WASHINGTON, Sept 16, (Agencies): Autopsies on people who have died from the new pandemic H1N1 flu show this virus is different from seasonal influenza, even if it has not yet caused more deaths, experts told a meeting on Tuesday. Americans who died from swine flu had infections deep in their lungs, Dr Sherif Zaki of the US Centers for Disease Control and Prevention told a meeting of flu experts, including damage to the alveoli — the structures in the lung that deliver oxygen to the blood. This in turn caused what is known as acute respiratory distress syndrome — an often fatal development that leaves patients gasping for breath. The World Health Organization has confirmed 3,205 deaths globally from swine flu but experts agree all estimates of the extent of the pandemic are grossly understated because so few patients are ever actually tested. Seasonal flu kills, too — about 250,000 to 500,000 cases a year globally, according to the WHO. But not in the same way as swine flu, which unlike seasonal flu frequently causes severe disease in young adults and children.

“It is very rarely you see what we call diffuse alveolar damage in fatal seasonal influenza,” Zaki told a meeting sponsored by the US Institute of Medicine, which advises government on health matters.
Seasonal flu causes bronchitis and other upper respiratory disease. But Zaki, the chief infectious disease pathologist at CDC, said the new virus had burrowed into the lungs of the 90 or so people he examined after they died, and they had huge amounts of the virus in their blood.
“This is almost exactly what we see with avian flu,” Zaki said. “This looks like avian flu on steroids.”
Dr Yoshi Kawaoka of the University of Wisconsin said tests in monkeys showed the virus lives and replicates 1,000-fold better in the lungs than does seasonal flu.
He said the No. 1 drug of choice against H1N1 — Roche AG’s and Gilead Sciences Inc’s Tamiflu — lowered the so-called viral load of virus in the lungs just enough to help the body fight back.
Experimental flu drugs lower it even more, notably Daiichi Sankyo Co Ltd’s CS 8958 and another drug called T-705 or favipiravir, made by Fujifilm Holdings Corp unit Toyama Chemical Co, Kawaoka said.
Zaki said 90 percent of the fatalities he looked at had some condition that would predispose them to serious disease. They had a median age of 38 and one victim was a two-month-old infant who died within a day of getting sick.
Nearly half — 46 percent — were obese, many had fatty liver disease, 27 percent had heart disease and 22 percent had asthma, he said.

New vaccine
The Food and Drug Administration approved the new swine flu vaccine Tuesday, a long-anticipated step as the US government works to get vaccinations under way next month.
The vaccine is made by CSL Ltd of Australia; Switzerland’s Novartis; Sanofi-Pasteur of France; and US-based Medimmune, which makes the only nasal-spray flu vaccine.
Health and Human Services Secretary Kathleen Sebelius announced the vaccine’s approval to Congress — and said she hopes to get the first limited supplies distributed early in October.
The bulk of vaccine will start arriving Oct. 15, and Sebelius said it should be available at 90,000 sites around the US
“We will have enough vaccine available for everyone” eventually, Sebelius said — everyone who wants it, that is.

Rate
The death rate from the pandemic H1N1 swine flu is likely lower than earlier estimates, an expert in infectious diseases said on Wednesday.
New estimates suggest that the death rate compares to a moderate year of seasonal influenza, said Dr Marc Lipsitch of Harvard University.
“It’s mildest in kids. That’s one of the really good pieces of news in this pandemic,” Lipsitch told a meeting of flu experts being held by the US Institute of Medicine.
“Barring any changes in the virus, I think we can say we are in a category 1 pandemic. This has not become clear until fairly recently.”

Kuwait
Kuwaiti’s Minister of Education and of Higher Education Dr Moudhi Al-Humoud reported on Wednesday that two students in an English school had been diagnosed with swine flu and that a teacher at a private school was also diagnosed with the AH1N1 virus.
The minister told KUNA the two students underwent testing by the Ministry of Health and are now receiving care at home.
The teacher, she added, was also diagnosed through testing and measures have been taken such as decontamination and to prevent spread of the virus to others at the school.
The Education Ministry denied on Wednesday closing a school in Jahra because one of its teachers was diagnosed with swine flu on Tuesday.
The ministry said in a press release that it was keen on following all required procedures to prevent the spread of the virus, but there was no need for alarm in this case.
On Tuesday, Jahra High School for Boys Principal Hamid Khalaf told KUNA that the male teacher was absent since last Thursday and did not interact with any member of the staff, adding that he was infected during his absence.

He said the lab results came Tuesday confirming presence of the swine flu virus, upon which the teacher himself called the school and reported his condition adding that he was receiving care at home.
The principal added there is no need for any measures at the school since the teacher was not present there at anytime while infected.
Teachers must have full knowledge on how to deal with health-related situations, swine flu included, and lectures on this matter are being given to 250 school staff members every day in Kuwait’s six governorates, a Health Ministry official said on Wednesday.
Speaking to KUNA, Director of the Public Health Department Dr Rashed Al-Owaiyesh said that by the end of next week, 25,000 teachers and school administrative staff would have been trained on how to deal with swine flu cases and how to prevent the virus from spreading among students.
He said that such awareness campaigns would create a new generation of students that had greater knowledge about health care.
Asked about the regional conference on swine flu, the health official said that the meeting aims to place an Arab plan to deal with and limit the spread of swine flu, noting that representatives of Arab health and education ministries, and universities, would be present.
Guidelines will be placed on when it is necessary to close down individual classes or whole schools, and how to tackle the discovery of a swine flu case at any school, he explained, while underscoring the importance of consolidated efforts in order to overcome this matter.

Haj
Saudi Arabia has dismissed fears of swine flu striking the hundreds of thousands of Muslims expected normally to perform the Hajj (pilgrimage) in Makkah despite other Arab nations’ concerns over the A(H1N1) virus.
Twenty-six people have died from the flu in the kingdom but the Saudi Committee for Contagious Diseases said on Tuesday that there was no danger of a major outbreak during the pilgrimage in November.
“Not a single death was recorded” among pilgrims of the Umrah (the lesser pilgrimage), since the beginning of Ramadan, the Muslim month of fasting, which started on Aug 22, said the committee.
“All the patients (of H1N1) among the pilgrims and visitors (to Makkah and Medina) have recovered, which confirms the absence of the pandemic. The health situation is totally reassuring,” a committee statement said in Riyadh.
Not all countries in the region are convinced.

Egypt has warned that it could ban its nationals from going to the Hajj over any risk from swine flu.
“A decision could be taken at any moment to ban the Hajj this season if the situation so requires,” Egyptian Health Minister Hatem al-Gabaly said.
In Tunisia, the authorities have called on the pilgrims to “take reason and responsibility into consideration before making a final decision and to postpone the pilgrimage until next year.”
Arab health ministers in July recommended that Muslims over the age of 65 and under 12 should not go on the pilgrimage, while pregnant women and people with chronic diseases are also advised to stay away.
“Muslims should be vaccinated (against seasonal flu) in their countries of origin, and this vaccine should be taken 10 days before arrival in Saudi Arabia,” said Tarek Madani, a Saudi academic.

WHO
There is no need for closure of all schools and it is preferable to continue the school year plan unchanged while taking the recommended precautionary measures against the spread of swine flu, the World Health Organization said on Wednesday.
This came upon conclusion of the two-day meetings of the World Health Organization Regional Office for the Eastern Mediterranean, in which Kuwait was represented by Assistant Education Undersecretary for Educational Development Bader Al-Fraih and Musaab Al-Saleh of the Health Ministry.

Lung treatment
Patients with swine flu who experience severe respiratory failure should be given a specialist lung treatment, researchers said Wednesday. The treatment — which helped pregnant Scottish woman Sharon Pentleton — saves one extra life for every six patients compared with conventional treatment for those who are critically ill, doctors said.
There is only one adult unit in the UK which offers the treatment, called extracorporeal membrane oxygenation (ECMO). It involves circulating the patient’s blood outside the body and adding oxygen to it artificially.
The Glenfield Hospital in Leicester, central England, has five ECMO beds and treats around 100 patients a year on average. The unit can be expanded to 10 beds if necessary. Miss Pentleton had to be flown to University Hospital in Stockholm for the treatment in July because the Leicester unit was full.

Egypt
Egypt has ordered foreign schools and universities to close until October 3 over worries about swine flu, with local schools having already been told to delay opening until then, a health ministry official said on Wednesday.
Egyptian universities and schools had been set to begin their academic year the last week of September, but foreign ones started earlier this month. The government decided to delay the school year last week, the official said.
American University of Cairo vice president Brian MacDougall said the university was asked on Tuesday to delay classes, which the university began on Sept 6.
An official at the French embassy confirmed that it has been told all French schools in the country must close until next month.
A Western diplomatic official said the decision affected US, British, French and Italian schools, as well as others.

Iran
Two Iranian children have died after contracting swine flu, taking the number of A(H1N1) virus victims to four in Iran, the official IRNA news agency said on Wednesday.
Abbas Zareh Nejad, a spokesman for Iran’s health ministry, said the victims were under two years old and had been “susceptible to cerebral disease.”
He added that 391 people have so far been infected in Iran.
Iran reported its first swine flu death, that of a 36-year-old female drug addict, on Aug 26.

China
China’s state food and drug administration has approved a third swine flu vaccine, state media reported Wednesday, as the country braces for an expected winter outbreak.
The latest licence went to a vaccine produced by the Shanghai Institute of Biological Sciences, a research body run by the city’s government, the Xinhua news agency said.
China had already approved two privately developed A(H1N1) influenza vaccines — one by Beijing-based firm Sinovac and another by Hualan Biological Engineering, based in the central province of Henan.

Thailand
Thailand’s Public Health Ministry confirmed on Wednesday 11 new deaths from the A(H1N1) virus, bringing the country’s total death toll to 153, reported the Thai News Agency (TNA). TNA, quoting Deputy Secretary for Public Health Dr Paijit Varachit, said that in the week of Sept 6-12, 11 people died of swine flu, including six male and five female patients. Varachit said the World Health Organization (WHO) had warned the second wave of the A(H1N1) flu epidemic and the ministry was on full alert to response the spread of virus. He said the outbreak in Bangkok and its adjacent provinces had gradually decreased but had spread in other provinces.