Today Il Giornale di Sicilia, a newspaper of Palermo, wrote that the swine flu epidemic might hit again Italy, and that a further peak might occur in the next months. Apparently, the newspaper was quoting CDC Director Thomas Frieden. Meanwhile, the Bmj, a scientific journal, published an article on December 7th, with the title “Fall in swine flu cases may not signal an end of the epidemic, warns Professor Donaldson”, in which it was explained why experts are cautious about the end of the pandemic in Europe. It said also that UK health authorities are uneasy because “the continuing deaths from swine flu and the high rate of hospitalisations despite low levels of the disease in the community”. The death toll has reached 270 in the United Kingdom and there are still 1000 people in hospital. According to the last report of the Italian Ministry of Health, updated on December 24th , in Italy the deaths are 188. Campania accounts for 25% of the fatal cases (47 deaths). But Campania accounts for only 10% of the Italian population.
Many Italian news media don't cover the swine flu any more. Yesterday the Ansa press agency reported about the 10th death in Veneto, a man 56 years old, already ill by cancer, who died near Verona after 20 days in a hospital. And this is the only bit of news about the swine flu.
Yesterday the Italian Institute of Health updated its weekly report about the swine flu in the country. The swine flu incidence (as the number of new cases in a week out 1,000 people) is abating and now it has dropped to an incidence of 1.79‰ (or 0.179%). The incidence is moderately high only in the island of Sardinia, where it is still 7.68‰.
All the regions are past the peak. Meanwhile, there have been some differences in the regional peaks of the swine flu. In Basilicata, Campania, Emilia-Romagna, Lazio, Marche, Abruzzo, Molise, Sardinia the maximum incidence has been more than 1.5%, everywhere else less than that. In Abruzzo e Marche the peak has been 3-4%, but maybe the data is wrong.
Yesterday the Ministry of Health said that the swine flu has killed 163 people. In Campania the regional authority has recorded 45 deaths, in Puglia 25, in Lombardia e Calabria 12 each. In the South of Italy the fatal cases are 90, more than half of the national cases. Maybe there's a different kind of recording or updating the data, but it's really strange such a large number.
Until now the Ministry has recorded 811 hospitalized cases, which required respiratory aids in 439 cases. All the cases are 3,794,000. All over Italy the pandemic has already peaked, the total incidence is 0,22%. Only in Sardinia, where the incidence is above 1%, there's still some flu activity. The update has received almost no coverage by the newspapers.
Today the only piece of news about the swine flu is the WHO press conference in Geneva. Italian news media have covereved the talk of Dr Keiji Fukuda, Special Adviser to the Director-General on Pandemic Influenza. "Now we are about 8 months into the pandemic and one of the common questions coming to us is, that is the pandemic over, is it time to call it, and really the answer is, that it is still too early to make such a call." said Fukuda. In Italy the flu outbreak has already peaked, thus people expect the WHO to say that pandemic has ended.
Newspapers covered also the reason, according to Dr. Fukuda,to not call the pandemic over. The WHO expert said that the flu activity is still high in parts of Europe such as France and Switzerland, in the Czech Republic, and in parts of central Asia such as Kazakhstan and Kyrgyzstan, and in Russia. So it's to early.
Instead there was nothing about the second reason given by Dr Fukuda. "It is clear in some parts of the world, such as North America and in some parts of Europe, we have seen that the pandemic activity for now, has clearly peaked and is on the way down." said Fukuda "But the peaking has occurred extraordinarily early for influenza and we still have several months for winter to go and one of the big questions which is still before us is whether we expect to see yet another wave of activity occur or perhaps at late winter or in the early spring months".
"And if the virus were only a cold?" wrote La Repubblica some days ago. The article by Angelo Aquaro explains that the mortality of the swine flu has been by far inferior to the expected (0.018%, less than the seasonal flu), there's been a decrease of the hospitalized cases in the United States and Europe (except France) in the days of the expected peak, many controversies on the vaccines (in Italy only the 14% of the health care workers have been immunized), and on the role of the Big Pharma and on WHO. Italy has bought 24 millions of doses of Novartis vaccine for 184,8 million of euros.
"If until now the things have gone better than what was expected, the merit is not surely of the vaccination campaign that has involved a low number of people" is reported to have said in the article Mauro Moroni, Director of Infectious Disease Department of Sacco Hospital, in Milan. "The culprits of the flop, says De Martino, "are also who refused to get the shot themselves, and I speak about my medical colleagues, and the citizens".
And at the end there's the conclution of Giovanni Rezza, Director of Infectious Disease Department of Istituto superiore di sanità in Rome. "The truth is that from this crisis we have learned two lessons. First, that the opposite extremisms, alarmism and denyingser, are counter-productive. The second one is that we must learn to produce the vaccine more quickly in order to prevent situations more serious."
Today Professor Ferrucio Fazio has been appointed to the newly created role of Minister of Health. He has received strong support by his party's MPs, but also by medical associations and business unions. In the last months he managed to prepare for the pandemic of swine flu, and many people owe that to him.
Things are going quite well, especially in North Italy. In the southern regions, in Campania, Puglia and Calabria there's the highest death toll. Total deaths 149 Abruzzo 3 Basilicata 1 Calabria 16 Campania 32 Emilia Romagna 10 Lazio 14 Liguria 4 Lombardia 9 Marche 1 Molise 3 Piemonte 8 Puglia 19 Sicilia 11 Toscana 4 Umbria 5 Veneto 8 P.A. Bolzano 1
Italy have done well against the swine flu, and the country is ready to research a new universal vaccine against all the flu viruses. Yesterday the Deputy Minister of Health Ferruccio Fazio talked about the pandemic in Italy. Fazio said also that one of the goals of the Istituto Superiore della Sanità is the universal vaccine, active against all the influenza viruses. The target of the research will be the hemagglutinin, "the primary protein responsible for binding to receptor sites on the cell membrane, allowing the virion to enter the cell" (some weeks ago New Scientist published an article about this issue). Professor Fazio said also that Italy has spent for the vaccine campaign less money than other European countries, obtaining better results. However, it's too soon to draw conclusions: the number of cases is decreasing, and so the number of deaths, but the pandemic hasn't stopped yet, said Professor Fazio. In order to end it it's important to continue the vaccination plan, he said. In Italy there's an high incidence only in Sardinia right now.
"The Imaginary Virus. Swine flu milder than the seasonal one and almost nobody got the vaccine shot": this was the headline of Il Foglio newspaper on December 3. "As expected, the 'A' is a second class flu" wrote il Giornale after a week. In these days there are a few of editorials about the swine flu. The outbreak has already peaked, the emergency rooms are no longer crowded by scared people, there are fewer new flu cases. With "only" 146 deaths in total, the swine flu is judged a false alarm by some newspapers. So, the news media have started blaming WHO, flu experts, and a large part of journalists for what happened. Il Corriere della Sera shows a different point of view. It wrote on December 13: "Health care, a communication crisis", blaming on health authorities and on the lack of good communication for the false alarm.
Sardinia has been the last region in Italy to record an high incidence of the swine flu. But in the past week the number of cases recorded in the island has decreased to 2.033%. The total incidence in Italy has dropped to 0.373%. According to InfluNet, the H1N1 virus has spread more than the other seasonal flu viruses, apart from the 2004/05 virus. Meanwhile, the Deputy Health Ministr Ferruccio Fazio is going to be promoted to Minister of Health. Mr Silvio Berlusconi, who has never said anything about the pandemic, is likely to be happy about how Professor Fazio managed the pandemic.
What happens in South Italy? Yesterday the Ministry of Health updated the swine flu report. The number of deaths has risen to 137. A total of 67 people have died in the regions of South Italy: Abruzzo, Basilicata, Calabria, Campania, Molise, and Puglia. The virus has killed 30 people in Campania, 18 in Puglia, and 13 in Calabria. So, the 55% of swine flu deaths has occurred in the south, where live only the 25% of the Italians. According to the Ministry, the national update depends on the speed of the regional updates, so maybe there's a difference in the regional reporting. Or maybe something really happened in South Italy. By the way, the Italian news media are still covering the issue, even though there are fewer articles.
Some days ago there has been an outbreak of swine flu in a pig farm in Italy. The animals have been infected at the end of November by the H1N1 virus at a farm in Nerviano, near Milano, Lombardia. According to the report of the Italian Ministry of Health (through OIE), "the breeding sows were sick with lack of appetite, weakness and fever. All sows recovered fully in few days". There were 375 infected pigs out of 1250. There hasn't been any death and no control measures will be applied.
Untill now the Italian newspapers and televisions haven't covered this story, while reporting about a cat infected in France and two dogs in China, and also a pig in Germany. The German health Ministry has asked the ill farmers to stay away from the animals. In Italy there is no news about control measures.
The swine flu cases are decreasing in Italy. The national incidence has fallen to 0.664%. Only in two regions, in Sardinia and in Friuli Venezia Giulia, the pandemic is still at its peak. Meanwhile, the deaths have stopped to 114 (in Campania region 28), and to 410 the cases who needed respiratory aid. The government's ad is still aired on the State television to invite people to get the vaccine. Until now 611,425 people got the shot.
The swine flu has came to its maximum in Italy, but the deaths are still increasing. The Ministry of Health has said that the deaths are 101 (27 in the Campania region). It said also that 494,915 people has been vaccinated, out of 5,030,851 available doses. More than 131,000 health care workers have been vaccinated, more or less 13%. Italian mass media have covered about a two years old child who died in Lecce, Puglia region. Apparently, the child was healthy, before becoming infected.
The swine flu has hit the headlines again. Many mass media reported about the mutated virus that was found in one patient out of 100 tested in Italy. According to the Ministry, there was also a case of antiviral resistance to oseltamivir among 160 tested patients. Actually, Italian media haven't reported about antiviral drugs at all, and still now they don't seem interested in this issue. The Italian health authorities keep suggesting that people get the swine flu vaccine, besides the seasonal one. Quite interestingly, the Italian Deputy Health Minister Ferruccio Fazio has said that the vaccination campaign could include also people over 65 years in the risk group, as it has been asked by WHO. In Italy elderly people have been excluded from the vaccine campaign, even though they are asthmatic, obese or affected by other risky desease.