As of 31 of July 2009, 168 countries and overseas territories/communities have reported at least one laboratory confirmed case of pandemic (H1N1). All continents are affected by the pandemic.

Only 27 More Countries To Infect Before Every Country Has At Least One Case Of  H1N1
Only 27 more countries to infect before every country has had at least one case of H1N1

The WHO has reported six oseltamivir-resistant (Tamiflu) H1N1 cases so far, including three in Japan and one each in Denmark, Hong Kong, and Canada. All but one of the patients had been treated with the antiviral, and all have recovered. All the resistant viruses carried the characteristic resistance-linked mutation at position 274/275.



This question has been debated on flu sites going back to the days of avian flu concerns.  In years past, the nation’s attempts to prevent flu-related deaths have focused on limiting transmission of the virus through widespread vaccination programs. This year, with school starting up well before a vaccine for the pandemic H1N1 influenza virus will be available, there will be little that can slow the spread of the virus for the next few months.

Many of the serious consequences linked to the virus are the result of pneumonia, and an underused vaccine called Pneumovax could prevent, or at least limit, such complications in many patients. The vaccine, made by Merck & Co., stimulates the body’s ability to neutralize the bacteria responsible for many cases of pneumonia, and it has the potential to prevent an estimated one-third of pneumonia deaths linked to swine flu.

The normal target population for the pneumonia vaccine is a microcosm of those groups most likely to die or suffer serious complications from flu, so most experts say that eligible people should receive Pneumovax independent of its ability to affect the current pandemic.

Xray Showing An Adult With Pneumonia
Xray showing an adult with pneumonia

The vaccine provides protection against pneumonia for up to 10 years.  Some physicians are more skeptical about the pneumococcal vaccine’s potential to limit flu deaths. The problem is that there are many causes of pneumonia, an inflammation of the lungs that interferes with breathing and can be fatal. The influenza virus itself can cause pneumonia, as can many others. Or the lungs can be invaded by a bacterium such as Streptococcus pneumoniae or Staphylococcus aureus when the patient is weakened by a viral infection. Pneumovax protects against 23 strains of S. pneumoniae.

It is not yet clear what proportion of swine-flu-related pneumonia is caused by S. pneumoniae and thus could be prevented or ameliorated by immunization. But preliminary results presented to the CDC vaccine committee in June by Dr. Matthew R. Moore, a CDC medical epidemiologist, indicated that about 40% of swine-flu-related pneumonia had an unknown cause — and that about 30% were caused by S. pneumoniae. This suggests that at least a third of flu-related pneumonia deaths could be prevented by vaccination.

The committee has not recommended the vaccine for pregnant women, who are about six times as likely to die from complications of swine flu as the population at large. In fact, most of the pregnant women who have died from pandemic flu have suffered viral pneumonia, for which Pneumovax offers no protection.

Most physicians would probably give the vaccine to patients who are not in one of the high-risk groups, but who ask for it anyway.

Should you take this vaccine?  If you are in a high-risk group, it makes sense – talk with your health care provider.



Department of Homeland Security (DHS) Secretary Janet Napolitano, Department of Health and Human Services Secretary Kathleen Sebelius and Department of Education Secretary Arne Duncan joined today with Centers for Disease Control and Prevention Director for Immunization and Respiratory Diseases Dr. Anne Schuchat to discuss H1N1 preparedness and answer questions from the public.

Dr. Schuchat and Secretary Sebelius outlined the four pillars of President Obama’s “National Framework for Response”—surveillance, community mitigation, vaccination, and communication—and detailed planning and preparedness efforts used by the federal government to facilitate these goals.

Secretary Napolitano highlighted the role DHS plays as federal coordinator during public health emergencies, particularly by working closely and communicating clearly with state and local first responders and emergency communicators during a health emergency.

Secretary Duncan and Secretary Sebelius stressed the federal government’s ongoing commitment to reach out to parents and the education community to help them prepare for the upcoming school year.

Information for parents, families and communities can be found at www.flu.gov.