ingredients.
Dr. Jesse Goodman, acting deputy commissioner of the Food and Drug Administration, said at the same news conference that an H1N1 vaccine will not be available until well after school has begun. Companies and the National Institutes of Health are still planning clinical trials for the pandemic vaccine, and it will be at least two months into such trials before any data are available, he said.
There have also been fears that a vaccine might not be available. The handful of companies that produce influenza vaccineshave been inundated with orders, and some, such as Baxter International Inc., have said they are unable to accept any further orders.
Because the vast majority of vaccine production is done overseas, some experts have speculated that a shortage will lead the countries where it is produced to limit exports so that their own populations will have full access.
Schuchat, however, said health authorities are not worried about such a possibility. "We are not concerned about meeting expectations for the vaccine. We haven’t gotten any information that makes us question the supply."

Swine flu is spreading even in summer

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The FDA said Chantix and Zyban will carry the warnings to alert consumers to the risks of depression and suicidal thoughts when using the drugs.

The drugs also have been reported to cause changes in behavior, hostility and agitation in users, whether users had a history of psychiatric illness or not. In many cases, side effects started shortly after use began and ended when the medication was stopped. The FDA does not know what is causing the changes and said people taking these products should be monitored by their doctor.

“The risk of serious adverse events while taking these products must be weighed against the significant health benefits of quitting smoking,” said Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research. “Smoking is the leading cause of preventable disease, disability and death in the United States, and we know these products are effective aids in helping people quit.”

The agency also is requiring Pfizer Inc., which makes Chantix, and GlaxoSmithKline, maker of Zyban, to conduct a study looking at how often these serious symptoms occur.

Pfizer says it updated its label in 2007 to include information of neuropsychiatric symptoms and has revised the label again to reflect Wednesday’s warning.

“The labeling update underscores the important role of health care providers in treating smokers attempting to quit and provides specific information about Chantix and instructions that physicians and patients should follow closely,” said Dr. Briggs W. Morrison, senior vice president of the primary care development group at Pfizer. “Quitting smoking is one of the best things people can do for their health, but the quitting process is both difficult and complex.”

The FDA says that since Chantix was approved in 2006, the agency has had reports of 98 suicides and 188 attempted suicides. Zyban has had reports of 14 suicides and 17 attempts.

Zyban contains the same active ingredient as the antidepressant Wellbutrin and already carried a box warning about the increased risk of suicidal thinking and behavior.

Neither Chantix nor Zyban contains nicotine, and the FDA said some symptoms could be the result of nicotine withdrawal. Still, the agency said, people using these drugs experienced some of these symptoms while they were still smoking.

In a review of side effects in patients using the nicotine patch, the agency said it didn’t find a clear link between those products and suicidal events.

Two anti-smoking drugs to carry mental-health warnings

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“Bao” began his journey at St. Louis, Missouri, took a connecting flight at St. Paul, Minnesota, for Tokyo, Japan on May 7th, according to Xinhua state-run news agency.

On May 8, according to the Health Ministry, he flew from Tokyo on flight NW029 and arrived at Beijing Capital International airport on May 9 at 1:30 a.m. At the time of his arrival in Beijing, he had no symptoms and had a body temperature of 37 degrees Celsius (98.6 degrees Fahrenheit).

Soon after, he took a flight onwards to Chengdu and felt feverish, with throat pain, coughing, and a stuffy and slightly running nose and was confirmed with human swine flu on Monday, the Health Ministry said.

The patient is in isolation and is being treated at the Chengdu Infectious Diseases Hospital where he’s listed as having recovered with a normal body temperature, the Health Ministry said.

Most of the passengers aboard the same Beijing-Chengdu flight have been tracked down in 21 different provinces and sent to medical observation, according to the Health Ministry.

The case comes more than a week after a 25-year-old Mexican man with the H1N1 virus arrived in Hong Kong from Mexico via Shanghai, leading to the weeklong quarantine of more than 340 people in the Chinese special administrative region.

There have been 4,657 confirmed human cases of H1N1 in the world as of Sunday.

China confirms mainland swine flu case

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Health ministers from the 10-member Association of South East Asian Nations (ASEAN) plus China, Japan and South Korea will intensify cross-border cooperation and establish joint response teams to fight the spread of the virus, also known as swine flu.

According to the statement, the ministers were concerned that most of the production capacity for vaccines was located in North America and Europe and it was inadequate for a global pandemic.

Asia has no capacity to produce vaccines at the moment.

“Despite other regions having begun to acquire the technology to produce influenza vaccines, access to effective pandemic vaccines is a major problem in the region,” the statement said, calling for the transfer of technology to make vaccines and antiviral medicine.

Chinese Health Minister Chen Zhu told reporters Beijing was pressing drug companies in China to increase the existing “quite small” national antiviral stockpile, but admitted it was a tall order to provide enough in a country of 1.3 billion people.

“Our objective is a stockpile for eventually one percent of the population. One percent is already quite huge,” he said.

He defended the quarantine of passengers on a flight from Mexico, lifted Thursday after one week.

“At this time, we think this kind of precaution and measures are still necessary, but things may change according to the analysis of the WHO and our experts,” Zhu said.

NO TRAVEL BANS

The 13 countries will look at screening people leaving affected areas but are not planning travel bans.

Evidence showed that “imposing travel restrictions would have very little effect on stopping the virus from spreading, but would be highly disruptive to the global and regional communities and pose major negative impacts on the current global economic downturn,” the statement said.

Margaret Chan of the World Health Organization (WHO) told the meeting Asian governments had to stay vigilant, but urged them to “refrain from introducing economically and socially destructive measures that lack solid scientific backing and bring no clear benefit.”

“The rational use of travel- and trade-related measures is always wise at a time of severe economic downturn,” she added.

Asia has seen far fewer confirmed cases of the H1N1 virus, which has killed 44 people in Mexico and two in the United States, and spread across Europe.

However, after the damage wrought by SARS and bird flu in recent years, Asian countries are taking no chances this time.

The statement said they would “assess the potential need and increase national stockpiling of antivirals and essential medicines, medical supplies and personal protective equipment to the level necessary for effective responses” if the flu spreads.

They would also “consider the establishment in ASEAN+3 countries of a system to facilitate the sharing of essential supplies in the region in case of emergency needs.”

ASEAN comprises Indonesia, Thailand, Singapore, Malaysia, Myanmar, Vietnam, Cambodia, Laos, Brunei and the Philippines.

Asian countries pledge common fight against flu

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International tensions triggered by the new H1N1 virus, which contains mostly swine components with bits of human and avian influenzas, emerged after about 20 nations banned imports of pork, pigs and other meat from the United States, Canada and Mexico, the three most flu-affected countries.

Mexico, the epicentre of the new flu outbreak which has surfaced in 21 countries, declared it was winning the battle against the flu, which has killed 26 people in the Latin American oil producer nation.

Health Minister Jose Angel Cordova told reporters on Monday the government would lift the five-day shutdown it imposed on public and business activities on May 1 after the epidemic swept across the country.

“(We will) resume, as planned, activities in the public and private sector on May 6 with recommendations on matters of health and hygiene at the workplace,” Cordova said.

Most of Mexico’s schools will remain closed until May 11.

As infections of the new H1N1 flu strain continued to appear across the globe, the World Health Organisation wavered over whether it might declare a full pandemic alert.

Canada threatened to take China to the World Trade Organisation unless Beijing backed down from its ban on imports of pigs and pork from Alberta province, where a herd of pigs was found to have the H1N1 strain.

While the new H1N1 virus is not food borne, fears it may spread through animal products have prompted restrictions on live pigs, pork, cattle, poultry, livestock, feed and animal semen from countries with infections.

U.S. hog futures fell on Monday and meat packing companies cut pork production this weekend amid the import bans and an apparent slide in retail orders due to the H1N1 flu, which has also caused exports from Canada to tumble.

CALL FOR CAUTION

WHO chief Margaret Chan said the apparent good news from Mexico over the epidemic had to be treated with caution.

“Flu viruses are very unpredictable, very deceptive … We should not be over-confident,” she said. “One must not give H1N1 the opportunity to mix with other viruses.”

More than 1,000 people in 21 countries have caught what has become known as the swine flu, but U.N. chief Ban Ki-moon said WHO does not plan to raise its pandemic alert to the highest level if the current outbreak of the new strain of flu continues as is.

However, epidemic experts warned that while the impact on world health appeared to be relatively mild at present, the fast-mutating flu could come back with a vengeance later.

“The next year it may break out in wild ways,” said Dr. C.J. Peters, a microbiologist at the University of Texas Medical Branch at Galveston and specialist in emerging infectious diseases. “If we don’t pay attention to this outbreak as a bad actor, we could be very, very sorry.”

In the United States, the second biggest focus of infection after Mexico, the new virus has now infected 286 people in 36 states, the Centres for Disease Control and Prevention said.

Before issuing a level 6 pandemic alert, WHO would need to see the virus spreading within communities in Europe or Asia.

“We are not there yet … No one can say right now how the pandemic will evolve, or indeed whether we are going into a pandemic,” Chan told a U.N. General Assembly session.

MEXICO BREATHES EASIER

Mexican President Felipe Calderon has said the outbreak that has sickened 701 people in the country is stabilising.

Mexico’s peso made its biggest gains in over six months on Monday and stocks jumped as fears eased about the outbreak’s economic impact.

Many Mexicans, chafing after days of isolation at home, are desperate to get back to work after a period of inactivity that has hit family incomes at a time of global recession.

“It’s going to be a disaster if this carries on,” said Martin Velasquez, 28, a construction worker.

In a brewing diplomatic dispute between Mexico and China over the treatment of Mexican citizens caught up in the flu alert, Mexico was sending a plane to retrieve dozens of its nationals quarantined by Chinese authorities.

Mexico accused Beijing of discrimination against Mexicans, but China’s Foreign Ministry rejected the criticism.

Mexico breathes easier but flu pandemic likely

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“We think very few of the cases we have confirmed are in people over 50,” the U.S. Centers for Disease Control and Prevention’s Dr Anne Schuchat told reporters in a telephone briefing. “Whether this will pan out over the weeks ahead we don’t know.”

The CDC reported 226 cases of the new H1N1 swine flu virus and one death in 30 states. The CDC previously had confirmed 160 cases in 21 states.

Mexican officials say they believe the outbreak there is starting to ease, although they are still trying to get a full picture of just how far the disease has spread.

Schuchat said the virus is fairly widespread in the United States, meaning that most states have reported cases. New York has the most cases with 63, many linked to a school in the New York City borough of Queens. Texas has 40 cases.

U.S. health officials said they were encouraged by signs in Mexico that the number of cases are leveling off and that there was only one death in the United States — a toddler visiting from Mexico.

Most cases in the United States have been reported to be mild. But 30 people, mostly older children and young adults, have been hospitalized with the disease, U.S. officials said.

Schuchat said that with seasonal flu, the elderly and very young are most likely to be sick enough to be hospitalized — 200,000 a year on average.

“I don’t think we are out of the woods yet,” Schuchat said. “From what I know of influenza, I do know there will be more cases, more severe cases and more deaths.”

Health and Human Services Secretary Kathleen Sebelius said on Sunday that flu vaccines for both the new strain of the H1N1 virus and the seasonal flu should be ready by autumn.

She told NBC’s “Meet the Press” that the government is accelerating production of a vaccine against the seasonal flu, which is expected to infect millions of Americans, and is beginning laboratory work on the new H1N1 virus.

Companies already are making the vaccine for the autumn months with a mixture of three influenza viruses that was chosen this year before the new strain broke out.

They have a number of choices — leaving the new strain out of the mix altogether, replacing the current H1N1 component with the new H1N1 strain, or making it a so-called quadrivalent vaccine that includes the new swine H1N1, the circulating seasonal H1N1, the H3N2 component and the influenza B strain.

It takes months to formulate influenza vaccines and they must be made fresh every ear, with new strains of the constantly mutating virus.

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And a lab with the new test has been set up in Mexico in the hope of finding out how many of the 2,500 suspected cases are in fact the new strain of H1N1 swine flu.

“Now there is a lab that is up and running in Mexico that is able to do diagnoses,” Centers for Disease Control and Prevention acting director Dr. Richard Besser told reporters.

Before, Mexico had to send samples to the CDC in Atlanta or a World Health Organization lab in Winnipeg, Canada, meaning a lag of several days.

“This is really a big step. It is going to help us with the studies there. We will be able to confirm cases, the risk factors for those cases. It is going to be very helpful in terms of speeding up the course of those studies.”

Besser said the CDC is sending out testing kits to U.S. states that will allow individual state labs to confirm their own cases of swine flu. “We are in the process of rolling out testing capability in every state,” Besser said.

The new strain, a strange mix of two swine flu strains with dribblings of genetic material from avian and human flu virus, may have killed up to 176 people in Mexico and a toddler in Texas.

But the symptoms it causes are virtually identical to regular seasonal flu, as well as a host of other respiratory illnesses from the common cold to more exotic coronaviruses.

ON THE SPOT TESTS

A quick on-the-spot test can tell doctors if a patient has influenza and some will tell whether it is type A. But more sophisticated tests must be done to show whether it is an H1N1, the type that includes both one of the seasonal influenza strains and the new swine flu strain.

Even further testing will show if it is the new strain, but this requires either a process called PCR, which amplifies and analyzes the genetic material of the virus, or using a test called an antibody test to see if the patient’s immune system has mounted a defense against the virus.

“What is being rolled out right now by the CDC is a specific test for this new virus,” said the CDC’s Dr. Lyle Petersen.

It will fit onto the PCR platform used in state health departments for influenza surveillance and will produce a result in a matter of hours, Petersen said. But it is not something a doctor or clinic can do. “You need a fancy machine to do it,” he said in a telephone interview.

For now, the CDC recommends only that people with flulike symptoms who have some kind of recent travel to Mexico or who have been in close contact with a known swine flu patient should get the test.

Petersen said there is a limited amount of material, called reagent, that can be used to make the PCR tests work.

And if the disease is spreading, that will become clear anyhow. “No one is going to recommend doing wholesale testing anyway. If you have a giant outbreak of flu you don’t need to test every single person if you know what it is,” he said.

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The boy, whom officials did not identify, traveled to Mexico during spring break. While there, he spent time at a farm, a fair, a couple of different cities and in Mexico City, according to Elyria City Health District officials.

He got back from the trip last Monday and started having symptoms Wednesday. He went to EMH Regional Medical Center in Elyria on Friday with an elevated temperature and cold- and flu-like symptoms, Elyria City Health District Commissioner Kathryn Boylan said.

After learning about the symptoms and the family history, hospital officials decided it could be a case of swine flu.

A specimen was taken to the Ohio Department of Health lab and forwarded to the Centers for Disease Control, Boylan said.

Officials were notified Sunday morning that it was a confirmed case of swine flu.

“The child is doing just fine,” she said.

“And so for that, we are extremely grateful.”

The child, who is taking the antibiotic Tamiflu, is resting at home, officials said.

None of the other immediate family members have any symptoms, but they are taking medication as a precaution.

Elyria City Schools Superintendent Paul Rigda said officials originally did not plan to close Ely, which has about 350 first- through sixth-grade students.

However, the Elyria City Health District later got an advisory from the CDC that there could be a longer incubation period than what was originally thought, Rigda said.

Officials did not want the kids to be together for at least one week after the first case might have created the exposure to the illness. As a result, the school will be closed all week. The closure only applies to Ely.

“This is not a result of any new cases at all,” he said about the decision to close for the week.

He added the decision was just a precaution.

The district used its phone alert system to inform parents about the news, Rigda said. They sent one message to the parents of Ely students and a different message to parents with children at the other schools.

A letter with more information also will be sent home, he added.

Volunteers from the Community Emergency Response Team headed out Sunday to relay the information to families who could not receive the phone message, said Tom Kelley, director of Lorain County Emergency Management and Homeland Security.

Boylan said that if students from Ely have a sore throat, elevated temperature or other flu-like symptoms, they should consult a doctor or go to the emergency room and say they might have been in contact with the student who has swine flu.

The Centers for Disease Control and Prevention defines swine flu as “a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs.”

There was one other case in the county where a person went to Mexico and had flu-like symptoms, said Douglas McDonald, the medical director for the Elyria City Health District. However, the preliminary tests were negative.

The symptoms of swine flu are similar to the regular flu and include a fever of 102 to 103 degrees, runny nose, nasal congestion, coughing, sore throat and lack of appetite, according to information from the Lorain County Office of Emergency Management and Homeland Security.

Swine flu is contagious and can be spread either by people or through contact with infected pigs or in environments that are contaminated with the swine flu viruses, according to information provided by emergency officials Sunday.

It cannot be transmitted by eating pork.

There is not a vaccine for swine flu, but there are medicines to treat it. The seasonal flu vaccine does not protect against swine flu.

EMH spokeswoman Kristen Davis confirmed that the hospital does not currently have any patients with confirmed swine flu and no one there is exhibiting those symptoms.

“Our ER staff is getting supplies available for testing, making them readily accessible and going through the process to increase staff if we do need to do that” in the event that more cases come about, she said.

Jennifer Kennedy, director of marketing and communications for Community Regional Medical Center in Lorain, said no one has come into their hospital with any symptoms.

“Our entire staff has been notified about the signs and symptom of swine flu, and they’re taking the proper precautions,” she said.

“We feel prepared.”

Emergency officials have set up a hot line that people can call with questions. That line, 440-324-3177, will be staffed through at least 11 a.m. today with public health nurses.

Swine flu diagnosed in Elyria

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The outbreak of the new virus transmitted from human to human that has killed up to 60 people and infected hundreds in Mexico and infected eight in the United States is a “serious situation” with a “pandemic potential”, the head of the World Health Organization said Saturday.

In Mexico City, where 13 of 20 confirmed deaths occurred, officials said no deaths from swine flu had been registered on Friday, but reassurances came amid the severest public health measures seen here since a 1985 earthquake.

Meanwhile in the United States, where eight non-fatal infections occurred in Texas and California, reports said that 75 students in New York being treated for flu-like symtoms had recently traveled to Mexico, but no swine flu case was confirmed.

“A new virus is responsible” for the cases reported in Mexico and the United States, WHO Director General Margaret Chan said in a telephone press conference Saturday.

How the situation will evolve is “unpredictable,” she said, urging other countries to “increase vigilance”.

“This virus has clearly a pandemic potential,” Chan added.

Mexican Health Minister Jose Angel Cordova confirmed 20 deaths from swine flu late Friday and said authorities were probing another 48 who had died with similar symptoms.

Health officials have been investigating more than 1,000 possible swine flu infections.

Apart from the capital, four other deaths were in central San Luis Potosi, two in Baja California, in northwest Mexico, and one in Oaxaca, in the southeast.

But Cordova added that it was “an epidemic, not a pandemic.”

Mexican President Felipe Calderon said that the government would decree necessary emergency or preventative measures.

Authorities on Friday launched a huge campaign to prevent the spread of the virus, urging people to avoid contact in public.

In Mexico City, schools closed for up to a week, according to the health minister, and numerous public venues, including museums and sports stadia were closed to the public.

Mexico City Mayor Marcelo Ebrard said late Friday that 553 sporting and cultural events had been canceled for at least 10 days to avoid large public gatherings.

The capital did not register any deaths on Friday, Armando Ahued, the local health minister said Saturday.

“The good news is that sick people are reacting adequately to the medication,” Ahued said, without giving further details.

Mexico City authorities initially announced a mass vaccination campaign using regular human flu vaccines, but later admitted that the WHO had advised them that it was better to use antiviral medicines, and said they had more than one million doses of suitable drugs.

The CDC website states that there is no vaccine to specifically protect humans from swine flu, only to protect pigs.

The US Centers for Disease Control and Prevention (CDC) said tests show some of the Mexican victims died from the same new strain of swine flu that affected eight people in Texas and California, who later recovered.

The WHO, which was to send a team of experts to Mexico, said Friday that most Mexican cases had occurred in otherwise health young adults.

“Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern,” the Swiss-based body said in a statement.

Seven other countries on the continent on Friday adopted preventative measures to try to avoid the spread of the virus to their territory.

In Mexico City, medical teams were on stand-by at the international airport, and all passengers had to fill out a health questionnaire.

Human outbreaks of H1N1 swine influenza virus were recorded in the United States in 1976 and 1988, when two deaths were recorded, and in 1986. In 1988 a pregnant woman died after contact with sick pigs, according to the WHO.

In recent years, the global focus for a pandemic has shifted to the H5N1 bird flu virus, which has spread from poultry to humans and killed 257 of the 421 people infected by the virus since 2003.

If a pig is simultaneously infected with a human and an avian influenza virus, it can serve as a “mixing vessel” for the two viruses that could combine to create a new, more virulent strain.

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The study is the first to identify common genetic variants influencing stroke risk in the United States and may lead to better treatments, they reported on Wednesday.

While other stroke-related genes have been discovered, none involved such a wide portion of the population, said Eric Boerwinkle of The University of Texas Health Science Center.

“This is a first step in unraveling the genetic contributions of this debilitating disease,” said Boerwinkle, whose team was one of several contributing to the study published in the New England Journal of Medicine.

Stroke is the third-leading cause of death in the United States and causes serious long-term disabilities for many worldwide.

Boerwinkle said the teams found two genetic variants on chromosome 12 near two genes that are implicated in stroke. One, called WNK1, is associated with blood pressure control and the other, NINJ2, is linked with brain injury repair.

The two genes, next to each other, both are also strongly linked with ischemic stroke, which is the most common type of stroke and is caused by blocked blood vessels in the brain.

Boerwinkle said it is not clear which specific gene is implicated, but he said the most likely suspect is NINJ2.

They found two single-letter changes in the DNA, known as single nucleotide polymorphisms or SNPs — pronounced “snips” — near NINJ2 that seem to send the strongest stroke “signal.” One is found in about 20 percent of whites they checked and 10 percent of African-Americans.

Having just one copy of this genetic variation can raise the risk of ischemic strokes by about 30 percent, he said — although the study says it is unlikely the SNPs are the actual cause of stroke but probably associated with the actual genetic cause.

The findings come from an analysis of the genetic code of more than 19,000 people in the United States and Europe taking part in four long-term studies of cardiovascular risks.

The teams were looking for SNPs among 1,544 people who had strokes, compared with 18,058 people who did not.

Boerwinkle said more work needs to be done to sort out which genes are at play, but he said the findings should give drug companies a new target for researching better treatments.

Dr. Walter Koroshetz, deputy director of the U.S. National Institute of Neurological Disorders and Stroke, which supported the study, said the findings are not strong enough to alter a patient’s stroke prevention strategy.

But he said the results “will lead scientists to direct their attention to new, important biologic mechanisms and hopefully new treatments to prevent stroke.”

Scientists uncover genetic risks for stroke

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