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Health See other Health Articles Title: Flu Season This Year Means Shot Each for Swine, Seasonal Types, WHO Says By Jason Gale and Dermot Doherty May 6 (Bloomberg) -- The World Health Organization has determined that at least two influenza shots will be needed to protect against both the seasonal form of the disease and the new swine flu. The United Nation’s health agency will ask drugmakers soon to start producing a vaccine for swine strain once they finish making shots for seasonal flu, said Marie-Paule Kieny, director of the WHO’s initiative on vaccine research, in an interview. WHO is waiting to hear from Sanofi-Aventis SA, GlaxoSmithKline Plc and other vaccine manufacturers when they are ready to switch to making inoculations for the new pig- derived virus, Kieny said. The virus, formally known as A/H1N1, has spread to 20 countries since Geneva-based WHO first identified cases in Mexico and the U.S. on April 24. “It is important to have seasonal vaccine available,” Kieny said. The health agency is asking flu makers to produce immunizations against the swine variant even before it is certain H1N1 will re-emerge in Northern Hemisphere’s coming winter, she said. “Come November, if this isn’t a killer virus, and we don’t have seasonal flu vaccine, we’ll be crucified,” Kieny said. Margaret Chan, WHO’s director-general, and United Nations Secretary-General Ban Ki-moon will meet chief executive officers of the companies in Geneva May 19 to discuss how they can respond to the new flu strain, which threatens to spark the first influenza pandemic in 41 years. ‘Entirely Unpredictable’ “The only thing that can be said with certainty about influenza viruses is that they are entirely unpredictable,” she told the United Nations General Assembly in New York on May 4. The decision is being made even as the vaccine debate continues among scientists. “It would probably be premature to make the decision at this stage,” said Ian Barr, deputy director of the WHO Collaborating Center for Influenza in Melbourne, one of four laboratories globally that provides WHO data on flu and advises which strains to include in vaccines. Some vaccine makers will have completed their scheduled production of seasonal shots by the time seed vaccines for the new H1N1 strain are ready, Barr said in an interview today. “Manufacturers would normally have a period of work up in their own laboratories before they would be ready to go into a production phase,” he said. “It’s probably another month before that decision would need to be made” to start making a pandemic vaccine, he said. No Definitive Information The WHO request means the agency has decided it won’t have definitive scientific information about the swine flu outbreak in time to provide drugmakers the necessary time to manufacture millions of doses against H1N1. Officials at Sanofi, Glaxo, Novartis AG, Baxter International Inc., among the world’s largest flu vaccine makers, say they are prepared to begin production as they awaiting WHO recommendations and “seed virus.” “No one can say, right now, how the pandemic will evolve,” Chan said. “This places health officials, at national and international levels, in the difficult position of needing to make far-reaching decisions urgently, yet without the kind of solid scientific back-up we normally like to have.” In less than two weeks, swine flu has jumped from isolated reports in the U.S. and Mexico to a widening circle of infections spanning North America, Asia, Europe and the Pacific. Cases have been mild, with symptoms similar to the normal seasonal flu. World health officials have said they’re bracing for the possibility of the new disease worsening and flashing across a world population with little natural immunity to the new germ. Flu Peak Swine flu probably peaked last week in Mexico, the country hit hardest, health officials there said yesterday. Disease trackers are monitoring outbreaks in Spain, the U.K. and Germany to determine whether H1N1 has established itself outside North America. That would trigger the WHO to declare a pandemic, the first since 1968, the Geneva-based agency said. Critical to whether H1N1 resurfaces as a full-blown outbreak later this year is how it fares in the Southern Hemisphere’s coming winter. Since it can take four to six months to produce a full supply of new vaccine, the WHO is being advised by flu specialists to act quickly. “We cannot afford to just sit back and wait,” said Albert Osterhaus, head of virology at Erasmus University Medical Center in Rotterdam. He and others point out that the Spanish Flu of 1918 that killed as many as 50 million people, and also arose in swine, started relatively mild. “The decisions need to be made now,” Osterhaus said in an interview Too Late Even though vaccines were available for the 1957 and 1968 pandemics, they arrived too late to have an impact, WHO’s global influenza team wrote in a 2005 report outlining recommended responses to the threat of a pandemic sparked by bird flu. Chan doesn’t isn’t prepared to take any chances this time. The WHO may have expected the decision on whether to expedite production of a pandemic vaccine to be more clear-cut. The new H1N1 strain is causing no more deaths or illness than seasonal flu, which kills about 250,000 to 500,000 people worldwide each year. “Even in one of the more conservative scenarios, it has been calculated that the world will face up to several 100 million outpatient visits, more than 25 million hospital admissions and several million deaths globally, within a very short period,” according to the WHO statement.
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