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 12 July 2010- >214 country

 Over 18337 deaths.
 India, transmission of pandemic influenza virus remains active
but stable in the southern state of Kerala. The extent of illness
in the community is currently being assessed and monitored
by the Government of India.
 Total cases in India : 34115 [deaths 1646]
 Rajasthan: 3380 [deaths 198]


 



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o nne Schuchat, head of science and public health at the CDC,
said that the US virus is an unusually mongrelised mix of
genetic equences from North merican pigs, Eurasian pigs,
birds and humans.´

(http://www.newscientist.com/article/dn17025-deadly-new-flu-
virus-in-us-and-mexico-may-go-pandemic.html 
 

 













  







 Epidemiologists believe first identified case found in

 in 
 Other analyses suggest it may have begun circulating in
J  and possibly even  
(http://esd.mit.edu/WPS/2009/esd-wp-2009-07-072709.pdf)

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 Novel H1N1 was first detected in the   

 
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(http://www.cdc.gov/h1n1flu/qa.htm)
 

 

 

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Gov¶t says it arose naturally from existing viruses in either
pigs or humans.
  
 Russell Blaylock, MD, Neurosurgeon
oThis virus continues to be an enigma for virologists. In the
pril 30, 2009 edition of Nature, a virologist was quoted
as saying, ´Where the hell it got all these genes from we
don¶t know.´
(http://www.pandemicfluonline.com/wp-content/uploads/2009/07/Blaylock rticle_IO.pdf)


 

 

oThe swine flu virus had three parents from two continents and
appeared suddenly without warning, evading all routine flu
surveillance and quarantine; sequence data suggest it may
have been created from a faulty vaccine given to pigs in North
merica.´
Prof. drian Gibbs and Dr. Jean Downie

http://www.i-sis.org.uk/swineFluVirusFromPigVaccine.php
 

 









   

 

 James Chin, professor at the University of California,
Berkeley, and former WHO epidemiologist:
oMy bet is that the coming [U.S.] season will not be too
severe ± at or below that of a usual flu season.´
(http://www.pandemicfluonline.com/?p=1058#more-1058)
 oCompared with avian influenza H5N1 and seasonal
influenza epidemics, the 2009 outbreak of H1N1 is
relatively mild in terms of mortality rate.´
(http://download.thelancet.com/flatcontentassets/H1N1-
flu/virology/virology-39.pdf)


 









   

 XEverything we have seen, both in this country and abroad,

shows that the virus has not changed to become more deadly.
So although it may affect lots of people, most will not be
severely ill,´ Dr. Frieden [U.S. CDC Chief] said.
(http://www.thelancet.com/H1N1-flu/egmn/0c03b5b8)

 ·„





 




XMost people, including children, will experience very mild
symptoms and recover without any medical intervention,X she
said. (7/02/2009)
(http://www.abc.net.au/news/stories/2009/07/02/2614972.htm)


 









   

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"
#[Bowdoin spokesman Doug] Boxer-Cook says that, so far,
none of the confirmed cases has been particularly severe. XIn
our experience, the symptoms have been milder than those of
the regular seasonal flu, and the students are cycling through it
generally in three days or so, so we feel really fortunate that
it's been this mild.o´
(ü
 ü
(http://www.mpbn.net/Home/tabid/36/ctl/ViewItem/mid/3478/
ItemId/8970/Default.aspx)
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given as nasal spray

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administered as im injection
 



 

 


 Contain one instead of three strain of influenza virus

 So called as monovalent laiv



 






 Healthy people aged 2 to 49 years of age

 


 ounger than 2 year of age

 Older than 50 year of age
 Pregnant women
 Patient of chronic heart and lung disease, asthma, diabetes,
immunocompromised, kidney disease.
 Past history of GBS
 People having severe allergy to egg protein or other
component of vaccine
 ny other chronic illness


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 Breast feeding mother

 Health worker working in nicu
 Health care provider working in hematology dept other than
bone marrow transplant unit


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 es. Minor illness is not a contraindication.
 But avoid in nasal congestion as it affect uptake of vaccine.

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 Very rarely. Risk [0.6-2.4%] . Does not result in illness, as
virus is attenuated.




 In one large study among children aged 15-85 months, the

seasonal nasal-spray flu vaccine reduced the chance of
influenza illness by 92% compared with placebo
 

  
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Flu vaccination should begin as soon as vaccine is

available and continue throughout the influenza season, into
December, January, and beyond may be up to may.




       

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 dult only one dose is needed.
 Children less than 9 year of age
o CDC recommends two doses 1st as soon as possible 2nd 28
days afterward.
o WHO says only one dose is enough. Though more studies
needed for confirmation.
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yes it can be given with other killed as well as live

except the seasonal flu nasal spray as it may not be that
effective.
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If a person is taking an influenza antiviral drug (including
Tamiflu® or Relenza®, then the nasal spray flu vaccine
should not be given until ë
after the last dose of the
influenza antiviral medication was given. If a person takes
antiviral drugs within  !of getting the nasal spray flu
vaccine, that person should get revaccinated. (The antiviral
drugs will have killed the vaccine viruses that are supposed to
cause the immune response against those viruses.)
   
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 none.

  

 


 no.
 

 
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 Inactivated vaccines contain killed viruses or parts of viruses,
which cannot cause disease. Live influenza vaccine contains
weakened influenza virus that multiplies poorly but is unable
to cause disease.

 Both vaccines can cause some flu-like side effects (e.g.

muscle ache, fever) but the symptoms, sometimes associated
with vaccination, are generally less pronounced and of much
shorter duration.






 In children, side effects can include runny nose, headache,

wheezing, vomiting, muscle aches, and fever.

 In adults, side effects can include runny nose, headache, sore

throat, and cough. Fever is not a common side effect in adults
receiving the nasal spray flu vaccine.

 


 

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15 micrograms in 0.5 ml (Propagated in eggs)

 à

 
Thiomersal (45mcg per 0.5ml), Sodium Chloride, Potassium
Chloride, Disodium Phosphate Dihydrate, Potassium Dihydrogen
Phosphate and water for injection
 


 

 For adult up to 60 years of age

 Route of administration ± Intra muscular
 Dose ± 0.5ml
   

 



fter the first opening the vial should be used within 7 days
To facilitate tracking the timely disposal of multidose vials, it is
suggested that the date of opening be clearly written on the vial

Partially used multi dose vial should be kept at the required

temperature between 2*C ± 8*C.
(Never place the product in Freezer)
 |
 

 àVà„VJj„wڏ„jjVÚ
 person previously had life threatening reaction to any ingredient of
llergic to egg protein, chicken protein, ovalbumin, neomycin,
octoxinol-9, formaldehyde.

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 The person being vaccinated is allergic to the above said ingredients.
 The person is having high temperature ( Over 38*c).
 





    


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Headache, Muscular pain, Pain at the injection site

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Feeling generally unwell, shivering, fever, redness and swelling at the
injection site








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 Skin reaction that may spread throughout the body

( urticaria, pruritis, rash)
 Convulsions, Neuralgia, Parasthesia, encephalomyelitis, neuritis,
Gullian ± Barre Syndrome.
 naphylactic shock, Vasculitis and temporary Kidney problems.
 





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oTime constraints mean that clinical data at the time when

pandemic vaccines are first administered will inevitably be
limited. Further testing of safety and effectiveness will need to
take place  administration of the vaccine has begun.´

http://www.who.int/csr/disease/swineflu/notes/h1n1_safety_vacci
nes_20090805/en/index.html





ll four H1N1 vaccines that were approved by the FD earlier

this week contain inserts that state the exact same thing as
Novartis in terms of testing for carcinogenicity, mutagenicity
or fertility impairment.

Meaning«.VàV of them have been tested for these things.

( nd neither have the seasonal flu vaccines that these vaccines
are based on.)





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