WASHINGTON, Aug 4, (Agencies): Health officials raised the alarm about a strain of swine flu that is resistant to the Tamiflu treatment as the virus claimed more lives on Tuesday, with Vietnam reporting its first fatal case. India and South Africa both reported their first deadly cases of the A(H1N1) virus late Monday. Maria Teresa Cerqueira, head of the Pan-American Health Organization office in La Jolla, California, said a Tamiflu-resistant mutation of A(H1N1) had been found around the US-Mexico border in El Paso and close to McAllen, Texas. Experts had gathered in La Jolla, California, on Monday to discuss responses to the outbreak, and warned that resistant strains were likely emerging because of overuse of antivirals like Tamiflu. “In the United States Tamiflu is sold with a prescription, but in Mexico and Canada it is sold freely and taken at the first sneeze. Then, when it is really needed, it doesn’t work,” said Cerqueira late Monday. Cases of A(H1N1) that were resistant to the anti-viral medicine have now been found in the United States, Canada, Denmark, Hong Kong and Japan.

In Vietnam, officials reported the country’s first swine flu fatality after a 29-year-old woman died from the disease in the southern coastal province of Khanh Hoa. Nearly 1,000 people have been reported infected in Vietnam and about 500 of those are receiving hospital treatment, according to the health ministry. In South Africa, authorities said a 22-year-old student at Stellenbosch University near Cape Town had died after contracting the virus, while in India a 14-year-old girl in the western city of Pune died. With the world’s highest number of HIV/AIDS-affected people — nearly 19 percent of a 49-million-person population — South Africa is considered particularly at risk because people with compromised immunity are more likely to fall prey to the disease. South Africa’s swine flu caseload has increased fourfold since the country’s first case was reported on June 14. In India, the government said that 2,479 people had been tested for swine flu so far out of whom 558 had tested positive for H1N1. Some health officials in India have suggested a combination of climatic and meteorological factors — such as high temperatures and humidity — and social factors are likely to lower the risk of transmission there. The virus continued to disrupt plans for public events.

The Russian state health agency warned football fans to stay away from the national team’s World Cup qualifying tie with Wales in Cardiff on Sept 9. “This would be an extremely unnecessary and inappropriate undertaking at a time of a flu epidemic,” the head of Russia’s state health agency Gennady Onishchenko said, according to local news agencies. Onishchenko expressed fears that “the expressions of emotion on the part of football fans involving intense shouting” could lead to the airborne transmission of the flu virus. Russia has to-date been relatively unscathed by the pandemic, with just 55 confirmed cases. The World Health Organisation stuck on Tuesday to its statement that about two billion people could catch H1N1 influenza by the time the flu pandemic ends. But the estimate comes with a big health warning: no one knows how many people so far have caught the new strain, and the final number will never be known as many cases are so mild they may go unnoticed.

“By the end of a pandemic, anywhere between 15-45 percent of a population will have been infected by the new pandemic virus,” WHO spokeswoman Aphaluck Bhatiasevi said in a statement. “Thirty percent is a midpoint estimate and 30 percent of the world’s population is 2 billion.” But she added: “We must remember however, that attempts to estimate infection rates can only be very rough.” Early in the outbreak, which was first detected in April, Dr Keiji Fukuda, acting Assistant Director-General of the UN agency, fuelled accusations the WHO was creating panic about the disease when he used the two billion figure. But the WHO, which raised its global flu alert to the highest level on June 11, declaring a worldwide pandemic, has since said the strain is already spreading much faster than previous flu pandemics. At the same time, because most victims suffer only mild symptoms, it has told countries they no longer need to try to report each case, but concentrate on monitoring suspicious concentrations of the disease and tracking deaths.

Bhatiasevi earlier told a briefing the WHO was coordinating a network of independent institutions trying to project the total number of cases. Because no one currently has such an estimate, it is not possible to state the H1N1 mortality rate. The WHO’s latest update on July 27 said a total of 816 people had died from H1N1, while the total number of laboratory-confirmed cases, including deaths, was 134,503 — a figure well below the likely real total of infections which may already be in the millions, according to health experts. As the northern hemisphere autumn approaches, and with it the onset of seasonal flu, the WHO is working with drug companies to ensure vaccines to cope both with H1N1 and seasonal flu will be available. WHO spokeswoman Fadela Chaib said the agency hoped to give an update on its vaccine plans later this week. Leading flu vaccine makers include Sanofi-Aventis, Novartis , Baxter, GlaxoSmithKline and Solvay.

Kuwait
National health authorities declared 72 new swine flu cases on Tuesday bringing the total number of patients infected with the communicable virus to 386, mostly branded as mild cases.  In the afternoon Kuwait announced 47 cases and then 25 in the evening. Meanwhile, a female Kuwaiti vacationer in Sharm El-Sheikh has tested positive for the virus, said Kuwait Embassy’s Health Bureau on Tuesday. Acting bureau chief, Dr Eid Al-Adwani, told KUNA that the woman had come in contact with her brother, who tested positive for the virus yesterday. He said the bureau was following up on these cases, and that they were undergoing treatment, adding that all other family members tested negative for the virus.

Director of the General Health Department at the Ministry of Health Dr Rashid Al-Uwaish recently declared the first batch of the H1N1 Swine Flu vaccine is expected in the country by October 2009, while the second batch will be available here February 2010, reports Al-Seyassah daily. He stressed the hajj pilgrims will be vaccinated with the first batch of the vaccines and the second batch will be used for students. Meanwhile, Al-Uwaish added in a statement the Health Ministry is coordinating with the Ministry of Education, to make the required arrangements to receive students from the private schools. Moreover, the Ministry of Health is scheduled to meet with health authorities at the school clinics to provide them with adequate information about the disease and its precautionary measures, including masks which will be distributed to the students, he disclosed.

Saudi Arabia
Two new swine flu cases have been reported by the Kingdom of Saudi Arabia, taking the country’s total number of A(H1N1) virus death toll up to six. The first death case was of a 32-year-old Sri Lankan woman, while the other belonged to a 15-year-old Saudi boy, the Saudi Ministry of Health said in a release. The Kingdom had reported four swine flu death cases, with the number of infection cases increasing. The ministry claimed that it was normal for the country to see swine flu cases due to the growing outbreak of the virus. It urged anybody who may suffer from swine flu symptoms, including coughing, fever and difficulty in breathing, to go to the nearest clinic for examination.

Spain
A 35-year-old woman has died of “complications linked” to swine flu, bringing the total number of confirmed deaths from the disease in Spain to eight, the Spanish health ministry said Tuesday. The woman had been suffering from “various chronic diseases” before contracting swine flu and had been in hospital in the northeastern city of Girona since Monday, it said. Spain has 1,806 confirmed cases of the A(H1N1) virus, the ministry said in its most recent bulletin released on July 27.

Egypt

Nine new cases of the swine flu A(H1N1) virus were confirmed, among them eight Egyptian citizens and one Kuwaiti female, putting the toll of cases at 298, Egyptian Ministry of Health said on Tuesday. The Spokesman for the Ministry of Health, Abdul-Rahman Shaheen, said in a press release that 217 cases completely recovered from the disease, in addition to one fatality, an Egyptian female who died of the disease last month, and the rest were reported in stable conditions. Two of today’s nine cases were Egyptian females who were infected with the disease after their return from Saudi Arabia. All nine cases are being hospitalized and receiving the proper treatment, the spokesman added.

Netherlands
The Netherlands on Tuesday reported its first swine flu death after a 17-year-old boy died overnight, health officials said. “The boy had been very sick. He died last night,” Harald Wychgel, a spokesman for the National Institute for Public Health and the Environment told AFP. The teenager had already been sick when he contracted the flu. At the request of the victim’s family, Wychgel would not say whether or not the teenager had died in hospital or how he contracted the A(H1N1) virus. To date, 663 people in the Netherlands have tested positive for the virus, Wychgel added. Nine have been hospitalised since the first diagnosis, that of a three-year-old, was made on April 30. Some have since been discharged. The Dutch health department, meanwhile, announced it was making available 144,000 doses of the Tamiflu treatment to pharmacies countrywide to administer to swine flu patients for free.

Iran
Sixteen new swine flu cases have been confirmed in Iran, bringing the total number to 124 cases, the Health Ministry said on Tuesday.
The 124 swine flu cases involved those who have just arrived in the country from holidays abroad, said head of the ministry’s epidemics prevention department, Mohammed Koya, in a press release. Among the cases, 84 percent had arrived from holidays abroad, and 55 percent had come from Saudi Arabia after performing Umrah (smaller pilgrimage), he added. The number of people infected with the  disease in Tehran was at 105 just two days ago, and it quickly jumped to 124. Koya noted that the Second Islamic Solidarity Games, which were supposed to be held in Iran on Oct 16-30, would likely be canceled due to the swift spread of the disease worldwide.

Poland
Poland has recorded 100 swine flu cases since the end of April, health authorities announced Tuesday, but stressed there was no cause for alarm. “Since April 28 we have logged 100 cases in Poland of the A(H1N1) virus,” Andrzej Wojtyla, Poland’s chief health inspector, told reporters. Deputy Health Minister Marek Haber said: “The virus’ virulence is weak. It is not spreading among people living in Poland.” The majority of people with the virus have caught it abroad. But Haber said the number of cases could rise, notably when Poles return from summer holidays overseas. Poland, a nation of 38 million people, has not had any swine flu deaths.

Tunisia
Tunisia’s health ministry Tuesday reported nine new cases of swine flu in people who had travelled to the north African country from Canada, Spain, France, Britain and Mali. There were now a total of 19 cases of the A(H1N1) virus in Tunisia, the ministry said. The latest patients — four foreigners and five Tunisians — are between the ages of 19 and 52 and had entered Tunisia between late July and the start of this month, Mongi Hamrouni, the ministry’s director of health care, told AFP. He did not specify the nationalities of the foreigners. “All of the new cases are not serious. They are being treated with antivirals at home and are recovering completely,” Hamrouni, a physician, added.

Mexico

Mexico has recorded a big jump in swine flu cases with more than 1,100 in just five days, bringing the total number in the country where the pandemic began to 17,416, the health minister said Tuesday.

Vaccines
Novartis has started human testing of H1N1 swine flu vaccine candidates while Sanofi-Aventis, the world leader in flu shots, will commence within days, company officials said on Tuesday. The launch of clinical trials is a key part of a widening programme of work being undertaken by big pharmaceutical companies as they prepare for mass vaccination from next month. GlaxoSmithKline, the other “big three” flu vaccine supplier, said it would initiate clinical studies later this month. Healthcare officials are relying on a vaccine to contain the spread of disease, providing a potential sales windfall for those companies that are able to deliver quickly and in large volume.

Australia’s CSL has so far been the fastest commercial operator, after starting its first clinical trials in Australia two weeks ago. Now others are catching up. “We started a little over a week ago,” Novartis spokesman Eric Althoff said by telephone from Basel. Benoit Rungeard, product communications director for Sanofi Pasteur, the vaccines division of the French drugmaker, told Reuters his company would start “in the coming days or next week”. Althoff said Swiss-based Novartis was conducting its clinical trials in a number of countries, including the United States, Britain and Germany, and was testing both single and booster, or repeat, doses of vaccines. Novartis, in common with other manufacturers, will also compare vaccines with and without adjuvants — ingredients that boost the immune system response. AstraZeneca, whose MedImmune unit makes smaller amounts of a flu vaccine that is sprayed into the nose rather than injected, said it would start clinical trials in the United States around Aug 17.

Meanwhile, a Taiwanese biotech company on Tuesday started mass production of a swine flu vaccine before even completing clinical trials, in a bid to get a jump before the start of the winter flu season. Adimmune Corp, the island’s only human vaccine manufacturer, said it was starting production at its plant in central Taichung. The company is due to deliver five million doses of A(H1N1) influenza vaccine before the end of October, according to the purchase contract it has signed with the government, said deputy CEO and president Ignatius Wei. The company says it has completed some animal trials of the vaccine, but will only begin human trials in September — sparking criticism about the risks of manufacturing an as-yet unproven product. But Huang Li-min, a doctor at National Taiwan University Hospital who will oversee the human trials, says Adimmune is taking a calculated risk. “They have to do so... they are racing against time,” Huang told AFP, referring to the upcoming start of flu season. “There may be a risk for the company, but the risk is small to an experienced company,” he said.