CDC worked closely with countries in the Southern Hemisphere to monitor and enhance surveillance for influenza viruses throughout the summer months. After mid-July , disease activity in most countries decreased, and by November, temperate regions of the Southern Hemisphere were reporting very little H1N1 disease activity.
In general, the experience of the Southern Hemisphere with the H1N1 virus was similar to what is usually seen during a regular influenza season and did not seem to excessively impact the health care systems in the Southern Hemisphere. Also, surveillance systems did not find significant changes in the H1N1 influenza viruses circulating in the Southern Hemisphere as compared to viruses isolated from people in the Northern Hemisphere.
These findings provided the U. Importantly, the lack of significant changes in the virus indicated that the H1N1 vaccine being manufactured would closely match the currently circulating H1N1 viruses and likely provide people with good protection against H1N1 influenza. However, levels of influenza activity would remain above normal throughout the summer months with localized outbreaks. During the last two weeks of August, H1N1 influenza activity again began to increase United States.
In August , CDC reported an additional two instances of oseltamivir-resistant virus infection in two immunosuppressed patients in Seattle, Washington. CDC and partners continued to carefully track H1N1 influenza antiviral resistance. As of June the H1N1 virus remains susceptible to the antiviral drugs oseltamivir and zanamivir, with rare exception.
Cases of antiviral resistance are carefully tracked and updated numbers are posted each week as part of the CDC publication FluView. In late August, CDC began working with the commercial supply chain manufacturers, distributors, retailers for certain influenza countermeasures to monitor national inventory levels of critical supplies antivirals and respiratory protective equipment on a weekly basis.
This visibility provided important data to guide SNS decision-making leading to the release of additional SNS countermeasures. CDC also analyzed related surveillance data and based on the analysis over , bottles of pediatric oral suspension were distributed from the CDC SNS to states to fill production gaps and meet the increasing demand for the formulation.
Peramivir IV is an investigational intravenous antiviral drug used to treat people who have been hospitalized due to severe flu illness. Licensed clinicians were able to request this product through the CDC website electronic request system, and product was delivered directly to hospital facilities.
Also in October, HHS authorized the release of an additional CDC closed out reports of H1N1 hospitalizations and deaths for the season in late August. On August 30, , reporting modifications were implemented to allow states to report hospitalizations and deaths associated with any influenza or to report hospitalizations and deaths using a pneumonia and influenza syndromic case definition through the Aggregate Hospitalizations and Deaths Reporting Activity AHDRA.
This change in reporting was implemented in order to provide a fuller picture of the burden of serious flu illness and deaths during the pandemic. The new reporting season for the flu season began on August 30, , and the first new numbers for the season were reported in the September 11, issue of FluView. Over the course of the pandemic, CDC refined and revised its surveillance methods, eventually developing a methodology based on surveillance data to estimate the range of H1N1 cases, hospitalizations and deaths in the United States.
CDC released its first official estimates for H1N1 cases, hospitalizations and deaths on November 12, , and updated these on December 10, , January 15, , February 12, , March 12, , April 19, and for the final time on May 14, The emergence and spread of the H1N1 virus resulted in extraordinary influenza-like illness activity in the United States throughout the summer and fall months of During this period, influenza activity reached its highest level in the reporting week ending October 24, , with 49 of 50 states reporting geographically widespread disease.
A cornerstone of the U. Government response to the H1N1 pandemic was the launch of the national influenza H1N1 vaccination campaign that began in October. Starting in early June , weekly calls were held to provide state and local planners with vaccine-related updates, and on July 8, , CDC issued guidance for state and local public health departments to assist them in planning for the H1N1 influenza vaccination campaign.
On July 9, , the Department of Health and Human Services, the Department of Homeland Security, the Department of Education, and the White House held an influenza preparedness summit for federal, state, local and tribal officials to discuss existing pandemic plans, lessons learned, and preparedness priorities.
The National Influenza Vaccine Summit, a partnership of public and private stakeholders committed to achieving the Healthy People goals for influenza vaccine, convened on June During the Summit, attendees were provided updates by experts in several professional fields, including private medicine, public health, health communication, vaccine manufacturing, vaccine distribution, and vaccine-related policy.
Preliminary results from the clinical trials were announced publicly. This meant the H1N1 vaccine would be made in the same way using the same standards already in place for seasonal vaccines; it also allowed licensure to proceed more quickly since it did not require immunogenicity data or additional safety except for the live attenuated vaccine data for licensure. Certain groups of people were targeted to receive initially limited supplies of the H1N1 vaccine based on epidemiologic and virologic data indicating they were at higher risk for infection or for severe influenza complications.
The initial target groups for vaccination were estimated to consist of about million people and included: pregnant women, people who live with or care for infants younger than 6 months of age, health care and emergency medical services personnel, infants 6 months through young adults 24 years of age, and adults 25 through 64 years of age who are at higher risk for H1N1 complications because of chronic health disorders or compromised immune systems. The ACIP also recommended that local public health authorities and health care practitioners have flexibility to determine at the local level how quickly and when to expand vaccination to other groups because vaccine availability and demand would likely vary by area.
CDC convened three public engagement sessions in mid-August in ten regions of the United States with the purpose of soliciting citizen input into vaccination planning. The public provided opinions to CDC regarding how vaccine should be provided in the U.
Ultimately, it was decided that vaccine should be distributed as soon as it was ready so that people could be protected against influenza as soon as possible, versus waiting to distribute vaccine until large quantities were prepared. The study found that the overall attack rate was highest among children aged years per , population , which was 14 times higher than for adults older than 60 years of age.
These findings would also provide input into vaccination strategy. By the end of August , prototype vaccines to prevent H1N1 virus had been developed but were not yet licensed. Production of the enormous quantities of vaccine necessary to protect the entire U. Available vaccine supplies were allocated to states proportional to their total populations and shipped to public and private provider vaccination sites based on orders placed by the states.
Participating providers were asked to sign a Provider Agreement assuring they intended to meet state requirements for administering vaccine. Data showed that as of August 8, , deaths with laboratory confirmed H1N1 flu in the United States had been reported to CDC, including 36 children younger than 18 years of age. CDC continued to urge parents to recognize H1N1 in their children early and to seek medical attention when needed.
CDC also reiterated that all children 6 months or older and caregivers of children younger than 6 months should receive the H1N1 vaccine when it became available.
The NIH announced on September 21, , that early results from clinical trials of H1N1 influenza vaccine in children looked promising. Preliminary analysis indicated that the vaccines were safe, and that only one dose of H1N1 vaccine for the majority of 10 to 17 year olds would be needed to generate a sufficient immune response to be protective against H1N1 influenza virus, but younger children generally had a less robust early response to the vaccine.
CDC recommended that children younger than 10 years receive two doses of H1N1 influenza vaccine. Results of trials conducted among adults were later published in December, and the data indicated that the immune response among vaccinated adults was excellent. The safety data from these trials also indicated that vaccine side effects were similar to those seen with the seasonal flu vaccines. On September 30, , states were able to place their first orders for the H1N1 vaccine; forty-seven states placed orders on that day, and by October 9, , all states and the District of Columbia had placed orders for vaccine.
The first doses were administered on October 5, Because initial supplies of vaccine were limited, most state and local health departments requested that vaccine be given only to those in the initial target groups, and many restricted use to those in sub prioritization groups that had also been outlined by ACIP.
The first six weeks after vaccines were initially released where characterized by high demand for vaccine and limited availability. Usual methods of unpacking the virus code to examine its workings have been thwarted because the authors have encrypted it, using algorithms that render it almost uncrackable.
In the meantime, Conficker has gone on to become one of the most widespread internet worms in recent years. Last week a leaked memo revealed that the House of Commons computer system had become infected, leading to concerns that confidential or highly sensitive material could be stolen when the virus next updates.
In the document, Joan Miller, the director of parliamentary computer services, said that her team were "continuing to work with our third party partners to manage its removal and we need to act swiftly to clean computers that are infected". Ordinary PC users are being advised to keep their anti-virus software up to date and watch for news about the worm. Cluley suggested that the widespread coverage could help lessen the potential impact.
The creators of the virus have reportedly programmed it in such a way that the virus would report back to them for further instructions on April 1. Global reports indicate that already about 12 million computers have been infected with the virus which first struck in October The virus that is likely to hit on April 1, is known as Conficker C'. It has already wreaked havoc across the world affecting computers in the UK Ministry of Defence, computers on the Royal Navy warships, hospitals, 13 schools in England, Houston municipal courts and the Bundeswehr federal defence force in Germany, since October.
The virus could spread through file sharing mode, USB drives, computers without proper password management and those without latest security updates. Some experts point out that there is a probable threat of many computers already having been infected and could lose their data on April 1.
Without a good password policy, it becomes easy for the worm to infect the system. Minus Related Pages. Summary of Progress since H1N1 Pandemic Year in Review. Learn more about the timeline of major events that took place during the H1N1 pandemic. I never get the flu: Additional Resources.
Estimated global mortality associated with the first 12 months of pandemic influenza A H1N1 virus circulation: a modelling study. Lancet Infect Dis. Clin Infect Dis.
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