Here are some of the colleges and universities in Upstate New York, and the latest information they have on their websites about Swine Flu. It is good to see that several of them have received the H1N1 vaccine and are distributing it.

• University at Buffalo (UB):
  

  So far, UB officials are aware of only a small number of cases of influenza-like illnesses on campuses—probably instances of swine flu, Raab says. Still, some offices are taking such precautions as cross-training employees and receiving briefings from information technology specialists on how staff can work and access files on UB servers from home.

• The College at Brockport:
  

  The number of Brockport students with influenza-like illness (10 today) reflect the general trend of increasing flu activity on campus and in the community. Information on vaccine clinics will be available as soon as we receive the vaccine, which is expected in the near future. Symptom severity is unchanged; mild to moderate illness. There have been no known hospitalizations. There have been no particular patterns regarding students’ residences or academic majors. Students who have symptoms of fever, cough and/or sore throat are requested to call the Student Health Center at 585.395.2414 to talk with a nurse.

• Houghton College:
  

  H1N1 remains the prominent circulating influenza strain, and continues to be a significant issue on many campuses. During the week of Oct 3–9 nearly 6,000 new cases of influenza like illness (ILI)—presumed to be H1N1—with 8 hospitalizations, were reported by 259 colleges across the country (ACHA surveillance data). While we have had a handful (or two) of people who have had symptoms consistent with ILI, so far no one on campus (that we are aware of) has tested positive for influenza.

  The Allegany County Department of Health will be on campus this Wednesday, October 21, between 1:30 and 5 p.m. to administer the H1N1 vaccine to all interested students age 24 and under, and to anyone else who meets CDC priority criteria. I strongly encourage you all to take advantage of this opportunity.

• SUNY College at Geneseo:
  

  It is important that we keep an accurate count of our students with Influenza-Like-Illnesses, so please keep us informed!

  SUNY Geneseo has a dedicated team of professionals who have been working closely together for several years to establish an effective plan for handling a pandemic flu outbreak. This team has been monitoring the recommendations of the CDC, WHO, State, and local government health departments to stay current on updated information regarding the HINI virus.

  Although the H1N1 influenza outbreak has not proven to be as severe as expected, Geneseo will continue to take additional precautions to prevent the spread of the flu as much as possible.

• University of Rochester:
  

  The University recorded its first case of influenza-like illness among students this semester on Sept 8th. Three new cases was identified today. The total number of cases identified is now 62. Five students are confined to their rooms at present.

  There are no changes to University of Rochester operations or activities because of public concern worldwide about novel H1N1 influenza.

• Rochester Institute of Technology:
  

  The RIT Student Health Center reported it treated five students with an influenza-like illness between Oct. 12 and Oct. 19. It is difficult to distinguish between seasonal and H1N1 flu. The center has advised these students to recover in their rooms. Students who are ill must self-isolate until they feel well and have had no fever for 24 hours (with out fever-reducing medicine).

• St. John Fisher College
• Elmira College:
  

  At this time there are no students or employees with confirmed cases of H1N1. However, due to the increase in reported Influenza-Like Illness cases in Chemung County and no further testing being done for confirmation of H1N1Flu unless a person is hospitalized, EPIC is initiating the Flu Protocol at this time. The information in the link below provides specific guidelines concerning how Elmira College will respond to the H1N1 Flu on our Campus. Included is a list of expectations of students, parents and employees.

• Syracuse University
• Cornell University:
  

  The first, limited, shipment of H1N1 influenza vaccine arrived at Gannett Health Services late on Friday, Oct. 16. Following CDC guidelines for situations in which vaccine supplies are limited, these initial doses will be targeted to STUDENTS at greatest risk of complications from the flu, including: those with underlying health conditions, those who are pregnant, and/or those who care for infants under 6 months old.

  There is no doubt that your vigilance and thoughtfulness are making a difference in reducing spread of the virus in our community. The number of students with H1N1 influenza has dropped dramatically since the early weeks of the semester. At Gannett, we have been diagnosing 5 to 10 students per day for the past couple of weeks (as compared to 50 to 100 during in early September). Levels of illness in the communities surrounding Cornell are also reported to be low.

Latest Upstate New York data

Local media nationwide have been reporting the cancellation of seasonal flu vaccine clinics as well as the limited availability of vaccine for the Swine Flu. The limited number of doses of vaccine for both types of influenza is due to several factors.

Dr. Ann Schuchat, the director of the National Center for Immunization and Respiratory Diseases, spoke to reporters on October 13. Several of the questions related to the short supply of seasonal influenza vaccine and the distribution of the Swine Flu vaccine. 77 million doses of seasonal vaccine have been distributed and nearly 10 million doses of Swine Flu vaccine were available for order.

For the rest of this article, please visit the Rochester Infectious Disease Examiner.

All military personnel will be vaccinated against the H1N1 flu virus, and the vaccine will be available to all military family members who want it, a Defense Department health affairs official said today.

The H1N1 vaccination program will begin in early October, said Army Lt. Col. (Dr.) Wayne Hachey, director of preventive medicine for Defense Department health affairs.

The vaccine, which has been licensed by the Food and Drug Administration, will be mandatory for uniformed personnel, the colonel said. “What we want to do is target those people who are at highest risk for transmission,” he said.

Health-care workers, deploying troops, those serving on ships and submarines, and new accessions are at the top of the list. “Any place where we take a lot of people, squash them all together and get them nice and close and put them under stressful conditions will get the vaccine first,” he said.

The department will use the usual seasonal flu vaccine distribution chain for the H1N1, Hachey said, noting that while the mass H1N1 vaccinations are new to the general population, the process for vaccinating against seasonal flu is old hat for the Defense Department. “We’ve been doing this for decades,” the colonel said. “The system is tried and true.”

The department initially will receive 1 million doses of the H1N1 vaccine, and another 1.7 million doses later in October.

Officials don’t know yet whether people will need one dose or two, Hachey said. “The assumption right now is that people will need two doses, 21 days apart,” he said. “That may change.”

FDA officials still are studying H1N1 and the vaccine, and the results should be known by the end of the month.

Seasonal flu vaccine already is available, and the Defense Department will begin giving those shots shortly, Hachey said. “That has been our message to immunizers: to try and get as many people as they can immunized against the seasonal flu early,” he said.

Guidelines for giving priority to family members will follow those for the general population, Hachey said. The Department of Health and Human Services is buying millions of doses of the vaccine.

“Installations are going to register with each state as an immunizer,” Hachey said. “They will tell how many people they care for. This includes dependents, retirees and so on.”

The Centers for Disease Control will place the order and will ship the vaccine where needed. Family members will have multiple opportunities to get the vaccine, whether at Defense Department medical facilities or off post, Hachey said.

The CDC has established target groups for those at greatest risk for transmitting or being affected by the H1N1. They include pregnant women, health-care workers, those younger than 25 or older than 65, and those with pre-existing health conditions.

Hachey said previous plans are serving the Defense Department well. “We have been preparing for pandemic flu because of its potential impact on the mission,” he said.

The symptoms of the H1N1 flu are almost the same as the seasonal flu: fever, sore throat, runny nose, nausea, muscle aches and feeling rundown. The 2009 H1N1 virus – formerly known as swine flu – is a pandemic virus, according to the World Health Organization. U.S. officials call the virus “troubling” and urge communities across the United States to take actions to mitigate the effects of it. The federal government is urging states and municipalities to begin preparing now for the fall flu season.

President Barack Obama addressed the H1N1 pandemic following a White House meeting today.

“As I said when we saw the first cases of this virus back in the spring, I don’t want anybody to be alarmed, but I do want everybody to be prepared,” he said. “We know that we usually get a second, larger wave of these flu viruses in the fall, and so response plans have been put in place across all levels of government.”

But government cannot do it all, and the American people have a responsibility to stop the spread of the disease, Obama said. “We need families and businesses to ensure that they have plans in place if a family member, a child or a co-worker contracts the flu and needs to stay home,” he said.

“And most importantly, we need everyone to get informed about individual risk factors, and we need everyone to take the common-sense steps that we know can make a difference,” the president said. “Stay home if you’re sick. Wash your hands frequently. Cover your sneezes with your sleeve, not your hands. And take all the necessary precautions to stay healthy. I know it sounds simple, but it’s important and it works.”

The H1N1 is a never-before-seen combination of human, swine and avian flu viruses, officials said. First detected in Mexico in February, it quickly spread around the world. According to July WHO statistics, there have been 94,512 H1N1 cases worldwide, and 429 people have died from it. In the United States, 33,902 contracted H1N1, and 170 have died.

DVIDS
Story by Jim Garamone

The World Health Organization has published the following, detailed explanation of the pandemic flu vaccine development process.

Pandemic (H1N1) 2009 briefing note 7

6 AUGUST 2009 | GENEVA — It takes approximately five to six months for the first supplies of approved vaccine to become available once a new strain of influenza virus with pandemic potential is identified and isolated. These months are needed because the process of producing a new vaccine involves many sequential steps, and each of these steps requires a certain amount of time to complete. The vaccine development process from start (obtaining a virus sample) to end (availability of vaccine for use) is summarized below.

Activities at WHO Collaborating Centers

1. Identification of a new virus: As part of a network set up for surveillance, laboratories around the world routinely collect samples of circulating influenza viruses and submit these to WHO Collaborating Centres for Reference and Research on Influenza for analysis. The first step towards the production of a pandemic vaccine starts when a Centre detects a novel influenza virus that differs significantly from circulating strains and reports this finding to WHO.

2. Preparation of the vaccine strain (called vaccine virus): The virus must first be adapted for use in manufacturing vaccine. To make the vaccine virus less dangerous and better able to grow in hen’s eggs (the production method used by most manufacturers), the virus is mixed with a standard laboratory virus strain and the two are allowed to grow together. After a while, a hybrid is formed which contains the inner components of the laboratory strain, and the outer components of the pandemic strain. It takes roughly three weeks to prepare the hybrid virus.

3. Verification of the vaccine strain: After its preparation, the hybrid virus needs to be tested to make sure that it truly produces the outer proteins of the pandemic strain, is safe and grows in eggs. Upon completion of this process, which takes roughly another three weeks, the vaccine strain is distributed to vaccine manufacturers.

4. Preparation of reagents to test the vaccine (with reference reagents): In parallel, WHO Collaborating Centres produce standardized substances (called reagents) that are given to all vaccine manufacturers to enable them to measure how much virus they are producing, and to ensure they are all packaging the correct dose of vaccine. This requires at least three months and often represents a bottleneck for manufacturers.

Activities at vaccine manufacturers

1. Optimization of virus growth conditions: The vaccine manufacturer takes the hybrid vaccine virus that it has received from the WHO laboratories, and tests different growth conditions in eggs to find the best conditions. This process requires roughly three weeks.

2. Vaccine bulk manufacture: For most influenza vaccine production, this is performed in nine to twelve-days old fertilized hen’s eggs. The vaccine virus is injected into thousands of eggs, and the eggs are then incubated for two to three days during which time the virus multiplies. The egg white, which now contains many millions of vaccine viruses, is then harvested, and the virus is separated from the egg white. The partially pure virus is killed with chemicals. The outer proteins of the virus are then purified and the result is several hundred or thousand liters of purified virus protein that is referred to as antigen, the active ingredient in the vaccine. Producing each batch, or lot, of antigen takes approximately two weeks, and a new batch can be started every few days. The size of the batch depends on how many eggs a manufacturer can obtain, inoculate and incubate. Another factor is the yield per egg. When one batch has been produced, the process is repeated as often as needed to generate the required amount of vaccine.

3. Quality control: This can only begin once the reagents for testing the vaccine are supplied by WHO laboratories, as described above. Each batch is tested and the sterility of bulk antigen is verified. This process takes two weeks.

4. Vaccine filling and release: The batch of vaccine is diluted to give the desired concentration of antigen, and put into vials or syringes, and labeled. A number of these are then tested:

• for sterility
• to confirm the protein concentration and
• for safety by testing in animals.

This process takes two weeks.

5. Clinical studies: In certain countries, each new influenza vaccine has to be tested in a few people to show that it performs as expected. This requires at least four weeks. In some countries this may not be required as many clinical trials were done with similar annual vaccine preparation, and the assumption is that the new pandemic vaccine will behave similarly.

Activities at regulatory agencies – regulatory approval

Before the vaccine can be sold or administered to people, regulatory approval is required. Each country has its own regulatory agency and rules. If the vaccine is made with the same processes as the seasonal influenza vaccine, and in the same manufacturing plant, this can be very rapid (one to two days). Regulatory agencies in some countries may require clinical testing before approving the vaccine, which adds to the time before the vaccine is available.

The full process, in a best case scenario, can be completed in five to six months. Then the first final pandemic vaccine lot would be available for distribution and use.

Key: The arrows with dotted lines preceded by non-broken arrows indicate the time period required for the first time an activity is done (non-broken arrow line) that is then repeated (dotted arrow line). The solid lines signify that the activity takes place within a finite period.

© Copyright World Health Organization (WHO), 2009. All Rights Reserved.

The WHO also offers these comments on vaccine safety:

Influenza vaccines have been used for more than 60 years and have an established record of safety in all age groups. While some serious adverse events have been reported, these have been rare.

Nonetheless, special safety issues will inevitably arise during a pandemic when vaccine is administered on a massive scale. For example, adverse events too rare to show up even in a large clinical trial may become apparent when very large numbers of people receive a pandemic vaccine.

Some adverse events will be coincidental – that is, associated in time with vaccine administration, yet not directly caused by the vaccine. Genuine adverse events directly caused by the vaccine may also occur, but cannot be predicted in advance. Given the safety record of seasonal vaccines, such events are expected to be rare.

Time constraints mean that clinical data at the time when pandemic vaccines are first administered will inevitably be limited. Further testing of safety and effectiveness will need to take place after administration of the vaccine has begun.