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Injectable swine flu vaccine now becoming available

October 13, 2009 | 10:28 am

Pig The first batches of injectable vaccine against pandemic H1N1 influenza were shipped Sunday and Monday, and the first immunizations with them should begin Wednesday or Thursday, federal officials said this morning. The intranasal flu vaccine FluMist was shipped last week, and immunizations with it have already begun, but it is not suitable for everyone. It is currently licensed only for use in healthy people between the ages of 2 and 49 and for those who are not pregnant. That doesn't mean that it is dangerous in others -- simply that it has not been tested in them.

As of Monday, there were 9.8 million doses of swine flu vaccine available, about half of them injectable, Dr. Anne Schuchat, director of the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases, said in a morning news conference. About 5.8 million doses had been ordered by states as of Monday, but orders continue to flow in, she noted. Most people who desire the vaccine are still having trouble finding a provider who has it, but much larger numbers of doses will be available soon. Once more doses become available, people seeking vaccination can look for providers on the CDC's website.

Five more reports of pediatric deaths associated with swine flu have been received since last week, she said, bringing the total since April to 81.

The agency has been studying hospitalizations through its Emerging Infectious Diseases Network, which covers 10 sentinel states. Between April and the end of August, those states had about 1,400 hospitalizations for swine flu in adults and an additional 500 in children under the age of 18. "The vast majority of hospitalizations are occurring in young people" and not the elderly, as is common with seasonal flu, she said. About 45% of those hospitalized did not have an underlying medical condition listed on intake forms. About 26% of the adults had asthma, 8% had other lung diseases, 10% had diabetes and 7.6% had immunosuppression for various causes. Percentages were not available for children, but the most common underlying conditions were asthma and other lung diseases, neurological diseases such as multiple sclerosis and muscular dystrophy, and sickle cell disease.

Schuchat noted that there are currently delays in the availability of seasonal flu vaccine, even though 77 million doses have already been sent to providers. "A lot more doses will be available in November," she added.

-- Thomas H. Maugh II

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The H1N1 virus has been declared a global pandemic. Here is some critical information that you should know about. Of great concern is the number of people that are ending up in the hospital with severe influenza. Once you are in the hospital, and begin to have severe respiratory problems, there are very limited treatment options available.

Keep in mind, vaccines help prevent you from getting the flu but are useless for treatment of the disease.

Once in the hospital with severe influenza, the only real treatment are “anti virals”. These attack the virus. The approved drugs are Amantadine, Rimantadine, Oseltamivir (Tamiflu®) and Zanamirvir (Relenza). While these drugs have their place, they have their problems. These drugs take a number of days, typically five, to have a full impact. The H1N1 virus has begun to show resistance to these drugs.

Peramivir is a drug developed by BioCryst Pharmaceuticals with funding provided by the U.S.government. Peramivir has finished Phase III testing in Japan where they are filing for commercial deployment of the drug). It has a very clean safety profile and an intravenous method of delivery (IV). An IV is what you will need if you are in the ICU. It is the only way to administer drugs if you have acute influenza. It has not been approved here in the U.S…yet. The drug is undergoing Phase III trials in the US…but Phase III trials have been completed in Japan. However, due to the published results by the international scientific community, and the urgent need for an IV based treatment, the Secretary of Health and Humans Services (HHS) here in the U.S. has filed a declaration for the use of Peramivir under the Emergency Use Authorization. Hopefully, the FDA will issue the EUA any day now.

Until this Emergency Use Authorization is issued, Peramivir can be obtained for patients in the hospital by a special provision called an E IND. Essentially your doctor has to request the drug via an application to BioCryst , who in turn has to have it authorized by the FDA. Most doctors are not aware of this drug and how much good it can do. You will need to make them away of it. The information about all of this can be found at www.biocryst.com/e_ind or by calling 205-989-3262.



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