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How bad is swine flu? Without numbers, who knows?

in.reuters.com

How bad is swine flu? Without numbers, who knows?

WASHINGTON  –  july 15 – Many people are confused about just how many patients have been infected with the new H1N1 flu, which in turn makes it hard to tell how bad the pandemic is, British researchers said on Tuesday.

But better methods of measuring the swine flu toll in real-time could help reduce some of that confusion, according to the team at Imperial College London.

And without this information, they said, governments are operating in the dark when assessing what their response should be.

“If you don’t test people, you don’t know how many people are out there who have it,” Dr. Tini Garske, an expert in disease modeling who led the study, said in a telephone interview. “The number of confirmed cases doesn’t tell you a lot.”

The World Health Organization has confirmed 94,512 cases globally and 429 deaths from the new H1N1 swine flu, which was declared a pandemic last month.

But these numbers represent only a fraction of the real cases — the U.S. Centers for Disease Control and Prevention says at least a million people have been infected and the virus is spreading out of control.

Most countries are now only testing a sample of patients, and many people who become infected are not ill enough to even seek medical attention, let alone get tested.

Diagnostic kits for H1N1 are expensive, and most governments save them for when they are really needed.

But if no one knows just how many people are infected overall, with serious disease and with mild disease, how can anyone say how severe the pandemic is?

DEATH RATES

Writing in the British Medical Journal, Garske and colleagues said current case fatality ratios — the number of deaths from swine flu divided by the total number of cases — is only around 0.5 percent. This is similar to the death rate from seasonal influenza, which kills anywhere between 250,000 and 500,000 people globally each year.

But Garske noted this varies greatly from country to country. Unlike seasonal flu, influenza H1N1 is causing severe illness in previously healthy young adults and children.

“Accurately predicting the severity of this swine flu pandemic is a very tricky business, and our research shows that this can only be achieved if data is collected according to well-designed study protocols and analyzed in a more sophisticated way than is frequently being performed at present,” Garske said.

“If we fail to get an accurate prediction of severity, we will not be providing healthcare planners, doctors and nurses, with the information that they need to ensure they are best prepared to fight the pandemic as we head into the flu season this autumn.”

Garske’s team outlined ways to improve estimates, including using individual towns as examples.

Watching families can also help give researchers an idea of how the flu spreads. If one sick family member infects one other family member, or two, or three, that number can be used to estimate the infection rate in places where cases are not being painstakingly diagnosed and recorded, she said.

“You don’t need to know about everybody, but you need some subpopulations,” she said.

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Britain “the most beautiful family”: three generations of four received the title of beauty queen

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The photo shows three generations of their elected “beauty queen” when the photo: From left to right in 1949 when Betty, in 1977 when Zoe and now Suzanne

Britain “the most beautiful family”: three generations of four received the title of beauty queen

25, according to British media reports, the British 82-year-old woman Betty. Spink three generations of a four (including her own, her 57-year-old twin daughters, Zoe and Guy, as well as 25-year-old granddaughter, Suzanne Sailun Su) has removal of “beauty queen” title, known as “Britain’s most beautiful family.”

According to reports, now 82-year-old Betty. Spink is the United Kingdom, West Yorkshire Kelaikexi Dayton City, in 1948, when he was 21 years of age the instigation of her husband, Neville, participants at a local beauty pageant competition, do not want to actually took first place and win any prize money £ 100. Later, Betty also participated in the “Isle of Man Miss” beauty contest, and won the title in one fell swoop; In addition, she was elected the “New Brighton Miss” beauty contest runner-up.

After the beauty out of the stage, Betty returned home to start a full-time housewives, and in 1952 with her husband birth to a pair of beautiful lovely twin daughters – Zoe, and Gay. But let Betty never dreamed that his “beauty queen” road actually from generation to generation.

In 1977, when he was 25-year-old Zoe in one fell swoop aspirations to, the “Miss” title, followed by British singer Elton John in person a national treasure for its Coronation “25 anniversary of the ladies,” the crown to commemorate the event organized by 25 anniversary. Zoe 25 minutes later when compared to identical twins born sister Gay, more than 20 years old, also won the title of beauty queen, its glamorous extent in comparison with the older sister said it was comparable.

70s of last century, which is “the sister of Britain’s most beautiful flower” has traveled around the world, and act as models, photographs, film, travel between countries among the social elite. Until both retired, the sisters formed their own separate family, plays a wife, mother, wife and mother role.

Betty, now 25-year-old granddaughter, Suzanne Sailun Su also inherited her “beautiful genes”, since four years ago for the first time to participate in beauty contests, Suzanne will be hopelessly hooked on T Taiwan walk catwalk. Outstanding record as a tennis player, she has a fit body and a tall blonde hair shawl. Even more remarkably, she also holds a master’s degree in Business, North Carolina State University. Suzanne has always been keen on environmental protection and small-animal rights advocacy work.

Began in August of this year’s “Miss United Kingdom Earth,” the competition, Susanna, downing, reached the final. That night, she wore a well-known by the British “green architect” Christine Spencer for its tailor-made “junk bags evening,” appears in many beauties in the maverick. In the end, voted by the general audience text messages, and she won one fell swoop of environmental protection the theme of the beauty contest queen title.

One went so far as three generations are “beauty queen”, Betty has been a British media described as “Britain’s most beautiful family.” According to Zoe said that they had a three generations become a “beauty queen” Obviously, thanks to their family in the blood flowing “beautiful genes.”

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Companies claim single-dose swine flu vaccine

chan

Companies claim single-dose swine flu vaccine

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ZURICH/BEIJING  – Novartis AG said on Thursday a single dose of its swine flu vaccine might protect against the virus, raising hopes that potentially tight supplies could go further when mass immunization starts this month.

Novartis said a single dose of the Celtura H1N1 vaccine, boosted with an immune-stimulating compound called an adjuvant, produced desired effects in 80 out of 100 volunteers.

The new H1N1 strain of flu, declared a pandemic on June 11, could eventually infect 2 billion people, according to World Health Organisation (WHO) estimates.

Because it is a new strain, infectious disease experts have said people will need two doses to get full immunity against the virus. They are rushing vaccine programmes as the weather cools in the Northern Hemisphere and the traditional flu season starts.

Chinese health authorities have given a green light to Sinovac, which says its vaccine needs only one shot to be effective.

“This is good news as one dose of Celtura may be sufficient to protect adults against the swine flu. This potentially boosts that availability of flu vaccines for the upcoming flu season when a large outbreak of swing flu is expected,” said Karl-Heinz Koch, an analyst at Swiss brokerage Helvea.

But health officials are cautious

“While we do not yet have full details, these appear to be encouraging results. Any vaccine which can be administered in one dose only will substantially increase the number of overall doses available to the world’s people,” said WHO spokesman Gregory Hartl.

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, noted that the Novartis vaccine uses the MF59 adjuvant, while the United States will only use vaccines without an adjuvant.

Cell-based vaccines like Novartis’s are quicker and easier to manufacture than traditional flu vaccines grown in chicken eggs. However, supplies are limited for now and currently make up about 30 percent of the Swiss group’s capacity.

Novartis said a pilot trial of Celtura run by Britain’s Leicester University with 100 volunteers showed a potentially protective immune response in 80 percent of patients after one dose and more than 90 percent after two doses. Other studies with 6,000 adults and children are continuing.

Sinovac, the first company to complete clinical trials, received approval from Chinese health authorities to mass produce a vaccine for the new strain of H1N1 and raised its annual sales forecast. Some experts remain sceptical, as Sinovac has not published data to back up its claims.

“We look forward to seeing the data from China and elsewhere about vaccine efficacy,” Frieden told reporters.

Sinovac shares rose some 16 percent to $9.90 by 1351 GMT, while Novartis slipped 0.8 percent to 48.62 Swiss francs, in line with the DJ Stoxx European healthcare sector.

WINDFALLS

Other pharmaceutical companies like Sanofi Aventis, GlaxoSmithKline and AstraZeneca’s MedImmune unit are also racing to develop H1N1 vaccine as governments scramble to secure supplies.

Clinical trials to see what kind of dose will be needed are under way in the United States, Australia and Europe. Australia’s CSL is already producing H1N1 vaccine and is making 1.0 million to 1.5 million doses per week until it fills all orders.

There is also high demand for antiviral drugs Relenza, from Glaxo, and Tamiflu, made by Switzerland’s Roche, which treat flu rather than immunizing against it. Sales to governments will provide a revenue and profit windfall for many drugmakers this year and in 2010.

“At the beginning of this year, we forecast our sales would rise by 20 percent,” Sinovac Chief Executive Yin Weidong said on Thursday. “Looking at things now, H1N1 has given us an opportunity, so the rise should be more than 20 percent.”

H1N1 vaccines would be given separately from regular seasonal flu shots.

(Reporting by Sam Cage and Lucy Hornby; Additional reporting by Emma Thomasson in Zurich, Stephanie Nebehay in Geneva and Ben Hirschler in London and Michael Perry in Sydney)

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