The second wave of pandemic H1N1 influenza is winding down in North America and much of Europe, but flu activity is still widespread and intensifying in India, Egypt and elsewhere and it's too soon to say the pandemic is over, officials of the World Health Organization said this morning. "It is still premature and too early for us to say we have come to an end of the influenza pandemic worldwide," WHO director-general Dr. Margaret Chan said in her annual year-end address to the media. "It would be prudent and appropriate ...to continue to monitor the evolution of the pandemic for the next six to 12 months," she said, in large part because many experts expect a third wave. She added that she is very happy that the pandemic has proved to be milder than most experts had anticipated. "The fact that the long overdue influenza pandemic is so moderate in its impact is probably the best health news of the decade," she said. But "the one thing we need to guard against is a sense of complacency."
She also noted, however, that areas where the swine flu is now active are among the areas where officials have seen activity of avian flu, also known as H5N1. Avian flu is much more lethal than swine flu, killing as many as 60% of those it infects, but it is only very poorly transmitted from human to human. The WHO's biggest fear is that the two viruses will intermingle and produce a new mutant that retains the lethality of H5N1 while acquiring the ready transmissibility of H1N1. "The world is not ready for a pandemic to be caused by H5N1," she emphasized.
Swine flu has now been observed in more than 200 countries and more than 12,000 deaths from laboratory-confirmed infections have been recorded. Experts consider that to be a gross underestimate of the actual number of deaths, but Chan noted that it may be a year or two before the full impact of the pandemic can be tabulated.
In other swine flu news:
-- Doctors in China are treating severely stricken victims of swine flu with blood plasma donated by survivors or by those with a strong immune response produced by vaccination. The hope is that the swine-flu antibodies in the donated plasma will limit the infection and help the patients recover more quickly. Plasma therapy is used to treat hepatitis B, rabies and some other infectious disease, and some results with seasonal influenza outbreaks suggest it can also be valuable with flu, particularly when hospital intensive care units become strained from large numbers of cases. It is not clear how many patients have been treated in this manner, but media reports indicate at least 10 have received plasma.
-- The Food and Drug Administration has approved a new high-dose influenza vaccine for seasonal flu for elderly people. Fluzone High-Dose, manufactured by Sanofi-Pasteur Inc, contains 60 micrograms of each of the three seasonal flu strains used in the normal vaccine. A conventional flu vaccine contains only 15 micrograms of each. "As people grow older, their immune systems typically become weaker," said Dr. Karen Midthun, acting director of the FDA's Center for Biologics Evaluation and Research. "This is the first influenza vaccine that uses a higher dose to induce a stronger immune response that is intended to better protect the elderly against seasonal influenza."
-- President Obama and his wife, Michelle, got their swine flu shots before they went to Hawaii on vacation, and he encouraged everyone else to get their own. His children got theirs earlier in the year when their school classes were vaccinated.
-- Swine flu has been found in two pigs on farms in North Carolina, and such a finding is now becoming relatively routine. Both pigs are recovering under the care of a veterinarian. Swine flu has now been found in pigs in North Carolina, Minnesota, Indiana and Illinois; cats in Iowa, Oregon and Pennsylvania; ferrets in Oregon; turkeys in Virginia; a dog in New York; and a cheetah in California. In all these cases, the animals apparently caught the virus from humans.
-- Thomas H. Maugh II