
WHO says preparation vital for next swine flu wave

BEIJING (AFP) - - World Health Organization chief Margaret Chan on Friday urged governments to prepare for a likely second wave of swine flu cases, cautioning they will face tough decisions on how to dispense vaccines.
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Chan's statement came as more than two dozen pharmaceutical companies around the world scramble to produce a safe and effective vaccine against A(H1N1) influenza, with the northern hemisphere's winter fast approaching.
"We cannot say for certain whether the worst is over or the worst is yet to come," Chan said via videotaped address at the start of a three-day symposium on flu in the Asia-Pacific region.
"We need to be prepared for whatever surprises this capricious new virus delivers next... constant random mutation is the survival mechanism of the microbial world.
"We also need to prepare for a second or even a third wave of spread as typically seen in past pandemics."
About 1,800 people have died since the A(H1N1) virus was first uncovered in April, according to the latest update from the WHO issued this week. The vast majority of those deaths have been recorded in the Americas.
The WHO declared a global pandemic in June, and the UN health agency now says there are confirmed cases in more than 170 countries.
While the epidemic appears to be weakening in the southern hemisphere, preparations should be stepped up in the northern hemisphere as the seasonal flu season approaches, Chan said.
"Like all influenza viruses, H1N1 has the advantage of surprise on its side," she said.
"We have the advantage of science and rational investigation on our side, supported by... data collection, analysis and communication that are unprecedented in their power."
Chan said the issue of how to ensure adequate vaccine supplies worldwide needed to be tackled "head on."
"We need to gather advice on priority groups for initial protection," Chan said.
"This is one of the most difficult decisions governments around the world will need to make, especially as we know that supplies will be extremely limited for some months to come."
The WHO said earlier this week that countries in the northern hemisphere alone had ordered more than one billion doses of swine flu vaccine, sparking warnings about shortages, given the intense demand and production delays.
A Chinese drug company, Sinovac Biotech, this week announced positive preliminary data from its clinical trials after giving test subjects just one dose of its vaccine.
But many experts have said that double doses will be needed because most people have no immunity to A(H1N1).
WHO assistant director general Keiji Fukuda said that nations should share information about swine flu vaccines in the same way that data about the virus has been shared.
"In this kind of situation, the access to vaccines, the access to other critical benefits by all countries, is really as important as the sharing of information on viruses," Fukuda said.
In addition to speeding up access to vaccines and anti-viral drugs, the WHO response to a possible second wave of swine flu cases would focus on tracking and monitoring outbreaks and providing information and support, he said.
"The preparedness undertaken by many countries and organisations really did make a significant difference in the response" to the virus so far, Fukuda said.
"It is clear however that we still need to continue to work on the preparedness aspect. What this really means is that we need to improve awareness and knowledge and strengthen national and international capacities."

Director General of the World Health Organization, Margaret Chan, is seen on a large screen as she speaks to an international symposium on pandemic response and preparedness in Beijing. Chan urged governments to prepare for a likely second wave of swine flu cases, cautioning they will face tough decisions on how to dispense vaccines.
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Prevention is better than cured.....totally agreed..
But if you have underlying condition - like heart disease, asthma, high blood pressure, high cholesterol, diabetes, kidney problem, obesity then how?
I think MOH message that patient with underlying problem should get treatment as fast as possible havent sink in to the general public...... that my honest opinion... so I expect more death..
singaporegal ( Date: 09-Jul-2009 21:29) Posted:
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Latest: total 3 death.... the 13 year old boy also died...
FOR IMMEDIATE RELEASE
Influenza A (H1N1-2009)-related deaths
The 13-year-old male suffering from epilepsy who was admitted to NUH’s Paediatric ICU on 19 Jul 09 and diagnosed with Influenza A (H1N1-2009) has passed away this morning. The cause of death was status epilepticus (prolonged seizures), with influenza A(H1N1-2009) infection as a contributing factor.
The deceased had sought medical treatment at NUH’s Emergency Department on 19 July 09 after a day of fever and cough. He suffered cardio-respiratory arrest at the emergency department and was admitted to NUH's Paediatric ICU. Laboratory tests confirmed that he had Influenza A (H1N1-2009) on 20 July 09.
The 55-year-old man suffering from motor neuron disease who was admitted to CGH ICU on 18 Jul 09 and diagnosed with Influenza A(H1N1-2009) also passed away this afternoon. The cause of death was severe pneumonia with advanced motor neuron disease and underlying Influenza A (H1N1-2009).
The deceased had sought medical treatment at CGH’s Emergency Department on 18 July 09 after two days of fever and increasing shortness of breath. He suffered cardiac arrest at CGH Emergency Department on 18 Jul 09 and was admitted to CGH ICU. Laboratory tests confirmed that he was infected with Influenza A (H1N1-2009).
Update on latest ICU H1N1 case
A 42-year-old female foreigner with a history of hypertension and who is overweight sought treatment at TTSH’s Emergency Department on 22 July 09 with a three-day history of shortness of breath. She was found to have low oxygen saturation and low blood pressure. Laboratory test confirmed that she has Influenza A (H1N1-2009). She is currently on a ventilator and is in critical condition.
Status update
The 42-year-old woman with co-morbidities (hypertension, thyroid disease) admitted to CGH's ICU on 18 Jul 09 remains in critical condition.
The 46-year-old female foreigner with hypertension and kidney disease on dialysis admitted to Mount Elizabeth’s ICU on 20 Jul 09 is currently in stable condition.
Dun worry about d A flu, dance n drink as per usual, as wat d minister mentioned in cabinate lately.
But be considrate if visiting patients,as their immunity is much lower, they may be affected if visiting guests got flu, cough or other commutable deseases. Maintaining per hygiene is paramount important, for ownself n families.
Repost, sori for the jumble post earlier....
Please see below, MOH's statement on the new H1N1 ICU cases as well
as updates on the hospitalised cases. Appreciate it if you could continue
to advise high-risk groups who develop flu-like symptoms to seek medical
treatment early.
Thank you.
==========================================
As at 21 July 09
New ICU cases
A 46-year-old female foreigner with hypertension and kidney disease on
dialysis sought medical treatment at Mount Elizabeth Hospital’s Emergency
Department on 19 Jul 09 with a 7-day history of sore throat and fever. She
was admitted and transferred to the hospital's ICU on 20 Jul 09 when she
became breathless. Laboratory tests confirmed that she is positive for
Influenza A (H1N1-2009). She is currently in a stable condition.
A 51-year-old female with asthma sought treatment at TTSH’s emergency
department on 20 Jul 09 with a 2-day history of fever and 1-day history of
breathlessness. She was admitted to ICU on the same day as her condition
had worsened. Laboratory tests confirmed that she is positive for Influenza
A (H1N1-2009). She is currently in a critical condition.
A 13-year-old male suffering from epilepsy sought medical treatment at
NUH's emergency department on 19 Jul 09 after a day of fever and cough. He
suffered a cardiorespiratory arrest at the emergency department and was
admitted to NUH's Paediatric ICU. Laboratory tests confirmed that he has
Influenza A (H1N1-2009) on 20 Jul 09. He is currently in a critical
condition.
Status update
The 55-year-old man suffering from motor neuron disease and the 42-year-old
woman with co-morbidities (hypertension, thyroid disease) admitted to CGH's
ICU on 18 Jul remain in critical condition.
There are three other patients still in SGH's ICU; they are in stable
condition.
Actually, to be fair to those in charge, this virus is unlike the SARS virus where the fever comes BEFORE the patient becomes infectious.
In this H1N1 case, the fever comes AFTER the infectious stage. This alone causes many problems for pandemic screening and zoning efforts.
Also, many other countries have simply given up trying to contain the virus. They are just treating the virus like any normal strain of flu.
Singapore's inabilities to handle such an outbreak even after Sar experiences show how inefficient are those in charge.
They should have passed a law requiring everyone coming to Singapore wear masks for a week.
If people can afford to fly, how much can a week of mask cost? If not then fine them for not wearing masks.
Swine flu may not be dangerous but to those suffering chronic illness, pregnant women, it can be deadly. fyi
Media statement from MOH
The 63-year-old patient with H1N1 admitted to TTSH ICU on 6th Jul has stabilised and been transferred to the general ward today.
Meanwhile, a 51-year-old man with multiple co-morbidities (diabetes, hypertension) is in critical condition in CGH. He sought treatment at the Hospital Emergency Department yesterday, after 4 days of flu-like symptoms. His family sent him to CGH when his condition deteriorated. He was immediately admitted to ICU. Laboratory diagnosis confirmed that he was also infected with H1N1.