The World Health Organization (WHO) has said that the “swine flu” has sickened more than 134,000 people and killed more than 800 worldwide as of July 27, according to a report from August 3rd by Bloomberg.
But just how does WHO know the precise figures since WHO itself said on July 16th that governments should stop keeping track of the number of cases of “swine flu”? If WHO does not have solid and up-to-date data on the spread of the so-called “swine flu” around the world, then how can WHO possibly release these kinds of “worldwide” figures?
“…WHO will no longer issue the global tables showing the numbers of confirmed cases for all countries,” a WHO press release of July 16th announced.
Moreover the WHO said in that same press release that it was “extremely difficult, if not impossible” to confirm the mysterious “swine flu” through laboratory testing.
However, if no data is being collected by WHO on the spread of the “swine flu”, and the mysterious “swine flu” is anyway all but impossible to confirm through laboratory testing by WHO’s own admission, then how on earth does WHO come up with these kinds of figures?
Is this an example of hype or is it an outright lie coming from WHO? Will WHO be maintaining there are 1,345,678 cases of “swine flu” and 42,000 deaths by the end of August and 1, 103,402,500 cases and 146,000 deaths by the end of September, making up whatever figure suits its purpose?
Though the Bloomberg report cites WHO’s figures without any discussion as to where WHO got the data from since it has discontinued gathering data on the ground such data is superfluous, the report does go on to state that pharmaceutical companies were the ones who paid for medical trials that approved their own antiviral drugs for the “swine flu,” albeit only at the end.
Aug. 3 (Bloomberg) — Treating healthy individuals for weeks with Roche Holding AG’s Tamiflu or GlaxoSmithKline Plc.’s Relenza may prevent some from later displaying swine flu symptoms, researchers found.
The drugs didn’t stop people from getting infected with flu, according to a report in the Annals of Internal Medicine that analyzed previous studies. For every 25 people getting the treatments, one case of flu symptoms would be prevented, the researchers found. Worldwide supply of the drugs isn’t enough to give to everyone to prevent illness from flu, doctors said, so some people with higher risks may get priority.
Swine flu sickened more than 134,000 people and killed more than 800 worldwide as of July 27, according to the World Health Organization, and U.S. officials have declared the flu a public health emergency. Vaccines to prevent infections may be available as soon as September for U.S. patients, the National Institute of Allergy and Infectious Diseases said in July.
“It’s important to recognize that most people don’t have severe disease, so it’s important to save our antivirals for people who are at high risk or already sick,” said Shanta Zimmer, an assistant professor of medicine at the University of Pittsburgh Medical Center, who wasn’t involved in the report. “This type of treatment might be used in a front-line health- care worker, particularly if the pandemic is filling hospital beds and there isn’t a vaccine available.”
FDA Approved
Tamiflu is approved by the FDA for treating seasonal flu in patients at least one year old. Relenza is approved by U.S. regulators to treat seasonal flu in patients age 7 and older. People with underlying lung diseases shouldn’t take Relenza, according to the drug’s prescribing information. Doctors may prescribe either of the drugs, called antivirals, for swine flu as well.
The Health and Human Service’s pandemic influenza plan for the U.S. recommends preventive treatment with antiviral drugs to protect health-care workers and other high-risk outpatients from becoming ill. The highest-priority patients include those with organ transplants, people who take medication to suppress their immune system, some HIV patients and women in the second or third trimester of pregnancy. The people included in the group could change depending on the course of the pandemic, according to the plan.
Younger people are the age group at greater risk of catching swine flu, with most cases occurring in those aged 12 to 17 years, the World Health Organization said July 25.
Children Under 12
The authors of today’s report found that no studies have been conducted of long-term use of either Tamiflu or Relenza in patients younger than 12.
Overall, they reviewed 1,876 studies and selected seven that used rigorous scientific methods to test uninfected people who received one of two antivirals, Tamiflu or Relenza, for more than four weeks.
The authors concluded from the analysis of these seven studies that Tamiflu and Relenza are safe and effective ways to prevent swine flu illness in healthy people. That may help health officials make plans to protect the most vulnerable people who aren’t yet getting vaccinations.
“Flu waves last six to eight weeks, so a lot of these plans are looking at using antivirals for at least six weeks,” said the lead author, Nayer Khazeni, a researcher at the Center for Health Policy, at Stanford University School of Medicine near Palo Alto, California, in a telephone interview.
Pregnant Women
A study published in the journal Lancet online on July 29 found one in eight swine flu fatalities has been in pregnant women. Other studies have shown conflicting results about whether obese people are more likely to die from swine flu compared with others.
All seven of the medical trials analyzed in today’s research were sponsored by the drug companies, and none compared the effectiveness of Tamiflu to Relenza, the authors said. Their analysis was funded by the U.S. Agency for Healthcare Research and Quality and by the Veterans’ Affairs Palo Alto Health Care System.
To contact the reporter on this story: Elizabeth Lopatto in New York at elopatto@bloomberg.net.
WHO’s press release of July 16th is here:
Changes in reporting requirements for pandemic (H1N1) 2009 virus infection
Pandemic (H1N1) 2009 briefing note 3 (revised)
16 JULY 2009 | GENEVA — As the 2009 pandemic evolves, the data needed for risk assessment, both within affected countries and at the global level, are also changing.
At this point, further spread of the pandemic, within affected countries and to new countries, is considered inevitable.
This assumption is fully backed by experience. The 2009 influenza pandemic has spread internationally with unprecedented speed. In past pandemics, influenza viruses have needed more than six months to spread as widely as the new H1N1 virus has spread in less than six weeks.
The increasing number of cases in many countries with sustained community transmission is making it extremely difficult, if not impossible, for countries to try and confirm them through laboratory testing. Moreover, the counting of individual cases is now no longer essential in such countries for monitoring either the level or nature of the risk posed by the pandemic virus or to guide implementation of the most appropriate response measures.
Monitoring still needed
This pandemic has been characterized, to date, by the mildness of symptoms in the overwhelming majority of patients, who usually recover, even without medical treatment, within a week of the onset of symptoms. However, there is still an ongoing need in all countries to closely monitor unusual events, such as clusters of cases of severe or fatal pandemic (H1N1) 2009 virus infection, clusters of respiratory illness requiring hospitalization, or unexplained or unusual clinical patterns associated with serious or fatal cases.
Other potential signals of change in the currently prevailing pattern include unexpected, unusual or notable changes in patterns of transmission. Signals to be vigilant for include spikes in rates of absenteeism from schools or workplaces, or a more severe disease pattern, as suggested by, for example, a surge in emergency department visits.
In general, indications that health services are having difficulty coping with cases mean that such systems are under stress but they may also be a signal of increasing cases or a more severe clinical picture.
A strategy that concentrates on the detection, laboratory confirmation and investigation of all cases, including those with mild illness, is extremely resource-intensive. In some countries, this strategy is absorbing most national laboratory and response capacity, leaving little capacity for the monitoring and investigation of severe cases and other exceptional events.
Regular updates on newly affected countries
For all of these reasons, WHO will no longer issue the global tables showing the numbers of confirmed cases for all countries. However, as part of continued efforts to document the global spread of the H1N1 pandemic, regular updates will be provided describing the situation in the newly affected countries. WHO will continue to request that these countries report the first confirmed cases and, as far as feasible, provide weekly aggregated case numbers and descriptive epidemiology of the early cases.
For countries already experiencing community-wide transmission, the focus of surveillance activities will shift to reporting against the established indicators for the monitoring of seasonal influenza activity. Those countries are no longer required to submit regular reports of individual laboratory-confirmed cases to WHO.
Monitoring the virological characteristics of the pandemic virus will be important throughout the pandemic and some countries have well-established laboratory-based surveillance systems in place already for seasonal influenza virus monitoring. Even in countries with limited laboratory capacity, WHO recommends that the initial virological assessment is followed by the testing of at least 10 samples per week in order to confirm that disease activity is due to the pandemic virus and to monitor changes in the virus that may be important for case management and vaccine development.
Updated WHO guidelines for global surveillance reflect in greater detail these recommended changes, in line with reporting requirements set out in the International Health Regulations.
