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Nov. 17
Vincent Pedre, MD, a New York City primary care physician specializing in integrative medicine has authored "The Ultimate Swine Flu Survival Guide," designed to help consumers make informed decisions during the H1N1 influenza epidemic. "Boosting our immune systems with basic healthy precautions can go a long way in the prevention and treatment of swine flu," Pedre says.

Pedre, whose approach to care combines holistic natural remedies and Western medicine, gives prevention tips in his guide that emphasizes the top two priorities — washing hands regularly throughout the day and getting plenty of rest.

Other tips in order of importance in his book are boosting immunity with a healthy diet, optimizing Vitamin D levels, taking black elderberry daily, taking a daily dose of Vitamin C, and starting zinc supplements at the first sign of flu symptoms.

Nov. 16
The U.S. Centers for Disease Control and Prevention has revised its estimates on deaths from H1N1 influenza from 1,200 to about 4,000, which includes mortality from related pneumonia and bacterial infections.

A revision of H1N1 rates based on more accurate data than was previously available shows the flu pandemic has infected an estimated 22 million Americans and put 98,000 in the hospital, the CDC says.

Children account for 8 million of the infected, 36,000 of those hospitalized and 540 deaths, the CDC reports.

The FDA has approved use of the Swiss drug giant Roche’s RealTime H1N1 diagnostic test for the 2009 H1N1 influenza, but only for the duration of the current public health emergency.

A number of other diagnostics companies are also marketing H1N1 tests, including Gen-Probe Inc. and Quest Diagnostics Corp.

Nov. 14
Scripps Health in San Diego has become the first healthcare system in the country to begin equipping its employees with a new type of N95 respirator for protection from the H1N1 influenza virus.

The new N95 respirators with antimicrobial protection from San Diego-based Safe Life Inc. provides added protection against microorganisms for Scripps’ front-line physicians and nurses who are working with patients who have flu symptoms, says Patty Skogland, Scripps’ administrative director of emergency preparedness.

The masks cost about $1 to $2 apiece and can filter out at least 95% of the airborne particles that may contain harmful viruses, bacteria, and other microorganisms, the company says.

Nov. 13
A new report by a top official at the Centers for Medicare & Medicaid says overall spending on healthcare would rise with the overhaul legislation approved in the House, and billions in projected savings in the bill will be difficult to maintain.

The CMS report is a blow to the White House and House Democrats who have vowed that healthcare reform would curb the growth of healthcare spending.

While the legislation would expand insurance coverage to an estimated 32 million people, according to the report by Richard Foster, the chief actuary at CMS, it would “could lead to price-increases, cost-shifting and/or changes in providers' willingness to treat patients with low-reimbursement health coverage."

Interpretation of the report differed along party lines. Rep. John Boehner of Ohio, the House GOP leader, issued a statement saying the study "confirms that this bill violates President Obama's promise to 'bend the cost curve’."

But Brendan Daly, a spokesman for House Speaker Nancy Pelosi, D-Calif., said the report "estimates that our bill will cover 10% more of the population with less than a 1.3% increase in national health expenditures that illustrates a bending of the cost curve."

Nov. 11
Federal Food and Drug Administration Commissioner Margaret Hamburg, M.D., has posted an open letter praising doctors, nurses, and other health professionals for their “extraordinary efforts” in responding to the 2009 H1N1 influenza outbreak, for which 41 million doses of vaccine have been allocated to the states with more becoming available every day.

“Although a gap still remains between the demand for the vaccine and the currently available supply, this is the first time in history that any vaccine has been available at the time that an influenza pandemic has struck,” Hamburg writes.

Hamburg also gave details of the series of steps necessary for drug manufacturers to make the effective and safe “swine flu” vaccine strain with FDA oversight over a six-month period, resulting in the Sept. 15 licensing of four approved brands. The National Institutes of Health and vaccine manufacturers initiated clinical trials to determine the proper dosage for optimal immune response and for healthy adults, the elderly, and older children, one dose provides protection, while children ages nine and younger should get two doses, she reports.

The FDA chief encourages health professionals to report any unexpected or serious adverse effects believed linked to the 2009 H1N1 inoculations to the Vaccine Adverse Event Reporting System via the Internet at: http://vaers.hhs.gov/index. Other resources related to H1N1 activities are online at www.flu.gov.

Nov. 10
GlaxoSmithKline has won FDA approval for an unadjuvanted H1N1 swine vaccine and the British Company says it will send a modest shipment of 7.6 million doses to the U.S. next month. Given the green light by the FDA is a modified version of the pharmaceutical company’s FluLaval seasonal influenza vaccine with the H1N1 strain that doesn’t contain an additive.

Worldwide, Glaxo has taken orders for more than 440 million doses of its adjuvanted Pandemrix H1N1 vaccine, which has the additive. The vaccine for the U.S. will be made in Canada and be delivered before the end of the year, the pharmaceutical company says.

A survey of California voters finds that 52% of those polled have no plans to be vaccinated for protection against the H1N1 influenza virus even though most believe it is safe.

Only 5% of 1,500 registered voters surveyed between Oct. 7 and Nov. 3 report being inoculated, a figure that remains consistent across income levels. Among the 40% who want the vaccine, 12% couldn’t find any available, the survey says.

Blacks and Latinos, who are more at risk to be hospitalized than whites with H1N1 flu, are also twice as likely to believe the vaccine is unsafe, says the poll commissioned by the Los Angeles Times/USC College of Letters, Arts and Sciences. Blacks are also the least likely to have plans to get the vaccine.

Nov. 9
Thousands of people began showing up as early as 3:20 a.m. Saturday for free H1N1 influenza vaccinations at the Santa Clara County fairgrounds in San Jose, Calif. By noon, the 5,400 doses vaccine available for high-risk people — children, pregnant women, adults with chronic health conditions —were given and a long line of others were sent home.

County health officials say 36 nurses inoculated about 700 people an hour at the free clinic, which will be repeated the weekend of Nov. 13 as more vaccine arrives.

Health officials say the county has received only about 55,000 of the 211,000 doses of vaccine it expected by now and most were distributed to doctors' offices, health clinics, and hospitals, with some held back for the free giveaway.

Nov. 8
Patients hospitalized with the H1N1 flu virus should be evaluated to determine if they will benefit from use of intravenous antiviral drugs, according to the U.S. Department of Health and Human Resources.

The federal agency has awarded contracts for up to 120,000 treatment courses of IV drugs from BioCryst, Roche, and GlaxoSmithKline, and will initially receive 10,000 units from each for $31.5 million. Roche manufactures Tamiflu; GlaxoSmithKline, Relenza; and BioCryst manufactures Peramivir. Some patients are not able to take the drugs that are available as pills or liquid and may benefit from the IV medications, according to DHS.

Because there are no federally approved antiviral medications that can be administered intravenously to treat influenza, the FDA has issued an emergency use authorization for Peramivir, an investigational antiviral drug in the class of drugs known as neuraminidase inhibitors. The HHS orders for intravenous oseltamivir (Tamiflu) and intravenous zanamivir (Relenza), also neuraminidase inhibitors, are predicated on FDA emergency use authorization for these medications.

For more information on the emergency use of IV Peramivir authorized by FDA, including rules for healthcare providers on patient eligibility, see www.cdc.gov/h1n1flu/eua/. Healthcare providers also can call 1-800-CDC-INFO (1-800-232-4636).

Sonoma County hospitals in Northern California are pulling in the welcome mat for visitors age 14 and under because of official concern that youngsters with lax hygiene habits may attract and spread the virulent H1N1 influenza bug.

Public health leaders in the rolling wine-growing region also are recommending other restrictions, such as allowing patients only two visitors at a time, and turning away anyone with a high fever or other flu-like symptom.

Health officials say the protective initiative has been implemented at Kaiser Permanente Medical Center in Santa Rosa, and Healdsburg District Hospital. Working to make the policy change is Sutter Medical Center, Memorial Hospital, and Petaluma Valley Hospital, and other acute care facilities are studying the directive.

Nov. 5
About 30% of 1,088 people hospitalized with the H1N1 virus in California during a four-month period ending Aug. 11 required treatment in an ICU, and 11% died, according to a study in the Nov. 4 issue of the Journal of the American Medical Association.

The clinical and epidemiologic studies warn that severe illness can occur at all ages and that 32%, or 344 cases, were children under age 18 that included a high rate of infants. The highest death rate was among patients over age 50 with underlying conditions, the report says.

“Clinicians should maintain a high level of suspicion for pandemic 2009 influenza H1N1 infection in patients presenting currently with influenza-like illness who are older than 50 years or have known risk factors for influenza complications, regardless of rapid-test results,” the researchers report. “Hospitalized infected cases should be carefully monitored and treated promptly with anti-viral agents.”

Nov. 4
The California Nurses Association says its tentative four-year contract with Catholic Healthcare West will give RNs a 20% pay raise over four years and contains a novel agreement to enact the “highest possible safeguards” to contain spread of the H1N1 flu virus and protect nurses and patients from contagious disease outbreaks.

"With this historic agreement, we are charting a new course for limiting the spread of not only swine flu but all other dangerous pandemics that are yet to come," says Rose Ann DeMoro, executive director of the CNA/National Nurses Organizing Committee.

The strategy evolved during contract negotiations calls for an emergency task force of RNs and hospital representatives to set a course of action for the CHW network when pandemics occur. This includes implementing federal, state and local guidelines, assuring that protective safety equipment is available, and setting training standards for all clinical personnel.

Hospitals also will form nurse committees to work with infection control teams in implementing new policies and procedures, according to a joint announcement. The task force, for example, could designate alternative emergency triage and treatment sites to keep EDs from being overwhelmed and to limit spread of the virus by isolating contagious patients.

The contract specifically calls for RNs to have access to “appropriate equipment and attire to stem contagion” such as single-use, N95 respirator masks when available, the CNA says.

Nov. 3
The H1N1 virus has swelled to epidemic levels nationwide — pandemic globally — with widespread flu activity reported in 46 states as of Oct. 17, according to a weekly report from the U.S. Centers for Disease Control. However, only 11.3 million vaccine doses were shipped to communities as of Oct. 23, “nowhere near” the amount expected to be in circulation by then, says CDC Director Thomas Frieden, MD, MPH.

Unexpected delays in producing influenza vaccine and the virus' rapid spread have resulted in many doctors having to allocate meager supplies selectively, while some people waiting in line for hours at local vaccine clinics had to be turned away, according to the CDC.

The federal agency identified at-risk groups, including children, young adults, and pregnant women, who should be given priority for vaccinations. However, some physicians say they haven’t received enough vaccine to inoculate all their high-risk patients, according to the CDC’s Nov. 3 update.

The H1N1 virus has been cited in more than 1,000 deaths and more than 2,000 hospitalizations since the U.S. pandemic began in April, according to the CDC. President Barack Obama officially declared the viral disease a national epidemic Oct. 24.