Hawaii Biotech Initiates Phase 1 Clinical Trial For Dengue Vaccine


Hawaii Biotech, Inc. President and CEO Elliot Parks, Ph.D., announced that the company has initiated a Phase 1 clinical study with its monovalent dengue vaccine candidate. The double-blind, placebo controlled, dose escalation safety study in healthy subjects is being conducted at the St. Louis University Center for Vaccine Development. http://vaccine.slu.edu/ Vaccine recipients in this study will also be monitored for virus neutralizing antibodies.

"This dengue clinical study is an important milestone in Hawaii Biotech's maturation as a clinical stage company. In addition it confirms the versatility of our subunit vaccine technology platform," Parks notes. "This Phase 1 study will also prepare us for the initial clinical testing of Hawaii Biotech's tetravalent dengue vaccine."

Hawaii Biotech's dengue monovalent vaccine candidate is the first recombinant subunit vaccine for dengue to enter clinical studies. Previous dengue vaccine candidates tested in the clinic have been either live-attenuated or DNA-based vaccines. Hawaii Biotech intends to test a dengue tetravalent vaccine candidate, developed using the company's recombinant subunit vaccine technology, within a year.

The first phase of clinical development program is designed to assess safety, determine a dose range and identify potential side effects. Results from this clinical study are expected within a year.

Hawaii Biotech's dengue subunit vaccine candidate has been developed with financial assistance from the National Institutes of Health, the Department of Defense, and the Pediatric Dengue Vaccine Initiative.

About Dengue: Dengue, also known as "break-bone fever," is a prevalent infectious disease in tropical and subtropical countries throughout the world. Approximately 3.5 billion people live in endemic countries and about 100 million people are infected with dengue every year. Dengue infections result in an estimated 20,000 deaths. Dengue is caused by one of four closely related, but distinct, virus serotypes (DEN1, DEN2, DEN3, and DEN4), of the family Flaviviridae, which also includes yellow fever, West Nile, Japanese encephalitis, and tick-borne encephalitis viruses. Dengue is transmitted by the bite of a mosquito infected with any one of the four dengue viruses. Infection with dengue virus results in severe flu-like symptoms that can lead to a life-threatening hemorrhagic fever. During the last quarter century, many tropical regions of the world have seen an increase in dengue cases. The southern United States is potentially susceptible to dengue epidemics as the types of mosquitoes that transmit dengue virus are prevalent there.

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Start Of U.S. H1N1 Vaccine Clinical Trials


CSL Biotherapies has announced the initiation of the company's first U.S. clinical trials of its candidate Influenza A/H1N1 2009 vaccine. Study investigators will administer vaccinations to the first U.S. study volunteers today, August 24. The studies will determine the safety of CSL's candidate vaccine and its ability to elicit an immune response (also referred to as immunogenicity) in adults and children. The pediatric study will evaluate CSL's candidate vaccine in a thimerosal-free (i.e., preservative-free) formulation.

The clinical studies are sponsored by CSL Biotherapies and are being funded in whole or in part with Federal funds from the U.S. Office of the Assistant Secretary for Preparedness and Response, Biomedical Advanced Research and Development Authority. They will take place at 24 study sites throughout the country. It is anticipated that findings from these trials will be used to determine the most appropriate dosing schedule of the Influenza A/H1N1 2009 vaccine for use in the general population. This clinical trial program is part of a larger, global effort by CSL Biotherapies, in partnership with government and regulatory bodies, to bring an Influenza A/H1N1 2009 vaccine to market in the United States, in Australia and in select regions of the southern hemisphere.

"The H1N1 pandemic has had a significant toll on the health and well-being of people worldwide, which makes the development of an effective vaccine against the virus an urgent public health need," said Kawsar Talaat, MD, principal investigator of the CSL vaccine adult trials and assistant scientist in the Johns Hopkins Bloomberg School's Department of International Health. "Through these trials, we hope to identify the most effective dose and dosing regimen to protect the public against this highly infectious new strain of influenza virus."

"Children are often at greater risk from influenza infection and its complications than adults, so it is extremely important to understand the efficacy of an H1N1 vaccine in this very vulnerable population," said Pedro Piedra, MD, principal investigator for the vaccine pediatric trials and professor in the department of molecular virology and microbiology, and pediatrics at Baylor College of Medicine. "The clinical trials of CSL's candidate vaccine will be the first to use a thimerosal-free formulation of the H1N1 vaccine antigen."

About CSL's H1N1 Clinical Trial Initiative

The goal of CSL's H1N1 clinical trial program is to evaluate the safety and efficacy of the Influenza A/H1N1 2009 vaccine in adults and children (http://www.clinicaltrials.gov). Approximately 1,300 adults (aged 18 years and older) and 450 children (aged ≥ 3 months to < 9 years) are expected to be enrolled in the randomized, placebo-controlled U.S. studies. In the adult trials, three doses of the vaccine - 7.5, 15 and 30 mcg - will be evaluated, administered as two vaccinations, three weeks apart.

In the pediatric trials, two doses - 7.5 and 15 mcg - will be evaluated, administered as two vaccinations, three weeks apart. The studies will also evaluate the incidence of adverse events up to six months after first injection. CSL's Influenza A/H1N1 2009 vaccine is manufactured by a process identical to the one used in manufacturing CSL's U.S. Food and Drug Administration-licensed trivalent seasonal influenza vaccine; only the single A/H1N1 flu strain differs between the two.

CSL Limited, the parent company of CSL Biotherapies, initiated Australian clinical trials of its Influenza A/H1N1 2009 vaccine candidate with a design and study objectives similar to its U.S. program. First administration in healthy adult volunteers began on July 22, 2009 and in healthy pediatric volunteers on August 3, 2009, making CSL the first vaccine manufacturer to initiate human studies of this vaccine. CSL expects to report interim post-dose 1 data from the adult trials in Australia by mid-September.

CSL Biotherapies recently signed an initial contract for $180 million to supply the U.S. Department of Health & Human Services with Novel influenza A (H1N1) antigen.

About Influenza and the Novel Influenza A/H1N1 Virus

Influenza (commonly referred to as the flu) is a serious illness that accounts for approximately 36,000 deaths annually in the U.S. While most healthy individuals recover from influenza within a few days to a week, some people, especially those with certain chronic illnesses, such as heart or lung disease, can develop complications. Seasonal influenza vaccination has been shown to reduce illness, hospitalization and death. The emergence of the novel H1N1 flu, which was first detected in humans in April 2009, has proven to be very contagious, spreading worldwide, and has led to the World Health Organization declaring a pandemic on June 11, 2009. The pandemic virus has caused more than a thousand deaths worldwide and created a significant burden on hospitals.

Vaccination against pandemic influenza is the most important step in bringing the pandemic under control and protecting those most at risk from infection. CSL Biotherapies is developing and producing candidate Influenza A/H1N1 2009 vaccine, drawing on four decades of experience with its proven vaccine production processes.


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Brentuximab Vedotin (SGN-35) Pivotal Trial For Patients With Hodgkin Lymphoma


Seattle Genetics, Inc. (Nasdaq:SGEN) announced that it has completed enrollment of its pivotal clinical trial of brentuximab vedotin (SGN-35) for relapsed and refractory Hodgkin lymphoma. Brentuximab vedotin is an antibody-drug conjugate (ADC) targeted to CD30 utilizing the company's proprietary ADC technology.

"Strong interest in brentuximab vedotin from investigators and patients has allowed us to rapidly complete our target enrollment of 100 patients in the pivotal trial in six months, emphasizing the substantial unmet medical need in the relapsed and refractory Hodgkin lymphoma setting," said Clay B. Siegall, Ph.D., President and Chief Executive Officer of Seattle Genetics. "The pivotal trial allows for patient treatment up to approximately one year, and we expect data to be available in the second half of 2010. Our goal is to submit both a New Drug Application (NDA) with the U.S. Food and Drug Administration (FDA) under the accelerated approval regulations and a Marketing Authorization Application (MAA) with the European Medicines Agency (EMEA) for conditional marketing authorization in the first half of 2011. Assuming priority review of our NDA, we would then plan to commercially launch the drug in the United States in the second half of 2011, with potential European launch to follow."

The brentuximab vedotin pivotal trial is a single-agent, single-arm study evaluating 100 patients with relapsed or refractory Hodgkin lymphoma who previously received autologous stem cell transplant. Patients receive 1.8 milligrams per kilogram (mg/kg) of brentuximab vedotin every three weeks. The primary endpoint of the study is objective response rate assessed by independent review. Secondary endpoints include duration of response, progression-free survival, overall survival and tolerability. The pivotal trial is being conducted under a Special Protocol Assessment (SPA) from the FDA. The SPA is an agreement between the FDA and Seattle Genetics regarding the design of the pivotal trial, including size and clinical endpoints necessary to support an efficacy claim in an NDA. Brentuximab vedotin has also been granted fast track designation by the FDA for the treatment of Hodgkin lymphoma as well as orphan drug designation in the United States and Europe for both Hodgkin lymphoma and anaplastic large cell lymphoma (ALCL).

Brentuximab Vedotin Phase I Clinical Trials

In a phase I dose-escalation study, 45 patients received doses of brentuximab vedotin every three weeks, ranging from 0.1 milligrams per kilogram (mg/kg) to 3.6 mg/kg. Among 28 evaluable Hodgkin lymphoma and systemic ALCL patients treated at doses of 1.2 mg/kg and higher, the overall response rate was 54 percent based on investigator assessment, compared to 57 percent based on independent review. At the higher dose levels, 39 percent of patients achieved a complete response based on investigator assessment, compared to 32 percent based on independent review. The median duration of response was at least 7.3 months.

The company is also conducting an ongoing phase I dose-escalation trial of brentuximab vedotin administered weekly to patients with Hodgkin lymphoma or systemic ALCL. Interim data have shown that out of 20 evaluable patients treated at doses of 0.8 mg/kg and higher, 60 percent achieved an objective response, including 50 percent with complete responses. Across all dose levels, 81 percent of patients achieved tumor reductions.

In both phase I clinical trials, brentuximab vedotin has been generally well tolerated. The majority of adverse events were Grade 1 and 2, with the most common being fatigue, fever, peripheral neuropathy, diarrhea and nausea.

About Brentuximab Vedotin

Brentuximab vedotin is an ADC comprising an anti-CD30 antibody attached by an enzyme cleavable linker to a potent, synthetic drug payload, monomethyl auristatin E (MMAE), using Seattle Genetics' proprietary technology. The ADC is designed to be stable in the bloodstream, but to release MMAE upon internalization into CD30-expressing tumor cells, resulting in targeted cell-killing.

Seattle Genetics is also conducting a single-agent phase II study of brentuximab vedotin in relapsed and refractory systemic ALCL, as well as a phase II study evaluating the potential for retreatment with brentuximab vedotin in patients who have relapsed after discontinuing previous brentuximab vedotin therapy.


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Resolvyx Announces Positive Data From Phase 2 Clinical Trial Of The Resolvin RX-10045 In Patients With Dry Eye Syndrome


Resolvyx Pharmaceuticals, Inc., the leading resolvin therapeutics company, announced positive data from a Phase 2 clinical study evaluating RX-10045, a resolvin administered as a topical eye drop for the treatment of patients with chronic dry eye syndrome. In this 28-day, randomized, placebo-controlled, 232-patient trial, RX-10045 produced dose-dependent, statistically significant improvement on the primary endpoints for both the signs and symptoms of dry eye, and was generally shown to be safe and well tolerated. These Phase 2 results represent the first demonstration of clinical efficacy for the novel class of resolvin compounds and suggest that resolvins have the potential to treat a broad range of inflammatory diseases.

"There is an urgent need for new treatment options in dry eye and the results of this Phase 2 study are as strong as any I have seen," said Stephen Pflugfelder, MD, an expert in dry eye at Baylor College of Medicine. "Based both on these clinical results and on its unique mode of action, I am confident that RX-10045 can be an important new treatment modality for these patients."

The 28-day, randomized, multi-center, placebo-controlled study in 232 patients with moderate dry eye patients was designed to evaluate the safety, tolerability and efficacy of RX-10045 administered twice daily. The Phase 2 study examined three doses of RX-10045 and utilized a controlled adverse environment (CAE) to measure corneal staining in a stressful drying environment, as well as daily patient diaries using a standard visual analog scale to assess symptom improvement over the course of the study.

RX-10045 produced a significant dose-dependent improvement from baseline in symptoms recorded in daily patient diaries. The improvement was observed across all symptoms evaluated in the study, including dryness, stinging, burning, grittiness, ocular discomfort and the composite of each patient's most severe symptom (Worst Symptom Score). RX-10045 was superior to placebo on the primary symptomatic endpoint of Worst Symptom Score (p < 0.02), as well as on several individual symptoms. The onset of symptom relief occurred within the first week of treatment, and symptoms continued to improve over the course of the 28-day study, suggesting the potential for even greater benefit with longer treatment durations.

"I am very encouraged by the symptom relief achieved with RX-10045," said Ira Udell, M.D., Chairman of the Department of Ophthalmology at the North Shore-Long Island Jewish Health System and Professor of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine. "Symptomatic improvement is what really matters to patients."

RX-10045 also produced a 75% reduction from baseline in CAE-induced staining of the central cornea (p < 0.00001), the primary sign endpoint in the study. This improvement was greater than that observed for placebo, the difference approaching statistical significance (p = 0.11). RX-10045 also produced a significant improvement in CAE-induced staining in the inferior cornea and in the composite of central and inferior cornea, which also approached statistical significance over placebo (p = 0.09).

"We are very enthusiastic about the results of this Phase 2 study which, in only a 28-day study, achieved what we believe is unprecedented dose-dependent improvement in the symptoms of dry eye, as well as strong improvement in the signs of dry eye. The results of this study will help Resolvyx design the pivotal trials for RX-10045, which are currently targeted to begin in the first half of 2010," said Greg Weinhoff, Executive Chairman of Resolvyx. "In addition to demonstrating the potential of RX-10045 to treat dry eye patients, this study also shows the potential of the entire resolvin class to treat a range of inflammatory diseases."

Resolvyx is also currently conducting a Phase 1 study with a second resolvin, RX-10001, an orally-administered drug candidate for the treatment of systemic inflammatory diseases such as asthma, inflammatory bowel disease and other inflammatory diseases.

About RX-10045

RX-10045 is Resolvyx's lead resolvin therapeutic, and is a synthetic analog of RvE1, a naturally occurring resolvin. RX-10045 has been shown to have potent anti-inflammatory and cell-survival benefits in laboratory testing. In preclinical studies, RX-10045 was highly effective in preventing signs of dry eye, including decreasing corneal inflammation, reducing corneal epithelial damage, preventing loss of goblet cells (cells that play an important role in maintaining tear film integrity) and improving tear volume. In addition, those studies demonstrated that RX-10045 potently inhibited the release of several key pro-inflammatory mediators from corneal epithelial cells and accelerated corneal tissue repair with an effect level comparable to that seen with epidermal growth factor, the most potent previously-known mediator of corneal tissue repair. RX-10045 is formulated as a clear, aqueous, preservative-free solution for ocular administration.

About Dry Eye Syndrome

Dry eye syndrome is one of the most common problems treated by eye physicians; an estimated 25-30 million Americans suffer from dry eye and the worldwide prevalence closely parallels that of the United States. Dry eye is a chronic, multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Dry eye can make it more difficult to perform some visual activities for an extended period of time, and it can decrease tolerance for dry environments.

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CDC Drafting Recommendation Of Routine Circumcision For Male Infants To Prevent Spread Of HIV


The Centers for Disease Control and Prevention is drafting a formal recommendation that all male infants born in the U.S. be circumcised as a way to reduce the spread of HIV/AIDS, the New York Times reports. Recent studies have shown that in African countries circumcision reduces a man's risk of infection by 50%; however, those studies focused on heterosexual men who are at a high risk of contracting HIV from female partners. The procedure does not seem to protect men who have sex with men -- the population at greatest risk of infection in the U.S. It is unclear whether male circumcision reduces the risk for women, experts say. "There's mixed data on that," according to Peter Kilmarx, chief of epidemiology for the division of HIV/AIDS prevention at CDC. He added, "If we have a partially successful intervention for men, it will ultimately lower the prevalence of HIV in the population, and ultimately lower the risk to women."

The recommendation is expected to be released by the end of the year, but the issue already has generated controversy. Critics contend that the procedure subjects male infants to medically unnecessary surgery without their consent, while proponents argue that any measure that can reduce HIV infection rates should be taken under consideration. About 79% of adult men in the U.S. are circumcised. The Times reports that rates have fallen in recent years in part because the American Academy of Pediatrics does not endorse routine circumcision. AAP's policy states that circumcision is "not essential to the child's current well-being." As a result, many state Medicaid programs do not cover the operation, the Times reports. However, AAP is revising its guidelines and is expected to replace the neutral tone with a policy stating that circumcision has health benefits even beyond HIV prevention, such as reducing urinary tract infections in infants, according to Michael Brady, an AAP consultant.

Kilmarx said, "We have a significant HIV epidemic in this country, and we really need to look carefully at any potential intervention that could be another tool in the toolbox we use to address the epidemic." He added, "What we've heard from our consultants is that there would be a benefit for infants from infant circumcision, and that the benefits outweigh the risks." Still, according to Kilmarx and other public health officials, the benefits of such preventive measures would be muted in the U.S. compared with

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50 Percent Of Healthcare Workers In Hong Kong Refuse To Get The Swine Flu Vaccine


Research just published on bmj.com reports that about half of healthcare workers surveyed in Hong Kong say they would not be vaccinated against swine flu because of fears of side effects and doubts about effectiveness.

Still, the authors underline that vaccination is one of the most effective ways to reduce illness and death linked with pandemic flu. They believe that the benefits highly compensate for any possible risks.

The results of the research are unexpected, according to the authors, given SARS had such a huge impact in Hong Kong. Also, the study was underway at the same time as the World Health Organization (WHO) escalated its alert for swine flu to phase 5.

The results are comparable to a recent UK poll of almost 1,500 Nursing Times readers. It revealed that 30 percent of nurses said they would not have the swine flu vaccine.

The study documents that practically all countries with a pandemic flu plan intend to vaccinate healthcare workers as a priority group in order to protect the essential health infrastructure of their countries. However, this policy will only be successful if there is a high uptake of the vaccine.

Given the results of this study, lead author Professor Paul Chan from the Chinese University of Hong Kong mentions that a campaign to promote vaccination among healthcare workers is required.

Over 8,500 doctors, nurses, and related health professionals were surveyed. All were working at 31 hospital departments of internal medicine, pediatrics, and emergency medicine in Hong Kong.

Participants were initially surveyed from January to March 2009. This was when the WHO influenza pandemic alert was at phase 3. Then they were surveyed again in May 2009. At that point, the WHO raised its pandemic alert to phase 5 and it was the first time participants were specifically asked if they were willing to be vaccinated against swine flu. There was a response rate of 46.6 percent for the first survey and 48 percent for the second.

About 28 percent of respondents in the initial survey said they would be willing to be vaccinated against avian flu (H5N1).Interestingly, the authors explain, "no significant changes in the level of intention to accept pre-pandemic H5N1 vaccine were observed, despite the escalation to phase 5 because of the wide spread of H1N1 virus (swine flu)."

When the WHO alert level was at phase 5, 47.9 percent of respondents said they would be willing to be vaccinated against swine flu (H1N1).

The most frequent reasons for an intention to accept were:
• "wish to be protected"
• "following health authority's advice"

The most common reasons for refusal were:
• "worry about side effects"
• "query on the efficacy of the vaccine"
• "simply did not want the vaccine"
People who said they would accept the swine flu vaccination tended to be younger. They usually had received the seasonal flu vaccine in 2008-9 and feared they were more likely to get swine flu.

The authors write in conclusion: "To our knowledge, this is the largest study conducted to assess the willingness of healthcare workers to accept pre-pandemic influenza vaccination, and it provides important information on barriers to vaccination. Campaigns to promote vaccination should consider addressing the knowledge gap of staff and the specific target groups for intervention."

In an associated editorial, Rachel Jordan from the University of Birmingham and Andrew Hayward from the UCL Centre for Infectious Disease Epidemiology, emphasize that vaccination for healthcare workers is vital for their own protection and the safety of their patients. It could be of assistance to keep the NHS functioning at full capacity during the swine flu pandemic.

They claim that education and promotional campaigns alone have not been sufficient to convince healthcare workers to get vaccinated, "but the additional use of convenient mobile systems, monitoring and feedback systems, and the use of "opt-out" systems (where healthcare workers need to indicate their reasons for not accepting the vaccine) show promise."

30% of nurses 'don't want' flu jab

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2009 H1N1 Flu Outbreak Map


2009 H1N1 Flu Outbreak Map


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Swine Flu: Top 20 Questions and Answers


Rumors are rife as the swine flu theme evolves. Here are twenty questions answered by Charles Ericsson M.D., Prof. Internal Medicine, Director of Travel Medicine, University of Texas Medical School, and Robert Emery DrPH, VP Safety, Health, Environment & Risk Management, UT Health Science Center, and Associate Prof. at the UT School of Public Health.

1. Are swine flu symptoms different from normal human flu?

They are similar. Swine flu is more likely to include diarrhea and vomiting, as well as the respiratory symptoms that come with typical seasonal human flu. Symptoms include:

* Chills
* Cough
* Fatigue
* Fever (greater than 100°F or 37.8°C)
* Headache and body aches
* Sore throat
* Stuffy nose

For information on what swine flu is, please see our what is swine flu? article.

2. How would I know I had swine flu if I had some symptoms?

You wouldn't, neither would your doctor. A respiratory specimen would have to be taken within the first four to five days. The specimen would be sent to a lab, which in the USA would be a CDC lab.

Authorities and experts still do not know why symptoms have been worse in Mexico than in the USA, Canada and other countries.

The important point is to call your doctor if you think you have the flu. Prescription anti-viral drugs such as TamiFlu or Relenza can be called in by your doctor. Unless you are:

* exceptionally ill with flu-like symptoms
* chronically ill
* immune-suppressed
* quite elderly
* or have a very young child, under age 2

It is best not to report to a hospital, as you could risk spreading the disease. Call your doctor and do what he tells you.

3. How long are infected people contagious?

An adult is usually contagious as long as they have symptoms - usually up to seven days following the beginning of the illness. The "shedding stage" of the virus is during the first 4-5 days of illness. Children can be considered contagious longer, up to 10 days. The initial incubation period is 24-48 hours.

4. What medications are there?

There is Tamiflu or Relenza - both have shown to be effective against these recently reported strains of swine flu. There are four anti-viral drugs altogether that are commonly used to treat various strains of flu.

5. Do these medicines prevent me from catching swine flu?

That is not currently advised. Preventative medication might be advisable for very special circumstances where a person had to expose themselves to potentially ill people during an epidemic (which we do not yet have here). Such people might include ER workers. An outbreak in a nursing home, for instance, might lead to protecting all the other residents with a drug like TamiFlu.

As the coverage time is limited, the preventative use of anti-viral medications is not advised for the general public.

Do not confuse OTC (over-the-counter) cold and flu preparations for anti-flu medications that you can only get with a prescription.

6. Do children and adults have the same symptoms?

Symptoms are similar. However, the signs of potentially life-threatening complications are not. The CDC advises those with these symptoms to seek emergency care immediately:

* Being extremely irritable
* Bluish skin color
* Rapid breathing or trouble breathing
* Fever with a skin rash
* Not drinking enough liquids
* Not waking up or interacting

Emergency warning signs in adults are:

* Confusion
* Difficulty breathing or shortness of breath
* Pain or pressure in the chest or abdomen
* Severe or persistent vomiting
* Sudden dizziness

7. Are there any swine flu vaccines?

Not currently. Authorities, such as the CDC in the USA are considering adding the current swine flu strain to next year's vaccine.

8. If I took the swine flu vaccine in the swine flu scare during the 70s, would that protect me now? Will this year's flu shot offer me any additional protection?

Nobody knows whether protection may be full, partial, or not at all. The current swine flu strain also has avian flu components. The avian flu component is not from the deadly bird flu strain.

9. Can I catch it from pigs?

No, you can only catch this strain from other humans. It is a mutated pig virus.

10. Can I catch it from eating pork meat and pork products?

No. Swine flu is not transmitted by the food you consume - it is not a foodborne illness. All pork food products are safe to consume - as long as they are prepared properly. The virus dies at 160 degrees Fahrenheit.

Swine flu is transmitted in the same way normal flu is - through airborne droplets form a sick person's cough or sneeze

11. How does it cross from a pig to a human?

The swine virus mutates so that it can infect humans and be spread by humans.

12. Can it kill me?

Deaths have been reported from the Mexico City outbreak. So far the cases in the US have been mild and there have been no deaths as of this writing (Monday, April 27) We do not know all the factors geographically and demographically that may contribute to the mildness or severity of this flu. But, like seasonal flu, there is the potential for serious outcomes.

13. Why the big concern if the regular flu kills 35,000 people a year, which is why we are all encouraged to get a flu shot?

This is a new flu strain that our bodies have not been exposed to before. The flu strains that the CDC creates a vaccine for each year all have the potential to cause great harm, especially in elderly, pediatric and chronically ill patients. This particular flu strain has struck seemingly healthy, young adults, with some resulting in death in Mexico. It also appears to be quite contagious. We will know more about this strain in the coming days.

14. How is it different from avian (bird) flu?

Avian flu so far has had difficulty infecting humans unless they are exposed intensely to birds, because the virus has not mutated in a way that makes it transmissible by humans to other humans. This virus has origins genetically from both pigs and birds, and the big difference from the avian flu is that this swine virus can be transmitted readily from human to human.

15. Is this just another scare that will go away like bird flu?

Bird flu is a theoretical threat and will need a mutation to be able to be transmitted among humans to become a serious threat. The present "swine/avian" virus clearly has already caused a major outbreak in Mexico City and San Luis Potosi, Mexico and has spread to places in the US (California, New York, Texas, Kansas and Ohio). What is not clear yet is whether this virus will result in a so-called pandemic worldwide spread with major outbreaks--or whether it will fizzle out. But, even if it fizzles out, there is logical concern that it might re-emerge next flu season.

16. Should I cancel my vacation to Mexico?

At this writing, the situation is very fluid, changeable. I suggest checking frequently with the CDC Web site for possible Travel Alerts. I probably would not travel to Mexico City for a vacation that could easily be rescheduled, if for no other reason than the city has tried to limit access to crowded or public places where transmission might be facilitated. That does not sound like a very pleasant vacation to me!

Having said that, there are more than 4,000 flights to Mexico from the US and none have been cancelled as of this writing. However, some international airports in Europe and Asia are stepping up precautions and issuing alerts. Again, check the CDC's Travel Alerts page.

17. What if I'm on a plane? Should I wear a mask?

Not necessary. The air on a plane is filtered. Transmission might occur if someone sitting close to you coughs or sneezes on you. The newer designs of aircraft airflow keep the air in a top-down flow, not forced air from front to back. However, if you do have a respiratory illness, it might be best not to travel.

18. How long does the germ live on surfaces, like on my desk if someone sneezes in my office?

Influenza virus survives only minutes on inanimate objects or hands, so these are very inefficient ways to spread the illness. Influenza is most easily spread by droplets that come into contact with our mucus membranes such as when someone coughs or sneezes in our faces. If we shake hands with an infected person who has just wiped their nose and then we rather quickly rub our nose or eyes with our own hand, then we could get the flu. So, good hand washing does play a role in diminishing the spread of the disease.

19. Other than hand washing and covering my mouth if I sneeze or cough, what can I do to take care of myself and others?

If you are ill, stay home. Control your sneezes and coughs. If you cough into your hand, remember the virus could be live on your hand at least for a few minutes, so wash your hands before touching anyone else. If you get symptoms suggesting the flu, call your doctor, who can call in a prescription for medication to treat the flu. Resist going to the doctor's office or a hospital ER for influenza symptoms unless you are seriously ill. You do not want to spread the disease to others.

20. What else can I do?

Keep in touch with the most recent CDC messages through the following links:
http://www.cdc.gov/swineflu/investigation.htm
http://www.cdc.gov/swineflu/general_info.htm
http://www.cdc.gov/swineflu/whatsnew.htm

Go to the sources of verifiable information such as WHO (World Health Organization) or the CDC.

Most important, be alert, not panicked.

"There is a huge difference between preparedness and paranoia", says Dr. Robert Emery, occupational health expert at the UT School of Public Health at Houston. "Although we're dealing with a new strain of flu, a set of universally applicable preventive measures exist that can be employed right away by everyone to help stop the spread of this disease"
Proper hand hygiene:
There's a right way and useless way to wash hands and wash away micro-organisms. The object is to break down the protective membranes of germs, dislodge them from your hands and let them go down the drain. Plain soap in the right hands is strong stuff.

* Lather well with a bar of soap or squirt a coin size of liquid soap in the palm of your hand.

* Vigorously rub your hands together, soap up between your fingers, AND your wrists, front and back for 15 seconds. Sing the first chorus of any song you know and that'll take you through the 15 seconds.

* Rinse under warm, RUNNING water. Remember, the object is to dislodge germs. The force of water is key.

* Thoroughly dry your hands with a disposable towel or under the blower, again, rubbing your hands together.

* Discard the towel.

If you're using alcohol-based gels as hand cleansers:

Put a dime-sized amount in one hand:

* Vigorously rub your hands together and in between your fingers until the GEL IS DRY about 30 seconds.

* DO NOT touch your face!

Once your hands are clean, do not touch your face, nose, eyes or lips.

Rubbing your eyes and nose provides a freeway for micro-organisms and good breeding ground once they've arrived.

Cover your cough

If you must cough or sneeze, cover your mouth with a tissue, your sleeve or your hand. Throw the tissue away in a waste basket. Do not leave discarded tissues on your desk or other surfaces.

Then, wash you hands thoroughly.

The throw-it-away part is essential.

Micro-organisms live a life span from a few seconds to days on inanimate surfaces such as desks, table tops, faucets…tissues. If your tissues are scattered on your coffee table, they then are in contact with community surfaces. Both the tissues and the surface it sits on can spread germs to the person who touches the coffee table.

If you begin to feel ill: feverish, achy, have a dry, painful cough, sore throat, go home from school or work and call your health care provider for further instructions.

If you feel sick with flu-like symptoms and you care for the very young or the very elderly or the chronically ill, inform your health care provider when you call their office.

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Total confirmed human cases of Swine Flu A(H1N1) infection, and total deaths, 3rd July, 2009 (Source CDC) by state


# Alabama - 330 cases, 0 deaths
# Alaska - 60 cases - 0 deaths
# Arkansas - 42 cases - 0 deaths
# Arizona - 761 cases - 10 deaths
# California - 1985 cases - 21 deaths
# Colorado - 136 cases - 0 deaths
# Connecticut - 1247 cases - 6 deaths
# Delaware - 316 cases - 0 deaths
# Florida - 1302 cases - 5 deaths
# Georgia - 118 cases - 0 deaths
# Hawaii - 616 cases - 0 deaths
# Idaho - 92 cases - 0 deaths
# Illinois - 3166 cases - 13 deaths
# Indiana - 267 cases - 0 deaths
# Iowa - 92 cases - 0 deaths
# Kansas - 117 cases - 0 deaths


# Kentucky - 130 cases - 0 deaths
# Louisiana - 183 cases - 0 deaths
# Maine - 82 cases - 0 deaths
# Maryland - 591 cases - 1 death
# Massachusetts - 1308 cases - 3 deaths
# Michigan - 484 cases - 7 deaths
# Minnesota - 576 - 1 death
# Mississippi - 161 cases - 0 deaths
# Missouri - 65 cases - 1 death
# Montana - 67 cases - 0 deaths
# Nebraska - 111 cases - 0 deaths
# Nevada - 301 cases - 0 deaths
# New Hampshire - 224 cases - 0 deaths
# New Jersey - 1159 cases - 9 deaths
# New Mexico - 232 cases - 0 deaths
# New York - 2499 cases - 44 deaths
# North Carolina - 255 cases - 2 deaths
# North Dakota - 57 cases - 0 deaths
# Ohio - 120 cases - 1 death
# Oklahoma - 128 cases - 1 death
# Oregon - 366 cases - 4 deaths
# Pennsylvania - 1748 cases - 4 deaths
# Rhode Island - 158 cases - 1 death
# South Carolina - 160 cases - 0 deaths
# South Dakota - 29 cases - 0 deaths
# Tennessee - 174 cases - 0 deaths
# Texas - 3991 cases - 17 deaths
# Utah - 920 cases - 10 deaths
# Vermont - 49 cases - 0 deaths
# Virginia - 191 cases - 1 death
# Washington - 588 cases - 4 deaths
# Washington, D.C. - 33 cases - 0 deaths
# West Virginia - 154 cases - 0 deaths
# Wisconsin - 5861 cases - 4 death
# Wyoming - 81 cases - 0 deaths
Territories
# Puerto Rico - 18 cases - 0 deaths
# Virgin Islands - 1 case - 0 deaths

TOTAL - 33,902 cases - 170 deaths

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33,902 Swine Flu A(H1N1) Cases Including 170 Deaths In USA


The Centers for Disease Control and Prevention (CDC) informed in its weekly update on Friday evening, 3rd July, 2009, that the total number of confirmed human cases of swine flu A(H1N1) infection stands at 33,902, including 170 deaths

In a Swine Flu conference held today in Cancun, Mexico, the World Health Organization (WHO) warned that the virus' spread is now "unstoppable". The WHO added that swine flu infection cases are mostly mild, with the vast majority of people recovering unaided.

Health authorities in the UK predict that British infection numbers should exceed 100,000 by the end of this summer

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