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zoom RSS 季節性インフルエンザの拡大は新型インフルエンザが関連/米国医療事情 新型インフルエンザ

<<   作成日時 : 2009/05/16 17:13   >>

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 豚インフルエンザが米国中で急速に蔓延しており、通常は呼吸器疾患がみられなくなる時期になってもインフルエンザ様の病気が多発している。
画像 インフルエンザの半数が新型ウイルス陽性反応を示し、この病気の異常パターンを表している。季節がくれば終息すると期待していたが、呼吸器感染は増加しており、インフルエンザの最盛期と同じだ。2人死者が増え合計が少なくとも5人となったと報告され、異常な活動を示す。5月6日テキサスで33才女性が死亡して州の合計が3人となり、先週アリゾナで40代後半の女性が死亡して州の最初の死亡例となった。少なくとも173人が入院となり、ニューヨーク州で学校関係者が入院したため2つの学校が閉鎖となった。
 CDCは47州で4,714人が確認または疑われ、10万人以上が感染したと推計された。
 感染したニューヨークのミッチェル・ウィーナー(55才のクイーンズの中学校238の副校長)はフラッシング病院メディカル・センターで人工呼吸器管理され、息子は、ここ1日で状態が悪化したと言った。1週間前病気になった後に肺炎と腎不全を患い、発熱がひどく、治療に反応していなかった。痛風以外の持病を全然持っていなかったと言う。
 昨日オバマ大統領がCDCのトップに選んだニューヨーク市の保健局長トーマスR.フリーデンは、「私達が学校で大きい集団発生を見るという事実は少し驚きだ」と言った。
 一方、GlaxoSmithKlineは昨日、欧州諸国で1億2700万本の新型インフルエンザワクチンの注文を受けたと発表した。英国、フランス、ベルギー、フィンランドの4国がパンデミックに備えて注文したと言う。生産には4ヶ月かかり、WHOからウイルス種サンプルを受け取り次第生産開始する。免疫反応を押し上げるアジュバントと呼ばれる成分を含み、ワクチンに関する議論がおこなわれている。成分はFDAの認可は得ないが、緊急事態での製品使用の許可権限をFDAは持っている。
 しかしワクチン監視グループは副作用の危険性を指摘している。兵士に与えられたワクチンの中のアジュバントは湾岸戦争症候群との関連が議論されている。FDAは複合ワクチンに伴う副作用を非常に心配している。
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New Virus Appears to Be a Factor in Extended Flu Season
By Rob Stein and Kimberly Kindy
Washington Post Staff Writers
Saturday, May 16, 2009
http://www.washingtonpost.com/wp-dyn/content/article/2009/05/15/AR2009051503533.html

A woman and boy walk past Primary School 16 in Queens, which is closed and guarded by police because of concerns over a possible outbreak of flu. (By Chris Hondros -- Getty Images)

The new swine flu virus is spreading rapidly around the United States, and more than half of the states are reporting unusually high levels of flu-like illness at a time of year when the respiratory disease usually disappears, federal health officials said yesterday.

About half of the people with flu are testing positive for the new virus, indicating it is playing a significant role in the unusual pattern of disease, officials said.

"We would be expecting to see the season to be slowing down or almost completely stopped," said Daniel Jernigan of the federal Centers for Disease Control and Prevention. "But what we're seeing is there are some areas that actually have reports of the amounts of respiratory disease . . . that are equivalent to peak influenza season."

The unusual activity comes as two more U.S. deaths were reported from swine flu, bringing the total in the United States to at least five. A 33-year-old man succumbed in Corpus Christi, Tex., May 6, bringing that state's total to three, while a woman in her late 40s died last week in Maricopa County in Arizona, marking that state's first death. Washington state had previously reported a death.

At least 173 infected people have been hospitalized across the country, including a New York school official who fell ill in the midst of a new outbreak that prompted the closing of two schools.
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"We know the outbreak is not localized but is spreading and appears to be expanding throughout the United States," Jernigan said. "This is an ongoing public health threat."

The CDC has officially reported 4,714 confirmed or "probable" swine flu cases in 47 states, and 22 states are reporting widespread flu, but there could be as many as 100,000 cases around the country, Jernigan said.

"This is not something we would expect to see at this time," said Jernigan, adding that the rising count is not simply the result of doctors looking harder for cases.

Despite the spread in the United States, the CDC lifted its warning against all unnecessary travel to Mexico. So far, that country has suffered the most severe outbreak, but Mexican officials predicted yesterday that they would bring it under control by the end of the month. The CDC said individuals with other health conditions should consult with their doctors before traveling to Mexico, because such people appear to be the most prone to serious complications from the virus.

The infected New York school administrator remained on a ventilator at Flushing Hospital Medical Center, and his son told reporters that his father's condition had deteriorated over the previous 24 hours.

After falling ill a week ago, Mitchell Wiener, assistant principal of Intermediate School 238 in Queens, had developed pneumonia and kidney failure, his son Adam Wiener told local television reporters. Wiener's fever was "much worse," and he was not responding to medicine, he said. Contrary to previous reports, Wiener, 55, had no preexisting medical conditions other than gout, the son said.

Four students at one school had confirmed cases of the virus, and more than 50 have been sent home this month with flu-like symptoms. At a second school, 29 students had visited the nurse with flu-like symptoms on Thursday, and at a third, 241 students were absent on Thursday. Maintenance crews were cleaning all three schools, which were closed for a week on Thursday.

Late yesterday, officials announced they were closing two more schools in Queens and another in Brooklyn for as many as five days beginning Monday after documenting unusually high levels of the flu.

"The fact that we're seeing large clusters in schools is a little surprising," said New York City Health Commissioner Thomas R. Frieden, whom President Obama selected yesterday to lead the CDC.

Meanwhile, vaccine manufacturer GlaxoSmithKline announced yesterday that four European countries have collectively placed orders for 127 million doses of a vaccine it will develop to combat the new flu strain. The four countries -- Britain, France, Belgium and Finland -- are ordering the doses as a precaution in the event of a widespread outbreak, said Sarah Alspach, a company spokeswoman.

Production will take about four months and will begin as soon as the manufacturer receives "seed" samples of the virus from the World Health Organization, she said. The WHO is considering whether to ask drug manufacturers to begin producing a vaccine in case the virus returns in a more dangerous form in the fall.

Already, there is controversy over the vaccine, which will include an ingredient called an adjuvant that boosts the body's immune response. The ingredient is not licensed by Food and Drug Administration, but the agency has the power to authorize the use of such products in an emergency. Some health officials and vaccine watchdog groups say the accelerants may cause a severe reaction -- specifically, swelling in the joints and in the liver -- in people with compromised immune systems.

"It's a big issue. An adjuvant in vaccines given to soldiers is at the center of the debate with the Gulf War syndrome," said Vicky Debold, a public health nurse who serves on the FDA's vaccines advisory committee. "The FDA is very concerned about them, especially what happens when people are given multiple vaccines at once that use a combination of adjuvants that have not been tested together."

Staff writer Robin Shulman in New York contributed to this report.

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