WHO: A/(H1N1) and A/(H5N1) Updates

The WHO continues to issue regular updates on both A/(H1N1) and A/(H5N1) posted on the WHO main page, as well as other advisories linked from that page. Here are the current updates:

– Pandemic (H1N1) 2009 – update 58
6 July 2009 – The title of this update has now evolved to “Pandemic (H1N1) 2009.” WHO notes 94,512 officially reported cases of influenza A(H1N1) infection (up from 59,814 a week ago and 44,287 a week earlier), including 429 deaths (up from 263 a week ago and 180 a week earlier).
http://www.who.int/csr/don/2009_07_06/en/index.html
WHO has included an interactive “timeline of all cases” (requires Flash player) at:
http://gamapserver.who.int/h1n1/atlas.html?select=ZZZ&filter=filter4,confirmed

– Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO
2 June 2009  [No update since 2 June 2009]
The published tabular chart reports 436 confirmed cases (up from 433 cases reported as of 2 June 2009) and 262 deaths (unchanged from the 2 June 2009 report).
http://www.who.int/csr/disease/avian_influenza/country/cases_table_2009_06_02/en/index.html

WER for 3 July 2009

The Weekly Epidemiological Record (WER) for 3 July 2009, vol. 84, 27 (pp 261–280) includes: Human infection with new influenza A (H1N1) virus: WHO Consultation on suspension of classes and restriction of mass gatherings to mitigate the impact of epidemics caused by influenza A (H1N1), May 2009; Progress towards the 2012 measles elimination goal in WHO’s Western Pacific Region, 1990–2008, and Monthly report on dracunculiasis cases, January– May 2009

http://www.who.int/wer/2009/wer8427.pdf

White House announces H1N1 Preparedness Summit with states

The White House announced that it will host an all-day H1N1 Flu Preparedness Summit with states to further prepare this nation for the possibility of a more severe outbreak of H1N1 flu. Health and Human Services Secretary Kathleen Sebelius, Homeland Security Secretary Janet Napolitano, Education Secretary Arne Duncan, and Homeland Security Advisor John Brennan will lead the Summit, to be held on July 9, 2009 at the Natcher Conference Center at the National Institutes of Health in Bethesda, Maryland. Secretary Sebelius said, “Scientists and public health experts forecast that the impact of H1N1 may well worsen in the fall – when the regular flu season hits, or even earlier, when schools start to open – which is only five or six weeks away in some cases. The goal of the Summit is to launch a national influenza campaign by bringing federal, state and local officials, emergency managers, educators and others together with the nation’s public health experts to build on and tailor states’ existing pandemic plans, share lessons learned and best practices during the spring and summer H1N1 wave, and discuss preparedness priorities.”

http://www.cdc.gov/media/pressrel/2009/a090702.htm

US to donate 420,000 Tamiflu courses to PAHO to fight novel H1N1

HHS Secretary Kathleen Sebelius announced that the United States will provide 420,000 treatment courses of Tamiflu (Oseltamavir) to the Pan-American Health Organization (PAHO) to fight the novel H1N1 influenza in Latin America and the Caribbean. Secretary Sebelius commented, “The U.S. is committed to supporting and enhancing the health security in the region by reducing transmission and severity of illness. Viruses know no borders. The U.S. recognizes that a novel virus such as the H1N1 is a burden borne by all nations, and all of us have a responsibility to help support one another in the face of this challenge.”  HHS said that on June 23 it received a request from PAHO to partner with the U.S. government to increase the PAHO stockpile of Tamiflu in the regional stockpile available for Latin America and the Caribbean countries. PAHO is working to ensure that its member countries have the capacity and resources to respond to outbreaks of H1N1. HHS holds approximately 50 million courses of antiviral medications in the Strategic National Stockpile (SNS). In April, HHS deployed 11 million treatment courses from the SNS to the states across the country to fight the H1N1 influenza. Since then, HHS has purchased antiviral drugs to replenish the SNS along with an additional 2 million treatment courses.

http://www.businesswire.com/portal/site/home/permalink/?ndmViewId=news_view&newsId=20090702005463&newsLang=en

The Obligation to Participate in Biomedical Research

JAMA
Vol. 302 No. 1, pp. 7-108, July 1, 2009
http://jama.ama-assn.org/current.dtl

The Obligation to Participate in Biomedical Research
G. Owen Schaefer, BA; Ezekiel J. Emanuel, MD, PhD; Alan Wertheimer, PhD

The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. Participation in research is a critical way to support an important public good. Consequently, all have a duty to participate. The current social norm is that individuals participate only if they have a good reason to do so. The public goods argument implies that individuals should participate unless they have a good reason not to. Such a shift would be of great aid to the progress of biomedical research, eventually making society significantly healthier and longer lived.

A Malaria Vaccine for Control: More Progress

Journal of Infectious Diseases
1 August 2009  Volume 200, Number 3
http://www.journals.uchicago.edu/toc/jid/current

EDITORIAL COMMENTARY
A Malaria Vaccine for Control: More Progress

Joel G. Breman1 and
Christopher V. Plowe2,3

1Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, and 2Howard Hughes Medical Institute and 3Malaria Section, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore

“Prepandemic” Immunization for Novel Influenza Viruses

Journal of Infectious Diseases
1 August 2009  Volume 200, Number 3
http://www.journals.uchicago.edu/toc/jid/current

Perspective
“Prepandemic” Immunization for Novel Influenza Viruses, “Swine Flu” Vaccine, Guillain-Barré Syndrome, and the Detection of Rare Severe Adverse Events
David Evans, Simon Cauchemez, and Frederick G Hayden

The availability of immunogenic, licensed H5N1 vaccines and the anticipated development of vaccines against “swine” influenza A(H1N1) have stimulated debate about the possible use of these vaccines for protection of those exposed to potential pandemic influenza viruses and for immunization or “priming” of populations in the so‐called “prepandemic” (interpandemic) era. However, the safety of such vaccines is a critical issue in policy development for wide‐scale application of vaccines in the interpandemic period. For example, wide‐scale interpandemic use of H5N1 vaccines could lead to millions of persons receiving vaccines of uncertain efficacy potentially associated with rare severe adverse events and against a virus that may not cause a pandemic. Here, we first review aspects of the 1976 National Influenza Immunization Programme against “swine flu” and its well‐documented association with Guillain‐Barré syndrome as a case study illustration of a suspected vaccine‐associated severe adverse event in a mass interpandemic immunization setting. This case study is especially timely, given the recent spread of a novel influenza A(H1N1) virus in humans in Mexico and beyond. Following this, we examine available safety data from clinical trials of H5N1 vaccines and briefly discuss how vaccine safety could be monitored in a postmarketing surveillance setting.