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Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National of Medicine.

Here is what's new this week in MedlinePlus.

To listen to Dr. Lindberg's comments, click here

Let's briefly tackle the intent of the President's declaration, the availability of H1N1 vaccine, the prevalence of H1N1 cases, seasonal and swine flu vaccination recommendations, and some helpful swine flu resources on MedlinePlus.gov.

First, President Obama's declaration enables hospitals to set up a make-shift facility, such as a triage (priority emergency treatment) tent, dedicated to H1N1 cases. Without the declaration, hospitals might be blocked by federal laws (that among other things protect patient privacy) from creating special clinics to handle a future surge of H1N1 patients.

Several U.S. news organizations reported a few hospitals in some states set up triage tents and temporary facilities to assist H1N1 patients.

The White House also was careful to note the emergency declaration should not be interpreted as a turning or tipping point in the nation's response to H1N1. In June, the World Health Organization declared a H1N1 - swine flu pandemic; the first global flu epidemic in 41 years.

Regarding H1N1 vaccinations, in the past two weeks the news media reported lines of children and adults to receive the H1N1 vaccine within many areas of the U.S. Government public health officials widely describe the current lines as linked to the H1N1 vaccine's limited availability rather than other factors, such as the President's emergency declaration.

At the end of October, the U.S. Centers for Disease Controls and Prevention (CDC) reported more than 23 million doses of H1N1 have been allocated in the U.S. As we reported in our last podcast about swine flu in August, the U.S. government hoped to have 45 million doses of H1N1 vaccine allocated (or ready to distribute) by the fall.

The CDC partially attributes any shortfall to production delays in manufacturing flu vaccine, which uses a time honored process of growing a vaccine within eggs. As several public health officials have explained, unfortunately, H1N1 takes longer to grow in eggs than some vaccines.

In our last H1N1-related podcast in August, we discussed an editorial in the New England Journal of Medicine that predicted a similar fall shortfall. But the author's prognosis was based on the limited number of firms capable of manufacturing flu vaccine as well as high international demand.

Regarding the flu's current prevalence, the CDC reports H1N1 is now widespread in 48 U.S. states and is present in all U.S. geographical areas. Since H1NI was first identified in March, the New York Times reports more than 20,000 persons have been hospitalized with H1N1 and more than 1000 deaths have been attributed to swine flu in the U.S.

The CDC reported on Oct. 30 that 114 American children have died since April from H1N1, including 19 during the last week of October.

Incidentally, both the World Health Organization and the CDC stopped estimating the number of H1N1 cases in July after acknowledging they could not provide accurate, updated statistics.

To provide a basis of comparison, the CDC reports 36,000 Americans die annually from seasonal flu and more than 200,000 persons are hospitalized by flu related complications. To provide additional perspective, U.S. public health officials expected the number of H1N1 cases to increase this fall because it is easier for the virus to spread from person to person in cooler/colder climates. This explains, for example, why H1N1's incidence was tracked in nations, such as Chile, New Zealand and Australia, from May-August – because these are the southern hemisphere's winter months.

Regarding vaccine recommendations, the CDC currently encourages adults and teenagers to receive a seasonal flu shot and the H1N1 vaccine. Some children under nine years old need to obtain a second dose of both seasonal and H1N1 vaccine in order for the vaccine to be effective. Infants younger than six months old are too young to receive either the seasonal or H1N1 vaccine.

For more vaccine recommendation information, see: '2009 H1N1 Flu and You' which is available in the 'start here' section of MedlinePlus.gov's H1N1 flu (swine flu) health topic page. Once you are on the '2009 Flu and You' webpage, click on '2009 H1N1 Flu Vaccine,' which is near the top of the left hand side of the page.

We should add the information in this podcast was current as of the morning of Nov. 2, 2009. The scientific, clinical, and public health implications of swine flu will change. Please look to MedlinePlus.gov's H1N1 flu (swine flu) health topic page for the latest information.

To help you keep up, MedlinePlus' H1N1 flu (swine flu) health topic page recently added an interactive tutorial that provides background information about swine flu. The interactive tutorial is narrated and is especially recommended for anyone who is vision impaired or new to the topic.

MedlinePlus' H1N1 flu (swine flu) health topic page also has information about swine flu in 14 languages, including Spanish, French, Chinese, Korean, Russian, Thai, and Vietnamese.

Other new links on MedlinePlus' swine flu health topic page include a summary of how all U.S. federal and many international agencies have responded to H1N1. Some links on the same website provide recently released guidelines for medical professionals. All these are available within: 'Enviro-Health Links � 2009 HIN1 (Swine) flu (National Library of Medicine)' – found within the 'overviews' section.

A recently added link in the 'specific conditions' section includes information (provided by the CDC) that explains some of the issues associated with H1N1 and pregnancy. Recently added links in the 'related issues' section provide information about unapproved H1N1 products. In addition, MedlinePlus' H1N1 flu (swine flu) health topic page provides links to the latest relevant research – and information tailored for women and children is in a separate section.

Before I go, this reminder……. MedlinePlus.gov is authoritative,….. free…. does not accept advertising …and is written to help you.   

To find MedlinePlus.gov, just type in 'MedlinePlus.gov' in any web browser, such as Firefox, Safari, Netscape, or Explorer.

We encourage you to use MedlinePlus and please recommend it to your friends. MedlinePlus is available in English and Spanish.

Your comments about this or any of our podcasts are always welcome. We welcome suggestions about future topics too!

Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov

That's NLMDirector (one word) @nlm.nih.gov

A written transcript of recent podcasts is available. Just click on the 'Director's comments' link on MedlinePlus' home page.

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A disclaimer –the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you….

Dr. Lindberg returns in the future.

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