AFD - Australia & Pandemic

[sharon sanders]

Australia To Refresh Antiviral Stockpile




http://afludiary.blogspot.com/2008_08_01_archive.html



# 2217



In case there are any thoughts about whether the threat of a pandemic has diminished over the past few years, the moves of a number of governments would seem to say otherwise.


The UK has just released their national threat assessment, and pandemic flu tops the list. The UK is also doubling their antiviral stockpile.


Japan, as well, is looking to double their antiviral stockpile and is seriously considering deploying some 20 million doses of pre-pandemic vaccine next year before it expires.


And Australia has just allocated 167 Million dollars to replace soon-to-be out of date antivirals from their national stockpile.

Time's up for antiviral stockpile
by Louise Durack

Australia will not be left without antivirals to deal with an influenza pandemic as the stockpiled drugs reach their use-by date over the next two years the government says.


About $167 million is to be spent on renewing the ageing stocks of Tamiflu as they reach their expiry date between now and 2010, a Federal health department spokesman has told 6minutes.


Researchers have expressed concern of how Australia would deal with a bird flu pandemic if the nation?s stockpile of anti-viral drugs, including Tamiflu and Relenza, were not renewed.


The National Medical Stockpile (NMS) is believed to consist of about nine million courses of the two drugs, over 90% of which comprises Tamiflu.


The spokesman for the Department of Health and Ageing said stocks of Relenza will not begin to expire until 2011.


He added that there is ?no evidence to suggest a need for a change in composition of the [stockpile] at this time, however, the Department is continuing to monitor the situation?.

8 August 2008
​

posted by FLA_MEDIC @ 6:01 AM

 

[sharon sanders]

Re: AFD - Australian Preparedness

Re: AFD - Australian Preparedness

Editorial: Australia Unprepared for Epidemic



# 2220




Over the past few years the most pessimistic numbers I've seen about fatalities from a pandemic came from Dmitry Lvov, Director of the Ivanovsky Research Institute of Virology at the Russian Academy of Medical Sciences.


Dr. Lvov has suggested (see From Russia With Lvov ) up to 1 Billion people could die in a pandemic. I hasten to add, that is at least 5 times higher than most scientists have been willing to entertain.


Now, quite astonishingly, we have an even higher estimate from Dr. John Graham, chairman of the department of medicine at Sydney Hospital, in an editorial piece that appears today in The Australian.


He speculates that up to 4 Billion people could die in a matter of months during a pandemic.

I confess, I have a hard time taking this estimate seriously.
​

It presupposes that the attack rate of a pandemic would be 100%, and that 2/3rds of those infected would die. Possible, I suppose, in the sense that `just about anything is possible'.


But not terribly likely.


Granted, he prefaces his statement with a big `if'; `if the new virus retains the same pathogenicity of the current avian influenza virus'. And unsaid, but implied, the attack rate would have to be near 100% as well.


Whether you agree with the numbers or not, it is worth following the link to read the entire editorial.

Australia unprepared for epidemic

• OPINION: John Graham | August 09, 2008

IN February 2008, 10 swans in Dorset, south-west England, were found to be positive for the H5N1 avian bird flu virus. The virus has long since escaped from Asia. Could Australia be next?


Much virological opinion suggests that if this virus is ever to create a human-to-human influenza world pandemic, it will probably have to undergo a recombination mutation inside a human who is already suffering from a transmissible human strain of the influenza virus. In many ways it is a bit surprising that this has not already happened.


Given the magnitude of international air travel and the likely length of the asymptomatic incubation period of any new influenza virus, which would certainly exceed the time taken to fly between any two points on the earth's surface, it is highly likely that the entry of a new virus into Australia is almost unstoppable.


Professor Peter Curson of the Centre for International Security Studies at the University of Sydney has recently highlighted the difficulties facing traditional quarantine measures in an age of mass air travel.


If, however, the first case arriving in Australia is detected and isolated in time, there is still a chance that an epidemic on our continent can be prevented.


The current H5N1 virus has been known so far to have infected at least 385 people around the world, mostly in Asia, and the death rate -- despite all modern available treatment, including all the currently available vaccines and antivirals -- is approximately 63 per cent.


If and when a pandemic next occurs, if the new virus retains the same pathogenicity of the current avian influenza virus, we can expect about 4 billion people to die in the world over a six-month period. And that is how long it will take for a truly protective new vaccine to be developed and produced.

(Continue . . .)

​

posted by FLA_MEDIC @ 12:40 PM

 

[sharon sanders]

Re: AFD - Australian Preparedness

Re: AFD - Australian Preparedness

Emergency Department Stats From Australia


# 3398

We?ve charts from two Children?s hospitals in and around Sydney, Australia (Westmead is a suburb of Sydney) showing the number of influenza-related emergency room visits over the past 6 years.

The increase during the June-September period coincides with their influenza season.

There are two things of interest here.

First, and most obvious, is the huge spike in emergency room visits at both hospitals over the past couple of weeks. Some of that may be the `worried well?, but reports indicate that these hospitals are seeing a lot of sick kids.

This spike is nearly double the highest numbers seen during the previous 6 years.

Less obvious, perhaps, but just as important is that in years past, mid-to-late June has been a relatively quiet time for Emergency Department visits in Sydney. The peak for flu-related visits normally doesn?t come until late July or August.
​

These are just two data points, and so we shouldn?t try to draw too many conclusions from them. They do, however, suggest that the H1N1 virus is having a major impact very early in Australia?s flu season.


Children's Hospital Westmead ED Visits. The black line represents activity over the past year.

Sydney Children's Hospital Randwick ED Visits. The black line represents activity over the past year.

Below we have a statement issued by the NSW Health Department, warning people not to take this virus lightly.

26 June 2009
Community Transmission of H1N1 Influenza 09

NSW Chief Health Officer, Dr Kerry Chant, today said that with an increasing level of community transmission of H1N1 Influenza 09, it is important that people throughout NSW understand the potential impact on the community.

"We currently have two children in Intensive Care units and two other people hospitalised," Dr Chant said.

A five year old girl was admitted to Intensive Care, yesterday, with influenza infection. She had no pre-existing medical risk factors for severe influenza. A nine year old boy with a medical history of asthma was also admitted to Intensive Care.

"This is the very confronting side of H1N1 Influenza 09 that can't and shouldn't be dismissed. What these cases highlight is that, although mild in many people, H1N1 Influenza 09 can be severe in some, especially those with underlying medical conditions.

Dr Chant reiterated steps that can be taken to reduce the chances of contracting H1N1 Influenza: washing hands regularly with soap, covering up coughs and sneezes, and staying at home if you have influenza-like symptoms.

"I also want to again alert those vulnerable members of our community to be especially vigilant - pregnant women, people with underlying health conditions like diabetes, respiratory, heart and renal disease, and Indigenous Australians. They need to immediately seek help from their GP or, if one is not available, the nearest flu clinic or Emergency Department, if they develop flu symptoms."

(Continue . . .)
​

 

[sharon sanders]

Re: AFD - Australia & Pandemic

Victoria: H1N1 Crowding Out Seasonal Flu?



# 3397





For much of the last century, mankind only had to deal with one circulating influenza `A? strain at a time.

When a new pandemic strain showed up, as it did in 1918, 1957, and 1968 ? it overran, and replaced, the previously circulating influenza strain.

Whatever happened before 1918 is a matter of conjecture, as modern testing methods did not exist back then.

And while scientists weren?t sure exactly why this happened, they came to expect it when a new pandemic virus arrived on the scene.

It would, in short order, replace the existing flu strain.

Then in 1977 the H1N1 virus, driven into extinction in 1957 by the H2N2 virus, showed up again after a 20 year absence (the H2N2 virus, in turn, had been replaced by the H3N2 virus in 1968).

How H1N1 reemerged is a bit of a mystery, although it seemed to start in Russia (hence it was called the `Russian Flu?), and many people suspect it was the result of some kind of laboratory accident.
​

Those people who were around in the mid to late 1950s had exposure to the H1N1 virus, and had some acquired immunity. Those under the age of 20 were the hardest hit. While not a true pandemic, 1977 will be remembered as a very difficult flu season.

This time, however, the H1N1 virus didn?t replace the H3N2 virus . . . it began to co-circulate along with it. For the first time in our (admittedly) limited experience, we now had two influenza `A? viruses at the same time.

The fact that Russian Flu wasn?t a true pandemic across all age groups may explain why this happened.

Since older people had acquired some immunity to the H1N1 virus in the 1950s, it wasn?t strong enough to drive the H3N2 virus out of that population.

​

Vaccine manufacturers suddenly had to move to a trivalent (3 strain vaccine) in order to cover both `A? strains, and influenza `B?.

In 2002, a third `A? Strain was identified, the H1N2 ? clearly an assortment between the H3N2 and the H1N1 virus. It appears no more virulent that its parents, and has produced no detectable surge in influenza cases.

Fortunately, since H1N2 shares the hemagglutinin and neuraminidase surface proteins of the H1N1 and H3N2 viruses, the vaccines for those appear to work for this reassortment.
​

It is into this crowded field that the novel H1N1`swine? flu virus enters, and how it interacts with these other viruses is a big unknown.

Will it co-circulate with the other H1N1, H3N2, and H1N2 viruses?

Or will it replace them, and become the dominant flu strain around the world?
​

As the H1N1 virus spreads globally, particularly in the Southern Hemisphere where it is there regular flu season, we will watch carefully to see how it acts, and whether it begins to replace the existing flu strains.

According to this report by Jason Gale of Bloomberg news, in the early going in Victoria, Australia, the novel H1N1 virus appears to be driving the other viruses out.

Swine Flu Supplanting Seasonal Strains in Australia?s Victoria
By Jason Gale
June 26 (Bloomberg) -- Swine flu is supplanting seasonal strains in Australia?s Victoria state, suggesting the pandemic virus will be the major cause of influenza this winter.

Tests on 138 type-A flu samples collected by a network of doctors confirmed 60 cases of the new A/H1N1 variant and only five of seasonal influenza in the eight weeks ended June 21, according to a report today by the Victorian Infectious Diseases Reference Laboratory in Melbourne.

A typical feature of previous pandemics is for a novel virus to crowd out the most common flu strains during winter, Margaret Chan, director-general of the World Health Organization, said this month. It?s also a factor the agency will consider in determining when vaccine makers should switch to producing only shots against the pandemic virus, which is spurring an increase in flu cases in Australia including New South Wales state.

?We are seeing a big increase compared to the same stage of the flu season last year, and the increase is predominantly in 5- to 16-year-olds,? Kerry Chant, chief health officer for New South Wales, said in a statement today. Two children are in intensive care and two other people hospitalized, she said.

Continue . . . .)
​

 

[sharon sanders]

Re: AFD - Australia & Pandemic

Emergency Department Stats From Australia


# 3398

We?ve charts from two Children?s hospitals in and around Sydney, Australia (Westmead is a suburb of Sydney) showing the number of influenza-related emergency room visits over the past 6 years.

The increase during the June-September period coincides with their influenza season.

There are two things of interest here.

First, and most obvious, is the huge spike in emergency room visits at both hospitals over the past couple of weeks. Some of that may be the `worried well?, but reports indicate that these hospitals are seeing a lot of sick kids.

This spike is nearly double the highest numbers seen during the previous 6 years.

Less obvious, perhaps, but just as important is that in years past, mid-to-late June has been a relatively quiet time for Emergency Department visits in Sydney. The peak for flu-related visits normally doesn?t come until late July or August.
​

These are just two data points, and so we shouldn?t try to draw too many conclusions from them. They do, however, suggest that the H1N1 virus is having a major impact very early in Australia?s flu season.


Children's Hospital Westmead ED Visits. The black line represents activity over the past year.

Sydney Children's Hospital Randwick ED Visits. The black line represents activity over the past year.

Below we have a statement issued by the NSW Health Department, warning people not to take this virus lightly.

26 June 2009
Community Transmission of H1N1 Influenza 09

NSW Chief Health Officer, Dr Kerry Chant, today said that with an increasing level of community transmission of H1N1 Influenza 09, it is important that people throughout NSW understand the potential impact on the community.

"We currently have two children in Intensive Care units and two other people hospitalised," Dr Chant said.

A five year old girl was admitted to Intensive Care, yesterday, with influenza infection. She had no pre-existing medical risk factors for severe influenza. A nine year old boy with a medical history of asthma was also admitted to Intensive Care.

"This is the very confronting side of H1N1 Influenza 09 that can't and shouldn't be dismissed. What these cases highlight is that, although mild in many people, H1N1 Influenza 09 can be severe in some, especially those with underlying medical conditions.

Dr Chant reiterated steps that can be taken to reduce the chances of contracting H1N1 Influenza: washing hands regularly with soap, covering up coughs and sneezes, and staying at home if you have influenza-like symptoms.

"I also want to again alert those vulnerable members of our community to be especially vigilant - pregnant women, people with underlying health conditions like diabetes, respiratory, heart and renal disease, and Indigenous Australians. They need to immediately seek help from their GP or, if one is not available, the nearest flu clinic or Emergency Department, if they develop flu symptoms."


(Continue . . .)


​