Dutch H5N1 Flu researchers Eager to Restart their Hybridisation work

After six months of dispute, research in the Netherlands that made a deadly H5N1 flu airborne will be published this week. The scientists behind it now want to get on with their work – but they can't.

In December 2011, a US biosecurity committee advised against publishing the research, fearing it was "dual-use research of concern" (DURC) – done for noble reasons, but dangerous if pathogens escaped or if bioterrorists obtained them. Most committee members changed their minds in April, and approved publication.

But in January, before that turnaround, the world's top flu labs declared a moratorium on any further such research in a bid to calm the situation. "Now, we don't know under what conditions we can lift the moratorium," says Ab Osterhaus of the Erasmus Medical Center in Rotterdam, where the research was done.

In theory they can at any time, because the agreement was voluntary. The problem, says Anthony Fauci, head of the US National Institute of Allergy and Infectious Diseases, is that any similar research done before ground rules for DURC are clarified could run into a similar dispute over publishing.

The US hastily published a new DURC policy in March. It says that if work with any of 15 pathogens increases virulence, transmission, hosts or resistance to defences, researchers must apply a mitigation plan to be agreed by relevant authorities. 

This may include increased containment, changing the experiment, withholding results, classifying the work under secrecy rules – or just not doing it.

A further plan will be published soon, says Fauci. It will flesh out what risks are unacceptable and how to mitigate them, and draw up a committee from US government agencies to apply the rules.

Some researchers welcome the move. "The policy adds another layer of oversight to make sure that all angles have been discussed before and after an experiment with potential dual use," says Adolfo García-Sastre at the Mount Sinai School of Medicine in New York City.

Others fear trouble. Ron Fouchier, who led the Dutch work on H5N1, says the Dutch authorities are happy with his biocontainment precautions, but a US committee is re-examining them under the new DURC rules. 

He worries that pathogen research could simply leave the US. Fouchier thinks researchers and authorities should discuss safety while planning research – and that it should apply to more than the 15 pathogens.

"We need international guidelines on how to decide who can do what, based on the risks and benefits of the research," says Osterhaus. At the moment, he adds, not even bio-containment labs are standardised. He has asked the European Commission to get involved.

The World Health Organization will publish new guidelines on biosafety in coming weeks, and plans a global meeting on DURC issues next year.

David Heymann, chairman of the UK Health Protection Agency, agrees that global standards are needed.

"Stronger regulations are easy, but they're false security, as they either are not enforced, or affect law-abiding scientists but not rogues," he says. What will work, he adds, is if scientists agree on how to do research safely – and enforce this through peer pressure.

H1N1 influenza virus prevalent in domestic animals in Africa

UCLA life scientists and their colleagues have discovered the first evidence of the H1N1 virus in animals in Africa. In one village in northern Cameroon, a staggering 89 percent of the pigs studied had been exposed to the H1N1 virus, commonly known as the swine flu.

“I was amazed that virtually every pig in this village was exposed,” said Thomas B. Smith, director of UCLA’s Center for Tropical Research and the senior author of the research.

“Africa is ground zero for a new pandemic. Many people are in poor health there, and disease can spread very rapidly without authorities knowing about it.”

H1N1 triggered a human pandemic in the spring of 2009, infecting people in more than 200 countries. In the U.S., it led to an estimated 60 million illnesses, 270,000 hospitalizations and 12,500 deaths, according to the Centers for Disease Control.

The virus, known scientifically as Influenza A (H1N1), is made up of genetic elements of swine, avian and human influenza viruses. The pigs in Cameroon, the researchers say, were infected by humans.

“The pigs were running wild in that area,” said lead author Kevin Njabo, a researcher in UCLA’s department of ecology and evolutionary biology and associate director of the Center for Tropical Research. “I was shocked when we found out it was H1N1. Any virus in any part of the world can reach another continent within days by air travel. We need to understand where viruses originate and how they spread, so we can destroy a deadly virus before it spreads. We have to be prepared for a pandemic, but so many countries are not well-prepared — not even the United States.”

Njabo and his colleagues randomly collected nasal swabs and blood samples from domestic pigs that were part of 11 herds in villages and farms in Cameroon in 2009 and 2010. The results are published in the current issue of Veterinary Microbiology, a peer-reviewed scientific journal specializing in microbial animal diseases.

Nasal swabs can detect a current infection, and blood samples reveal past exposure to a virus. Because an active infection lasts only about five days, “we have to be lucky to get an active infection in the field, but evidence of the infection stays in the blood.”

In the village in northern Cameroon, Njabo found two pigs with active H1N1 infections, and virtually every other pig had evidence of a past infection in its blood.

“The pigs got H1N1 from humans,” Njabo said. “The fact that pigs in Africa are infected with the H1N1 flu virus illustrates the remarkable interconnectedness of the modern world with respect to diseases. The H1N1 virus that we found in livestock in Cameroon is virtually identical to a virus found in people in San Diego just a year earlier, providing an astonishing example of how quickly the flu can spread all over the globe.

“The discovery of H1N1 in African swine is also important because it shows how farming practices can trigger disease outbreaks and suggests opportunities for improving human and livestock health. Our studies indicate that H1N1 infections are more common in swine that wander freely in villages than in animals that are confined to farms.”

The biologists used a diagnostic test called ELISA — enzyme-linked immunosorbent assay — to test for potential viruses. ELISA revealed the pigs had the human strain of H1N1.

H5N1: Chickens engineered to be bird flu decoys

Scientists have engineered chickens that block the spread of avian influenza viruses.

These chickens – which are not intended for human consumption – still got the flu and died, but they didn’t pass the virus on to the healthy chickens they lived with.

These genetically modified chickens (pictured) could one day thwart outbreaks of a global threat to poultry production and human health that has caused the destruction of hundreds of millions of birds and the death of 306 people. But whether these chickens will be safe to eat is yet to be determined.

“Chickens are potential bridging hosts that can enable new strains of flu to be transmitted to humans,” says lead investigator Laurence Tiley of University of Cambridge. “Preventing virus transmission in chickens should reduce the economic impact of the disease and reduce the risk posed to people exposed to the infected birds.”

In this new study, chicken cells produced an RNA ‘decoy’ that resembles the viral genome. It binds to an important part of the virus, preventing its spread.

In particular, the researchers introduced a new gene into these chickens that produces a small molecule that mimics a vital enzyme of the H5N1 flu virus. The decoy tricks the virus’s production machinery into recognizing the decoy instead of the virus’s genome. This makes the enzyme useless, interfering with the replication of the virus.

And none of their cagemates – engineered or not – caught the flu. That means that only one or a few chickens would become infected if the virus entered a flock.

This strategy of developing chickens genetically resistant to infection has advantages over vaccinating the birds. Vaccination, the authors say, still allows the virus to circulate undetected through flocks of chickens, possibly mutating and developing resistance.

It costs approximately $79,000 to produce “a small number of stable transgenic birds you can characterize and breed from,” says study author Helen Sang of University of Edinburgh.

A truly disease-resistant bird wouldn’t be available any time soon, but the chicken method could help develop flu-fighting pigs, ducks, quail and turkeys.

Science reports:

Transgenic chickens could theoretically replace nontransgenic breeds worldwide in a few years, says Michael Greger, director of Public Health and Animal Agriculture at the Humane Society of the US. That’s because the trade in both broiler and egglaying chickens has become consolidated in a handful of companies, which essentially determine what stocks are used by chicken farmers worldwide.

It would inevitably be more expensive, not to mention that these companies don’t sell to the vast number of people in the developing world who have a small flock in their backyard or on their rooftop – and that’s where avian influenza has been the most difficult to control [Science].

The study was published in Science last week and was partly funded by Cobb-Vantress, a major international chicken-breeding company.

Image by Norrie Russell, courtesy of Valerie White and The Roslin Institute

H5N1 Avian Flu: Labs Producing Virulent Flu Strains

Engineered hybrids of H5N1 bird and H1N1 human flu strains have proven virulent in mice, raising the danger that a natural recombination would be deadly to humans.

For years, researchers have worried that H5N1 avian influenza would mix with human flu viruses, evolving into a form that keeps its current lethality but is far more contagious.

That hasn’t happened in the wild yet but the latest findings, published Feb. 22 in the Proceedings of the National Academy of Sciences, show how easily it can happen.

“Fortunately, the H5N1 viruses still lack the ability to transmit efficiently among humans.” However, the virus may soon be overcome this obstacle when it mixes with human flu strains. These are the findings of researchers led by University of Wisconsin virologist Yoshihiro Kawaoka. “The next pandemic is inevitable and it will be more devastating than the last.”

Current strains of H5N1 have infected 478 people since 2003, and killed 286 of them. It’s has difficulty transmitting to humans. It requires close contact and exposure to an infected person, bird or animal.

In birds, however, H5N1 is far more contagious, and here the virus has killed tens of millions of fowl. Fortunately, cases have been concentrated in Africa and Eurasia, but as the swine flu pandemic demonstrated, any flu contagious to humans will quickly spread on a global scale. This is mainly thanks to air travel and the free movement of peoples across state boundaries.

Influenza viruses mutate and swap genes easily, with co-infections turning animals into mobile petri dishes. In 2008, hoping to learn more about how H5N1 might evolve, researchers from the Centers for Disease Control and Prevention combined it with a common human flu strain.

The researchers engineered all 254 possible variants of hybridisation between the deadly H5N1 avian flu strain found in Borneo, and a, H1N1 human flu virus from Tokyo. They identified three strains that were both contagious and deadly, in mice.

A flu virus that kills mice won’t necessarily kill humans, but the results are very disturbing. All three killer hybrid strains possessed a protein taken from the human strain. Called PB2, the protein appeared to help the virus survive in the mice’s upper respiratory tract. As of now, bird flu stays in the lower respiratory tract, where it’s less likely to be casually transmitted.

Although the recent H1N1 pandemic has not proved to be as lethal as originally feared, it certainly exposed how unprepared the world is for new influenza strains. At the same time it also exposed the ability of pharmaceutical companies to frighten the WHO, governments and politicians into spending $Millions to stockpile ineffective vaccines.

In May, Hong Kong University virologist Yi Guan, best known for finding the animal origin of SARS, was asked by Science Insider about the possibility of H5N1 and swine flu mixing.

“If that happens, I will retire immediately and lock myself in a sealed laboratory", said Guan. "But, historically the Chinese mainland would be the most likely source of such a virus."

"Unfortunately, in such a situation, the imposed cover-up by local authorities would mean that the virus will have spread with a high rate of cross-infection and will have escaped globally, even before we are alerted to it's existance. We will not be alerted until it has spread to the Western world and many people have become infected and died."

H5N1: AVIAN Flu death in Vietnam

A 38-year-old woman has become the first victim of bird flu in Vietnam in 2010, bringing the country's toll from avian influenza to 58, the health ministry said Friday.

The woman died Tuesday in the southern province of Tien Giang after two days of unsuccessful hospital treatment, said the ministry in an online statement.

The victim had killed and cooked sick waterfowl, the statement added.

Vietnam's last death from the H5N1 virus was in December.

At present, outbreaks of bird flu among poultry have been reported in five provinces.

Vietnam ranks second after Indonesia for the highest bird flu death toll, according to the World Health Organization.

The H5N1 virus typically spreads from birds to humans via direct contact, but experts fear it could mutate into a form easily transmissible between humans, with the potential to kill millions in a pandemic.

H1N1: Britain probes transmission of drug-resistant swine flu

British health authorities said Friday they are investigating what could be the world's first cases of person-to-person transmission of a strain of drug-resistant swine flu. Five people in a hospital unit in Wales have a strain of the A(H1N1) virus that is resistant to Tamiflu and "three of these appear to have acquired the infection in hospital", the public health service in Wales said.

"Although further epidemiological investigation is under way, it would seem likely that transmission of oseltamivir-resistant H1N1 virus has taken place," added the Health Protection Agency (HPA) in a separate statement.

This was a possible world first. The HPA noted that while almost 60 incidences of Tamiflu-resistant flu had been reported worldwide, "there have been no documented episodes of person-to-person transmission." It said the risk of drug-resistant flu remained "low" noting the five patients affected had severe underlying health conditions and were being treated at a special unit at the University Hospital of Wales in Cardiff.

The emergence of influenza A viruses that are resistant to Tamiflu is not unexpected in patients with serious underlying conditions and suppressed immune systems. The resistant strain "does not appear to be any more severe than the swine flu virus that has been circulating since April", and Tamiflu, made by Swiss drugs giant Roche, remained partly effective for most other people.

Scientific research confirms that Tamiflu and Relenza were never the 'cure all' drug that they were marketed as being.

The HPA said that another leading antiviral drug, Relenza, was being used to treat the five Welsh patients and they were "responding well". Two patients had recovered and been discharged from hospital, one remained in critical care and two others continue to be treated, officials said.

Britain is the European country most affected by swine flu, with about 715,000 cases of the virus and 100 deaths since the pandemic began.

The latest data from the World Health Organisation showed that around 6,750 people worldwide had died from swine flu since the virus was first uncovered in Mexico and the United States in April.

H5N1: Bird Flu, Sexually Transmitted Disease - in Ducks

Bird flu may be a sexually transmitted infection – at least in ducks. That's the suggestion of an analysis of flu prevalence and mating behaviour that also proposes an easy way to spot duck populations most at risk of harbouring avian flu.

Surprisingly, the more rampant the sex a particular duck species indulges in, the lower the chance of spreading the virus. It's all to do with penis size and the complexity of the females' vagina.

Lethal strains of avian flu virus can evolve from harmless versions and then jump to other species, so it is important to also monitor less dangerous strains in wild birds. Ducks are the main wild hosts of bird flu, but surveillance is difficult without easy markers of infection risk.

Now Gergely Hegyi at Eötvös Loránd University in Budapest, Hungary, and colleagues think they may have found just such a marker: the "covert" wing patches that ducks display during mating. This finding builds on the previous work by the team, in which they found that species with large penises tend to have smaller wing patches, which are also more likely to be a single colour.

Sexual arms race
Most ducks form monogamous pairs but the males also often force sex on females because, unlike most birds, they have a phallus. This has led to an evolutionary "arms race" between the sexes, with males evolving longer penises the better to inseminate the female, and females responding by evolving more complex vaginal anatomy to make insemination by unwelcome partners less likely.

When the researchers compared data on the prevalence of low-pathogenic bird flu strains in different duck species with what is known about the anatomy of duck reproductive parts and mating behaviour, they found that ducks with the smallest penises and tamest sex lives had the highest flu levels.

"This is intriguing and a bit counter-intuitive because a long phallus prolongs copulation, and forced copulations characteristic to species with a large phallus should further promote virus transfer," says Hegyi.

The explanation may lie in the counter-adaptation of the female ducks. "Long and elaborate vaginas may hinder unwanted fertilisation but may also make it difficult for viruses acquired during copulation to reach the site of egg formation," Hegyi says.

Infection peak
This idea might help to explain why infections often peak during the breeding season. The researchers think that mating may spread flu by pushing water contaminated with the virus onto developing eggs and so infect chicks before or during hatching – and that this will happen more readily in ducks with less complex vaginas.

Bird flu specialist John McCauley at the National Institute for Medical Research in London says that the idea of sexual flu transmission and its dependence on reproductive anatomy and copulation habits is interesting. "It's quite feasible that they are right, but it will be important to make sure that the epidemiological evidence is robust and not biased by differences in sampling methods."

Because duck species with small penises have larger and more colourful wing patches, Hegyi hopes that confirmation of the link between sex and flu might help to identify which wild populations are most likely to spread bird flu. Monitoring effort can then be concentrated on these populations.

In addition, recognition of sexual transmission "may require different biosafety measures in captive birds than those currently implemented," he says.

Journal reference: Behavioral Ecology, DOI: 10.1093/beheco/arp133

H1N1 Swine Flu: A Serving UK Soldier dies after contracting the virus

A serving UK soldier has been revealed as the latest patient to die after contracting H1N1, swine flu virus.
Bombardier Lee Porter, from Coleraine in Northern Ireland, died last week, two weeks after contracting the bug - it is reported that he had underlying health problems.

The 30-year-old member of the Royal Artillery is thought to be the first UK serviceman to have fallen victim to the bug.

According to the announcement, Bombardier Porter died on Friday at Frimley Park hospital in Surrey, making him the 28th person known to have died after getting swine flu in England.

A spokesman for the Ministry of Defence said: "It is with great sadness that the MoD must confirm the death of Bombardier Lee Porter, who contracted Swine Flu two weeks ago, which complicated existing health problems. Our thoughts go out to his family, who were at his bedside at the time."

110,000 New Cases
The latest figures on swine flu show that cases of the virus "may have plateaued", according to the Government. Their data, released today, showed that there were 110,000 new cases in England last week.

That represents a 10 per cent rise on the 100,000 new cases estimated in the previous weeks. Twenty seven people in England have died from swine flu, while 793 patients are being treated in hospital, that figure is down on the 840 of last week.

UK Schoolgirl on Life-Support
A British schoolgirl being treated in Greece for swine flu is on a life support machine but is showing signs of improvement and is said to be 'a little better.'

Natasha Newman, 16, from Highgate, north London, is in an Athens hospital after falling ill on the island of Cephalonia. Doctors at the intensive care unit of Penteli Children's Hospital described her condition as 'serious but stable.'

Pneumonia
One doctor, who did not wish to be named, said: "She has better lung function than yesterday and the day before. She has pneumonia, which is not something easy, but she has no lasting damage to her lungs and she is not in a dangerous condition."

H1N1: 'First' Official Swine-flu death in African Continent

South Africa has confirmed its first death from swine flu, believed to be the first officially documented fatality from the virus in sub-Saharan Africa.

Health officials said a 22-year-old student had died on 28 July, and tests had confirmed the cause of death as the onset of Pneumonia following the initial infection by the H1N1 influenza virus.

150 Confirmed Cases

The country has had at least 150 confirmed swine flu cases, the highest officially reported rate in sub-Saharan Africa. This may be due to more stringent testing and reporting methods carried out by the South Africans.

Cases Unreported

The illness has caused hundreds of deaths in North and South America. Dozens more have died in Asia and Europe. Africa was thought to be one of the last continents to be hit by the virus and so far the number of officially reported cases are low.

ECDPC report

South Africa confirmed its first case of the disease on 18 June 2009 and has had 151 cases in total, according to the European Centre for Disease Prevention and Control. The SA health ministry called the student's death "unfortunate and deeply regretted".

Pneumonia

A statement from the ministry said he had been ill for about a week before going to a Western Cape hospital, where he was treated with antibiotics for the onset of pneumonia, often the final stage of the disease. Unfortunately the treatment was unsuccesful and he died two days later.

Mild Cases

The ministry's statement added: "We are encouraged by the fact that the majority of cases in South Africa have so far been mild and we hope that this will remain so, despite this unfortunate death."

Young Children suffer Tamiflu side-effects

pa.press.net

More than half of children taking Tamiflu suffer side-effects such as nausea, insomnia and nightmares, researchers have said.

Two studies from experts at the Health Protection Agency (HPA) showed a "high proportion" of British schoolchildren reporting problems after taking the anti-viral drug.

Data was gathered from children at three schools in London and one in the South West who were given Tamiflu earlier this year after classmates became infected.

The researchers behind one study said that, although children may have attributed symptoms that were due to other illnesses to the use of Tamiflu, "this is unlikely to account for all the symptoms experienced".

Their research, published in Eurosurveillance, looked at side-effects reported by 11 and 12-year-old pupils in one school year in a secondary school in South West England. The school was closed for 10 days in response to a pupil being confirmed with swine flu on return from a holiday in Cancun, Mexico.

A total of 248 pupils took part in the study and were given Tamiflu prophylactically. Compliance with prophylaxis was high, with 77% of children taking the full course, the researchers said. But they added: "Fifty-one per cent experienced symptoms such as feeling sick (31.2%), headaches (24.3%) and stomach ache (21.1%).

The researchers said "likely side-effects were common" and the "burden of side-effects needs to be considered" when deciding on giving Tamiflu to children prophylactically. The researchers concluded that a "high proportion of school children may experience side-effects of oseltamivir (Tamiflu) medication".

H1N1 Swine Flu Vaccine - Human Trials start in Australia

The number of people calling in sick with swine flu symptoms has tripled in a week, with 130,000 people staying away from work.

Worldwide, 700 people have died!

News of the increase in absenteeism came as the British death toll from the virus rose to 31, with a 51-year-old woman from Wiltshire and the 15-year-old from Glasgow the latest victims.

Greatest Challenge to NHS
Sir Liam Donaldson, the chief medical officer, yesterday warned that swine flu “almost certainly” posed the biggest challenge to the NHS for a generation. Fears of swine flu crisis grow as six-year-old girl and doctor dieAlmost 130,000 people stayed off work with flu, coughs and colds on July 14, up from 45,000 a week before, according to FirstCare, an absence management company.

Absentees triple
While absences tripled, the number of people who have actually contracted the virus is thought to have only doubled over the same period, highlighting how fear of infection is damaging business.

Septic Shock
Meanwhile, it has emerged that Chloe Buckley, the girl thought to have been the first healthy young victim of swine flu, died from septic shock after a bout of tonsillitis, a post mortem examination indicated. The death of Chloe, six, from West Drayton, west London, alarmed parents of young children.

Dr Simon Tanner, London’s regional director of public health, said it was impossible “to say to what degree swine flu contributed to her death”.

Andrew McCombe, a leading surgeon, said it was rare for a child to die from septic shock after contracting tonsillitis. “Normally septic shock affects old people,” he said.

Human Vaccine Trials to Begin
Human trials of a vaccine to protect against the H1N1 swine flu virus have begun in Australia.
Vaxine and CSL have both started injecting human volunteers this week, but it will be at least six weeks before the initial results are known.

Morbidity rate increases
The overall morbidity figure is likely to climb on Thursday when the Department of Health gives its weekly update. Worldwide, more than 700 people have died.

H1N1 Pandemic: Sudden Spike in swine flu alerts GPs & MDs

pa.press.net

GPs have seen a leap of almost 50% in the numbers of people contacting them with fears they have swine flu in the last week, new figures reveal.

Around 40,000 people a week in England and Wales are now complaining to their doctor of "flu-like illness", with a dramatic rise in the number of young children being affected.

The Royal College

The figures, from the Royal College of GPs' monitoring system, showed 50.3 people per 100,000 were reporting flu-like illness between June 29 and July 5, but this leapt by 46% to 73.4 people per 100,000 between July 6 and 12.

Financial Times

Almost one in eight workers are likely to be kept at home with the virus in the next few weeks, according to Government figures. This could leave many businesses struggling to run as normal, the Financial Times reported.

Sir Liam Donaldson is expected to announce that 30% of the population is likely to be infected during this first wave of the pandemic, the FT newspaper said.

Young at most Risk
Wednesday's weekly report from the Royal College of GPs said: "National incidence of influenza-like illness increased for all regions and is now evident in all age groups but remains highest in five to 14 age groups."

Central England Hotspot
The study said the highest number of cases was being seen in central England but the North had seen "a marked increase compared to previous weeks".

There has been a small decrease in the number of cases being seen in London although the capital remains a major hot spot for the virus.

Statistics
The rate of influenza-like illness is highest among those aged five to 14, at 159.57 per 100,000 population. The next most affected group is youngsters and babies aged up to four, at 114.12 per 100,00 population. This is followed by people aged 15 to 44, those aged 45 to 64 and then people aged 65 and over.

Ant-viral Vaccine
The Government has insisted that the swine flu vaccine should begin arriving at the end of August, amid genuine fears of a delay in this delivery date, and further delay before people receive jabs.

The UK claims, it is in line to get around 60 million doses of the vaccine - enough to cover half the population - by the end of December, with the rest of the doses following next year.

Vaccine Production Delayed
This is a substantial turn around in their earlier claims and the first phase of the virus should have run its course by then. The mutated second phase will take over and the vaccine will be ineffective against it.

Virus Dictates Timeline
It is impossible to determine how the H1N1 virus will mutate, so scientists are unable to prepare in advance for this strain. Only when the new strain is identified will they be able to start on development of a new anti-viral vaccine.

So, the development, testing and distribution of a second antiviral vaccine will need to start after January 2010 and is therefore unlikely to be in production before the Spring 2010.

Swine Flu Vaccine Delayed: Further tests on swine flu victims

Whilst the world waits, anxiously for the new vaccine against this outbreak of Swine Flu, news of further delays in production and testing come to light.

Meanwhile the number of victims and fatalities increase.

Further post-mortem tests are to take place this week, to determine the causes of death of a six-year-old girl and a GP who both died after contracting the disease.

Chloe Buckley, from north west London, and Bedfordshire GP, Dr Michael Day, died after suffering from the virus. Their deaths took the number of UK deaths linked to swine flu to 17.

On Monday health bodies, the British Medical Association (BMA) and the The Royal College of General Practitioners, urged the public not to panic.

Chloe died last Thursday at St Mary's Hospital in Paddington. A post-mortem is due to be carried out to determine if she had underlying health conditions.

Dr Day died on Saturday in the Luton and Dunstable Hospital. A subsequent swab test revealed he had swine flu although it is not yet known if this was the cause of his death.

Health Secretary Andy Burnham said the UK was well placed to deal with the outbreak but could not rule out further deaths.

He said: "Although the swine flu virus is proving generally mild in most people, in some cases it is more severe. Unfortunately, as with seasonal flu, people may develop complications and in some cases will die."

The first British patient without underlying health problems died on Friday after contracting swine flu. The patient, from Essex, died in Basildon.

Nearly 10,000 Britons have been confirmed with the swine flu infection but hundreds of thousands more are thought to have the virus.

Confirmed sufferers are dosed with Tamiflu and confined to their home with minimal or no contact with the outside world.

H1N1: Vaccine Production Delayed

Flu viruses contain eight genetic elements. Vaccine strains contain two genes for the main surface proteins of the virus the vaccine is aimed at, plus six from a strain that grows well in chicken eggs, which is where most flu vaccines are produced.

These vaccine strains are produced either by reverse genetics, in which the eight genetic elements are artificially combined using genetic technology; or by allowing the two viruses to mix naturally. WHO collaborating labs used both methods to produce seed strains for the pandemic virus to make sure there were no unforeseen problems with one or the other.

Yet both methods have performed equally badly, each producing one of the two fastest-growing strains. The other strains are presumably growing even more slowly.

Vaccine companies are trying to tweak the vaccine strains to select faster growing ones, while WHO collaborating laboratories are feverishly generating new strains, which they hope will grow faster.

H1N1 Vaccine Production delayed: Poor most at risk

The WHO says countries such as China and India expect to produce their own vaccine supplies, but smaller low- and middle-income countries representing 2.7 billion people have "no current access to H1N1 vaccine".

The report was presented to a closed, extraordinary meeting last week of the Strategic Advisory Group of Experts on Immunisation (SAGE), a panel of independent scientists who advise the WHO on vaccine issues.

Wenqing Zhang of the WHO's flu programme told SAGE that five different "seed" viruses have been produced and evaluated (pdf format). But the two highest yielding strains are growing only half as fast as the seasonal H1N1 viruses used to make vaccine for ordinary flu.

H1N1 Slow growing flu vaccine; Critically Delayed Production

Vaccine producers have hit a snag making vaccine against the swine flu pandemic. According to a report by the World Health Organisation, the fastest-growing of all the vaccine strains tested so far grows only half as fast as ordinary vaccine viruses.

Vaccine companies must fill pandemic vaccine contracts with countries such as Britain, Australia, France and the US before they can start making vaccine for the rest of the world – notably developing countries. Marie-Paul Kieny, the WHO's head of vaccines, told a meeting in Geneva last week (pdf format) that if the pandemic vaccine virus grew as fast as ordinary strains, these contracts could be filled by November 2009.

That date applies only if the vaccine works at half the dose of ordinary vaccines, with one shot enough to induce the required immune reaction. If the usual dose and two shots are needed, the contracts cannot be filled until April 2010.

But the slow-growing virus means these dates could be pushed back to January 2010 and June 2010 respectively. If the current pandemic behaves like the last H1N1 pandemic in 1918, the next, possibly worse waves of infection could be long over by then.

H1N1 Swine Flu; UK Government covering their backs and capitulating to pharmaceutical lobbyists

'Plan' to vaccinate whole UK for flu is a knee-jerk reaction from a beseiged government and political system, with dubious strategic or tactical value!

In what would be the biggest vaccination programme of the last 50 years, experts are already drawing up a priority list of patients to be given immunity before the bug becomes more virulent.

This is clearly a politically motivated ass-covering measure by the UK authorities, admitting defeat in the face of overwhelming odds.

It comes after the first British patient without underlying health problems died from the disease, taking the number of swine flu-linked deaths in the UK to 15.

Risk and Perspective
In reality the risk of dying from the influenza pandemic is very low. The number of casualties of this disease is also extremely low, especially if you consider the hundreds and thousands who die each year from smoking, diabetes and chronic heart disease. All of which are preventable. The greatest cause of death in the younger ages groups is still RTA's - Road Traffic Accidents.

The mis-use of NHS funds in the face of mis-diagnosed threat levels

Pharmaceutical donations

This move by the UK Government will further please the pharmaceutical companies and will bring a welcome boost to their dwindling profits. Hopefully, the political parties will, in return, be assured of increased funding and support in the coming years.

H1N! Swine Flu Devastating South America

A passenger takes precautions at Ezeiza International Airport, Argentina, as the swine flu pandemic intensifies (Image: Daniel Garcia / AFP / Getty Images)

THE swine flu pandemic is intensifying in South America and finding little resistance. The US White House will meet with state representatives on 9 July to discuss preparations for the autumn flu season in the US. The UK has shifted its response from protection, to dealing with the impact of widespread infection in the UK.

Meanwhile, in South America, in the midst of its winter flu season, swine H1N1 virus seems to be replacing the seasonal flu viruses that circulated till now, a classic pandemic behaviour. This raises further concerns that seasonal flu vaccine, which some companies are still making, may be useless when the northern hemisphere's flu season arrives later this year.

In the flu pandemics of 1918, 1957 and 1968, the pandemic virus completely replaced the circulating seasonal flu but in 1977, an accidentally released mild H1N1 virus simply circulated alongside the existing flu, H3N2. So, no one is sure how this swine flu H1N1 will behave. It is overwhelming what is not known about this influenza and its potential devastating impact on the civilised world.

If it does not replace the seasonal viruses - the milder H1N1 and the H3N2 - the world faces the prospect of being infected by all three viruses at once. This would be a very complicated and dangerous scenario: both seasonal and pandemic vaccines would be needed and differing age groups of people would be affected. Let's hope that what is happening in South America, is not indicative of this influenza's emerging profile.

In North America, swine flu also dominates: as expected, more than 98 per cent of flu cases genotyped in the US in late June were caused by the pandemic virus. While seasonal flu viruses normally die out in the summer, the pandemic virus has the advantage that few people have any immunity to it.

H1N1: How pandemic swine flu kills

As the H1N1 swine flu pandemic continues to spread around the world, most cases are still mild but reports are starting to emerge of people who sicken and die very quickly of what appears to be viral pneumonia.

Now two independent groups of scientists have now found out why and it's all down to where the virus binds within the body.

H1N1 swine flu comes from pigs, so it binds well to cell-surface molecules in the respiratory tracts of other mammals, including humans but there are slight differences in the way different flu proteins bind to these receptors.

Two separate teams – one led by Ron Fouchier at Erasmus University in Rotterdam, the Netherlands, and the other by Terrence Tumpey at the Centres for Disease Control in Atlanta, Georgia – both report that the pandemic virus binds deeper than ordinary flu in the respiratory tract of ferrets, the animal most like humans when it comes to flu.

A virus of the same H1N1 family as the pandemic flu has been circulating as ordinary seasonal flu since 1977. Both groups found that the seasonal virus binds almost exclusively to cells in the ferrets' noses. But, the pandemic H1N1 binds deeper, in the lung's trachea, bronchi and bronchioles. The pandemic virus also replicated more, and caused more damage, though none of the ferrets were severely ill.

Pneumonia

Viral and bacterial pneumonia is ever present in the human body. It is kept at bay by the body's normal defense mechanisms, referred to as the immune system. When the immune system is severely weakened and then overwhelmed by other infections, the pneumonia gets a chance to take hold and as it is already endemic in the respiratory system, it can very quickly reach fatal levels. The build up of fluid in the lungs, effectively drowns the patient i.e. the lungs are unable to absorb oxygen in gaseous form.

This is why so many older people or people suffering from long term chronic conditions, can succumb and die from the pneumonia, rather than the original illness or infection that they were diagnosed with or receiving treatment for.

Treat respiratory system and chest infections with greater concern during the H1N1 outbreak.

• Be quick to seek help
  
• Be quick to take the doctor's advice
  
• Be quick to take the treatment
  
• Finish the course of treatment,
  
• ......even after you feel better
• Don't give Pneumonia a chance!
  

H1N1 - Swine flu claims fourth UK victim

© ITN 2009 An H1N1 swine flu sufferer has died in London, health officials have announced.

This is the fourth person to die in the UK is understood to have been a 19-year-old man from south London who had serious underlying health problems. He died on Wednesday and tests afterwards found he had the virus.

His was announced a day after it was revealed that the number of new cases could reach 100,000 per day by the end of next month.

Chief Medical Officer Sir Liam Donaldson, who confirmed on Thursday that the UK has moved past the stage of containing the swine flu outbreak and into the "treatment phase", said there was no need for people to resort to the internet to self-medicate amid fears over the spread.

He said Britain had a massive stockpile of the now discredited, Tamiflu and would be one of the first countries to have access to a new potent vaccine, when the first supplies started arriving at the end of August, if all goes well with the testing and certification. By which time, the virus is likely to will have burned itself out and the death toll will have risen dramatically.