Tamiflu (Oseltamivir) is effective in the treatment of the new H1N1 influenza virus, the so called Swine Flu. Canada and the United States have stockpiled this antiviral drug for it's population should the infection reach epidemic proportions. The dose is 75 mg twice daily for five days, must be started within 48 hours of onset of illnes. By prescription only. Public Health guidlines advise against the use of Tamiflu for 'low risk' cases. Treatment advised for high risk individuals under age 65 with chronic health conditions (ie heart disease, COPD, diabetes), residents of nursing homes, those aged 65 years or older, healthy children 6-23 months. Running commentary: May 1, 2009, Canada has 51 confirmed cases. My province of Ontario has 12 cases, all mild, everyone recovering. All travelled recently to Mexico. Expecting many more cases. May 2, Canada reports first case of human to pig transmission of N1H1 virus. May 4, Canada's cases reach 140, one seriously infected child admitted to hospital. Twenty countries ban Canadian pork. May 5, Public Health officials in Canada predict 1 in 4 will get ill with Swine Flu. May 6, Canada's total 165, Ontario 36 confirmed cases. May 7, 171 total cases. It's behaving like a seasonal flu. May 8, 191 cases. Canada's first death attributable to Swine flu is reported. Tina l'Hirondelle, a 39 year old asthmatic died of posible flu complications, at High Prairie Alberta. She did not have a history of travel to Mexico. May 9, The national total is now 281 cases, 76 in Ontario. May 10, China reports it's first case. May 13, 389 cases nation wide. May 18, Worldwide, 8,829 cases, 76 fatal, mostly in Mexico.. There is a global unease as the virus seems to spread easily from person to person and country to country. May 19, Mexico reported total 3,734 cases, with 74 deaths, and advises that the epidemic "continues its tendency to decline". May 22, More than 12,000 worldwide cases, more than half in the USA, Canada up to 805. June 2, The numbers mount, 1,530 cases in Canada with 3 deaths, more than 19,000 worldwide. June 3, In the Province of Ontario, there are 969 lab confirmed cases, of these 525 cases were aquired in Ontario. Nearly all cases here considered mild. June 4, The Ontario Ministry of Health and Long Term Care advises that all influenza cases in the community should be assumed to be the novel H1N1 virus. Testing of routine cases no longer required. Treatment with Tamiflu is recommended within 48 hours of the onset of symptoms for those with: 1) Acute illness requiring hospitalization (pneumonia), and 2) Those at risk for complicated disease (ie Diabetes, COPD, etc.) June 9, Particularily hard hit are native aboriginals in Canada's North, not sure if this population is genetically predisposed or related to comorbid illnesses more common in natives (ie Diabetes). June 11 The World Health Organization raised the H1N1 flu virus pandemic alert level from Phase Five to Phase Six. In doing so the WHO underscored: The decision is based on the spread of the virus and not the severity of illness it causes. The virus has caused sustained community level outbreaks in more than three countries across two WHO regions; In general, the H1N1 flu virus continues to cause moderate illness globally with most people affected recovering at home without medical treatment. For instance in Canada most infections to date have been mild; and, That borders should remain open. June 16, Canada reports eleven deaths thus far, one, a male in his forties with no antecedant illness. June 19, Researchers theorise that high levels of arsenic contamination of well water in Mexico could have contributed to the high mortality of cases there. A study of mice exposed to arsenic indicated more severe disease with H1N1. These results suggest that chronic arsenic exposure particularily in Southeast Asia and Mexico may be a factor that could enhance the potential impact of a pandemic strain of influenza. June 21. It was reported that a six year old girl from Toronto died from H1N1, and there have been two casualties in Quebec. June 25. Public Health officials estimate that out of Canada's population of 32 million, there are 100,000 active N1H1 cases. There are 2,667 confirmed cases in Ontario alone, and 18 deaths. Typically, during a regular flu season, 500 deaths are expected to occur in the province of Ontario. June 29. For the first time, a case of Swine Flu has proven resistant to Tamiflu! The resistance was seen in a patient in Denmark, who has recovered. July 2. Public health officials in the UK predict 100,000 cases by the end of the summer. July 20. Four cases of Tamiflu resistance have been reported in Canada. They are unrelated, it is NOT felt that a new resistant strain is emerging. July 23. The UK reports a dramatic rise in cases, upto 100,000 nationwide. Tamiflu is being released to the general public without physician screening. Canada has stockpiled enough Tamiflu to treat only one quater of it's population. Aug 9, I personally started a theraputic course of Tamiflu after direct contact with a severe case of N1H1 and the start of mild URI symptoms. The drug is well tolerated with only slight GI disturbance (transient nausea). So far, I have not developed an Influenza like illness. Aug 11, Public health measures in Canada now directed at managing the second wave of Influenza cases expected for the Fall/Winter season. Efforts to encourage mass immunization for the usual Flu shot plus H1N1 when it becomes available. Also because of the tendency for pneumonia to complicate the infection, pneumococcal vaccine is being promoted. Sept 25, Ontario Ministry of Public Health has decided on a two phase seasonal flu vaccination for this year. Beginning in October the seasonl flu vaccine will be offered only to Ontarians over 65 and residents of long term care homes. The H1N1 vaccine will be offered to the general population in November, and the seasonal flu vaccine will be available to the rest of the province following the H1N1 vaccination program. Reasons for this are as follows: Emerging unpublished data shows a possible link between immunization with seasonal flu vaccine and infection with H1N1. Epidemiological studies show seniors are more at risk of serious complications from seasonal flu infection. On the other hand, data shows that infection from the pandemic H1N1 virus is less likely to occur in persons born before 1957. Based on what occurred in the southern hemisphere, H1N1 is expected to be the main strain circulating in the nothern hemisphere this fall. There is no scientific evedence that administering both seasonal and H1N1 at the same time is safe and effective. A staggered immunization approach will help ease the challenges of multiple vaccines this season. October 8, After repeated contact with cases of Influenza like illness, I come down with fever, sore throat, myalgias and take a second course of Tamiflu within 24hrs of symptoms and I rapidly improve. October 28,Canada's so called second wave of H1N1 is well underway with southern Ontario particularily hard hit. Many schools and institutions reporting at least 10% of individuals absent due to illness. Canada's total deaths is reaching 100, and two fatal cases involving healthy children ( girl age, 10 and a boy aged, 13) has caused a bit of a panic just as the H1N1 vaccination program was started this week. People are waiting in lines for several hours at vaccination clinics. This first to get the shot are healthcare workers, children, pregnant women and medically high risk individuals. October 26, I recieve the Adjuvanted H1N1 Vaccine. My side effects are a sore arm for 3 days, and muscle aches for 2 days. I usually have no side effects with the Flu shot. The estimated risk of a serious reaction (allergy etc) is 1 in 10,000. It's a safe vaccine. Nov 5, Public Health officials recommend the use of Tamiflu beyond the first 48 hours, the traditional time limit of effectiveness. It should be added when those beyond 48hrs develop respiratory complications. The drug has been stockpiled in Canada, and free to the individual but still requires a physician's prescription.
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