Swine flu deaths at more than half a million worldwide
DEATHS associated with the 2009 H1N1influenza pandemic could be 15 times higher than previously thought, according to estimates from the US Centers for Disease Control and Prevention (CDC).
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swine flu
The following articles have the tag swine flu
Australian flu vax not ‘out of date’ despite WHO tweaks
THE seasonal flu vaccine made for this Australian winter is not out of date, GPs are being assured, despite the WHO’s recent ‘tweaking’ of the strains that will be targeted in the northern hemisphere.
Indigenous at higher risk of death from swine flu outbreak
ANOTHER swine flu outbreak would result in avoidable deaths among Indigenous people unless there is more emphasis on education and vaccination of these communities, a researcher is warning.
GPs an afterthought in pandemic flu response
GPs were left dazed and confused as Australian health officials scrambled to respond to the 2009 swine flu pandemic, a review has acknowledged.
Flu case influx similar to swine flu pandemic
GPs are being urged to ensure at-risk patients are vaccinated against influenza, following a surge in transmission that echoes the experience of the 2009 swine flu pandemic. Respond to our poll question : Will you be vaccinating yourself against influenza this year? “We are seeing the same thing as 2009, which is desperately sick young people,” said Dr Ian Seppelt, an intensive care physician from NSW who was involved in recording influenza cases in ICU during the pandemic. ...
Swine flu outbreak renews epidemic fears
AN OUTBREAK of swine flu in Mexico has authorities scurrying to introduce preventive measures for fear of a renewed epidemic. In the state of Chihuahua, which is along the US border, four people have died of H1N1 in the last week, a government spokesman said. He said a vaccination program had been launched and school checks would be implemented in a bid to staunch the outbreak. Mexico raised the first H1N1 alert in April 2009, with the ensuing swine flu epidemic killing about 18,500 people globally, including nearly 200 in Australia. An H1N1 outbreak has ...
Whooping cough vax rates in adults concerning
FEW Australian adults have had a booster dose of whooping cough vaccine, according to new research, despite the recent epidemic. An Australian Institute of Health and Welfare (AIHW) vaccination survey showed that only one in nine Australians aged 18 years and over had ever received a pertussis vaccination as an adult or adolescent. However, 45% of those vaccinations had been received during 2009. Pertussis vaccine coverage was 43% among the 'at-risk' group, which included parents of young infants, adults working with young children and healthcare workers. Adult vaccination against whooping cough varied widely among the ...
Lesson learnt from 1918 Spanish flu uses plasma to treat H1N1
A TREATMENT used in the 1918 Spanish influenza A (H1N1) pandemic may reduce deaths from severe swine flu, a study shows. Drawing on reports of the 1918 outbreak and the 2006 bird flu (H5N1) infection, Hong Kong researchers in 2009 tested the theory that convalescent plasma might be effective against the new H1N1 pandemic. In a prospective cohort study, researchers administered plasma from patients who had recovered from swine flu to 20 intensive-care patients out of a cohort of 93 with severe infection. Only 20% of the plasma patients died, compared with 55% of controls with ...
GP advice swayed many patients to get swine flu vax
DOCTOR advice was one of the main reasons people chose to get vaccinated against swine flu, particularly for elderly Australians, a survey shows. Among people who took up the offer of free vaccine, most did so because they believed the threat of the flu was serious (24.7%) or it was offered at work (13.7 per cent). Doctor advice was the most compelling reason among the elderly, cited by 37.8% of those older than 65 years, and also influenced nearly one in 10 people aged 18 to 64 years. A survey by the Australian Institute of Health ...
Swine flu threat downgraded to ‘post-pandemic’
THE World Health Organization (WHO) has declared the swine flu pandemic is over. WHO director-general Dr Margaret Chan says while the H1N1 virus has largely run its course, localised outbreaks are still a threat, with some countries including New Zealand currently experiencing significant transmission. Dr Chan said WHO had determined the world had entered a “post-pandemic period” following assessment by its international emergency committee yesterday. However, “pandemics are unpredictable and prone to deliver surprises”, she told a news conference, emphasising a need to continue vaccination of vulnerable groups in the community. The pandemic affected more ...
Software glitch hampers child flu vaccine records
SEVERE reactions to this year’s seasonal flu vaccination appear to occur in children naïve to flu vaccine and in those younger than three, rather than the entire under-five cohort as initially suspected. But establishing a precise denominator for this year’s vaccinated cohort has been fraught with difficulty because a software glitch has prevented optimum recording of doses on the Australian Childhood Immunisation Register (ACIR). Perth paediatric immunologist Associate Professor Peter Richmond said the affected children were mostly younger than three years. “It seems to have affected more children who are getting vaccine for the first time – ...
Multi-dose vial vaccine risk debate reignites
CONCERNS over the infection risk posed by the use of multidose vials (MDV) to deliver swine flu vaccine are being exaggerated, experts say. Dr Greg Rowles, AGPN immunisation representative, has taken outspoken specialist Professor Peter Collignon to task over a recent editorial where he said the use of MDV was “a needless additional risk” for the mass vaccination campaign. “In the past, many infections such as Staphylococcus aureus, hepatitis B and HIV” had been caused by vaccination programs using MDV, Professor Collignon wrote in Australian Prescriber. But Dr Rowles said there were few cases of infection ...
Swine flu may cause encephalopathy, experts warn
CLINICIANS should be alert to the potential neurological complications of swine flu, experts warn. Specialists from The Children’s Hospital at Westmead, NSW, have published details of two cases of severe encephalopathy in previously healthy children who were positive for H1N1. A five-year-old girl presented with hemiplegia and fever and required mechanical ventilation, anticonvulsants, oseltamivir and steroids before recovering fully. A five-year-old boy presented with ascending paralysis and fever, and was quadriplegic and comatose within 24 hours. After treatment with oseltamivir, immunoglobulin and steroids, he was discharged a month later with mild left arm weakness. “We ...
Swine flu: still a looming threat?
Was the threat of swine flu over-estimated, and do we really need to vaccinate everyone now? Rada Rouse reports. HYPE or hoax? Whatever the swine flu pandemic was, a lot of people believe it was never a deadly threat. Earlier this year, the chair of the Council of Europe’s health committee, Dr Wolfgang Wodarg, forced an inquiry into the continent’s multibillion dollar expenditure on swine flu vaccine, saying governments had been hoodwinked by pharmaceutical companies wanting to make big bucks. Worse, he accused the WHO of being in cahoots with Big Pharma ...
Four out of five patients shun swine flu vaccine
FEWER than one in five adults received the swine flu vaccine last year, new figures show, and experts have warned this uptake must double in order to avoid a second wave of the virus this winter. Provisional national data from the Australian Institute of Health and Welfare shows that among the most vulnerable adult age group (ages 18 to 64 years), uptake of the Government’s $100 million-plus H1N1 vaccine program was only 14 per cent. “There is certainly a possibility, if we don’t get enough people vaccinated, of having a second wave and filling up our intensive ...
H1N1 vigilance vital in pregnancy
NEW swine flu research has underlined the importance of prompt treatment and timely vaccination of pregnant women, experts say. A study of 211 pregnant women with H1N1 presenting to a Singapore hospital showed admission was more likely with comorbidities or breathlessness. Nine developed complications, including first trimester miscarriage and premature labour. The researchers said the study suggested that the effects of swine flu infection in the cohort were overall “relatively benign”, but they attributed this to early presentation, diagnosis and treatment. Most of these women received oseltamivir within 48 hours. However, in a study ...
Study backs one dose for kids' swine flu vax
A SINGLE dose of the Panvax Junior H1N1 vaccine could protect children from swine flu, Australian research suggests, a finding that could result in even more of the Government's vaccine supply not being used. Concerns have already been raised about underuse of the 21 million stockpiled doses of the vaccine purchased by the Federal Government on the basis that all paediatric patients would require two doses. Demand for the vaccine has proved lower than expected with around a quarter of the purchased doses administered, according to media reports. Now, the pediatric study, funded by the vaccine’s ...
Swine flu vax side-effects reported
THE rate of anaphylaxis following swine flu vaccination is within the expected range, a TGA review of adverse reactions has revealed. In its first report on adverse reactions since the national immunisation program began, the TGA said six reports of possible anaphylaxis had been received between 30 September and 29 October. On advice from the Adverse Drug Reactions Advisory Committee, the TGA concluded that only four of the cases were likely to have been associated with the vaccine. Overall, some 654 suspected side-effects were reported from a program in which 3.75 million doses had been distributed. ...
Facebook group claims swine flu vaccine is 'poison'
A CONCERNED Queensland GP has alerted authorities to a Facebook group which claims the swine flu vaccine is “poison” and contains ingredients that cause brain damage and harm unborn children. The Australians Against the Swine Flu Vaccine group, which has 2200-plus members, was created by a man who has a Bachelor of Pharmacy from the University of South Australia. An email circulated by him says that the vaccine contains “horribly dangerous” compounds, thimerosal and squalene, and that another ingredient, neomycin, is a “positive risk to unborn children”. However, Peter Halstead, registrar of the Pharmacy Board of ...
Swine flu vaccine: check for latex allergy
GPs are being advised to inquire about latex allergy before using the syringes supplied for swine flu vaccine delivery. However, the advice from Commonwealth Chief Medical Officer Professor Jim Bishop was purely precautionary, the Federal Health Department said. A spokeswoman said expert advice to the Commonwealth was that the chances of latex leaking from the syringes would be “infinitesimal”. This followed an incident in Perth earlier this week in which a 26-year-old woman with latex allergy had a severe reaction following vaccination against the pandemic flu. State health officers are urging immunisation providers to use ...
GPs face pressure test with swine flu vax rollout
GPs will be under pressure as Australia’s biggest mass vaccination campaign rolls out over the next three months, Health Minister Nicola Roxon has acknowledged. Practices may have to hold dedicated flu clinics to cope with the demand as five million doses of Panvax H1N1 are distributed in a bid to vaccinate a third of the population as fast as possible, GP spokesmen said. Another two million doses a month will be released by the manufacturer, CSL, up to January. “I think [the rollout] will put pressure on – significantly – on GPs,” Ms Roxon told journalists ...
Suing for swine flu
Could it happen here – a wrongful death lawsuit for swine flu? Amanda Sheppeard reports on your duty of care. IN what will not cause great surprise to most, the first lawsuits relating to swine flu have kicked off in the US. The one that’s attracting the most international attention is that of New York’s first victim, Mitchell Wiener. Recently his family filed a notice of claim stating their intention to sue the city’s education and health departments for $US40 million ($46 million) worth of damages for wrongful death. Mr Wiener, a 55-year-old assistant ...
Experts promote safety of swine flu vaccine
AUSTRALIA may face a second wave of pandemic swine flu due to travellers coming back from the Northern Hemisphere winter, health authorities warn. Chief medical officer Professor Jim Bishop urged GPs to start vaccinating vulnerable groups this week when the first batches of Panvax became available. “We may face a major out-of-season influenza outbreak due to importation of the virus back into Australia from infected travellers from the large number of new cases now expected in the Northern Hemisphere,” he said, adding that the virus might also mutate and become more virulent. Federal Health Minister Nicola ...
World report - 11 September 2009
• CHINA STARTS VOLUNTARY ORGAN DONATION SYSTEM THE Chinese Government has launched a voluntary organ donation system in an attempt to curb the country’s thriving illegal organ trade. Coordinated by the national Red Cross Society in conjunction with China’s Health Ministry, the pilot program was unveiled at a news conference in Shanghai last month. The voluntary donor scheme will be trialled in 10 cities and regions throughout China, including Shanghai and the prosperous Guangdong province, with the program expected to be rolled out nationwide, The New York Times reports. Vice-Minister of Health Dr ...
Insuring swine flu
MDOs have agreed to indemnify doctors giving the H1N1 vaccine, but is that the end of the story? Amanda Sheppeard finds out. JUST when the national rollout of a vaccine for H1N1 will begin is anyone’s guess, but most experts predict it will be sometime soon. With clinical human trials still underway, the Federal Government has indicated it may begin before full registration of the vaccine is received from the TGA. The vaccine is also expected to be supplied in multi-dose vials – a move that has sparked plenty of controversy and debate in ...
Free H1N1 vax approved for early rollout
GPs will be able to offer the swine flu vaccine free to all Australians and not just high-risk groups, health officials have decided. Today, the Therapeutic Goods Administration approved CSL's Panvax H1N1 vaccine in adults but is awaiting data before approving the vaccine in children younger than 10 years. Data indicate a single dose of the vaccine provides an acceptable immune response 8-10 days after vaccination in healthy adults. RACGP president Dr Chris Mitchell told MO that guidelines for multi-dose vials had been signed off with rollout of the vaccination program expected to start from 30 September. ...
Trial shows single swine flu shot effective
ONLY one dose of swine flu vaccine will be needed in adults, paving the way for faster immunisation of Australians most at risk from the pandemic virus, experts say. Australian vaccine developer CSL has published the first data from its trial of 240 healthy adults, showing that a single standard dose of 15 µg of the new Panvax H1N1 vaccine, which does not contain an adjuvant, provided a “robust” immune response. The vaccine’s side-effect profile was reported to be similar to seasonal influenza vaccine. Professor Robert Booy, head of clinical research at the National Centre for ...
Swine flu vax may need signed consent
GPs will be required to obtain written consent from patients before administering the swine flu vaccine if the Government starts the vaccination program before the registration process is complete. Dr Greg Rowles, AGPN representative on the National Immunisation Committee, last week called for clarification on the issue following concerns that GP indemnity was in limbo with an unlicensed vaccine. Immunisation expert Dr Peter Eizenberg has also raised concerns that critical questions about the vaccine’s safety and handling are yet to be resolved. The indemnity issue appeared resolved this week after major insurers, including Avant, announced ...
Insurers play down indemnity fears over H1N1 vax
MEDICAL defence organisations (MDOs) are reassuring GPs they will have medico-legal protection when the Federal Government’s swine flu vaccination program rolls out later this month. However, a leading immunisation expert is still urging GPs to exercise caution, noting the H1N1 vaccine has yet to be licensed. The moves follow media reports that MDOs were debating their position amid fears the H1N1 vaccine had been inadequately tested, and its distribution in multi-dose vials could potentially expose patients to blood-borne cross-infection. MDA National president Associate Professor Julian Rait confirmed on national radio it would cover GPs administering the ...
Swine flu panic prompts surge in ‘worried well’
PUBLIC concern over swine flu may have flooded GP surgeries with the ‘worried well’ over the past three months, a study suggests. Analysis of GP sentinel surveillance data in Victoria showed that the pandemic had produced rates of flu-like illness consistent with moderate flu seasons in previous years, but with an early start and early peak. Since April, when surveillance for 2009 began, the proportion of patients presenting with influenza-like illness who had laboratory-confirmed flu was around 44%, said Associate Professor Heath Kelly, head of epidemiology at the Victorian Infectious Diseases Reference Laboratory (VIDRL). He said ...
Opinion: Swine flu from both sides of the fence
By Belinda Caldwell, CEO, Australian Practice Nurses Association NOTHING beats the insight personal experience can deliver on the practical implications of a major public health issue. For me, it has been the H1N1 pandemic and what an interesting experience it has been. Having previously sat on the Victorian Department of Human Services state pandemic planning committee and with a master’s in public health under my belt, I am acutely aware of the importance of pandemic planning. So it was with this background that I found myself at home with a 14 year old displaying classic ...
Govt stands firm on multi-dose vials for swine flu vaccine
THE Federal Government is adamant that multi-dose vials will be used when swine flu vaccination rolls out, despite criticism from infectious disease specialists. Australia’s Chief Medical Officer Professor Jim Bishop said vaccination providers would be trained in the use of the vials to maximise infection control and minimise wastage. “General practice peak bodies are comfortable and believe the GP workforce is competent with the use of multi-dose vials,” he said. Professor Bishop was responding to concerns raised by the Australasian Society for Infectious Diseases (ASID) that multi-dose vials put patients at risk of blood-borne and viral ...
Multi-dose vials to return for swine flu vax
GPs will have to return to the old days of vaccine administration when the Government’s new swine flu vaccine program is rolled out. The vaccine is expected to be delivered in multi-dose vials, requiring careful administration, storage and infection control procedures. “Multi-dose vials have not been used for a long time, and the college has identified this as an issue which needs to be addressed,” RACGP pandemic spokesman Dr Ron McCoy said. The college has developed draft guidelines on best practice infection control when drawing up vaccine from multi-dose vials. Failure to separate clean from ...
Legal experts urge triage policy review to prevent treatment gaps
MEDICAL defence organisations are urging doctors to review their triage protocols as the swine flu pandemic continues to flood GP waiting rooms with concerned patients forcing GPs to prioritise consultations. Dr Sara Bird, MDA National medico-legal manager and advisory services coordinator, said receptionists and practice nurses needed a clear triage protocol. “Ideally the doctor should come out [and triage], but when a patient telephones, that’s where it’s important that a protocol is applied,” Dr Bird said. “There needs to be some guidance for those on the front line.” Avant medical adviser Dr Penny Browne said if ...
Shroud of secrecy remains over priorities for swine flu vaccine
DECISIONS about which groups would be prioritised to receive the swine flu vaccine are being kept under wraps as Health Minister Nicola Roxon admitted vaccine rollout could be “months away”. Ms Roxon said last week that it might not be necessary to wait until all clinical trial data was in before releasing the vaccine but that decision had not been made. Immunisation experts and federal and state health officers met last week to discuss vaccination priorities. However a spokeswoman for the Federal Health Department said no information would be released from the meetings. US authorities ...
Frontline GPs deserve swine flu vaccine first
AS the morbidity and mortality rates for swine flu continue to mount, there has been some debate about who gets the first vaccines off the production line once the clinical trials phase has been analysed. Peak GP groups have been arguing that GPs should be among the first healthcare workers to get the vaccine. I may be missing something, but isn’t this a no-brainer? I, for one, hate being a patient. Some people appear to fall with seamless ease into the role of being looked after, but I am not one of them. And from what I ...
GP groups at odds over funding for swine flu vax scheme
LEADING GP groups hold differing views about the most efficient way to fund Australia’s massive swine flu vaccination program, which will see up to 21 million doses of the new vaccine administered. AGPN chair Dr Emil Djakic proposed the existing fee-for-service funding system should be scrapped for the program in favour of a more flexible model that would see doctors receive block payments for undertaking the work. However, the move received a cool response from the RACGP, with president Dr Chris Mitchell arguing there was not enough time to negotiate such a system before vaccinations started in ...
GPs better equipped to monitor resistant H1N1
THE Federal Government has upscaled the resources available to GPs on the frontline of influenza monitoring so they are better placed to detect resistant strains of H1N1 early. This year the Government began funding members of the Australian Sentinel Practice Research Network (ASPREN) to begin regular pharyngeal swabbing of patients with influenza-like illness, director Professor Nigel Stocks said. ASPREN is a national network of GPs that has provided clinical reports since 1991. Latest testing results from ASPREN showed that 39% of respiratory tests conducted on patients with influenza-like illness were positive for influenza and, of these, ...
Production problems could delay swine flu vax supply
PRODUCTION of the H1N1 vaccine could be slower than anticipated, leading to shortfalls late in 2009 when mass vaccinations are expected to start. The vaccine manufacturer, CSL, has confirmed that it is battling to improve yield from the vaccine seed virus, forcing the company to explore alternative production options. A CSL spokeswoman said the yield was “about 50% of standard” but new techniques were being tried. “This is proving to be a real challenge,” she said. Professor Robert Booy, co-director of the National Centre for Immunisation Research and Surveillance, said the supply of vaccine and ...
Govt’s swine flu record doesn’t inspire confidence
THERE have been moments over the past few weeks, while watching the events of the swine flu pandemic unfold, that have provided a certain level of bemusement for GPs at the frontline. Especially as we were feeling fairly sure that this was a mild illness and perhaps an over-reaction played out in the media. But at the time of writing, we now know of some relatively healthy young people fighting for their lives on cardiac bypass machines, and pregnant mothers being ventilated to save their babies. I am feeling a new level of concern arising among ...
Pandemic precautions needed for pregnant GPs
GPs are being warned to protect their pregnant colleagues during the current H1N1 pandemic by ensuring where possible they avoid patients with flu-like symptoms. The RACGP is advising triage systems be set up in all practices to ensure pregnant GPs only see non-flu cases, particularly those women in their second and third trimesters. It also advises pregnant GPs to consider wearing surgical masks and protective eyewear – which is changed regularly – while consulting. The warning comes as a number of pregnant women in Western Sydney were reported to be in intensive care with H1N1 and ...
Spotlight on Australian swine flu vaccine trial
THE world is watching the first trial of a swine flu vaccine, which commenced last week in Adelaide. A total of 240 volunteers were vaccinated against the virus last week, with half given the standard dose of 15 mcg, and half given 30 mcg. The interim dose data results are expected to be available in September. A CSL spokeswoman said the Government was likely to base its future programs on the basis of the interim results. Also read: Pandemic precautions needed for pregnant GPs
Pressure rising for GP swine flu prophylaxis
THE Federal Health Department has rejected calls for GPs to be given antiviral prophylaxis against swine flu. The move comes as experts debate the benefits of such a move and as intensive care admissions and the death toll continue to rise. Writing in the MJA , epidemiologists and infectious disease experts have said the Australian pandemic management plan recommended continuous pre-exposure prophylaxis to healthcare workers, and they believed this could be accommodated from the national stockpile. However, a spokesperson for the Federal Health Department said GPs would not be given Tamiflu unless they had an ...
Swine flu vaccine is still a long way off
A SWINE flu vaccine may still be many months away, despite the continuing rise in cases, Australia’s first fatalities and the growing threat to vulnerable Indigenous communities. The Therapeutic Goods Administration (TGA) is not commenting on whether the vaccine will be fast-tracked, with the manufacturer’s scheduled trial program due to take six months to complete. While batches of the vaccine could be ready for use in August, little trial data will be available to the TGA by then, CSL spokeswoman Dr Rachel David said. “Given that currently the mortality from the H1N1 [flu] is not high, ...
Demands for swine flu all-clear stretching GPs
SWINE flu hysteria is stretching GPs unnecessarily, as employers and childcare centres begin demanding doctors’ certificates from employees and parents to prove they or their children do not have the virus. Dr Adrian Elliot-Smith said his Mount Gambier practice in regional South Australia was straining under the weight of relatively well patients requesting such certificates to enable them to return to work. “We have people coming into our clinic who are not unwell, but have been told they have to leave work because they have a viral illness,” Dr Elliot-Smith said. The practice is now asking ...
Woes continue in H1N1 fight
AS the Federal Government moves to a new, unplanned, ‘Protect’ stage of alert in response to the swine flu epidemic, more stories are emerging of GPs battling H1N1 being left in the dark by poor communication from health authorities. Dr Lyndsey Kabat, a GP at a 24-hour clinic in northern Melbourne, said the Victorian Department of Human Services did not provide clear instructions about where to send tests, how to get results or how to access Tamiflu, causing delays that left patients irate and confused. On the day that Victoria changed from the ‘Contain’ to the ‘Sustain’ ...
Swine flu: replace full PPE with surgical masks
GPs have been urged to wear a surgical mask at minimum when swabbing swine flu suspects, despite acknowledgement that the disease is relatively mild. The RACGP said today it supported the Commonwealth Chief Medical Officer’s approach in moving Australia to a newly created ‘protect’ pandemic phase. RACGP pandemic preparedness group spokesman Dr Ron McCoy said the college would modify its advice on wearing personal protective equipment (PPE), which had called for P2 (N95) masks, gowns, eye protection and gloves when swabbing. “If there was a higher case fatality rate we would be still thinking PPE, but ...
Division acts on swine flu protection
AS the WHO declares a global flu pandemic and swine flu cases mount at home, the inability of GPs to secure personal protective equipment (PPE) from the national stockpile has prompted one division to take matters into its own hands. The Northern Sydney General Practice Network last week negotiated a deal with industrial safety equipment supplier Blackwoods that will allow doctors to access discounted PPE, including masks, goggles, gloves and gowns. The discounts, which range between 25% and 30%, will initially be available to NSW doctors, but are expected to be expanded to all GPs in Australia. ...
Chronically ill hit hardest by swine flu
PEOPLE who are asthmatic or obese are at especially high risk of developing complications from swine flu, a leading virologist warns. Professor John Mackenzie, a pandemic adviser to the World Health Organization and professorial fellow in infectious and emerging diseases at Curtin University, WA, said most hospitalised cases worldwide involved people aged 20 to 40 years who had an underlying medical vulnerability. “Most of the serious cases are in people with asthma, the morbidly obese, and those with diabetes,” he said. Professor Mackenzie said others at risk were young to middle-aged people with COPD or underlying cardiac disease, and ...
Doctor groups roll out urgent pandemic training
LEADING professional bodies have joined forces to offer GPs urgent “pandemic preparedness” training in the wake of the growing swine flu outbreak. The training – to be delivered by the RACGP and the AGPN and funded by the Federal Government – will instruct doctors on identification of influenza H1N1, patient management and the use of personal protection equipment (PPE). AGPN chair Dr Emil Djakic said the network had already been approached by GPs requesting information on best practice in managing swine flu. “They have also raised concerns about access to PPE and appropriate regional protocols for ...
Give high-risk patients flu vaccine for overseas travel
PREGNANT women and those at high risk of complications from influenza are being advised to be immunised against seasonal flu before travelling overseas. However, the department advises the degree of protection against H1N1 influenza 09 (swine flu) is not clear. The latest advice from the Department of Foreign Affairs urges the elderly, children younger than five years and people with chronic conditions to discuss the risks with their GP before deciding to travel overseas. There is currently no specific advice on whether Tamiflu should be prescribed, with the decision being left to the GP. As ...
GP nightmare highlights swine flu 'shambles'
CASES continue to emerge that highlight the difficulties GPs face in dealing with the swine flu outbreak. While GPs have been at the forefront of efforts to contain and treat H1N1 (swine flu), questions are being raised about the support they have received. Melbourne GP Dr Kirstin Charlesworth said her experience had left her disillusioned with the way the crisis was being handled, prompting her to write an open letter to the Health Minister, Nicola Roxon. “It’s been a bit of a shambles really,” she told MO . “We’ve been fortunate it’s turned out to ...
Swine flu: GPs told to swab anyone with symptoms
GPs are being asked to swab everyone presenting with a febrile respiratory illness, but patients should be triaged over the phone. Following talks with the Commonwealth Chief Medical Officer last night, RACGP president Dr Chris Mitchell said doctors should ring public health units for advice as case definitions for swine flu were subject to change. Each state would have different arrangements for fever clinics but more clinics were imminent. The reason for swabbing everyone with flu symptoms was not to diagnose swine flu but to diagnose seasonal influenza, Dr Mitchell said. “Whether general practice or ...
GPs fend for themselves as swine flu cases surge
CONCERN is increasing among GPs that despite being on the front line of the fight against swine flu, they have not been offered free personal protective equipment (PPE) or Tamiflu. At the same time, GPs are being asked to swab everyone with febrile respiratory illness, so health authorities can monitor the pandemic in the midst of the normal flu season. Victorian GP Dr Nick Demediuk, chair of the Dandenong Casey General Practice Association, said “the wheels are already falling off” at the micro level of pandemic planning with individual GPs exposed to swine flu being refused Tamiflu. ...
World report - 29 May 2009
• RESPONSE TO SWINE FLU OUTBREAK UNDER SCRUTINY INTERNATIONAL health authorities have rejected claims that the current swine flu crisis has exposed delays and procedural flaws in international disease detection systems. The director of Mexico’s National Epidemiology Center said the Pan American Health Organization (PAHO), a WHO sub-group, should have acted faster based on alerts of unusual seasonal influenza outbreaks from mid-April. Mexican health authorities alerted PAHO about a possible epidemic following the death of a woman in Oaxaca on 16 April. But it seems it was only when seven H1N1 cases were confirmed in the ...
GPs urged to step up swine flu containment measures
GPs are being warned to have high suspicion for swine flu as Australia moves to try to contain internal transmission of the virus. Federal Health Minister Nicola Roxon raised the pandemic alert level to the ‘contain’ phase on Friday. Japan and Panama have been added to the list of high-risk countries, meaning GPs should suspect swine flu in a recently returned traveller with febrile respiratory illness. Previously only Mexico, the USA, and Canada were considered high-risk sources. Australia is now in full pandemic alert with 18 cases and confirmed local transmission. Another 40 people ...
Swine flu is more contagious than seasonal influenza
THE strain of swine flu continuing to spread around the world is more contagious than seasonal influenza, the WHO warns. Experts assessing the pandemic potential of the A/H1N1 virus said the severity of illness was comparable with that seen in the 1957 pandemic, but less than the 1918 pandemic. “Transmissibility is therefore substantially higher than seasonal flu,” they wrote in the journal Science . Dr Alan Hampson (Hon MD), a pandemic flu adviser to the Australian Government, said it was important to keep in perspective that swine flu was still not spreading rapidly outside of ...
First Australian transmission of swine flu confirmed
AUSTRALIA’s pandemic alert level may be raised following the first transmission of swine flu locally. A classmate of a Victorian boy who returned from the USA with the virus has contracted swine flu, with the latest national total of confirmed cases standing at 11. Victoria’s Department of Human Services responded by closing his school for the remainder of this week. The Australian Health Protection Committee was meeting this morning to consider upgrading the nation’s pandemic alert status from the ‘delay’ phase, a spokesman for the Federal Health Department said. More than 25 people, mainly ...
Swine flu overreaction?
CYNICS have accused health authorities of pushing the panic button unnecessarily following outbreaks around the world of a so-far mild swine flu. But one thing’s for sure – no-one is likely to rush headlong into mass vaccination. US infectious diseases experts have been recalling the swine flu “debacle” of 1976. That’s when an outbreak of swine flu hit 200 soldiers at an army base, sending health officials into a spin because it was similar to the virus causing the deadly 1918 pandemic. The Centers for Disease Control and Prevention (CDC) convinced then President Gerald Ford of ...
Poised for pandemic?
Did communicable disease experts cry wolf over the swine flu threat or is the worst yet to come? Rada Rouse reports. THE emergence in Mexico of an apparently virulent novel strain of influenza that spread rapidly throughout North America triggered a worldwide pre-pandemic alert last month. Was this the ‘big one’ we’d been warned was long overdue? At the end of April, experts said we would have the answer within 48 hours – but nearly a month later, the world is still waiting to know what’s in store. “It’s anyone’s guess as to ...
Forget swine flu – normal flu is a killer
ANOTHER year, another epidemic. We’ve seen a veritable zoo of flus over recent years. Bird flu locking down parts of South-East Asia. Horse flu hitting our equine and racing industries, and locking down parts of eastern Australia. Now swine flu has arisen from Mexico cutting a swathe across... well, the world’s media. This even beats the horse flu epidemic for alarmist reporting. At the time of writing, the WHO is poised to declare a global pandemic. This classification has everything to do with the nature of spread and little to do with the clinical severity of ...
UPDATE: Swine flu – what you need to know
How many cases are there worldwide? Australia: 449 people have been tested for H1N1 influenza A 2009 and cleared. A further 27 people are awaiting test results (as at 6 am 6 May). Suspect cases: NSW 19, Qld 3, SA 2, Tas 1, Vic 1, WA 1, ACT 0, NT 0. Worldwide: 21 countries have reported 1490 laboratory-confirmed cases with 30 deaths. Mexico: 29 deaths, 822 cases laboratory confirmed. USA: 1 death, 403 cases. The following countries have reported laboratory-confirmed cases with no ...
Swine flu antiviral prophylaxis not advised
IT would be premature to recommend taking neuraminidase inhibitors for swine flu prophylactically, leading researcher Professor Robert Booy says. However, should a pandemic be declared, it was reassuring that the US Centers for Disease Control had found the drugs oseltamivir and zanamivir to be sensitive to the swine influenza A/H1N1. Professor Booy, co-director of the National Centre for Immunisation Research and Surveillance, Sydney, said people might want to take a supply of the drugs with them in case they got the flu overseas, but taking it prophylactically “every day for a month’s holiday” would be costly and ...
GPs hampered by lack of P2 masks
GPs may be prevented from taking swabs from people with suspected swine flu because of problems in accessing supplies of P2 masks. If a GP does not have appropriate personal protective equipment (PPE), they should not take a nose and throat swab from a high-risk patient, the RACGP warned as health authorities braced for a pandemic. However, suppliers of P2 masks are posting “sold out” notices on their websites, and some say warehouses are almost empty with little likelihood of manufacturers being able to keep up with demand. State stockpiles of PPE might have to be ...
Swine flu cases could number 200,000 already: expert
THE number of cases of swine flu overseas is likely to be many thousands more than is showing up in official statistics, according to a leading Australian researcher. Professor Robert Booy, co-director of the National Centre for Immunisation Research and Surveillance, said while the virus was clearly “nasty”, the fatality rate did not appear to be high. His comments came as 114 Australians were awaiting test results for swine flu, and WHO raised its global alert to level 5, one level below declaring a pandemic. As at 30 April, 11 countries had reported 257 confirmed cases ...
Swine flu alert as worldwide cases mount
GPs have been warned to wear full personal protective equipment, including P2 face masks, when taking swabs from people with suspected swine flu, as fears mount that an international outbreak of a new influenza A strain may spread to Australia. Virologists say it’s inevitable that a case of the virus, described as a new subtype of A/H1N1 not previously detected in swine or humans, will turn up in Australia. In Mexico there have been 150 deaths among 1300 suspected cases, with 20 deaths confirmed as being related to swine flu. In the US there have been 20 ...