Native Americans at higher risk from H1N1 swine flu, report warns

President Obama’s advisory council led by the nations’ leading scientists and engineers released a report assessing preparations for H1N1 Influenza A. The report outlined steps to implement nationwide to curtail a serious H1N1 outbreak.

It said that while the precise impact of the resurgence of H1N1 infection is impossible to predict, a plausible scenario is that it could produce infection in 30 to 50 percent of the U.S. population this fall and winter.

And it said that certain populations including Native American groups are considered high risk, with elevated risks of severe outcomes.

The report said it is unlikely that the 2009-H1N1 pandemic will reach the same deadly proportions as happened in the 1918-1920 Spanish flu, also an H1N1 swine flu, but that the outbreak of 2009-H1N1 will be more dangerous than the 1976 swine flu outbreak.

The seriousness of H1N1 is not due to it’s severity but rather the fact that people have no immunity to the virus. The report indicates the possibility that overwhelming numbers of people could become infected, and that mortality could reach 30,000 to 90,000.

Dr. James Cheek, director of the Indian Health Service Division of Epidemiology and Disease Prevention said the IHS is doing much the same as are the Centers for Disease Control and Prevention, like identifying which people are at risk.

"We’ve been in the field the last month and a half, spending a lot of time with the over 200 hospitalized cases among Native Americans in Arizona," Cheek said. "They’re confirmed respiratory disease cases though not 100 percent confirmed H1N1 cases. We’re testing the blood of those who have recovered to see if it was H1N1. " He said the IHS hasn't received additional funding to fight H1N1.

Federal health officials recently announced $350 million in national grants to fight H1N1, but that money is going to states and hospitals, not to the federally recognized tribes, prompting the National Indian Health Board to cite this policy as making reservation communities increasingly vulnerable to epidemics.

An internal document produced by the CDC says a disadvantage of the Public Health Emergency Response grant is that it doesn’t allow enough time for local and tribal concurrence, but instead uses alternative strong language that asks that most or a significant amount of funding should go to local and tribal efforts.

This grant is a little different in that by using the states as a conduit the money is available very fast for communities to use, CDC spokesman Von Roebuck said. “We’re trying to work within the system, and we’re definitely running against the clock.”

Roebuck said the CDC has asked the state health departments to reach out to all local and tribal communities to provide them information about how this funding could be used, and asks that tribal governments provide the states information as to how they could use that funding and why they deserve the highest priority.

“As we learn more about the virus we’ll continue to reach out based on the science into where we feel that it is going to get the most information out to populations,” Roebuck said. “Protecting as many folks and as many locations is definitely our goal.”

Cheek said the IHS as a great record of providing vaccinations, and that their vaccination machine "is geared up to deliver the new H1N1 vaccine to all our populations the minute we get them."

Detailed guide to caring for flu stricken family without getting sick

A recent survey in a medical journal found that 76 percent of Americans worry about becoming ill if they have to stay home and take care of their sick during a severe flu pandemic.

Pandemic Flu Home Care: A Detailed Guide for Caring for the Ill at Home is a practical resource manual by health care professionals to caring for the ill at home in a public health emergency or pandemic. It’s free to download at http://www.pandemichomecare.com/.

The authors took on the project after citizens at local and regional pandemic planning meetings – including one with tribal representatives from the New Mexico area – asked for information about how to take care of themselves and their families during a severe pandemic.

In their review of existing resources, they found that most materials covered primarily mild symptom management and recommended that people contact physicians and hospitals when symptoms were more severe. But their historical review and current analyses of health care systems determined that people may have to manage severe symptoms and death at home if a virulent influenza outbreak is widespread.

“Existing resources lacked instructions on infection prevention, setting up a sick room, how to monitor a sick child or adult by taking a temperature with a thermometer, preventing dehydration, keeping the person comfortable and knowing when to contact a health care provider if one is available,” said co-author Sandra L. Schwanberg, Ph.D., R.N.

The authors decided that the more detailed information people had the better their coping would be in a changing situation. They also wanted to cover the key public health information people were likely to see in the news; infectious disease transmission, severity, reasons for vaccination, isolation of the sick and possible quarantine of those exposed to the disease.

“We took the same care in writing the book for the public that we would take in preparing information for a professional audience,” Schwanberg said. “We felt that if people had thorough information, they could cope effectively with a difficult situation and make good decisions for themselves and their families.”

The book took Schwanberg and co-authors Maurine Renville, L.I.S.W., M.Ed, and Lesley J. Mortimer, M.S.N., M.P.H., F.N.P., nine months to write, review and edit. Lay people and health care professionals reviewed the work throughout the process. There was a charge for the book until April 2009, when the U.S. declared a public health emergency.

Their goal now is to locate fiscal sponsors to increase the book’s distribution, provide more illustrations and include coloring books for kids, DVDs and games. They’ve translated the entire book into Spanish, and illustrations are complete for one chapter.

It’s distribution includes acute care facilities, public health centers, churches, businesses, tribal nations and other groups. It is also a resource for doctors, nurses, paramedics and community health workers.

“We wanted people to have information that hopefully they will never have the need to use,” Schwanberg said.

If you have a problem downloading the eBook contact info@pandemichomecare.com for assistance, or ask that they send you the pdf file to copy and print.

CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices met today to make recommendations for use of vaccine against novel influenza A (H1N1).

The committee met to develop recommendations on who should receive vaccine against novel influenza A (H1N1) when it becomes available, and to determine which groups of the population should be prioritized if the vaccine is initially available in extremely limited quantities.

The committee recommended the vaccination efforts focus on five key populations. Vaccination efforts are designed to help reduce the impact and spread of novel H1N1. The key populations include those who are at higher risk of disease or complications, those who are likely to come in contact with novel H1N1, and those who could infect young infants.

When vaccine is first available, the committee recommended that programs and providers try to vaccinate: pregnant women, people who live with or care for children younger than 6 months of age, health care and emergency services personnel, persons between the ages of 6 months hrough 24 years of age, and people from ages 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.

The groups listed above total approximately 159 million people in the United States. The committee does not expect that there will be a shortage of novel H1N1 vaccine, but availability and demand can be unpredictable. There is some possibility that initially the vaccine will be available in limited quantities. In this setting, the committee recommended that the following groups receive the vaccine before others: pregnant women, people who live with or care for children younger than 6 months of age, health care and emergency services personnel with direct patient contact, children 6 months through 4 years of age, and children 5 through 18 years of age who have chronic medical conditions.

The committee recognized the need to assess supply and demand issues at the local level. The committee further recommended that once the demand for vaccine for these prioritized groups has been met at the local level, programs and providers should begin vaccinating everyone from ages 25 through 64 years. Current studies indicate the risk for infection among persons age 65 or older is less than the risk for younger age groups. Therefore, as vaccine supply and demand for vaccine among younger age groups is being met, programs and providers should offer vaccination to people over the age of 65.

The committee also stressed that people over the age of 65 receive the seasonal vaccine as soon as it is available. Even if novel H1N1 vaccine is initially only available in limited quantities, supply and availability will continue, so the committee stressed that programs and providers continue to vaccinate unimmunized patients and not keep vaccine in reserve for later administration of the second dose.

The novel H1N1 vaccine is not intended to replace the seasonal flu vaccine. It is intended to be used alongside seasonal flu vaccine to protect people. Seasonal flu and novel H1N1 vaccines may be administered on the same day.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Having one less child dramatically reduces your CO2, new study finds

People serious about wanting to reduce their “carbon footprint” on the Earth have one choice available to them that may yield a large long-term benefit – have one less child.

A study by statisticians at Oregon State University concluded that in the United States, the carbon legacy and greenhouse gas impact of an extra child is almost 20 times more important than some of the other environmentally sensitive practices people might employ their entire lives – things like driving a high mileage car, recycling, or using energy-efficient appliances and light bulbs.

The research also makes it clear that potential carbon impacts vary dramatically across countries. The average long-term carbon impact of a child born in the U.S. – along with all of its descendants – is more than 160 times the impact of a child born in Bangladesh.

“In discussions about climate change, we tend to focus on the carbon emissions of an individual over his or her lifetime,” said Paul Murtaugh, an OSU professor of statistics. “Those are important issues and it’s essential that they should be considered. But an added challenge facing us is continuing population growth and increasing global consumption of resources.”

In this debate, very little attention has been given to the overwhelming importance of reproductive choice, Murtaugh said. When an individual produces a child – and that child potentially produces more descendants in the future – the effect on the environment can be many times the impact produced by a person during their lifetime.

Under current conditions in the U.S., for instance, each child ultimately adds about 9,441 metric tons of carbon dioxide to the carbon legacy of an average parent – about 5.7 times the lifetime emissions for which, on average, a person is responsible.

And even though some developing nations have much higher populations and rates of population growth than the U.S., their overall impact on the global equation is often reduced by shorter life spans and less consumption. The long-term impact of a child born to a family in China is less than one fifth the impact of a child born in the U.S., the study found.

As the developing world increases both its population and consumption levels, this may change.
“China and India right now are steadily increasing their carbon emissions and industrial development, and other developing nations may also continue to increase as they seek higher standards of living,” Murtaugh said.

The study examined several scenarios of changing emission rates, the most aggressive of which was an 85 percent reduction in global carbon emissions between now and 2100. But emissions in Africa, which includes 34 of the 50 least developed countries in the world, are already more than twice that level.

The researchers make it clear they are not advocating government controls or intervention on population issues, but say they simply want to make people aware of the environmental consequences of their reproductive choices.

“Many people are unaware of the power of exponential population growth,” Murtaugh said.

“Future growth amplifies the consequences of people’s reproductive choices today, the same way that compound interest amplifies a bank balance.”

Murtaugh noted that their calculations are relevant to other environmental impacts besides carbon emissions – for example, the consumption of fresh water, which many feel is already in short supply.

OSU PRESS RELEASE July 31, 2009.

About the OSU College of Science: As one of the largest academic units at OSU, the College of Science has 14 departments and programs, 13 pre-professional programs, and provides the basic science courses essential to the education of every OSU student. Its faculty are international leaders in scientific research.