Background on Chile Earthquake

• USGS: Magnitude 8.8 – OFFSHORE MAULE, CHILE
• AMEMBASSY Santiago: Statement on February 27 Earthquake in Chile
• NOAA: Tsunami Warnings and Advisories
• PAHO: EOC Situation Report #3 – Damage and power shortages force suspension of H1N1 vaccinations

Guillain-Barré Syndrome (GBS) is a very rare disorder in which the body’s immune system attacks part of the peripheral nervous system. Specifically, “GBS damages the nerves’ protective covering (myelin sheath) and this interferes with the signaling process, causing weakness, numbness or paralysis.”  There is no cure for GBS but it is treatable.  Most recover and this may involve months of physical therapy.

GBS is termed a “syndrome” as there is no apparent disease-causing agent involved. There are 6000-9100 cases of GBS annually. Most instances of GBS (around two-thirds) have occurred after severe respiratory or intestinal infections.  GBS has also been associated with bacterium Campylobacter jejuni and the Epstein-Barr virus. Surgery or vaccinations, on rare occassions, can trigger GBS. 

In 1976, around 45 million Americans — almost 25% of the population — received swine flu vaccine as part of a national vacination campaign.  However, the program was halted after 10 weeks in operation.  “More than 500 people (were) thought to have developed Guillain-Barré syndrome after receiving the vaccine; 25 died. The federal government paid millions in damages to people or their families.”

Since that experience, most studies have found no association between GBS and the seasonal influenza vaccine.  However, two studies suggested that around one additional person out of one million vaccinated people may be at risk for GBS.  The H1N1 vaccine is expected to have the same safety record as seasonal flu vaccine.

HHS tracks adverse reactions to the H1N1 vaccine using a passive reporting system termed “VAERS” (Vaccine Adverse Events Reporting System), along with other surveillance mechanisms. VAERS data can be accessed online through CDC’s WONDER (Wide Ranging Online Data for Epidemiological Research). 

More than 60 million Americans have been vaccinated against H1N1 in 2009 (20% of the population). Suspected GBS cases associated with the H1N1 vaccine are rare.  Editor’s Note: A query of VAERS data on WONDER for GBS reports in 2009, involving the injection and nasal spray H1N1 vaccines, returned 38 records.

CBS: GBS a Side Effect of H1N1 Vaccine?
CDC: Fact Sheet: Guillain-Barré Syndrome (GBS)
CDC: General Questions and Answers on Guillain-Barré syndrome (GBS)
LA Times: Swine flu ‘debacle’ of 1976 is recalled
Mayo Clinic: Guillain-Barré Syndrome
MSNBC: Va. teen suffers rare illness after swine flu shot
NIH/NINDS: Guillain-Barré Syndrome Information Page
NYTimes: Fear of a Swine Flu Epidemic in 1976 Offers Some Lessons, and Concerns, Today
UPI: CDC H1N1 Guillain-Barre syndrome remote

BEIJING: Agence France Presse reported that all but six of China’s 659 deaths from H1N1 were recorded in the last two months of 2009, suggesting the flu is on the upswing. While H1N1 is declining in major cities, China’s Health Ministry reports H1N1 is spreading into the countryside. Ministry officials described the winter flu outlook as “grim” and fear a rise in cases in connection with upcoming Lunar New Year celebrations. China has vaccinated around 50 million people. The country’s population is 1.3 billion. News accounts suggest China’s H1N1 death counts are understated. In November 2009, Dr Zhong Nanshan (who had exposed government coverups in the 1993 SARS epidemic) accused officials of not testing deaths from severe pneumonia cases, resulting in lower H1N1 mortality figures.

AFP: China records 659 swine flu deaths in 2009
Reuters: China’s official H1N1 death count suspect: report
Reuters; China says H1N1 flu spreading into the countryside

Several events are planned for National Influenza Vaccination Week, which has been rescheduled to the week of Jan 10. New public-service announcements (PSA’s) are appearing on radio, TV and the Internet featuring young people, governors and congressmen urging people to fight and prevent the flu. The H1N1 vaccination information campaign will continue over the next eight weeks.

Editor’s Comment: All PSA’s have a positive and upbeat quality and will not scare the public. Some are quite clever. An unpredictable virus with unknown potential for more virulent waves, is a future that can be hedged against through widespread vaccination. This is an undercurrent in HHS and CDC communications.

Going forward, PSA planning perhaps can assume a difficult information environment as audiences may be harder to convince due to: “H1N1 fatigue“; perceptions that H1N1 dangers have passed; and entrenched suspicions about the H1N1 vaccine. Internet rumors and misinformation are always on the horizon. The H1N1 public information effort could require the dexterity of a political campaign.

Ad Council: H1N1 Flu Prevention
CDC: National Influenza Vaccination Week
FLU.gov: Flu Public Service Announcements
HHS: HHS Secretary Sebelius Unveils New H1N1 Advertisement That Will Air During New Year’s College Football Bowl Games
WSJ: U.S. Urges H1N1 Shots as Supplies Surge

“PBS NEWSHOUR” WEBSITE FEATURES H1N1 EXPERTS
AND RESOURCE GUIDE FOR “ANATOMY OF A PANDEMIC”
— Interviews, Latest News, Local and National Resources Featured in Companion Website to PBS Flu Special that Airs Nationwide on December 14 —

WASHINGTON, D.C. — “PBS NewsHour,” the premiere news and public affairs website at pbs.org, will launch today, Tuesday, December 8, the companion website to “Anatomy of a Pandemic,” a television special and on-going digital media initiative about a pandemic’s impact on modern society, in response to the 2009 H1N1 influenza virus pandemic.  The “Anatomy of a Pandemic” website (www.pbs.org/newshour/pandemic) will feature a forum after the program’s premiere to ask questions of influenza experts from the Centers for Disease Control (CDC) and the Center for Infectious Disease Research and Policy.  The site will also provide the latest public media news on H1N1, as well as national and local resources for viewers to learn more about H1N1, get information from their local health departments and find a vaccine site.  Segments of the documentary will be available online, along with web-exclusive extended interviews and lesson plans.  “Anatomy of a Pandemic” premieres Monday, December 14, 2009 at 9 p.m. ET on PBS stations nationwide.  (Check local listings.)

The public may send in questions to the website for an online forum that will take place on Tuesday, December 15 at 4 p.m. ET with Dr. Anne Schuchat, the Director of the CDC National Center for Immunization and Respiratory Diseases (NCIRD), and Dr. Michael Osterholm, world-renown influenza expert and Director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota.  The guests will respond to viewers’ questions and concerns about H1N1 and pandemics.  Betty Ann Bowser, health correspondent for “PBS NewsHour,” will moderate.  (Subject to change).  For more information, or to submit questions, visit www.pbs.org/newshour/pandemic.

PBS: Anatomy of a Pandemic portal
PBS: Anatomy of a Pandemic webcast