Singapore, Jan 18, 2010: According to the World Health Organization, as of December 13, 2009, more than 208 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 10,582 deaths. Of all the deaths reported to WHO, about 6,335 occurred in the Americas, and at least 1,654 occurred in Europe. The other four WHO regions, Western Pacific, South-East Asia, East Mediterranean and Africa reported 1,020, 892, 572 and 109 deaths, respectively.

WHO noted that in its update on pandemic (H1N1) 2009, in East Asia, influenza transmission remains active but appears to be declining overall. Influenza activity has recently peaked and begun to decline in Japan. Influenza-like-illness activity continued to decline but remained elevated in northern and southern China, Taiwan and Mongolia. In south Asia, influenza continues to increase in north India, Nepal, Sri Lanka and Maldives.

Mr Thomas Frieden, director of the US Centers for Disease Control (CDC) and Prevention, at a weekly 2009 H1N1 flu media briefing on December 10, 2009, noted that H1N1 flu has killed nearly 10,000 Americans, including 1,100 children and 7,500 younger adults, and infected one in six people in the US since arriving last April. CDC estimated that between April and November 2009, there had been nearly 50 million cases of H1N1 influenza in the US, mostly in younger adults and children. Mr Frieden said more than 200,000 Americans had been hospitalized—about the same number who are affected by seasonal flu in an entire year. To control the situation he said, vaccine supplies will continue to grow as more than 12 million additional doses. The total doses could shoot up to 85 million doses.

The situation is completely different in eastern part of the world i.e., in Asia Pacific region. One of the reasons of this was precautionary measures taken by the governments. Companies, governments and healthcare agencies joined hands with WHO to successfully launch swine flu vaccine. China and Australia, the front runners in this initiative, tasted early success followed by Korea and Taiwan.

China is the first country in the region to develop H1N1 vaccine indigenously and supply to the government to meet its local market. Australia’s CSL, Korean Green Cross and Taiwan’s Adimmune too launched vaccine successfully to supply the local markets.

CHINA

Chinese companies like Sinovac Biotech and Hualan Biological Engineering put in extra efforts to develop and supply vaccine to the government and health agencies.

Quoting the health officials, Chinese media reported, that the number of people who have died from A/ H1N1 influenza was 442 with over 240 deaths reported in the first two weeks of December. So far, the total number of reported cases is 110,590, and over 30 percent have been hospitalized. China’s State Food and Drug Administration has given approval for over 365 batches of the vaccine that can provide 65.87 million injections. Of that amount, 53.14 million have been dispatched to provincial-level regions across the mainland so far, according to the China’s Ministry of Health.

China has vaccinated more than 36 million people against the H1N1 flu since September, focusing mostly on elementary and secondary school students,the chronically ill, and medical workers.

Now the Chinese government has expanded its A/H1N1 vaccination priority group to include pregnant women, migrant workers, and people with close contacts with animals such as butchers and veterinarians so as to prepare for the coming New Year and Spring Festival, when China expects millions of travelers nationwide.

Sinovac, the first to launch H1N1 vaccine received its fourth purchase order for PANFLU.1, from China’s Ministry of Industry and Information Technology for the national purchase plan. Under this purchase order, Sinovac is required to produce an additional one million doses of PANFLU.1 (15ug/0.5ml) for the Chinese central government. The delivery of this order is expected to be completed early next year.

Besides, Chinese medical specialists had developed a Chinese herbal medication to treat the A/H1N1 flu. Quoting Dr Wang Chen, President of Beijing’s Chaoyang Hospital, the local media noted that seven months of scientific and clinical studies showed the remedy, called ‘Jin Hua Qing Gan Fang,’ was effective in treating A/H1N1 flu patients. It can shorten patients’ fever period and improve their respiratory systems.

The situation in Australia too is under control because of the immunization program undertaken by the government. According to the department of health and aging in Australia, as on December 4, 2009, there had been 37,462 confirmed cases of pandemic (H1N1) and 191 deaths..

Since the H1N1 vaccine was made available to the Australian public in September, CSL has distributed 5.1 million doses to immunization providers, of which 4.2 million doses have gone to general practitioners.

CSL, Australia’s leading biopharmaceutical company and the only commercial manufacturer of influenza vaccines in the Southern Hemisphere received a request for supply of 36 million doses from American health agencies. Of that amount, CSL has already shipped six million doses to the US since October. Besides supplying the Australian government, CSL also donated three million doses of pandemic H1N1 2009 vaccine to the WHO and 300,000 doses to Singapore government.

Panvax H1N1 Vaccine Junior, developed by CSL, received the Therapeutic Goods Administration’s approval enabling children between six months to nine years to be protected against the pandemic H1N1 influenza. The TGA has stated that children under 10 years of age will require two doses of the vaccine administered at least 28 days apart, in line with the process for children’s seasonal flu vaccinations.

The situation in Australia too is under control because of the immunization program undertaken by the government. According to the department of health and aging in Australia, as on December 4, 2009, there had been 37,462 confirmed cases of pandemic (H1N1) and 191 deaths..

Since the H1N1 vaccine was made available to the Australian public in September, CSL has distributed 5.1 million doses to immunization providers, of which 4.2 million doses have gone to general practitioners.

CSL, Australia’s leading biopharmaceutical company and the only commercial manufacturer of influenza vaccines in the Southern Hemisphere received a request for supply of 36 million doses from American health agencies. Of that amount, CSL has already shipped six million doses

to the US since October. Besides supplying the Australian government, CSL also donated three million doses of pandemic H1N1 2009 vaccine to the WHO and 300,000 doses to Singapore government.

Panvax H1N1 Vaccine Junior, developed by CSL, received the Therapeutic Goods Administration’s approval enabling children between six months to nine years to be protected against the pandemic H1N1 influenza. The TGA has stated that children under 10 years of age will require two doses of the vaccine administered at least 28 days apart, in line with the process for children’s seasonal flu vaccinations.

South Korea has reported 117 deaths due to A/H1N1 flu as of December 4, according to data collected by the health ministry. South Korea also reported world’s first Tamiflu-resistant death case on December 17. South Korean health officials noted in mid-November that nearly 7.5 million children and teenagers across Korea are expected to get vaccinated with a one-shot flu vaccine, produced by local drug maker Green Cross.

Green Cross will provide 32 million doses of its Influenza A(H1N1) vaccine by next February. Green Cross informed the Korea Food and Drug Administration that it will provide 12 million doses of its vaccine soon and an additional 20 million doses by February. The total surpasses an original estimate of 19 million doses that South Korean health authorities and Green Cross is expected to secure by next February.

North Korea, on December 8 reported nine cases of A/H1N1 flu. Considering this situation, South Korea handed over enough Tamiflu for 400,000 people and Relenza for 100,000 people to North Korean health authorities on humanitarian bases. However, on December 17, 2009, WHO quoting the North Korea’s Health Ministry officials, reported that the nine flu patients—all schoolchildren aged between 11 and 14 – years of age have recovered and no additional cases have been reported.

TAIWAN

According to the Central Epidemic Command Center (CECC) in Taiwan, the death toll due to swine flu has touched 35 since the outbreak began early this year. Itsaid, a total of 4,126,007 people were vaccinated against A/H1N1 flu, constituting 17.9 percent of the population as on December 15, 2009. The CECC noted that a total of 2,584 contracted hospitals and 354 temporary vaccination stations provided pandemic influenza A (H1N1) vaccination on December 12, 2009.

The CECC also noted that it received a total of 22 claims requesting compensation for individuals thought to be injured by the pandemic influenza A(H1N1) vaccine under the Vaccine Injury Compensation Program (VICP). The VICP has completed reviewing three petitions and determined that those three cases were not caused by the vaccine.

Adimmune, a leading vaccine player from Taiwan supplied vaccine to the government agencies as it won the bid to supply five million doses of influenza A (H1N1) vaccine. The contract to this effect was signed in July and deadline for supplying the requested amount of vaccine doses to the government was October, 30, 2009.

The CECC said, the number of vaccine that would be available, would be 10 million and the number of pandemic influenza A (H1N1) immunization is expected to reach 7.5 million.

INDIA

With the first case of A H1N1 being reported on May 13, India, one of the leading vaccines suppliers to the global agencies has reported 769 deaths with samples from 101,858 persons tested for influenza A H1N1 in government laboratories and a few private laboratories across India and 23,182 of them have been found positive. The Indian companies are still working on to produce vaccine against H1N1 influenza and the Ministry of Health still to give its nod for imported vaccine.

Three Indian manufacturers—Serum Institute of India, Bharat Biotech, and Panacea Biotech—are being supported to manufacture H1N1 vaccine. Four million doses are being imported to vaccinate the higher risk group. Besides these three companies, Zydus Cadila has announced of developing vaccine against swine flu.

VIETNAM

The A H1N1 flu has claimed 50 lives in Vietnam so far. Prof Nguyen Thu Van, director, Vabiotech, a company for vaccine and biological production says, spreading H1N1 virus from human-to-human has come down in Vietnam, but the ratio of severe cases among hospitalized patients is increasing.

Prof Thu Van says, “Vabiotech’s H1N1 vaccine is under development and started production in pilot scale.” He is optimistic that the company would be able to launch the vaccine by the end of 2010. The Ministry of Health Science and Technology of Vietnam have encouraged and granted permission to Vabiotech to develop H1N1 pandemic flu vaccine based on its experience on H5N1 technology as well as other vaccines. Vabiotech was keeping contact with WHO and its collaborating laboratories as well as CDC for supporting in H1N1 vaccine development.

HONG KONG

The Department of Health of Hong Kong noted that it will be commencing its influenza A/H1N1 vaccination program soon for two million people from five target groups including chronic patients and pregnant women, children aged six months to six years, seniors aged 65 and above, healthcare workers, and workers in the pig trade. Hong Kong has been buying vaccines from Sanofi Pasteur for its vaccination program.

THAILAND

According to the government sources, the death toll due to H1N1 flu in Thailand has reached 190. The Government Pharmaceutical Organization (GPO), the largest pharmaceutical manufacturer in Thailand, is stockpiling anti-viral drug Oseltamivir and gearing up to produce a nasal vaccine spray to combat H1N1 virus. The company which had hoped to start the clinical trials in September 2009, had to hold back the trials due to unstable vaccine viruses. After addressing these issues, on December 18, it started the trials with 24 volunteers. The volunteers were vaccinated with the nasal-spray-flu vaccine. This is the first clinical trial in Thailand related to the current H1N1 flu.

(With inputs from Ajeesh Anand, Anjana Pradhan in Bangalore & Rahul Koul in New Delhi.)