US Flu pandemic control strategies

[Guest guest]

Flu pandemic may change U.S. flu approach forever

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - The swine flu pandemic may have changed the U.S. approach

to handling influenza forever, and for the better, U.S. officials said on

Thursday.

While they said years of work were needed before vaccine production was up to

the desired standard, some experiments such as vaccinating children in schools

might work to help control seasonal influenza.

But there are still holes in the public health system that will take years to

patch, and communication with the public could use a bit more polishing, they

acknowledged.

" We still don't have the domestic capacity to make as much (flu vaccine) as we

need as fast as we need it, " Lurie, assistant secretary for preparedness

and response at the Health and Human Services Department, told a news

conference.

She said HHS had been forced by the H1N1 pandemic to work closely with state and

local health officials to monitor the virus and deploy drugs and vaccines.

" I actually think our nation's preparedness, our seasonal flu efforts and so on,

will never be the same, " Lurie said.

HHS Secretary Kathleen Sebelius said 100 million H1N1 vaccines will have been

delivered or would be ready for order by the end of the week. She urged

Americans to get vaccinated now and said everyone, not just people on the

priority lists, should feel free to get one.

" This is a serious flu that targets people who normally don't get seriously ill

from the flu, " Sebelius told the news conference.

" We have a chance to lessen the impact or even prevent a big third wave ... and

we need to seize this opportunity right now, " she said.

The U.S. Centers for Disease Control and Prevention estimates that 47 million

Americans have been infected with H1N1, nearly 10,000 have been killed by it and

more than 200,000 hospitalized.

EBBING SECOND WAVE

" The number of children and young adults killed by mid-November was five times

more than in the average flu season, " CDC Director Dr. Frieden said.

" We have an ebbing second wave but we have an uncertain future. "

School vaccinations have worked well and CDC may press to keep the programs for

seasonal influenza, Frieden said.

" Not only will vaccinating kids in school reduce the number of kids who get sick

.... but may well also tamp down the spread of flu in a community, " he said.

But Frieden fretted about losses to public health. The CDC reported that in

2009, 10 percent fewer epidemiologists were working in state health departments

than in 2006. Those specialists in the spread and pattern of disease are key to

keeping track of viruses like flu, Frieden said.

" This virus was undoubtedly circulating for several months before it was

identified, " Frieden said.

Had it been detected, he said, vaccine makers could have started work on a

vaccine month earlier.

Frieden also noted there was confusion about how many vaccines would be

available, and when. HHS has been criticized for at first saying 250 million

vaccines would be produced, and then rolling back on the numbers that could be

delivered.

" Clearly we need to do better at managing vaccine expectations, " Frieden said.

Much work remains on improving vaccine technology, said Dr. Fauci, head

of the U.S. National Institute of Allergy and Infectious Diseases. The goal is a

so-called universal vaccine that would not have to be reformulated as the virus

mutates every flu season.

" We need to harness the science to be able to make an influenza vaccine that not

only is good from season to season but ... that doesn't change from season to

season and from pandemic to pandemic, " Fauci said.

" It is going to be several years before we get there. "

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Dr. MOUNTS: I can't exactly break out the numbers, but I can tell you who's at

highest risk. We know from looking at a variety of countries' data that children

under the age of 5 are really at highest risk for requiring hospitalization for

having severe disease. But they're not at highest risk of death. It's actually

the age group between 50 and 59 or 50 to 65, that range.

HANSEN: Dr. Mounts, I'm kind of surprised to hear you say that, that those

between 50 and 59 are more susceptible to death because that is not the risk

group that is being vaccinated.

Dr. MOUNTS: You know, the vaccination strategies, it depends on what you're

trying to accomplish with vaccination. There is some evidence that you can

actually prevent transmission of the virus if you vaccinate school-age children,

for example. So, even though they may not be at highest risk for dying or even

being hospitalized by vaccinating them, you may protect older individuals just

because there's less transmission.

I mean, children of school age are certainly more likely to get infected and

probably transmit a lot more of the virus in the community than any other age

group. The strategy for vaccination depends on a lot more factors than just

individual risk...

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