PA Medical News about Influenza A Virus, H1N1 Subtype Vaccines

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H1N1 Vaccine Production, Availability Increasing Slowly
American Family Physician, 11/02/09

Mitchell D et al. – Vaccine manufacturers are expected to fall well short of having 40 million doses of novel influenza A (H1N1) vaccine available by the end of October. The U.S. government has ordered 250 million doses of the H1N1 vaccine. 26.6 million doses of the vaccine have been made available, and production and distribution should increase dramatically during the next few weeks. Influenza–like illness accounts for 6.1 percent of doctors visits nationwide. She also said that as many as 20 percent of patients being hospitalized with H1N1 require intensive care. With the virus continuing to spread, President Obama signed a National Emergency Declaration on Oct. 24 that allows health care systems to implement disaster plans if they become overwhelmed. The declaration will allow health care facilities to submit waivers to establish alternate care sites and to modify patient triage protocols and patient transfer procedures. The Agency for Healthcare Research and Quality released two online tools to help emergency planners select and run alternate care sites.

The FDA announced Oct. 23 that it has issued an emergency use authorization for the investigational antiviral drug peramivir, which is administered intravenously, in certain adult and pediatric patients with confirmed or suspected novel influenza A (H1N1). Peramivir, a neuraminidase inhibitor manufactured by BioCryst Pharmaceuticals Inc., is an unapproved drug being evaluated in phase three clinical trials. The agency said that peramivir may be used for the following reasons in hospitalized patients:

the patient is not responding to either oral or inhaled antiviral therapy;
when drug delivery by a route other than an intravenous route – enteral or inhaled – is not expected to be dependable or feasible; or
for adults only, when the clinician judges intravenous therapy is appropriate because of other circumstances.