13 July 2009
U.S. Summit Readies Communities for Autumn H1N1 Flu Surge
WHO: Pandemic flu spreading “pretty quickly” through Southern Hemisphere
Washington — As the number of cases of pandemic H1N1 continues to rise around the globe and uncertainties remain about the novel influenza’s continued spread, severity and genetic stability, the Obama administration held a high-level summit July 9 to help state and local governments and communities prepare for the coming flu season.
As of July 7, some 137 countries and territories had reported more than 98,000 cases of pandemic H1N1 infection and 440 deaths to the World Health Organization (WHO).
In the United States, the Centers for Disease Control and Prevention (CDC) on July 10 reported 37,246 confirmed and probable cases and 211 deaths in 54 states and territories, including the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands.
“I think it’s clear that, although we were fortunate not to see a more serious situation in the spring when we first got news of this outbreak, the potential for a significant outbreak in the fall is looming,” President Obama told attendees by telephone from another summit — the Group of Eight (G8) — in L’Aquila, Italy.
At the meeting, Assistant to the President for Homeland Security John Brennan, Health and Human Services (HHS) Secretary Kathleen Sebelius, Homeland Security Secretary Janet Napolitano and Education Secretary Arne Duncan joined with delegations from 54 states, tribes and territories to promote aggressive nationwide flu-preparedness efforts.
FLU.GOV
Administration officials announced new programs and resources to help state and local governments, the medical community and citizens prepare for H1N1 and the fall flu season:
• HHS is making $350 million in preparedness grants to state and local public health offices and health care systems for stepping up preparedness efforts.
• The federal government is centralizing communications about H1N1 and seasonal flu at the new www.flu.gov Web site. The one-stop site offers flu-related information from HHS and other agencies.
• HHS is launching a new public service announcement contest to encourage Americans to get involved in flu preparedness efforts by making 15- and 30-second announcements.
The contest seeks to “tap into the nation’s creativity” to educate citizens about planning and preventing the spread of the novel H1NI flu. The winning announcement will appear on national television, and its creator will receive $2,500.
SOUTHERN HEMISPHERE
In the Southern Hemisphere, which is nearly halfway through its winter season, H1N1 pandemic activity is heaviest in Argentina (2,485), Australia (5,298), Chile (7,376) and New Zealand (1,059).
As in the Northern Hemisphere, flu activity varies from country to country, Dr. Keiji Fukuda, WHO acting assistant director-general for health security and environment, said at a July 7 briefing in Geneva.
“For example, a few weeks ago Australia was reporting pandemic activity occurring quite heavily in some parts of Australia, in the Victoria area, whereas it was at lower levels in other parts of Australia for a while, then began picking up,” Fukuda said.
“In South America,” he added, “there are viruses which have been isolated from most of the countries there; however, much of the heaviest activity has occurred in Chile first and then more recently in Argentina.”
Twelve countries in Africa had reported H1N1 cases as of July 7, Fukuda said, with nearly 100 cases and no deaths.
“In Africa, if we go back a few weeks ago,” he said, “we would have said that there had been no viruses isolated from that continent. But as of today, 12 countries in the intervening period have reported detecting the virus. So it is clearly spreading pretty quickly through the Southern Hemisphere.”
WHO and other organizations have helped countries on the African continent prepare to fight influenza, Fukuda added. “As of today, we have two new national influenza centres in Africa, one in Cameroon and one in Côte d'Ivoire. Although surveillance is definitely not optimal everywhere in the world, I would say that surveillance is definitely much better than it was three or four years ago.”
ANTI-VIRAL DRUG RESISTANCE
Until June 29, all of the novel H1N1 viruses tested were sensitive to the anti-viral drugs oseltamivir (Tamiflu, produced by Roche U.S. Pharmaceuticals) and zanamivir (Relenza, licensed by United Kingdom-based GlaxoSmithKline).
These drugs are called neuraminidase inhibitors and they work by blocking the function of neuraminidase (the N in H1N1), a protein on the surface of flu viruses that allows copies of the virus to be released into the body from the infected host cell.
H1N1 is resistant to two other anti-viral drugs that are available to treat or prevent flu, amantadine and rimantadine, which work by blocking a pathway into the healthy cell that the virus creates using a protein called M2.
On July 8, WHO announced that health authorities in Denmark, Japan and Hong Kong had reported the appearance of H1N1 viruses that were resistant to oseltamivir. The viruses were found in three patients who had mild disease and have recovered. The viruses are still sensitive to zanamivir.
Laboratories in the WHO Global Influenza Surveillance Network have evaluated nearly 1,000 pandemic H1N1 viruses for anti-viral drug resistance and found all other viruses are sensitive to oseltamivir and zanamivir. WHO and its partners continue to monitor flu viruses for anti-viral drug resistance.
The instances of drug resistance seem to be sporadic, according to WHO, and there is no evidence to indicate the development of widespread anti-viral resistance among pandemic H1N1 viruses.
More information about the pandemic is available at the H1N1 Web sites of WHO, CDC and the U.S. government’s new Web site, flu.gov.
