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Health Experts Plot Strategy for Swine Flu Vaccine

World Health Organization expected to make recommendation next week, report says

THURSDAY, May 14 (HealthDay News) -- Vaccine manufacturers and other health experts met Thursday at the World Health Organization headquarters in Geneva, Switzerland, to plot potential strategies to combat the swine flu virus that is now blamed for nearly 6,500 cases of infection worldwide.

The Associated Press reported that drug companies are ready to start producing a swine flu vaccine, but many questions remain. They include how many doses to produce, particularly in relation to needed doses of seasonal flu vaccine.

The expert group's recommendations will be forwarded to the WHO's director-general, Margaret Chan, who is expected to issue advice to vaccine manufacturers and the World Health Assembly next week, the AP said.

But at least one infectious-disease expert said it was a "foregone conclusion" that drug manufacturers would be told to proceed with a vaccine for swine flu, technically known as H1N1 flu.

"If we don't invest in an H1N1 (swine flu) vaccine, then possibly we could have a reappearance of this virus in a mild, moderate, or catastrophic form and we would have absolutely nothing," said Dr. David Fedson, a vaccine expert and former professor of medicine at the University of Virginia.

One factor complicating a decision is that most flu vaccine companies can only make limited amounts of both seasonal flu vaccine and pandemic vaccine, such as that needed for swine flu, and not at the same time. The producers also can't make large quantities of both types of vaccine because that would exceed manufacturing capacity, the AP said.

On Thursday, the U.S. Centers for Disease Control and Prevention was reporting 4,298 U.S. cases of swine flu in 47 states, and three deaths. For the most part, the infections continue to be mild -- similar to seasonal flu -- and recovery is fairly quick.

The World Health Organization on Thursday was reporting 6,497 cases in 33 countries.

The swine flu is a highly unusual mix of swine, bird and human flu viruses. Experts worry that, if the new flu virus mutates, people would have limited immunity to fight the infection.

The CDC is concerned with what will happen as this new virus moves into the Southern Hemisphere, where the flu season is about to start. The agency is also preparing for the virus' likely return in the fall to the Northern Hemisphere.

Testing has found that the swine flu virus remains susceptible to two common antiviral drugs, Tamiflu and Relenza, according to the CDC.

Earlier this week, U.S. health officials said they were seeing some complications among pregnant women as the swine flu continues to spread across the country, and that this high-risk group needs to take antiviral drugs as soon as infection is suspected.

"Pregnant women are at higher risk of complications of influenza, whether it's the seasonal influenza or pandemics of the past. We are also seeing some severe complications in women with this year's novel H1N1 virus," Dr. Anne Schuchat, the CDC's interim deputy director for science and public health program, said during a Tuesday teleconference.

The CDC was investigating 20 cases of pregnant women with the swine flu, several of whom experienced complications, Schuchat said. Complications can include pneumonia, dehydration and premature birth.

Doctors can be reluctant to treat pregnant women with antiviral drugs such as Tamiflu and Relenza, and pregnant women may be reluctant to take them out of fear that they may pose a risk during pregnancy, Schuchat said. "Experts who have looked into this situation strongly say that the benefits of using antiviral drugs to treat influenza in a pregnant woman outweigh the theoretical concerns about the drugs," she said.

Of the three swine-flu-related deaths in the United States, one involved a 33-year-old pregnant woman from Texas who had other health problems before she was infected with the virus.

U.S. Human Cases of H1N1 Flu Infection
(As of May 14, 2009, 11:00 AM ET)
States # of
confirmed and
probable cases
Alabama 41  
Arkansas 1  
Arizona 431  
California 473  
Colorado 47  
Connecticut 38  
Delaware 58  
Florida 65  
Georgia 36  
Hawaii 10  
Idaho 5  
Illinois 620  
Indiana 70  
Iowa 58  
Kansas 28  
Kentucky** 13  
Louisiana 45  
Maine 13  
Maryland 28  
Massachusetts 109  
Michigan 141  
Minnesota 34  
Missouri 20  
Montana 5  
Nebraska 23  
Nevada 25  
New Hampshire 18  
New Jersey 12  
New Mexico 51  
New York 224  
North Carolina 12  
North Dakota 1  
Ohio 12  
Oklahoma 22  
Oregon 94  
Pennsylvania 50  
Rhode Island 8  
South Carolina 34  
South Dakota
Utah 80  
Washington 195 1
Washington, D.C. 10  
TOTAL*(47) 4,298 cases 3 deaths
*includes the District of Columbia
**One case is resident of Ky. but currently hospitalized in Ga.

Source: U.S. Centers for Disease Control and Prevention

More information

For more on swine flu, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: May 12, 2009, teleconference with Anne Schuchat, M.D., interim deputy director, science and public health program, U.S. Centers for Disease Control and Prevention; Associated Press

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