Wednesday, August 12, 2009

A CBS Video - Unplugged: H1N1 Vaccine Dangers

August 12, 2009 11:00 AM

Sharyl Attkisson, CBS News Medical Correspondent Dr. Jennifer Ashton and NVIC's Barbara Loe Fisher discuss the possible dangers with the H1N1 vaccine.

Fairfax Schools Air CDC's Strategy for Swine Flu's Return

By Nelson Hernandez
Washington Post Staff Writer
Wednesday, August 12, 2009

The expected resurgence of swine flu this fall could lead some public schools to become mass inoculation clinics. Infected students could be forced to wear surgical masks and put in isolation rooms before being sent home.

But school officials predict that the wave of school closings that caused much angst in the spring is unlikely to be repeated.
"School closures aren't really on the table," said Fred Ellis, director of safety and security for Fairfax County public schools. Unless the virus, known as H1N1, mutates to become more severe, health officials said, they will try to keep schools open and prevent the spread of the virus through other means.

"We really want people to get sick and tired, as I know you already are, of hand-washing and coughing etiquette," Ellis told about 200 Fairfax principals who had gathered for a back-to-school briefing Tuesday. A school might still be closed if there aren't enough healthy teachers and staff members to run the school or bus drivers to transport students, Ellis said.

The session at Luther Jackson Middle School, in the Falls Church area, offered a window into the preparations underway across the country as school officials pore over the latest guidance from the Centers for Disease Control and Prevention in the weeks before classes resume.

In the spring, when little was known about how deadly the disease might be, the CDC's advice frustrated some health officials, school principals and parents. Initially, a school could be closed for a week or more because of a single confirmed case of swine flu, and it seemed that the entire school year could crash to a halt. But that directive quickly changed because the virus's effects appeared to be fairly mild.

The CDC's latest advice gives local school systems more flexibility in dealing with the illness and on closing schools.

Students and staff members who are sick should stay home and should not return to school until at least 24 hours after the fever has broken, the CDC says.

Under CDC guidelines, sick students who do go to school would be asked to wear a surgical mask and sent to a quarantine room to be watched over by an adult also wearing a mask. The students would remain quarantined until their parents picked them up.

There could be more changes to the guidelines, particularly after a vaccine begins to be administered to the public en masse.

At the University of Maryland School of Medicine in Baltimore, 66 adult volunteers have received the first of two doses of an H1N1 vaccine. The university is one of 10 sites for national clinical trials of the vaccine, which started Monday.

The goal of the clinical trials is to determine how strong a dose is required to protect different age groups. To that end, researchers will test for antibodies in the volunteers' blood to assess their immunity.

Once testing is complete, the vaccine is to be given to states and local governments and administered to millions of Americans, starting with vulnerable populations such as children and young adults, pregnant women and people with weak immune systems. But there is no timeline or firm idea of how the vaccinations will be administered.

"Right now, we cannot stand here and tell you what the vaccination plan is going to look like," Ellis said. "We have no idea."

One option discussed would use schools as mass inoculation clinics. But Ellis also said Fairfax County's plan for dealing with the virus is "flexible and fluid," one of several remarks that drew laughs.

The H1N1 vaccine will not be a substitute for seasonal flu vaccine, and health officials recommended that their employees and everyone else get both.

Seasonal flu shots will be free for all school employees.

At Tuesday's briefing, Fairfax principals wrote out questions on blue index cards for health and school officials to answer. There were queries about the vaccine's effects (it should be as safe as a seasonal flu shot); about how to clean rooms in schools (with standard cleaning products, because antibacterial soap isn't any more effective against a virus); and about who will pay for cleaning products (the school system).

As they left the meeting, the principals seemed ready to face what will come.

"I think people are much more comfortable at this point in time," said Theresa West, principal of McNair Elementary School in Herndon. "Last spring, nobody knew what was happening. There was fear, getting in planes and everything else. Information, it helps people be calm."

Tuesday, August 11, 2009

CIDRAP-States to designate providers to give H1N1 vaccines

Robert Roos News Editor

Aug 10, 2009 ( News) – State health departments will decide which providers will administer the pandemic H1N1 influenza vaccine this fall, and a single company will be the distributor for all the doses, it was announced today.
McKesson Corp., based in San Francisco, announced it will be the central distributor of H1N1 vaccines under a contract with the Centers for Disease Control and Prevention (CDC). McKesson currently distributes vaccines under the CDC's Vaccines for Children (VFC) program.
"McKesson's role will be to distribute the vaccine to sites designated by state health departments across the country," the company said in a press release. "Each state will designate the providers who will receive and administer the vaccine."
That's different from how seasonal flu vaccines are handled, noted Jim Blumenstock, chief program officer for public health practice at the Association of State and Territorial Health Officials in Washington, DC.
"This is a government-controlled program, so it'll be the state agencies working with local partners and the CDC that will make the determination as to where the public will be able to get vaccine," Blumenstock said. "This is not like your seasonal flu [vaccination] program where healthcare providers decide whether or not they want to do it and then submit private orders."
Meanwhile, the CDC released a statement today saying that using a single vaccine distributor will be more efficient than having vaccine manufacturers ship doses directly to customers. The agency also repeated previous government predictions that vaccine shipments are likely to begin about mid-October, though a late September start for shipments remains a possibility. It said each person will probably need two doses.
"One of the key benefits of using a centralized, third-party distributor to support H1N1 vaccine distribution is that it allows distribution of doses to a much larger number of provider sites than would be feasible with direct manufacturer distribution," the CDC said in a question-and-answer document about H1N1 vaccination planning.
The McKesson statement said, "The H1N1 vaccine distribution effort will include the centralized distribution of the H1N1 flu vaccine to as many as 90,000 sites across the country, making it the largest public health initiative in the CDC's history."
The company said it distributes 80 million doses of vaccine to more than 40,000 providers each year under the VFC program, which serves uninsured and Medicaid-eligible children and children of Native Americans and Alaska natives.
The CDC said the same distribution process used in the VFC program will be harnessed for the H1N1 effort, but it will be "substantially enhanced" to increase capacity. Vaccine providers are likely to include a mix of public health and private sector sites.
Blumenstock said state health departments would probably consider requests from large employers who want vaccine for their workers, but he noted that the general population of healthy adults is not among the groups targeted for the first doses that become available.
The CDC recently announced that the initial target groups for immunization are pregnant women, close contacts of babies under 6 months old, healthcare and emergency medical workers, young people from ages 6 months through 24 years, and nonelderly adults with chronic health conditions.
State health departments are currently planning how to designate providers, Blumenstock said. "The CDC has drafted a provider agreement that will lay out terms and conditions for participation, so everyone going into this will know what's expected of a provider" and what support the states will provide, he said.
The federal government will pay for the vaccine and related supplies, including needles, syringes, and sharps containers, the CDC noted.
Funds for administering the vaccines will have to come from elsewhere, and today the CDC said a trade association of health insurance companies stated that its members will cover the administration costs for private-sector providers.

The group America's Health Insurance Plans (AHIP) told the CDC, "Public health planners can make the assumption that health plans will provide reimbursement for the administration of a novel (A) H1N1 vaccine to their members by private sector providers in both traditional settings . . . and in nontraditional settings, where contracts with insurers have been established."

The CDC also said today that vaccination planners should consider two scenarios for vaccine availability. The first possibility is that about 120 million doses will be released starting in mid-October and continuing over 4 weeks, followed by 80 million doses per month after that. The second scenario envisions about 20 million doses being released starting in late September, followed by 20 million doses a week thereafter.

On other points, the CDC said:
  • Though it is uncertain until clinical trial results are in, planners should assume that each person will need two doses of vaccine.
  • Practical considerations will make it difficult to ensure that any given person's first and second doses of vaccine will be the same product (five manufacturers are supplying vaccine).
  • The CDC's goal is to have enough preservative-free (ie, thimerosal-free) vaccine available for young children and pregnant women, in single-dose vials or nasal sprayers.
  • It is expected that seasonal flu vaccine and the pandemic vaccine may be administered together.
  • There will be no federal requirement for vaccinators to require people to provide proof of priority-group status, such as a doctor's note documenting pregnancy or risk status.
  • The CDC is not currently recommending pneumococcal vaccine to anyone not already covered by such a recommendation. Pneumococcal vaccination has been suggested as a way to reduce the risk of secondary bacterial pneumonia in H1N1 flu patients.

Monday, August 10, 2009

CDC: Leave school closings to local officials

The Atlanta Journal-Constitution

U.S. health officials said Friday they are discouraging the quick closure of schools where swine flu appears, a shift from recommendations in the spring that prompted many closures and disrupted the lives of many families.

In addition, the federal officials who gathered for a morning media conference in Washington said the decision to close schools should be left to local school and health officials.

“Closure of schools is rarely indicated,” said Dr. Thomas Frieden, director of the Atlanta-based U.S. Centers for Disease Control and Prevention.

He said local officials must weigh the options of closing a school, which can throw families off their normal routines and hamper education, against the need to stop what may be widespread flu in the school.

The updated school recommendations, which carry great weight with local and state education and health officials, come as some Georgia school systems resumed classes this week. Most of the state’s systems begin the 2009-2010 school year Monday.

While Georgia officials say many schools have put in place a line of defense against swine flu -- planning for increased sanitary education and practices and sending out preventative information to parents -- the officials acknowledge that important aspects of planning awaited these CDC recommendations.

State education and health officials said they agree that the closing of schools should be discouraged and that the decisions should be left to local school officials, with input from local health boards.

“The decision is best left up to the local officials, since they know their kids best,” said Matt Cardoza, spokesman for the Georgia Department of Education.

The new CDC guidelines say, “The decision to dismiss students should be made locally and should balance the goal of reducing the number of people who become seriously ill or die from influenza with the goal of minimizing social disruption.”

CDC officials say they expect a vaccine to be available for swine flu, also called novel H1N1, by mid-October.

Children with seasonal flu 'shouldn't take Tamiflu'

Writer: AFP
Published: 10/08/2009 at 09:00 PM

Children with seasonal flu should not be given antivirals such as Tamiflu because harmful side effects outweigh relatively meager benefits, according to a study released on Monday.

Boxes of Tamiflu. Children with seasonal flu should not be given antivirals such as Tamiflu because harmful side effects outweigh relatively meager benefits, according to a study by British researchers.

In some children Tamiflu caused nausea and vomiting, which can lead to dehydration and other complications, researchers reported.

The study did not cover the current outbreak of swine flu, but its conclusions suggest that antivirals may not significantly reduce the length of illness or prevent complications in children infected with the new A(H1N1) virus, the researchers said.

Carl Henegan, a doctor at John Radcliffe Hospital in Oxford and co-author of the study, said the current practice of giving Tamiflu for mild illness was "an inappropriate strategy."

"The downside of the harms outweigh the one-day reduction in symptomatic benefits," he said.

The research showed that antivirals oseltamivir and zanamivir shortened the duration of seasonal flu by up to a day and a half.

But the drugs had little or no effect on asthma flare-ups, increased ear infections or the need for antibiotics.

Tamiflu, the brand name for oseltamivir, was also linked to an increased risk of vomiting. Zanamivir is marketed under the name Relenza.

The study, published in the British Medical Journal, comes 10 days after Britain's Health Protection Agency (HPA) reported that more than half of 248 students given Tamiflu after a classmate fell ill with swine flu suffered side-effects such as nausea, insomnia and nightmares.

Most of the students did not have the flu when they were given the drug.

Preparing for 2nd flu wave


WASHINGTON - THE US and other countries in the Northern Hemisphere are bracing themselves for a second wave of Influenza A (H1N1) infections that could strike millions of people and contribute to the hospitalisation and deaths of thousands, including many children and young adults.

While flu viruses are notoriously capricious, making any firm predictions impossible, a second wave could hit the Northern Hemisphere within weeks and lead to major disruptions in schools, workplaces and hospitals, according to US and international health officials.

Since emerging last spring in Mexico, the H1N1 virus has spread to 168 countries at least, causing over 162,000 confirmed cases and playing a role in at least 1,154 deaths, including 436 in the US. As the first flu pandemic in 41 years spread through the Southern Hemisphere's winter recently, scientists have been closely monitoring the virus for clues to how much of a threat it might pose this autumn.

So far, no signs have emerged that the microbe has mutated into a more dangerous form. Most people who get infected seem to experience relatively mild illness.

Still, in the Southern Hemisphere, which experiences winter during the Northern Hemisphere's summer, the virus caused a more intense and somewhat earlier flu season in some places.

Its appearance in countries such as South Africa and India, both of which have just recorded their first deaths, is raising concern that the pandemic could be devastating if it begins to sicken large numbers of people in places with fewer resources.

Meanwhile, concern about a second wave has prompted a flurry of activity by federal, state and local officials in the United States.

Many experts suspect the second wave could be more severe than an average flu season, which hospitalises an estimated 200,000 Americans and contributes to 36,000 deaths. Because the virus is new, most people have no immunity against it.

The number of cases could increase rapidly as soon as schools begin to reopen in the next few weeks and could accelerate further as cooler, drier temperatures return, possibly peaking in October.

That is much earlier than the usual flu season, and it could create confusion. People could start getting sick with the H1N1 flu before a vaccine is widely available and nonetheless be urged to get vaccinated against the regular seasonal flu, which will be available first.


H1N1 Vaccines Not Expected Until Fall

Federal Officials Urge Preparedness

POSTED: 3:53 pm EDT August 10, 2009
UPDATED: 3:56 pm EDT August 10, 2009

BOSTON -- Federal health officials said Monday that it could be Thanksgiving before there is widespread protection from the H1N1 flu.

The prediction was based on the belief that the first batches of the vaccine will be available to the public in mid-October. Children, whom they said would be among the first to receive the vaccination, will require two doses, two weeks apart.

Centers for Disease Control and Prevention Director Dr. Thomas Frieden said given that timetable, he would not expect large numbers of the population to have immunity to the virus until approximately one month after the first dose is given.

Frieden said he believes “there will be plenty of vaccine” for everyone who wants to get the H1N1 shot to get it, but that the complete supply will not be available all at once.

Frieden and U.S. education secretary Arne Duncan held a conference call with reporters to brief the media on federal preparedness for the upcoming school year, which will begin before the H1N1 vaccine is available. There is growing concern that schools could become a hotbed for the virus to spread.

So far in Massachusetts, according to the Department of Public Health, there have been 1,383 confirmed cases of H1N1. Nearly half of all cases have involved children between the ages of 5 and 18.

That’s one reason why children 6 months and up will be first in line to receive the vaccine when it becomes available. So will pregnant women, health care workers, and people who care for infants under 6 months of age.

In Massachusetts, according to the DPH statistics, so far 51 of the confirmed H1N1 cases have been pregnant women. One hundred and seventy six of the 1,383 have required hospitalization and there have been 10 deaths attributed to the virus in the state.

The CDC recently released $260 million to states to prepare for the potential of widespread outbreaks this fall. Federal officials confirmed any decision to close specific schools would be made on a state or local level.

Even without a vaccine, the administration urged parents, students, teachers and members of the general public to follow three common sense steps to prevent the spread of the virus. They said if you’re sick, stay home until at least 24 hours after your fever is gone. Cover coughs and sneezes with a tissue, or cough and sneeze into your elbow. And third, they suggested everyone wash hands often.

Frieden said he does not expect side effects from the H1N1 vaccine to vary from those commonly seen after patients receive the seasonal flu vaccine, which, he said, 100 million Americans get every year.

Sunday, August 9, 2009

U.S. Homeland Security Secretary: H1N1 Flu will get jump on H1N1 Vaccine

August 9th, 2009 at 2:17 pm

Homeland Security Secretary Janet Napolitano said Tuesday that pandemic H1N1 flu probably will flare up soon after schools open at the end of August for this fall, before vaccine is available.

Napolitano also acknowledged that there would not be enough pandemic flu vaccine for everyone, at least in the early stages of the flu season. "There will be prioritization of vaccinations," she told members of the USA TODAY editorial board.

The flu strain causing the pandemic, a new H1N1 virus also known as swine flu, is especially dangerous because it differs from every other known flu virus. As a result, most people are defenseless against it. That makes a vaccine the keystone of any effort to prevent illness and save lives. The first batches of the vaccine are due in mid-October.

Napolitano said this year's flu season probably will be severe but not as severe as the 1918 pandemic, the world's worst. In 1918, flu killed at least 675,000 people in the USA and up to 50 million worldwide. She said it's more likely that the pandemic would mirror 1957, when flu killed about 70,000 people in the USA and 1 million to 2 million people worldwide, according to the Centers for Disease Control and Prevention.

About 36,000 people in the USA die and 200,000 are hospitalized in typical flu seaons.

William Schaffner, a flu expert at Vanderbilt University, cautions that "flu is fickle" and there's no way to predict precisely how the coming flu season will unfold. One difference between H1N1 flu and the 1957 version is that the new virus strikes a higher proportion of children and young people than the elderly. "If that holds, the group most vulnerable to the complications of influenza will continue to be spared," Schaffner says. "But H1N1 has a tremendous capacity to make children and young adults very sick."

Last week, a panel of experts advised the CDC that the first vaccinations should go to pregnant women; parents and contacts of children younger than 6 months; health care workers; all children and young adults; and all non-elderly adults with chronic medical conditions. The government recommends vaccinations for seasonal and swine flu.

WHO cautions against random purchase of antiviral drugs in India

The Daily
Srinagar, Aug 9

With the sudden rise in the frequency of pandemic H1N1 flu (Swine Flu) in India, World Health Organization Sunday issued a warning on the purchase of antiviral drugs without the prescription while four students with suspected Swine Flu symptoms were quarantined at Government Medical College Jammu.
“Two cases of suspected swine flu have been reported in Jammu,” said Medical Superintendent of GMC Jammu Ramesh Gupta.
He said the students - one studying in Bangalore and another in Pune, have been kept in isolation. “They had returned home to spend summer vacations here. One of them was staying in Kathua and the other at Nanak Nagar Jammu”.
“The blood samples of these suspects have been sent to Delhi,” Gupta added.
“Two more students checked into the hospital in similar condition and were quarantined by a special team of doctors,” Principal GMC hospital, Rajinder Singh told wire news agency.
Meanwhile, Communication Chief, UNICEF India Angela Walker while talking to Rising Kashmir over phone from New Delhi on behalf of WHO said, “WHO has advised people not to purchase medicines to fight or prevent influenza A (H1N1) unless prescribed by a health care practitioner in line with national pandemic influenza preparedness plans”.
“Testing has shown that the currently circulating influenza (H1N1) virus is sensitive to anti-virals such as Oseltmivir or Zanamivir, which are authorized in a number of WHO member States,” she informed.
The step, WHO India authorities say, has been taken as the widespread inappropriate use of these medicines could increase the risk of the virus developing resistance in them. “Antivirals should therefore only be purchased with a prescription from a health practitioner who has examined the patient,” Walker added.
The warning further says the products sold outside the authorized ‘national medicine supply chains’ should not be purchased. “Besides caution should be exercised in buying antivirals over the internet,” it said.
The warning further states that unlicensed and illegal internet pharmacies take orders and payments with no assurance of the medicines being delivered.
WHO had last month sounded an all-India alert saying that the pandemic can spread like never before in the coming flu seasons especially in tourist destinations all over India.
So far most of people, who have contracted the new influenza A (H1N1) virus have experienced influenza-like symptoms such as sore throat, cough, runny nose, fever, malaise, headache, joint/muscle pain.
WHO has issued following advice to those who experience flu-like symptoms:
. Stay home and avoid close contact with others until at least 24 hours after the symptoms are completely gone.
. Wash hands frequently and always cover his mouth and nose while coughing or sneezing.
. Wear a simple surgical mask when meeting others
. In case of severe symptoms like difficulty in breathing, pain or pressure in the chest abdomen, sudden dizziness confusion and severe or persistent vomiting, one should seek medical care immediately.

Int’l Swine Flu Conference Add More Breakout Sessions

Press Releases August 9th, 2009

Organizing Committee adds more sessions to conference as a result of delegates input

The International Swine Flu Conference organizing committee has responded to the needs of the ISFC delegates by adding more breakout sessions to the upcoming event. Sessions added include presentations on the school/university pandemic planning, continuity of operations (COOP) and government planning, Infectious Medical Waste, Psychological Issues and many more. ISFC will be held at the Hyatt Regency Washington DC on Capitol Hill, August 19-20 and will be followed by all day hands-on workshops on the 21st.

“Our delegates requested for more sessions at the conference and we responded,” said Ahmed Farajallah, Senior Vice President, events and conferences, New Fields. “Emergency Preparedness Leaders, Health and School Officials, Business, Public and Private sector Partners will have access to H1N1 Flu experts from around the world to address the issues of continuous planning for a possible severe outbreak of H1N1 flu this fall.”

The ongoing Swine Flu pandemic proved that now more than ever health, education, government, non-profit organizations, and business executives need to focus, discuss and share best practices and lessons that will be learned during this pandemic in the age of globalization.

With delegates from Tribal, local, state, federal along with 32 countries already registered, the ISFC will provide a platform for public health officials and community stakeholders to come together, to network and exchange preparedness and response efforts. Priority will be placed on identifying the responsibilities of various stakeholders in order to improve global communication coordination and collaboration.

Each day of the conference will offer papers on a wide range of topics including:
Preparing Community Strategies
Local Partnership and Participation
Delivery of Vaccine and Antiviral Medication
Emergency Response and Hospital/Healthcare Coordination
Prevention Education Efforts and Risk Communication
Command, Control and Management
Business Community’s Role

Panel Discussions include:
Clinical Picture: Country Report & Situation Update
Clinical Picture: Impact of US Export Regulations on International Cooperation in the H1N1 Pandemic Flu Response
Risk Communication, Prevention Education Efforts and Risk Communication
Understanding the Connection Between Human and Animal Disease, Exploring One World, One Health
Vaccines delivery

Over 20 breakout sessions will be offered addressing a wide range of issues, including:
Breakout- Agricultural Perspective: Socio-Economic Impact on Swine Industry
Breakout: Schools/University Planning: How and When to Close Schools
Breakout: Mass Fatality Management Planning
Breakout: Business Continuity Planning, “Pandemic Showstoppers: What leads to Success or Failure at the local Community level”
Breakout: School Emergency Preparedness
Breakout: Hospital and Emergency Medical Services
Breakout- COOP and Continuity of Gov’t Planning: “Gearing up for the Fall: Rapid Training & Exercises for Health Department Staff & Partners”
Breakout- Business Continuity: Preparing the Community for a Severe H1N1
Breakout- Business Continuity: Global Pandemic Planning at Visa
Breakout: Schools/University Planning: The Uniqueness of Planning for Swine Flu in Higher Education: We are Much Different than the k-12 System
Breakout: Prevention for Schools for Students, School Personnel, Parents and Communities
Breakout: Emergency Management: States Perspective and Strategy for Pandemic Influenza- Command, Control and Management
Breakout- Hospital & Emergency Medical Services: Impact of Swine Flu on Emergency Medical Services
Breakout- Community-Based Planning, Community Preparedness
Breakout: COOP & Continuity Govt Planning

And many more…

Workshops include:
Learn How to Plan – Contingency Scenario Exercise for Pandemic Influenza
Learn How to Plan
Protect your Community
Enhancing Pandemic Preparedness Through Volunteer Resources
Know How to Respond
Plan to Continue


The 2-day event is open to all interested governmental agencies, organizations, and businesses from all countries. To register, Call us at 202-536-5000, or download a registration form: Complete and fax to 202-280-1239.

Those interested in making presentations related to the Swine Flu or pandemic preparedness, please contact our research department by e-mail at Research {at} new-fields(.)com.

About New Fields:

The International Swine Flu Conference is organized by New Fields Exhibitions, Washington, DC, international specialists in public health and emergency planning events and disaster recovery conferences. For expedited registration and other information, contact 202-536-5000. To learn more about latest conference developments please visit:


New Fields Exhibitions, Inc.
Ahmed Farajallah

Egyptian authorities fear swine flu mutation

Martin Morris

on Sunday, 09 August 2009
SWINE FLU: Egyptian authorities fear H1N1 virus may combine with avian flu and mutate. (Getty Images)

Egyptian health authorities are concerned about the risk that the H1N1 swine flu virus and the much deadlier H5N1 avian flu virus could combine with seasonal human influenza.

Speaking to KUNA, Egyptian Minister of Health Hatem Al-Gabali said the bird and swine flu pose the same source of danger to human health.

The minister has urged all citizens to be vigilant and take seriously preventative measures designed to limit the spread of avian flu that has now become endemic in Egypt.

He added that Egypt had reported a total of 82 avian flu human cases since the virus first surfaced in the country, including 27 deaths - the highest rate in the world.

The Egyptian government has set in motion a preventive plan to curb the disease ahead of the school year, scheduled to start on September 26.

To date, 329 swine flu cases have been detected in Egypt so far, with just only death.
case, while 236 have recovered, and the remaining cases are still receiving medication at hospital.

The World Health Organization (WHO) has said that while the H1N1 virus was stable and there was no sign of it mixing with avian flu or other influenza viruses it has warned that the influenza virus is highly unpredictable and has potential for mutation.

Obama Heads to Summit as North America Braces for Swine Flu

By Roger Runningen and Nicholas Johnston

Aug. 9 (Bloomberg) -- President Barack Obama leaves today for a summit with his counterparts from Mexico and Canada as all three nations brace for a rebound of the deadly H1N1 swine flu, which may threaten cross-border commerce.

The two-day meeting in Guadalajara among Obama, Mexican President Felipe Calderon and Canadian Prime Minister Stephen Harper is to include talks on easing trade friction, dealing with the recession, battling drug crime and paving the way for climate talks later this year. A pressing topic is the return of the pandemic flu, which emerged in Mexico earlier this year.

“Everybody recognizes that H1N1 is going to be a challenge for all of us and there are going to be people getting sick in the fall and die,” John Brennan, Obama’s deputy national security adviser, said.

Officials are concerned that a widespread outbreak of the H1N1 virus as the regular flu season gets under way in the Northern Hemisphere’s fall may disrupt airline schedules and slow cross-border imports and exports.

All three countries still are being battered by the recession, and economics defines the relationship among them. Canada and Mexico are the U.S.’s first- and third-largest trading partners, generating more than $950 billion of imports and exports last year. Canada and Mexico account for 28 percent of all U.S. trade.

Common Strategy

At the North American Leaders Summit, Obama, 48, Calderon, 46, and Harper, 50, will focus on joint strategies for coordinating medical information, stockpiling vaccines and reviewing distribution plans to “minimize the impact and severity,” Brennan said at an Aug. 6 White House briefing.