University of Missouri researchers have found evidence that some over-the-counter drugs

“If you’re taking aspirin regularly, which many people do for cardiovascular treatment, or acetaminophen (Tylenol) for pain and fever and get a flu shot,there is a good chance that you won’t have a good antibody response,” said Charles Brown, associate professor of veterinary pathobiologyin the MU College of Veterinary Medicine. “These drugs block the enzyme COX-1, which works in tissues throughout the body. We have found that if you block COX-1, you might be decreasing the amount of antibodies your body is producing, and you need high amounts of antibodies to be protected.”

COX enzymes play important roles in the regulation of the immune system. The role of these enzymes is not yet understood completely, and medications that inhibit them may have adverse side effects. Recent research has discovered that drugs that inhibit COX enzymes, such as COX-2, have an impact on the effectiveness of vaccines. Brown’s research indicates that inhibiting COX-1, which is present in tissues throughout the body, such as the brain or kidneys, could also impact vaccines’ effectiveness.

These MU researchers also are studying the regulation of inflammation and how that leads to the development or prevention of disease. Many diseases, such as arthritis, cardiovascular disease and diabetes, are all chronic inflammatory diseases. Contrary to previous beliefs, inflammation is generally a good thing that helps protect individuals from infection. Many of the non-steroidal drugs that treat inflammatory conditions reduce antibody responses, which are necessary for treating infections.

“So far, we’ve tested this on an animal model and have found that these non-steroidal drugs do inhibit vaccines, but the next step is to test it on humans,” Brown said. “If our results show that COX-1 inhibitors affect vaccines, the takeaway might be to not take drugs, such as aspirin, Tylenol and ibuprofen, for a couple weeks before and after you get a vaccine.”

Officials also said they were investigating several troubling outbreaks of drug-resistant H1N1 but noted they were limited so far and that there were no indications yet the virus was mutating in a sustained way.

The World Health Organization said H1N1 flu was moving eastward across Europe and Asia after appearing to peak in parts of Western Europe and the United States.

At least 6,770 deaths have been recorded worldwide since the swine flu virus emerged in April — but officials always stress the confirmed count represents only a fraction of the actual cases, as most patients never get tested.

There are “early signs of a peak in disease activity in some areas of the northern hemisphere,” the WHO said in a statement.

Transmission keeps intensifying in Canada, with the highest number of doctor visits by children. But U.S. officials saw signs of a slowdown.

“We are beginning to see some declines in flu activity around the country but there is still a lot of influenza,” the Centers for Disease Control and Prevention’s Dr. Anne Schuchat told a news conference.

“It is still much greater than we would normally see this time of year.”

Recent decline in cases
A team at flu test maker Quest Diagnostics analyzed 142,000 U.S. flu tests and found a similar pattern, with tests showing a decline in flu-like illness since October 27.

WHO said Norway and countries farther east including Georgia, Lithuania, Moldova and Serbia were reporting sharp increases in influenza-like illness or acute respiratory infection.

Kazakhstan, Uzbekistan and parts of Afghanistan — particularly the capital, Kabul — are reporting higher numbers of flu cases. Israel is also reporting sharp increases.

“Essentially what is happening is that it is spreading eastward,” Anthony Mounts of WHO’s influenza team told Reuters. “Typically, seasonal influenza always starts west and moves eastward. It seems to be following that pattern except it is coming very early this year.”

Influenza can hit several peaks in a single season. Experts said weeks or months more of disease could be expected and noted that during the 1957 pandemic, a busy autumn was followed by a lull and then infections surged again starting in January.

Vaccination campaigns are beginning in many countries but companies reported some trouble making vaccine from the H1N1 virus. The United States was still struggling to distribute vaccines but Canadian Health Minister Leona Aglukkaq said enough vaccine for almost half of Canada’s population would have been shipped out by the end of the next week.

Mutant viruses
British health officials said they were investigating the likely person-to-person spread of a drug-resistant strain of swine flu.

The Health Protection Agency reported five confirmed cases in Wales of patients infected with H1N1 resistant Roche AG and Gilead Sciences Inc’s antiviral drug Tamiflu.

Another antiviral, GlaxoSmithKline and Biota Inc’s Relenza, were effective in the patients, the HPA said.

The patients had serious conditions that suppressed their immune systems, which can give the virus a better than usual opportunity to develop resistance, the HPA added.

U.S. CDC officials also said they were investigating four cases of H1N1 resistant to Tamiflu at Duke University hospital in North Carolina. “All four patients were very ill with underlying severely compromised immune systems and multiple other complex medical conditions,” Duke said in a statement.

Health experts are looking for any sign that H1N1 is mutating into a drug-resistant form. Last year, the seasonal version of H1N1, a distant cousin of the pandemic strain, developed resistance to Tamiflu.

In Norway, officials were investigating a mutated strain in some patients that they said could be responsible for causing severe symptoms.

“The mutation could be affecting the virus’ ability to go deeper into the respiratory system, thus causing more serious illness,” the Norwegian Institute of Public Health said in a statement.

WHO said the mutation did not appear to be widespread in Norway and the virus remained sensitive to antivirals and pandemic vaccines.

A similar mutation had been detected in H1N1 viruses in several other countries, including China and the United States, in severe as well as in some mild cases, it said.

But the Opinion Research Corporation survey, released Tuesday morning, indicates a small majority continue to say that the government and private industry eventually will produce enough of the vaccine for the virus, also known as swine flu, to inoculate everyone who wants it.

According to the poll, 51 percent of those questioned are confident in the government’s ability to prevent an H1N1 epidemic, with 49 percent not confident. The number of Americans who are confident is down 8 percentage points from August, while the number of those not confident is up 9 percentage points.

“Only one in 10 say they are ‘very confident’ that the government can ward off an epidemic,” says CNN Polling Director Keating Holland. “But the growing doubts may not be directly related to the shortfall of vaccine so far.”

Fifty-three percent of those questioned say that government and private industry can produce enough vaccine for everyone who wants a swine flue shot. That number is essentially unchanged since August.

The poll indicates that one group in particular is skeptical about the government’s efforts to battle swine flu.

“Only 43 percent of mothers with children under the age of 18 are confident in the government’s ability to prevent an epidemic,” says Holland. “That’s 7 points lower than fathers and 10 points lower than people who don’t have young children. Mothers are also most likely to think that there will not be enough vaccine to go around.”

According to the poll, 57 percent approve of how President Obama’s handling the government’s response to H1N1, with 4 in 10 saying they disapprove.

The CNN/Opinion Research Corporation poll was conducted October 30 through November 1, with 1,018 adult Americans questioned by telephone. The survey’s sampling error is plus or minus 3 percentage points for the overall sample.

Federal health officials report that the swine flu remains widespread in 48 states but add that the supply of vaccine has reached 32 million doses, double what was available two weeks ago.

Sources: cnn.com

Why bother, asks Dr. John Cmar, an infectious disease expert with Baltimore’s Sinai Hospital. “Washing with water alone does not get rid of microbes – the action of working up a lather with soap, and then rinsing it off, is what washes them away. Plus, by touching the sink faucet – one of the dirtiest things in a restroom – these people could be adding even more germs to their hands,” he says.
The study also found that people are washing their hands more often because of concern about the H1N1 “swine flu” virus. Nearly 8 out of 10 adults surveyed claim to wash their hands more frequently or thoroughly to avoid getting sick.

Proper and frequent hand-washing is said to be one of the most important things you can do to avoid the flu and other viruses.

Nutritional supplements containing vitamin C, vitamin D, zinc, echinacea and probiotics have also been shown to help boost immunity.

The 28 women who died were among about 100 pregnant women who required intensive care because of severe H1N1 swine flu disease.

“Doctors around the country have never seen this kind of thing before,” CDC respiratory disease chief Anne Schuchat, MD, said today at a news conference. “What we are seeing is quite striking.”

The CDC has never before tracked the impact of flu on pregnant women. Although flu is a known risk both to a pregnant woman and to her fetus, it’s not known for sure that H1N1 swine flu is any worse.

But that’s the impression doctors are getting. Schuchat said that obstetricians at the CDC are in close contact with colleagues across the country.

“The obstetric caregivers here and the ones they are speaking with have rarely seen this kind of thing in practice,” Schuchat said. “It has been very unusual.”

Fortunately, there’s a lot pregnant women can do.

Even though pregnant women are advised to avoid many medications, the flu drug Tamiflu is safe for pregnant women — and should be given to them at the first sign of flu symptoms.

“Antiviral medicine can be a very important treatment for pregnant women who have respiratory symptoms or influenza-like illness,” Schuchat said.

Moreover, the H1N1 swine flu vaccine and the seasonal flu vaccine — the kinds that are given as a shot, not the kind given as a nasal spray — are safe for use during pregnancy. Obstetricians and nurse midwives are urged to play a role.

“As the vaccine becomes available in appropriate formulations, we hope pregnant women and their caregivers will be taking advantage of it,” Schuchat said. “We encourage caregivers to either vaccinate pregnant women or refer them to a place they can be vaccinated.”

In the Canadian version of the vaccine, Health Canada has chosen to include an adjuvant. It is a substance that will increase the immunological response to antigens. As a result, this will slow its use but allow more people to be immunized. The use of an adjuvant requires a more careful review compared to a vaccine without an adjuvant.

Dr. Paul Hebert, Editor-in-Chief and Dr. Noni Macdonald, Senior Editor, Public Health at CMAJ recommend providing the vaccine without adjuvant to high-risk groups to facilitate quick vaccination. The US and Europe will follow this similar approach. The rest of the population can comply with the slower method with an adjuvant vaccine.

“Time is running out,” they write. “Only by providing fast-track standard vaccine can high-risk groups be protected in a timely way, while the general public awaits the arrival of the adjuvant vaccine.”

Written by Stephanie Brunner (B.A.)
Copyright: Medical News Today