This sort of hysteria is also fueling numerous internet scams. The products seem like a scam just by hearing about them. The FDA lists items such as air “sterilizers,” a photon machine, Immune system boosting pills, protective shampoos and fake Tamiflu.

Barack Obama has declared swine flu a national emergency doing so on Friday evening.

With H1N1 swine flu becoming a national emergency this allows medical treatment facilities to handle more H1N1 patients by lessening certain standard federal requirements. This also coincides with the news that seasonal flu vaccinations have increased dramatically in the previous 2 weeks.

Swine flu, also known as H1N1, may infect as much as half of the population and kill 30,000 to 90,000 people, double the deaths caused by the typical seasonal flu, according to the planning scenario issued yesterday by the President’s Council of Advisers on Science and Technology. Intensive care units in hospitals, some of which use 80 percent of their space in normal operation, may need every bed for flu cases, the report said.

The virus has sickened more than 1 million people in the U.S., and infections may increase this month as pupils return to school, according to the Centers for Disease Control and Prevention. If swine flu patients fill too many beds, hospitals may be forced to put off elective surgeries such as heart bypass or hernia operations, said James Bentley with the American Hospital Association.

“If you have 1.8 million hospital admissions across six months, that’s a whole lot different than if you have it across six weeks,” said Bentley, a senior vice-president of the Washington-based association, which represents 5,000 hospitals.

President Barack Obama was urged by his scientific advisory council to speed vaccine production as the best way to ease the burden on the health care system. Initial doses should be accelerated to mid-September to provide shots for as many as 40 million people, the panel said in a report released yesterday. Members also recommended Obama name a senior member of the White House staff, preferably the homeland security adviser, to take responsibility for decision-making on the pandemic.

‘Serious Threat’

“This isn’t the flu that we’re used to,” said Kathleen Sebelius, U.S. health and human services secretary. “The 2009 H1N1 virus will cause a more serious threat this fall. We won’t know until we’re in the middle of the flu season how serious the threat is, but because it’s a new strain, it’s likely to infect more people than usual.”

Data from clinical trials to assess the safety and effectiveness of swine flu vaccines will start to become available in mid-September, health officials reported Aug. 21. Full results from the two-dose trials won’t be available until mid-October.

“We are making every preparation effort assuming a safe and effective vaccine will be available in mid-October,” Sebelius said today at the CDC’s Atlanta offices.

Global Spread

H1N1 has already reached more than 170 countries and territories in the four months since being identified, the Geneva-based World Health Organization said. Swine flu causes similar symptoms as seasonal strains. It has so far resulted in worse than normal flu seasons, with increased hospitalizations and cases of severe illness, the WHO said in an Aug. 12 release.

New Zealand and Australia, in the midst of their normal flu seasons, have reported intensive care units taxed to capacity by swine flu patients. The experience provides clues to what the U.S., Europe and Japan may see when the H1N1 virus returns.

The president’s advisory council describes as a “plausible scenario,” that 30 percent to 50 percent of the U.S. population will be infected in the fall and winter. As many as 300,000 patients may be treated in hospital intensive care units, filling 50 percent to 100 percent of the available beds, and 30,000 to 90,000 people may die, the group’s report said.

“This is a planning scenario, not a prediction,” according to the report. “But the scenario illustrates that an H1N1 resurgence could cause serious disruption of social and medical capacities in our country in the coming months.”

Hospital Crunch

Peter Gross, chief medical officer at Hackensack University Medical Center in New Jersey, said if the group’s scenario comes true, “I think every hospital in America is going to be in a crunch. We’ll be hard pressed to deal with those predictions,” he said.

The estimates seem “overblown,” Gross said, given that swine-flu outbreaks in 1968 and 1957 failed to cause as many deaths, even with medical technology and disease surveillance less advanced than today.

“Influenza, you can make all the predictions you want, but it’s more difficult than predicting the weather,” Gross said yesterday in a telephone interview, after the advisory report was made public. “If influenza was a stock, I wouldn’t touch it.”

The 775-bed hospital is planning for an outbreak, upping its order of flu medications and discussing where to put patients if the worst occurs, Gross said.

President’s Advisers

The President’s Council of Advisers on Science and Technology is chaired by John Holdren, the director of the White House Office of Science and Technology, Eric Lander, the head of the Broad Institute of Massachusetts Institute of Technology and Harvard University in Cambridge, Massachusetts, and Harold Varmus, the chief executive officer of Memorial Sloan-Kettering Cancer Center in New York.

The 21-member group of scientists and engineers, created by Congress in 1976, advises the president on policy involving scientific matters.

Seasonal flu usually kills about 36,000 Americans, said Tom Skinner, a spokesman for the U.S. Centers for Disease Control and Prevention. Swine flu causes more severe illness needing hospitalization among younger people than seasonal flu, while leaving people 65 and older relatively unscathed, said Mike Shaw of the CDC.

The median age of those with the pandemic virus has been 12 to 17 years, the WHO said on July 24, citing data from Canada, Chile, Japan, U.K. and the U.S.

Attacks the Healthy

“People who get infected with this strain happen to be the healthiest members of our society,” said Shaw, associate director of laboratory science at the CDC’s flu division, in a presentation yesterday at the agency.

The H1N1 strain is genetically related to the 1918 Spanish Flu that killed an estimated 50 million people. Variations of the Spanish Flu circulated widely until about 1957, when they were pushed aside by other flu strains. People whose first exposure to a flu virus was one of those Spanish Flu relatives may have greater immunity to the current pandemic, Shaw said.

A: As safe as it ever was.

Handling and consuming animal products, such as pork, can transmit some viruses. But that’s not how the H1N1 swine flu virus is spreading, said Christine Layton, a public health policy analyst with the North Carolina-based nonprofit research institute RTI International.

Swine flu is a respiratory virus, spread from person to person. In other words: A sneezing chef is a threat, not the spare ribs he’s basting.

In fact, if the swine flu virus were primarily being transmitted from pigs to people, public health officials probably wouldn’t be so concerned. That kind of transmission tends to limit a virus’s human spread to farmers and meat workers—people who are likely to come into contact with animals’ bodily fluids.

Q. Can those face masks really protect me from swine flu?

A. Yes and no.

The blue surgical masks you’ve seen being passed out to Mexican pedestrians are better than nothing but probably only marginally useful, said Andrew Pekosz, associate professor of microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

While such masks block the relatively large, virus-carrying droplets sneezed out by infected people, the viruses themselves are much smaller and could easily pass through. Specialty masks, designated N-95 or N-99, are better filters but still not perfect.

For better protection, Pekosz recommends combining a mask with regular hand washing and keeping 3 to 4 feet (90 to 120 centimeters) away from other people.

Q. Is this just another media health scare? How worried should we be?

A. The truth lies somewhere in between panic and eye-rolling.

Making the jump from animal-to-person to person-to-person transmission is a rare skill for a flu virus to “learn.” This ability makes H1N1 swine flu potentially dangerous—and makes the concern about it a bit different from the worries over bird flu, which has yet to make such a transition.

Human-to-human transmission is a big part of why public health officials are pouring resources into swine flu and why they want you to be aware that the virus is out there.

That said, experts like Johns Hopkins’s Pekosz and RTI’s Layton say there’s currently no reason to lock yourself up in the house.

For one thing, the cases outside Mexico have been no more serious than your average flu bug. Right now, nobody is sure why that is. And while the severity of the symptoms could increase, Pekosz said there’s not really an immediate, serious threat to individuals within the United States.

“However,” he said, “it certainly merits the public paying attention, and it warrants the public health efforts that have been going on in terms of monitoring and research.”

Q. How does a pig-bird-human mash-up swine flu virus happen, anyway?

A. Blame the pigs, and the virus.

Flu viruses are “very messy reproducers,” RTI’s Layton said.

All eight flu genes replicate independently. If a cell is infected with three different flu viruses, reproduction can mean a reshuffling of genetic material from multiple parents, thrown together randomly into the “baby” flu virus.

Most of the time, those cut-and-paste viruses don’t work out very well, Johns Hopkins’s Pekosz said. But every so often, this natural reassortment will come up with a new flu virus that has some kind of advantage over its competitors.

H1N1 swine flu is one of those, but we’ve certainly seen others in the past 30 years, he said. Pigs are part of the problem because they can become infected with flu viruses from birds and humans. As such, swine seem to provide a particularly good environment for this genetic square dance to take place.

The figures were released by the Iraqi health ministry as it detailed steps being taken to control the spread of the virus, which last week claimed its first fatality in the southern holy city of Najaf. A 21-year-old Iraqi woman, who had visited the city’s Shiite shrines, later died of swine flu.

The health ministry has also confirmed that 23 Iraqis and six other foreigners have been diagnosed with the virus. Their nationalities were not disclosed.

All the U.S. troops had either been treated or were undergoing treatment, said Dr. Amer al-Khuzai, the deputy health minister. There have been no fatalities among American forces, he said.

The U.S. military did not immediately confirm the figures released by the Iraqis. But earlier this week, it said 51 soldiers had been diagnosed, while another 71 suspected cases were in isolation.

“We think they have this many cases because they come through different countries to come here. They come from the United States. They come from Europe,” al-Khuzai said.

He said the U.S. military has been giving the ministry weekly updates about the number of swine flu cases diagnosed on American bases in Iraq.

Col. Michael D. Eisenhauer, chief of clinical operations in Iraq, told The Associated Press in an e-mail earlier this week that the U.S. military had been completely open with the Iraqis on the cases of diagnosed Americans.

The cases in American troops have been diagnosed over the last three months since the military actively began screening for the virus, he said. “There has not been a sudden outbreak,” Eisenhauer added.

Swine flu cases have been diagnosed at six U.S. bases in Iraq, the military said. In May, 18 soldiers on their way to Iraq were diagnosed in Kuwait with the virus. Troops are now screened for the virus before they leave the United States and again when the arrive in Iraq.

Cases among Iraqis have been diagnosed in Baghdad and elsewhere.

Ten were caught at Baghdad’s International Airport, where health officials screen arriving passengers, said Dr. Sabah Karkukly, who oversees the ministry’s swine flu program.

The figures raise concern about Iraq’s ability to control the virus’ spread among millions of Shiites who visit the revered shrines in Najaf and another holy Shiite city, Karbala.

Two cases of swine flu were diagnosed in Najaf, while three others were diagnosed in Karbala, said al-Khuzai, the deputy health minister. He cautioned Iraqis to take extra steps to protect themselves, such as avoiding crowded places where the virus can easily be transmitted.

Iraq’s Cabinet on Wednesday banned trips to Saudia Arabia’s holy city of Mecca during the Muslim fasting month of Ramadan, which begins later this month.

Iraq also joined other Arab health ministers in banning children, the elderly and the chronically ill from the annual hajj pilgrimage in late November.

The World Health Organization, as of July 31, had tallied more than 162,000 swine flu cases worldwide. It counted at least 1,154 deaths, with more than 1,000 reported in the Americas, according to its Web site.

Iraq’s Cabinet also approved the purchase of $100 million worth of the anti-viral medicine Tamiflu, which is enough for a quarter of Iraq’s population, Karkukly said.

But there may yet be something that can be done to reduce hospitalizations and deaths associated with the virus, commonly known as swine flu, public health authorities say.

Most of the serious consequences linked to the virus are the result of pneumonia, and an underused vaccine called Pneumovax can prevent, or at least limit, such complications in many patients. The vaccine, made by Merck & Co., stimulates the body’s ability to neutralize the bacteria responsible for many cases of pneumonia, and it has the potential to prevent an estimated one-third of pneumonia deaths linked to swine flu.

“We would certainly like to see the vaccine used more extensively,” said Dr. William Schaffner, chairman of the preventive medicine department at Vanderbilt University School of Medicine and president-elect of the National Foundation for Infectious Diseases. Schaffner was a member of the Centers for Disease Control and Prevention advisory committee on vaccines that in early June strongly affirmed current recommendations for who should receive the vaccine.

The normal target population for the pneumonia vaccine is a microcosm of those groups most likely to die or suffer serious complications from flu, so most experts say that eligible people should receive Pneumovax independent of its ability to affect the current pandemic.

But those recommendations have apparently slipped by largely unnoticed, Schaffner said.

U.S. sales of Pneumovax have not increased since June, according to John D. Grabenstein, senior director of Adult Vaccine Medical Affairs for Merck Vaccines and Infectious Diseases. Sales in Europe have risen, however, in response to similar recommendations by health authorities there.

“Unfortunately, I think too much emphasis has been placed on inappropriate administration of [the antiviral drug] Tamiflu, which has its own side effects and, aside from that, may create resistance,” said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York. “Most of my pulmonary patients are already getting [Pneumovax], but I am broadening my recommendation to other patients, since it is such a relatively harmless thing to do.”

Further, the vaccine provides protection against pneumonia for up to 10 years, meaning one vaccination provides at least some safeguard not just this year but for future flu seasons as well.

Some physicians are more skeptical about the pneumococcal vaccine’s potential to limit flu deaths. Continue

“Any vaccination you get, there are side effects,” Witkamp said. “But the benefits of getting the vaccination definitely outweigh them. There are people dying from the swine flu.

“Some of my friends call us guinea pigs, but they are not fully informed. The vaccination that they will be studying will be the same that anyone can get at the health department [when it is approved].”

Witkamp and her girls, Baylee, 3, and Emmie, 5, are among thousands of people rolling up their sleeves for science as drug companies, doctors and government officials work to get a safe and effective swine flu vaccine on the market by October.

In June, the World Health Organization declared a global pandemic of H1N1, or the swine flu, which has killed more than 300 and sickened more than 43,000 in the U.S. In Texas, 5,373 cases have been reported, with 357 confirmed in Dallas County and 210 in Tarrant County, according to the Texas Department of State Health Services.

Officials expect to see those numbers rise when school starts, which is why large-scale clinical trials are being conducted worldwide.

In Fort Worth, Benchmark Research is conducting clinical trials for several drug companies, testing to see patients’ reactions to the experimental vaccine and whether it produces an immune response to the H1N1 virus. Benchmark, which is paying patients $200 to $600, depending on the study and its protocol, will begin administering injections next week.

“What we are doing is private and independent,” said Dr. William Seger, Benchmark’s principal investigator, who also has a private medical practice next door. “These are private companies that are developing the flu vaccine, and they need to prove to the FDA that they are acceptable. They may be the one to help bring us a vaccine that is first to the market. We are going to need them all to produce the gazillion H1N1s that we are going to need worldwide.”

Although studies are being conducted on all ages, Seger especially needs patients 6 months to 17 years old, the population that is most likely to come into contact with H1N1.