In this Issue

Current Pandemic Flu Threat Level 3

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

Avian Flu Deaths This Month

Avian Flu deaths in Asia and Africa. Avian Flu cases have recently sprouted up in Europe.

Flu Facts Did You Know?

H5N1 is just one of the many subtypes of the species Influenza A virus. Any one of them can combine with each other or with different variant genotypes within its own subtype creating new variants, any one of which could become a pandemic strain. SO HOW DOES IT SPREAD?

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Your Local and State Pandemic Planning Activities - July

Click here to view the June activities.

Pandemic Blog

Click here to read the Pandemic and Avian Flu Goverment Blog's

Worldwide Headlines:

Bird Flu Waning, But Global Pandemic Risk High

WHO To Provide Vaccines To Poor Nations

New Avian Flu Project In Africa

Experts Slam British Government Flu Outbreak Plans

UK Health Worker Contracts Avian Flu

LOW RESISTANCE TO TAMIFLU

According to information published by the World Health Organization, Tamiflu use in Japan has met low resistance development over the past 3 flu seasons.

Tamiflu is regarded as the source of treatment in the case of a bird flu pandemic and has been stocked in large quantities by governments around the world. Research showed that resistance levels were approximately .3 percent in a survey group of around 35 MLN patients, comparing favorably to a rate of 65 percent in the antiviral drug Amantadine2.

"These results confirm that the potential for the development of resistance to Tamiflu is very low, even when used extensively in the management of seasonal influenza," said Roche, manufacturer of Tamiflu. The Basel-based pharmaceuticals company has rejected claims of increased resistance to the drug.

VACCINE SHORTAGE

A global shortage of pandemic influenza vaccines will last for at least five years, leaving three-quarters of the population unprotected against a potential outbreak, a senior United Nations official said on Wednesday.

According to David Heymann, head of communicable diseases for the World Health Organization, drug makers can only produce enough vaccine for 1.5 billion of the world's 6.2 billion people. "The world is not prepared for a pandemic should it occur today. We don't have enough vaccine," Heymann said at the WHO's annual assembly meetings in Geneva.

This week the WHO agreed to revamp its 50-year-old policy stipulating that countries must share flu virus samples. The organization is seeking to address claims from developing nations that virus samples were being used to create costly commercial vaccines that they could not afford.

Tracking viruses is crucial to determine if strains have mutated, become drug resistant or grown more transmissible. In the past four years, the H5N1 virus has killed 186 people, mainly in Southeast Asia. Although the virus normally affects animals, the WHO has said it could spark a pandemic if it mutates into a form that spreads easily between humans.

If it does mutate into a new strain, drug manufacturers would need to alter flu vaccines, in what could be a lengthy process. Companies including Sanofi-Aventis, Novartis AG and GlaxoSmithKline are developing bird flu vaccines for human use.

OSHA UNVEILS NEW GUIDANCE

The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) has recently revealed new safety and health guidance that can help healthcare workers and their employers prepare for a possible influenza pandemic.

The guidelines offer a wide range of information and tools helpful to pandemic planners, including: Internet resources, communication tools, sample infection control programs, and self-triage and home care resources. It also provides advice on diagnosis and treatment of staff during a pandemic, the creation of planning and supply checklists.

Should a pandemic occur, OSHA will furnish up-to-date information and guidance to the public through the Web site.

FINAL FDA GUIDELINES REGARDING FLU VACCINE

The Food and Drug Administration recently issued its final recommendations regarding the increase of both seasonal and pandemic influenza vaccines.

"Having additional manufacturers of licensed influenza vaccines will enhance the capacity to produce more doses of seasonal influenza vaccines, as well as contribute to the nation's pandemic preparedness, one of our top priorities," said Jesse Goodman, director of FDA's Center for Biologics Evaluation and Research (CBER).

The original drafts contained detailed instructions to vaccine makers for producing safe, effective vaccines with the ways in which the drugs must be licensed.

Drug makers must provide evidence which shows that the vaccine protects from influenza. Or they must apply for "accelerated approval". In this process, companies must hold clinical trials and tests but may submit evidence of a biological indicator, such as the immuno-response caused by the vaccine, to show it works. The allowance could reduce the time it takes for the vaccine to be made.

Companies that receive accelerated approval must still hold the required clinical trials and tests. They must submit the results when they become available to make certain that the vaccine is effective.

WHO "Phases of Pandemic Alert"

Experts believe that the world is now closer to another influenza pandemic than at any time since 1968, when the last of the previous century's three pandemics occurred. WHO uses a series of six phases of pandemic alert as a system for informing the world of the seriousness of the threat and of the need to launch progressively more intense preparedness activities.

Each phase of alert coincides with a series of recommended activities to be undertaken by WHO, the international community, governments, and industry. Changes from one phase to another are triggered by several factors, which include the epidemiological behaviour of the disease and the characteristics of circulating viruses.

The world is presently in phase 3: a new influenza virus subtype is causing disease in humans, but is not yet spreading efficiently and sustainably among humans.