In this Issue

If this monthly Newsletter was forwarded to you and you do not want to miss an issue:

Current Pandemic Flu Threat Level 3

Each issue, Affiliated Physicians brings you the World Health Organization's current Pandemic Flu threat level.

Confirmed Cases of Avian Flu (H5N1)

Human Cases of
Avian Flu (H5N1).
Click here.

Animal Cases of
Avian Flu (H5N1).
Click here.

Antiviral drugs:
today's best prevention and treatment

Your Local and State Pandemic Planning Activities

Click here to find your State's activities.

Pandemic Blog

Click here for expert opinion on Pandemic and Avian Flu
from the completed D.H.H.S. Pandemic Blog.

Worldwide Headlines:

Bird Flu Cases In Europe

Summer Flu Alert Issued In Hong Kong

Bird Flu Dogs To Work In Holland

UK Bans Pigeon Racing From France After Bird Flu Case

Quick Links

Affiliated Physicians Pandemic & Seasonal Flu Services

Affiliated Physicians Corporate Web Site

World Health Organization

Centers for Disease Control and Prevention

Center for Infectious Disease Research & Policy

PandemicFlu.gov

US National Strategy for Pandemic Influenza

US Department of State

OSHA

American Red Cross

Roche

Pandemic Influenza Canada

World Organization for Animal Health

VACCINE MAKER GEARS UP
FOR FLU SEASON

Novartis Vaccines, a Novartis unit, plans to increase the U.S. supply of its influenza vaccine by 30% this upcoming flu season from the previous season.

The firm said Tuesday that it intends to produce about 40 million doses of its Fluvirin vaccine for distribution in the U.S. during the upcoming 2007-08 influenza season.

"The company estimates annual direct medical costs of influenza at $3 - $5 billion, while estimating that direct and indirect costs, including lost work days, could cost as high as $12-$14 billion."

With its accelerated production plans, the company expects to deliver about half of these doses by the end of September and the rest by October-end. The flu season usually starts in December, peaks in January or February, and continues through March and the best months for vaccinations are October and November.

Influenza vaccines are updated each year to address changes in the viruses and Novartis' Fluvirin contains the three influenza virus strains identified in the annual public health expert assessment for the 2007-2008 season in the U.S.

Vaccines can help prevent influenza-related deaths and hospitalizations. On average, influenza causes over 200,000 hospitalizations in the U.S. annually and kills about 36,000.

The company estimates annual direct medical costs of influenza at $3 - $5 billion, while estimating that direct and indirect costs, including lost work days, could cost as high as $12-$14 billion.

PANDEMIC WARNING SIGNS?

New research indicates that excess winter deaths have been declining steeply in the US, Canada, France and Australia since the last, mild flu pandemic of 1968, regardless of the predominant flu strain and whether vaccination programs were in place.

"...some experts believe that the steep decline in flu deaths suggests we could be due for another flu pandemic."

What worries experts is that whatever is making us less susceptible to flu might be setting the stage for a pandemic. In the Asian flu pandemic of 1957, a new flu strain, H2N2, ousted H1N1, the strain circulating since 1918. Reichert reported that, starting in 1947, H1N1 acquired a mutation that made it much less virulent.

That drop in H1N1 virulence might have made it less contagious, allowing a slightly more transmissible H2N2 to evolve and replace it. If so, the drop in virulence of today's circulating flu strains could equally be paving the way for a more deadly strain to take over.

REDUCING VACCINE DOSAGE TO COVER MORE PEOPLE

Even as Indonesia has forced the World Health Organization to find ways to provide access to bird flu (H5N1) vaccines by developing countries when a pandemic strikes, the current limited capacity to manufacture the vaccines is worrying. This turns the spotlight on the strategies that can make vaccines available to a larger population when needed.

With a current capacity to manufacture 350-400 million doses of bird flu vaccine, which can meet the requirements of just about 6.6 billion people, researchers are looking at maximizing the utility of the existing vaccines to cover a larger population.

Even after increasing the capacity to 780 million doses by 2009, as proposed by the WHO, a large section of the world's population would still have no access to vaccines.

PANDEMIC PLANNING NOT A PRIORITY FOR COMPANIES, DESPITE THREAT

According to Gartner Inc. analyst and risk expert Ken McGee few IT organizations are ready for a possible pandemic. "Most clients would not be prepared if this descended upon the world tomorrow -- they just simply would not be ready," he said. "I think it's just part of the human condition: You don't put the stop sign up until after the traffic accident."

McGee is as concerned as ever about the threat of a pandemic, but he's worried that fears are waning in the U.S. And, he said, he's afraid "that people will learn the hard way that they cannot respond to a pandemic situation once it has been declared, because everyone will be trying to do that and nothing will get done."

The declining level of concern cited by McGee was backed up by poll results released Monday by Ipsos Public Affairs, a research organization that has offices in New York, Washington and other U.S. cities.

The recent Ipsos poll received almost no news coverage, according to a Google News search. Indeed, one of the poll questions asked, "How much have you read, heard or seen about bird flu?"

"...people will learn the hard way that they cannot respond to a pandemic situation once it has been declared..."

The World Health Organization (WHO) has been keeping statistics on confirmed human cases of the H5N1 virus since 2003. The WHO reported a total of 317 cases and 191 deaths worldwide as of last Friday. It said that in 2006, 79 people died from avian flu. Thus far this year, there have been 33 deaths, according to the WHO.

Scott McPherson, CIO of the Florida House of Representatives and head of the Florida CIO Pandemic Preparedness Committee, tracks news about the avian flu on a daily basis. He believes that IT organizations not only need to plan for a potential pandemic but, more important, must have a planning process that can continuously adapt to changing conditions -- thereby remaining flexible.

CDC URGES FLU SHOTS FOR ALL HEALTH CARE WORKERS

In July Federal health officials released their influenza vaccine advisory for the upcoming flu season, and though they did not extend the vaccine recommendations beyond current age groups, they strongly recommended vaccination of all healthcare workers and urged providers to schedule later immunization clinics.

The Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices (ACIP) drafted the recommendations, which were published in the Morbidity and Mortality Weekly Report.

In effort to boost the rates of immunized healthcare workers, a group that has lagged behind desired levels, the CDC recommended that healthcare administrators consider vaccination coverage levels as a measure of patient safety quality programs. The CDC also recommends that administrators obtain signed declinations from workers who opt out of seasonal influenza vaccination for reasons other than medical contraindications.

"CDC recommended...to boost the rates of healthcare workers, a group that has lagged behind desired levels..."

According to the report Vaccine administered in December or later, even if influenza activity has already begun, is likely to be beneficial in the majority of influenza seasons.