Biotechnology, Health and Business in Canada, the United States and Worldwide
Tag Archives: H1N1
This week’s Ontario Ministry of Health Influenza Bulletin shows continuing increases across all metrics. Clinic hours have expanded, and the definition of “high risk” groups entitled to be vaccinated has expanded. Also this week, the CDC reported a cumulative total of 4,000 swine flu deaths.
The Ontario numbers continue to look grim:
- Nine new institutional influenza outbreaks were reported
- 212 hospitalized cases were reported from October 28 to November 4 as compared to 104 from October 21 to October 28
- Seven deaths caused by H1N1 were reported from October 28 to November 4
Here’s the overall picture:
Ontario H1N1 Swine Flu Update October 31: All Indicators Still Increasing. 2 New Deaths, 10 Toronto Clinics
Checking out this week’s Influenza Bulletin, indications are that the Fall’s Swine Flu outbreak in Ontario is going to get worse before it gets better. Unfortunately, the vaccine is just starting to become available. This coming week, there will be 10 public clinics open in the greater Toronto area, but still only for those among the currently-eligible “high-risk” groups.
Sadly, two Ontarians died as a result of the virus this week. To date (pdf), including over the summer:
“Thirty deaths have been reported among confirmed cases. Almost all of these fatalities (26/28 or 87%) were hospitalized prior to death… Of the fatal cases, 73% (22/30) occurred in individuals over the age of 40 years… [and] 26 (87%) had underlying chronic medical conditions reported.”
So Evan Frustaglio is a very sad exception to the general rule.
Here’s some of this week’s data:
The graph below shows the total number of swine flu cases. The brown rising line on the left is the current situation (with 553 cases this week), and the green peak on the right is the data from the first swine flu wave this past summer.
This graph shows hospitalizations due to swine flu. It lags a bit because the relevant records have to wend their way into the relevant database, but you get the picture.
While you’re perusing those, note that vaccine is on the way. The message from Deb Matthews, Ontario’s Minister of Health and Long-Term Care is: “Get vaccinated when it’s your turn.”
First in line:
- People under 65 with chronic conditions;
- Pregnant women;
- Healthy children 6 months to under five years of age;
- People living in remote or isolated communities;
- Health care workers; and
- Household contacts and care providers of persons at high risk who cannot be immunized or may not respond to vaccines.
Here’s the data for new confirmed cases. The big bump is the summer’s wave, the rising bars on the right are where we are today.
Here’s a view of how this Fall stacks up historically. That early-riser on the left is 2009. Not encouraging. Wash your hands, and go get vaccinated. Then wash your hands again.
Prostate cancer and H1N1 updates…
Nanotechnology is Coming: A research study by a group of University of Toronto engineers, nanoscientists, and pharmaceutical specialists has garnered a lot of media attention this week describing the use of nanomaterials in microchip technology to create a highly sensitive biosensor. In the more technical report published in Nature Nantotechnology this week, they describe a special nanostructuring technique arranged in an array architechture to expand the dynamic range and sensitivity of the system for nucleic acid and protein biodetection. The microchip is small, fast, and super sensitive.
In an earlier publication in ACS Nano, they applied their nanotechnology to detect prostate cancer biomarkers. They demonstrated the accuracy, sensitivity and speed of the non-invasive test, which they are trying to package into a small hand-held device that can readily conduct testing at the point-of-care. Of course, the application of this technology goes far beyond prostate cancer and can be adapted to detect other cancer biomarkers, HIV and other diseases. Nanomaterial, nanotechnology, nanomedicine – these are hot words that you will hear about more frequently in the near future.
The research was lead by University of Toronto scientists, Drs. Shana Kelley and Ted Sargent. A spinoff company based on the molecular diagnostic platform, tentatively called GenEplex, is in the works with the support of the Ontario Institute for Cancer Research’s Intellectual Property Development and Commercialization Program. Also, the Ontario Genomics Institute is funding a microRNA application of the technology to the tune of almost $1 million.
In other prostate cancer research news:
Targeting IGF-1R: Researchers targeted the Insulin-like growth factor-1 receptor (IGF-1R) with antisense technology to suppress IGF-1R expression in prostate cancer cells. They found that by inhibiting IGF-1R signaling activity, the cancer cells grew more slowly but also increased their rate of cell death. This is the first preclinical proof-of-principal that antisense therapy targeting IGF-1R in prostate cancer may be a viable treatment route and warrants further investigation.
Fatty Acids Promote Prostate Cancer: The hormone androgen, and its androgen receptor partner, have been shown to contribute to prostate cancer progression. In this research report, researchers at the University of British Columibia suggest that elevated fatty acid (arachadonic acid) levels in the tumors may lead to increased activation of steroid hormone synthesis and contribute to the progression of the cancer. Therefore, they recommended that fatty acid pathways should also be targeted as part of a therapeutic approach to treating prostate cancer.
H1N1 Update: Following last week’s “seasonal flu vs. swine flu” vaccination story, the Public Health Agency of Canada reviewed their own data and soon declared their position on the yet unpublished study saying that “there is no link between having a seasonal flu shot and developing a severe bout of pandemic flu.” More to follow on this as the controversial study should become public next week.
In other H1N1 news:
Big Pharma gets Immunity: As increasing H1N1 cases emerge and Health Canada is being encouraged to expedite the approval of H1N1 vaccines, the Public Health Agency of Canada is following other countries in stating that they will protect GlaxoSmithKline, the maker of the vaccine, from any lawsuits arising from potential side effects.
Surgical Masks are Adequate: Healthcare workers should be encouraged by a study comparing standard surgical masks versus N95 respirator in protecting against flu viruses (swine included). In the randomized controlled study, conducted by flu expert Dr. Mark Loeb at McMaster University, 446 nurses from eight hospitals in Ontario were equally distributed to wear either sugical masks or fit-tested N95s. The results showed that there was an insignificant difference (23.6%, surgical mask vs. 22.9%, N95) in the number who contract the ‘flu’ during the course of the season. However, this study is sure to raise more debate within the healthcare community as unpublished work in China found that N95 masks can cut the risk of catching the flu virus by 75% while surgical masks offer no protective effect. Dr. Loeb’s study is published in the early edition of JAMA. A commentary on this issue is also provided by the U.S. Centers for Disease Control and Prevention.
Benefits of Handwashing? And if you are not confused enough about how to avoid catching the virus, consider this article in CMAJ questioning the benefits, due to lack of scientific evidence, of hand washing in preventiing the transmission of influenza viruses.
A quiet week for journal publications but there were a few significant research related activities…
Canadian Stem Cell Charter: At the recent World Stem Cell Summit in Baltimore, Canada stepped up and demonstrated why we are one of the leaders in stem cell research. This time it was not a lab discovery but the Canadian Stem Cell Foundation’s launch of a charter outlining ethical principals and a code of conduct to guide stem cell research in a responsible and ethical way.
The Stem Cell Charter upholds the following principles:
• Responsibility to maintain the highest level of scientific quality, safety and ethical probity
• Protection of citizens from harm and the safeguarding of the public trust and values
• Intellectual Freedom to exchange ideas in the spirit of international collaboration
• Transparency through the disclosure of results and of possible conflicts of interest
• Integrity in the promotion and advancement of stem cell research and therapy for the betterment
of the welfare of all human beings
Bartha Knoppers, a bioethicist at McGill University’s Centre of Genomics and Policy, authored the charter in collaboration with a working group of scientists, patients, ethicists and laypeople. She describes the purpose of the charter:
“There have been a lot of spurious claims in this area, people doing the first of this or the first of that, and it not being true,”
“It’s a wake-up call to scientists to remind them that if they want to work in this field, they have to do so under a scientific code of conduct and it’s to reassure the public that this is not the Wild West.”
“We’d like to keep it a credible science,”
“We’d like to keep it a science that merits public investment and public funding.”
Signing on (www.stemcellcharter.org) and adhering to the charter is one way of doing just that. It is also a way for the public to show their support for stem cell research and to make their voices heard.
By the way, September 23rd was Stem Cell Awareness Day!
The Michael J. Fox Foundation for Parkinson’s Research (MJFF): This was mentioned in yesterday’s post on this blog. Michael J. Fox announced the charity status of the Canadian arm of his MJFF for Parkinson’s Research in association with The McEwen Centre for Regenerative Medicine (MCRM) and Toronto Western Hospital (TWH). I just want to emphasize the significance from a research perspective. He is an advocate for stem cell based therapy and his Foundation promotes and emphasizes the sharing of scientific information to facilitate quicker results – “We don’t just fund research. We fund results.”
Flu shot increases risk of H1N1 virus: An unpublished Canadian study is garnering attention by suggesting that a seasonal flu shot may actually increase an individual’s chances of catching the H1N1 virus. The report is still under peer-review and the details are not available but it was enough for Ontario to modify its flu vaccination program this season. Younger people will not be offered the seasonal flu vaccine until they receive the H1N1 vaccine, which will not be available until mid-November. Other provinces are also considering making some changes to their programs.
The CDC and WHO are looking into this controversial study but are taking a cautious stance, refraining from acting too quickly:
“The reason why this may be different in Canada and in this particular study than in other places of the world is not yet identified. It may be a study bias, it may be that something is real,”
“None of the other countries have been able to find anything like that”
This enhancing effect would be unusual for flu viruses but not completely new from a biological perspective.
Dr. Danuta Skowronski of the British Columbia Centre for Disease Control and Dr. Gaston De Serres of Laval University led the research study.
Ontario’s update yesterday brought the total number of cases in the province to 1,562 with two deaths, both fatalities having been people with underlying medical conditions. The number of people hospitalized has increased from 6 to 10 since our last update (no word on the turn-over in that number), some of whom do and some of whom do not have underlying medical conditions.
Notably, the World Health Organization finally gave up the ghost today and declared Swine Flu to be a Phase 6 pandemic (duh), but made sure to note that it’s not severe:
“At this early stage, the pandemic can be characterized globally as being moderate in severity,” WHO said in the statement. A spokesman added that the term pandemic was “measure of the spread of the virus, not the severity of the virus.”
So we have a historic, but not too scary, announcement. I guess the delay allowed some desensitization to the idea of a Phase 6 pandemic declaration. Meanwhile, lest you slip from panicked straight to complacent, here are the Ontario stats:
Some leveling-off on new cases, maybe:
Although the press release goes out of it’s way to emphasize that almost all the cases are considered mild, there is an interesting tidbit here:
Six people who have the H1N1 flu virus were in hospital as of June 2, a number of whom have underlying medical conditions.
… implying that at least some of those hospitalized do not have underlying medical conditions — i.e., they actually have a fairly severe case of flu.
Here’s the Ontario data:
what’s that word again? Oh, right … exponential. Here’s the new case average count, which I’ve moved to a 7-day rolling average:
Keep carrying that sanitizer a little longer, I think.
Don’t worry, CSL, Health and Human Services still loves you. To the tune of a $180 million order for CSL’s H1N1 swine flu vaccine bulk antigen. HHS will also fund the clinical trials.
Ontario reported yesterday that:
A 44-year old Toronto man with a chronic pre-existing medical condition passed away on May 23rd. On May 24th laboratory testing confirmed a positive test for H1N1 in this individual. It is not clear what role the H1N1 virus played in the fatality which is now under investigation by the Office of the Chief Coroner.
Also, there were 58 new cases since the previous report on May 22, bringing the total to 352. Here’s how things have looked so far in Ontario, where we appear to be averaging about 15-18 new infections per day:
Also, the cumulative total:
Ontario reported 36 new cases of Swine Flu today. All cases are still considered mild, although one patient was hospitalized for unrelated reasons.
I thought this would be a good time to look back at the Ontario press releases and plot the number of new cases reported since Ontario started releasing numbers on April 28th. When I did that, the plot was very erratic, so I took a 3-day rolling average. Here it is:
We’ll see where this goes over the next few days.
- The World Health Organization met today, and held off on a decision about whether to shift from seasonal flu vaccine production to swine flu vaccine production, nevertheless
- various groups are working on preparing for swine flu vaccine production, and Nature has an interview with one of them — Doris Bucher at New York Medical College — who walks through the seed strain production method.
Ontario has reached a total of 110 confirmed human swine flu cases, all still considered mild. The age range is between 1 and 62. Canada reported its first swine flu fatality, an Alberta woman with asthma.
ScienceInsider has had outstanding coverage, and I’m adding their swine flu RSS feed to the sidebar on the right side of this page. Interesting extracts from today:
- Epidemiologist Neil Ferguson of Imperial College London estimates an R0 of about 1.5 (consistent with last week’s report).
- Based on available data, Ferguson estimates a case fatality rate of 0.4%, with a range between 0.3% and 1.5%. That’s far less than the 1918 pandemic, and likely to decrease as more mild cases (less likely to have been reported or tested early) are confirmed.
Also, Colbert had author Laurie Garrett on his show last week talking about the Swine Flu outbreak.
You can watch here from the U.S.: http://www.colbertnation.com/the-colbert-report-videos/226864/may-06-2009/laurie-garrett
And here from Canada: http://watch.thecomedynetwork.ca/the-colbert-report/full-episodes/may-6-2009/#clip169176
You may also apply a level of skepticism appropriate for listening to someone who has their own eponymous website.
Ontario confirms 13 new cases as of Wednesday afternoon, bringing the total to 49 in the province, all considered mild. A lot of the public health messaging over the last 48 hours has been advising people not to relax too much.
Today also saw an interesting Canadian development on the scientific front. Although commentary around the different numbers of flu deaths in Mexico versus other areas has included the possibility that there are genetic variations in the virus, genetic differences do not appear to be responsible. Researchers at the National Microbiology Lab in Winnipeg sequenced Mexican and Canadian isolates and found no significant differences. According to Dr. Frank Plummer, the chief science adviser of the national lab:
“Essentially, what it appears to suggest, is that there is nothing at the genetic level that differentiates this virus that we got from Mexico and those from Nova Scotia and Ontario, that explains apparent differences in disease severity between Mexico and Canada and the United States.”
Also, speaking of not relaxing too much, the FDA just announced that they have approved a new Sanofi Pasteur vaccine manufacturing facility in Swiftwater, PA.
There are five new confirmed cases in Ontario today, according to the press release following the 3pm call, bringing the total to 36.
Nature has a good scientific update, including the latest thinking on the basic reproductive rate, R0, “which is the number of new cases that an infected individual will give rise to,” and the generation time.
Here are our other (Canada-centric) posts on H1N1.
As testing capacity ramps up in Ontario, suspect cases are becoming confirmed cases at a rapid rate — 17 new confirmations from yesterday (and two being re-assessed) brings the total number of confirmed cases in Ontario to 31. The geographic and age range are both expanding, but all cases are reportedly still considered mild. Here’s the full press release.
Oh, and in case you didn’t catch this bit of weekend payback: pigs on an Alberta farm were infected with H1N1 by a farm worker returning from Mexico.
The WSJ Health Blog has a full global update.
A warning from Health Canada about various products you should not buy or take that claim to “to fight or prevent H1N1 flu virus.” Basically, there is no such thing as generic Tamiflu or Relenza approved in Canada. Don’t get swine-dled.
UPDATED Sunday: A press release from Dr. David Williams, Ontario’s Acting Chief Medical Officer of Health, confirms 2 new cases of Human Swine Flu (aka H1N1 Influenza, aka Grippe Porcine) in Ontario
today Sunday, bringing the total confirmed so far to 1416, with all reporting mild symptoms and recovering at home.
More from the press release:
The breakdown of the Ontario cases is as follows:
FiveSix men and nineten women
- Three are in York, six are in Durham, one is in Peel and
foursix are in
- The age range of the cases is
21 – 4021-49
- People returning from Mexico who have symptoms of respiratory illness should contact their health care provider or call TeleHealth Ontario at 1-866-797-0000.
- For general information on the human swine flu, call the ServiceOntario INFOline at 1-800-476-9708.
A lot to catch up on over the last few days…
- A professor in Hong Kong says don’t relax just because flu cases outside of Mexico have been mild — more spread equals more chances for further mutation.
- You think Biden had a bad public speaking week? Check this one out from the Environment Minister in Prince Edward Island.
- Obama’s health care reform may be coming just in time. The WSJ Health Blog reports on employers shifting more health care costs to employees.
- Unexpectedly, the biggest impact on science and health issues coming out of Senator Arlen Specter’s switch to the Democrats may be indirect — Sen. Grassley (R-IA) may move to take the top Republican spot on the Judiciary Committee, which is being vacated by Sen. Specter. If he does, Sen. Grassley will be giving up the post on the Finance Committee that he has been using to aggressively pursue issues he sees with pharma companies and the FDA.
- Michael Sabia wasted no time putting his mark on the Caisse, implementing structural changes and accelerating planned developments.
- Good news: adding Telapivir to Hep C treatments produces 69% cure rates.
- Stockwell Day, Canada’s Minister for International Trade, announced that Canada will be seeking new WTO “consultations” around the Country of Origin Labeling laws passed in the U.S. earlier this year, as we noted in March.
- Healthreform.gov has started weekly updates on … health reform.
And last but not least:
- The $825 million fund announced in Québec’s budget in March launched this week as Teralys Capital, closing on $700 million from FTQ, the Caisse and the Québec government. $125 million from private sources pending. Jacques Bernier will manage the fund, with a mandate to invest in Cleantech, Biotech and Infotech.
This is not good news. FierceBiotech says at least 16 of 57 dead in Mexico have been confirmed killed by swine flu and hundreds more have taken sick, and that “there is abundant evidence that the flu is being spread from person to person.”
The New York Times reports that the Mexico victims died from the same new strain of swine flu that sickened eight people in Texas and California.
Update and Resources:
- Here’s the transcript from this afternoon’s CDC call. New stuff will be on this Swine Flu CDC page or in their Media area.
- Here’s a Canadian Broadcasting Company story that notes the work being done at a national lab in Winnipeg to analyzing 51 samples from Mexico.
- Here’s today’s World Health Organization release.