Aanbevelingen WHO over mogelijke vaccinatie Mexicaanse griep

Op 13 juli gaf de WHO deze aanbevelingen uit over terughoudendheid met vaccineren tegen de Mexicaanse friep (Varkensgriep):

Pandemic (H1N1) 2009 briefing note 2

WHO recommendations on pandemic (H1N1) 2009 vaccines
(13 JULY 2009 GENEVA)

On 7 July 2009, the Strategic Advisory Group of Experts (SAGE) on Immunization held an extraordinary meeting in Geneva to discuss issues and make recommendations related to vaccine for the pandemic (H1N1) 2009.

SAGE reviewed the current pandemic situation, the current status of seasonal vaccine production and potential A(H1N1) vaccine production capacity, and considered potential options for vaccine use.

The experts identified three different objectives that countries could adopt 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.

Countries could use a variety of vaccine deployment strategies to reach 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.

Although the severity of the pandemic is currently considered to be moderate with most patients experiencing uncomplicated, self-limited illness, 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.

Since the spread of the pandemic virus is considered unstoppable, vaccine will be needed in all countries. SAGE emphasized the importance of striving to achieve equity among countries to access vaccines developed in response to the pandemic (H1N1) 2009

***The following recommendations were provided to the WHO Director-General:

All countries should immunize their health-care workers as a first priority to protect the essential health infrastructure. As vaccines available initially will not be sufficient, a step-wise approach to vaccinate particular groups may be considered. SAGE suggested the following groups for consideration, noting that countries need to determine their order of priority based on country-specific conditions: 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.

Since new technologies are involved in the production of some pandemic vaccines, which have not yet been extensively evaluated for their safety in certain population groups, it is very important to implement post-marketing surveillance of the highest possible quality. In addition, rapid sharing of the results of immunogenicity and post-marketing safety and effectiveness studies among the international community will be essential for allowing countries to make necessary adjustments to their vaccination policies.

In view of the anticipated limited vaccine availability at global level and the potential need to protect against "drifted" strains of virus, SAGE recommended that promoting production and use of vaccines such as those that are formulated with oil-in-water adjuvants and live attenuated influenza vaccines was important.

As most of the production of the seasonal vaccine for the 2009-2010 influenza season in the northern hemisphere is almost complete and is therefore unlikely to affect production of pandemic vaccine, SAGE did not consider that there was a need to recommend a "switch" from seasonal to pandemic vaccine production.

WHO Director-General Dr Margaret Chan endorsed the above recommendations on 11 July 2009, recognizing that they were well adapted to the current pandemic situation. She also noted that the recommendations will need to be changed if and when new evidence become available.

SAGE was established by the WHO Director-General in 1999 as the principal advisory group to WHO for vaccines and immunization. It comprises 15 members who serve in their personal capacity and represent a broad range of disciplines from around the world in the fields such as epidemiology, public health, vaccinology, paediatrics, internal medicine, infectious diseases, immunology, drug regulation, programme management, immunization delivery, and health-care administration.

Additional participants in the SAGE meeting included members of the ad hoc policy advisory working group on influenza A(H1N1) vaccine, chairs of the regional technical advisory groups and external experts. Observers included industry representatives and regulators who did not take part in the recommendation process in order to avoid conflicts of interest.

Mexicaanse griep verspreidt zich verder

Het Chinese persbureau Xinhua geeft enkele updates voor de Mexicaanse griep:

U.S. deaths from A/H1N1 flu rise to 302, infections near 44,000

Japan's tally of A/H1N1 infections tops 5,000

Canada approves Tamiflu for babies under one year old

Death toll of A/H1N1 flu in Canada rises to 55


Laatste bericht van de WHO:

DEATH TOLL FROM INFLUENZA OUTBREAK NEARS 800, UN HEALTH AGENCY SAYS (UN: New York: July 24, 2009)

Influenza A(H1N1) is continuing to spread through all corners of the world, the United Nations World Health Organization (WHO) reported today, putting the global death toll from the pandemic at around 800.

Some 160 countries and territories have now reported laboratory-confirmed cases of the virus, but how it could potentially change over the coming weeks is still unknown, WHO spokesperson Gregory Hartl told reporters in Geneva.

Although five isolated cases of anti-viral resistance have been reported, no changes to the virus’ behaviour have been detected for now, he added.

Mr. Hartl warned that A(H1N1) is expected to increase this winter in the Northern Hemisphere due to the colder weather, but he underscored that WHO cannot predict the death toll over the coming months.

The highest percentages of deaths from the pandemic are among adolescents and young adults, he said, mostly likely because it spreads more quickly in schools and institutions.

On vaccines against A(H1N1), the spokesperson said that each manufacturer is working at their own pace, with clinical trials only having been started recently.

But WHO still expects the first doses to be ready by early fall in the Northern Hemisphere, he added.

Two manufacturers have guaranteed that 150 million doses will be made available, and the agency is pressing other partners to secure more doses, Mr. Hartl noted.

WHO plans to send the bulk of them to the least developed countries, with health-care workers, who work on the frontlines and are the most exposed to the virus, to be given priority.

Last month, the agency raised the alert level for A(H1N1) to Phase 6, the highest on its pandemic alert scale.

However, it stressed that Phase 6 refers to the spread of the virus and not its severity, and that the upgrade means that sustained human-to-human transmission of the virus has spread beyond North America, where it was initially concentrated.

Robots in de zorgverlening verwacht

Binnen twee jaar is het waarschijnlijk zover: extra handen aan het bed in de Nederlandse ziekenhuizen. Geen mensenhanden, maar stevige robotarmen die te hulp schieten bij de verzorging van patiënten in ziekenhuizen maar ook in de bejaardenverzorging.

In Japan zijn de zorgrobots al niet meer weg te denken. Ze worden humanoiden genoemd. Maar willen wij dat eigenlijk wel? Zo vraagt de actualiteitenrubriek Netwerk zich af.

In Netwerk: Robots in aantocht in de zorgverlening