H1N1 virus 'Unstoppable', WHO Says, Calls for Vaccine

World Health Organization (WHO) Gives Drug Makers the Go-Ahead to Manufacture Vaccines Against the Pandemic Influenza Strain.

WASHINGTON (Reuters) - Saying the new H1N1 flu is "unstoppable", the World Health Organization (WHO) gave drug makers a full go-ahead to manufacture vaccines against the pandemic influenza strain on Monday and said healthcare workers should be the 1st to get one.

Every country will need to vaccinate citizens against the swine flu virus and must choose who else would get priority after nurses, doctors and technicians, said Dr. Marie-Paule Kieny, WHO director of the Initiative for Vaccine Research.

Several reports showed the new virus attacks people differently than seasonal flu -- affecting younger people, the severely obese and seemingly healthy adults, and causing disease deep in the lungs.

Kieny briefed reporters on the findings of the WHO's Strategic Advisory Group of Experts on Immunization, or SAGE. "The committee recognized that the H1N1 pandemic ... is unstoppable and therefore that all countries need access to vaccine," Kieney said.

"The SAGE recognized 1st that healthcare workers should be immunized in all countries in order to retain a functional health system as the virus evolves," she added.

After that, each country should decide who is next in line, based on the virus's unusual behavior.

Seasonal influenza is deadly enough - each year it is involved in 250,000 to 500,000 deaths globally. But most are the elderly or those with some kind of chronic disease that makes them more vulnerable to flu, such as asthma.

ELDERLY ADVANTAGE

The elderly seem to have some extra immunity to this new H1N1, which is a mixture of 2 swine viruses, one of which also contains genetic material from birds and humans. It's a very distant cousin of the H1N1 virus that caused the 1918 pandemic that killed 50 million to 100 million people.

A study published in the journal Nature on Monday confirmed that the blood of people born before 1920 carries antibodies to the 1918 strain, suggesting their immune systems remember a childhood infection.

The work by Dr. Yoshihiro Kawaoka also supports other studies that this new H1N1 strain doesn't stay in the nose and throat, as do most seasonal viruses.

"The H1N1 virus replicates significantly better in the lungs," Kawaoka said. Other studies have also shown it can cause gastrointestinal effects, and that it targets people not usually thought of as being at high risk.

"Obesity has been observed to be one of the risk factors for more severe reaction to H1N1" -- something never before seen, Kieny added. It is not clear if obese people may have undiagnosed health problems that make them susceptible, or if obesity in and of itself is a risk.

On Friday, a team at the U.S. Centers for Disease Control and Prevention and the University of Michigan reported that nine out of 10 patients treated in an intensive care unit there were obese. They also had unusual symptoms such as blood clots in the lungs and multiple organ failure.

None have recovered and 3 died.

The CDC estimates at least a million people are infected in the U.S. alone and clinics everywhere are advised not to test each and every patient, so keeping an accurate count of cases will be impossible. The United States has documented 211 deaths and WHO counted 429 early last week.

Kieny said WHO would also work to get better viruses for companies from which to make vaccines. She said the strains that had been distributed didn't grow very well in chicken eggs - used to make all flu vaccines.

One exception - AstraZeneca's MedImmune unit makes a live virus vaccine that is squirted up the nose and it's easier to produce, Kieny said.

WHO said countries should continue with their normal vaccination programs against seasonal flu. Kieny said the seasonal H3N2 strain was also very active now in the southern hemisphere's winter.

Sanofi-Aventis, Novartis, Baxter, Schering-Plough's Nobilon, GlaxoSmithKline, Solvay, CSL and AstraZeneca's MedImmune are among those working on flu vaccines.

source:http://abcnews.go.com/US/WireStory?id=8073368&page=1

City H1N1/swine flu Death Toll Rises To 15

The Department of Health confirmed 3 more deaths linked to H1N1/swine flu Thursday, bringing the city's death toll to 15, as the World Health Organization(WHO) declares a swine flu pandemic.

According to the DOH, one victim was under the age of 4, one was between 5 and 24 years old, and the other was between 25 and 54. No other details have been released.

On Wednesday, 3 other deaths were confirmed.

Most of the serious cases and deaths have been in people with established risk factors for flu complications.

The news came as the Health Department released statistics showing that one in 7 New Yorkers had reported flu-like symptoms during the first 3 weeks of last month.

Officials say a telephon of those polled said they had symptoms like fever and cough or a sore throat between May 1 & May 20, meaning more than a half-million New Yorkers could have been sick with the H1N1 virus.

In response to flu concerns, New York Methodist Hospital in Brooklyn is restricting visits to the maternity and pediatric wards.

Only a husband or significant other will be allowed in to the maternity ward. And only parents can visit the pediatric ward.

A hospital spokeswoman says there was no H1N1 incident at the hospital, but since it is highly contagious, they wanted to limit the number of visits into units where patients are more vulnerable.

Meanwhile, the city's public safety, health, and governmental operation committees met Thursday to discuss the virus.

City Health Commissioner Thomas Farley, as well as education and emergency management officials, testified before City Council members.

Department of Education and Department of Correction representatives were also on hand to answer questions, but did not testify.

During the hearing, Farley was asked several pointed questions, including why the city has limited its sharing of details about those who have died from the flu strain.

"The information that the vast majority people who have died have had underlying conditions is important for people to know and that we have provided information about the frequency of underlying conditions that are important," said Farley.

"You have a panic with the failure to have information, you have less of a panic the more information that is out there," said United Federation of Teachers President Randi Weingarten.

The hearing also aired concerns over how the city decides to close schools when a high number of flu absences are reported.

"We did not have and we still do not have an absolute set of criteria, by which you can go down the list and check things off to determine whether a school should be closed," said NY City Deputy Health Commissioner Adam Karpati.

Looking ahead, Farley said the greatest challenge the city faces is making policy decisions in the face of medical and scientific uncertainty.

On a global level, H1N1 continues to spread.

In a statement sent to member countries, WHO said it decided to raise the pandemic warning level from phase 5 to 6 - its highest alert – after holding an emergency meeting on swine flu with its experts.

It is the 1st global flu pandemic in 41 years.

source: http://www.ny1.com/content/top_stories/100582/city-council-holds-hearing-on-response-to-h1n1/Default.aspx

CANCER specialists New Approach For Advanced Lung Cancer

ORLANDO - CANCER specialists, gathered for an annual meeting, are reporting progress in the fight against lung cancer, the most common and deadliest form of cancer, but little progress in treating colorectal cancer.

Doctors and researchers at the 45th gathering of the American Society of Clinical Oncology (ASCO) - the world's main cancer conference - on Saturday learned of two studies showing progress in the battle against lung cancer.

The first study showed how the combination of two anti-cancer treatments following standard chemotherapy can slow the advance of lung cancer. Patients treated with a combination of Tarceva, sold by the Swiss drugmaker Roche, and Avastin, a drug by Roche's Genentech unit, saw their cancer growth slow more than a control group treated with Avastin.

More than 750 patients were randomised to receive Avastin and a placebo, or Avastin and Tarceva. Those in the Tarceva group survived an average of 4.8 months before the cancer started growing again, compared to 3.7 months for the control group, said Vincent Miller, the study's main author. The numbers translated to a 29 per cent reduced risk of disease progression for patients who took a combination of Tarceva and Avastin.

'This is the first study to show that adding erlotinib (Tarceva) to maintenance therapy with bevacizumab (Avastin) delays disease progression in patients who have already received bevacizumab as part of their initial chemotherapy,' said Mr Miller.

A second study with 663 patients with advance lung cancer were given the drug Alimta, from US pharmaceutical Eli Lilly, which blocks cell growth. Preliminary results showed that patients who took the drug lived 26 percent longer compared to a control group that took a placebo: 13.4 months against 10.6 months. As in the first study, all the patients had already received four standard chemotherapy sessions.

'This study will change the overall standard of care,' said Chandra Belani, the deputy director of the Penn State Cancer Institute, as she presented the research. 'Maintenance therapy with Alimta (permetrexed) offers a new paradigm for patients who have advanced lung cancer, because it has a low toxicity and can be given on an ongoing basis over a prolonged period of time to extend patients' lives,' she said.

However there were few advances to report in the fight against colorectal cancer, the fourth most common in the United States and the second deadliest type of cancer. Research on 2,710 patients with Phase Three colorectal cancer taking the drug Avastine along with standard chemotherapy treatment showed no difference in the survival rate or the recurrence of the tumor after three and a half years when compared to those not taking the drug.

Another study conducted in Italy among 747 patients with advanced colorectal cancer showed that the drug Eloxatine from the French firm Sanofi did not reduce the size of the tumor when combined with standard treatment used ahead of cancer surgery.

On Sunday, several sessions at the ASCO event, scheduled to end on Tuesday, will focus on the result of clinical tests on female breast and uterus cancer. -- AFP

source: http://www.straitstimes.com/Breaking%2BNews/Tech%2Band%2BScience/Story/STIStory_384034.html