'Unstoppable Swine flu' and how to deal with it

Health authorities worldwide are preparing for what the World Health Organisation (WHO) has termed the 'unstoppable' spread of the new A/H1N1 virus (swine flu) for which Dr. Margaret Chan, Director-General of WHO, says a vaccine will not be available for several months to come.

Health experts around the world have been surprised by the rapid spread of swine flu and many believe a more deadly form of the disease could yet appear.

A panel of WHO experts say in order to deal with the swine flu pandemic and lessen it's impact countries should adopt three different objectives as part of their pandemic vaccination strategy;

• protect the integrity of the health-care system and the country's critical infrastructure,
• reduce morbidity and mortality,
• and reduce transmission of the pandemic virus within communities.

The WHO says countries should use a variety of vaccine deployment strategies to achieve these objectives but any strategy should reflect the country’s epidemiological situation, resources and ability to access vaccine, to implement vaccination campaigns in the targeted groups, and to use other non-vaccine mitigation measures.

Experts say the severity of the pandemic is currently considered to be moderate with most patients experiencing uncomplicated, self-limited illness, but it's spread is unstoppable and all countries will need vaccines.

Dr. Chan says currently there is no vaccine and while one might be available in August, having a vaccine available is not the same as having a vaccine that has been proven safe and clinical trial data will not be ready for another two to three months.

The WHO says all countries should immunize their health-care workers as a first priority to protect the essential health infrastructure and then decide an order of priority based on specific conditions.

Some groups such as pregnant women and persons with asthma and other chronic conditions such as morbid obesity appear to be at increased risk for severe disease and death from infection and the WHO suggests that the following groups should be considered;

• pregnant women,
• those aged above 6 months with one of several chronic medical conditions,
• healthy young adults of 15 to 49 years of age,
• healthy children,
• healthy adults of 50 to 64 years of age,
• and healthy adults of 65 years of age and above.

As of yesterday, Australia has had 9,828 cases of swine flu including 20 deaths mostly in people with underlying health problems but a peak in swine flu infections is expected next month.

Australia's Chief Medical Officer Jim Bishop says the novel A/H1N1 virus had already placed many hospitals under pressure and is on track to match one of the worse bad flu seasons in 2007 and it is expected to peak next month.

Dr. Bishop says the expected spike in infection rates will have to be managed without the benefit of a vaccine, but once a vaccine becomes available, the entire population could potentially be immunised if one dose proved to be effective - if two doses were required, the government would prioritise the most needy and give the vaccine to 10.5 million Australians.

Dr. Bishop says the Australian population will be one of the first populations around the world where the vaccine is available.

An announcement is expected next week from Australian vaccine maker CSL signalling the start of its clinical trials but the Therapeutic Goods Administration (TGA) will have to give it's approval before the vaccine can be deemed safe for use in the general public.