(MY092) Obesity emerges as risk factor in severe flu

WASHINGTON (Reuters) – People who are obese but otherwise healthy may be at special risk of severe complications and death from the new H1N1 swine flu virus, U.S. researchers reported on Friday.

They described the cases of 10 patients at a Michigan hospital who were so ill they had to be put on ventilators. Three died. Nine of the 10 were obese, seven were severely obese, including two of the three who died.

The study, published in advance in the Centers for Disease Control and Prevention's weekly report on death and disease, also suggests doctors can safely double the usual dose of oseltamivir, Roche AG's antiviral drug sold under the Tamiflu brand name.

"What this suggests is that there can be severe complications associated with this virus infection, especially in severely obese patients," said CDC virus expert Dr. Tim Uyeki.

"And five of these patients had ... evidence of blood clots in the lungs. This has not been previously known to occur in patients with severe influenza virus infections," Uyeki said in a telephone interview.

Dr. Lena Napolitano of the University of Michigan Medical Center and colleagues studied the cases of 10 patients admitted to the university's intensive care unit with severe acute respiratory distress syndrome caused by infection with H1N1.

"Of the 10 patients, nine were obese (body mass index more than 30), including seven who were extremely obese (BMI more than 40)," they wrote in their report.

Their study was not designed to see if obesity or anything else poses a special risk factor for flu. But the researchers were surprised to see that seven of the 10 patients were extremely obese.

MULTIPLE ORGAN FAILURE

Nine had multiple organ failure, which can be seen in influenza, but five had blood clots in the lungs, and six had kidney failure.

None has fully recovered, the researchers said.

The H1N1 swine flu virus first emerged in Mexico in March and was spreading out of control in the United States by the time it was identified at the end of April. The World Health Organization declared a pandemic in June.

While it is causing moderate illness, all influenza viruses can be deadly and this one is no exception. It has killed close to 500 people globally, more than 200 in the United States alone.

However, the new virus has a slightly different pattern from seasonal flu -- it spreads in the summer months, attacks young adults and older children, and may affect the body slightly differently.

As with H5N1 avian influenza, which only rarely attacks people, patients seem to survive better if they get Tamiflu for longer than the usual five-day treatment course, Uyeki said.

"We don't know if it is necessary for a higher dose of the drug to be given to patients who are obese," he said.

"The high prevalence of obesity in this case series is striking," the CDC's commentary accompany the report reads.

"Whether obesity is an independent risk factor for severe complications of novel influenza A (H1N1) virus infection is unknown. Obesity has not been identified previously as a risk factor for severe complications of seasonal influenza."

(MY091) H1N1 is ‘unstoppable’, says WHO as it calls for vaccines

WASHINGTON, July 14 — Saying the new H1N1 virus is “unstoppable”, the World Health Organisation gave drug makers a full go-ahead to manufacture vaccines against the pandemic influenza strain yesterday and said healthcare workers should be the first to get one.

Every country will need to vaccinate citizens against the swine flu virus and must choose who else would get priority after nurses, doctors and technicians, said Dr. Marie-Paule Kieny, WHO director of the Initiative for Vaccine Research.

Several reports showed the new virus attacks people differently than seasonal flu — affecting younger people, the severely obese and seemingly healthy adults, and causing disease deep in the lungs.

Kieny briefed reporters on the findings of the WHO’s Strategic Advisory Group of Experts on Immunisation, or SAGE. “The committee recognized that the H1N1 pandemic ... is unstoppable and therefore that all countries need access to vaccine,” Kieney said.

“The SAGE recognised first that healthcare workers should be immunised in all countries in order to retain a functional health system as the virus evolves,” she added.

After that, each country should decide who is next in line, based on the virus’s unusual behaviour.

Seasonal influenza is deadly enough — each year it is involved in 250,000 to 500,000 deaths globally. But most are the elderly or those with some kind of chronic disease that makes them more vulnerable to flu, such as asthma.

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(MY089) India gay sex ruling - protection, not acceptance

NEW DELHI (AFP) – For India's gay community, the joy that greeted this month's court ruling legalising gay sex is tempered by the fact that, although the law now accepts them, society still does not.

For all the celebrations and talk of an historic milestone, many believe it will take more than a court decision to change public attitudes toward homosexuality, which is largely taboo in India and considered by many to be a mental illness.

Although the Delhi High Court's verdict has served as a morale booster for men and women who lived in constant fear of being criminalised, they say it is unlikely to encourage those in the closet to come out.

"I don't think it will make a major impact," says Maya, 32, who runs a counselling centre for lesbians and people with gender identity issues.

"I'm sure some people who were afraid of the legal implications are more comfortable now, but there are still so many social issues.

"The major issues are how you're going to tell your family -- it has nothing to do with the law," she said.

Abhi's parents took him to a psychiatrist when he came out to them two years ago. They eventually came to terms with his sexual orientation, but the 22-year-old call centre employee believes it will take generations for India to tolerate, let alone embrace homosexuality, on a wider scale.

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(MY087) NZ porn king vows to push ahead with "Boobs on Bikes"

A porn entrepreneur has vowed to go ahead with his annual "Boobs on Bikes" parade of topless women in Auckland, despite financial woes and the opposition of the city's mayor.

Fairfax newspapers reported Steve Crow had said the annual parade, held since 2003 down the main street of New Zealand's largest city, would go ahead on September 23 to advertise his erotica show. The group did not quote him directly.

Two of Crow's companies have gone into liquidation at his request after earlier shows in the capital Wellington and the southern city of Christchurch lost money.

Auckland Mayor John Banks says he is vehemently opposed to the parade of topless porn stars, which attracts thousands of spectators, but is powerless to stop them.

A court ruled last year the parades are legal after the Auckland City Council, which Banks heads, tried to have them stopped.

"I am totally opposed to the exploitation of vulnerable woman," Banks told Fairfax.

"Taking... women down Queen Street on the back of Harley Davidsons bare breasted and paying them for such activity is, in my review, not in keeping with the family image with which I want Auckland to be portrayed.

"The council doesn't want to know anything about this."

(MY086) Webber on top after opening free practice

Australian Mark Webber topped the times in Friday morning's opening free practice for Sunday's German Grand Prix, narrowly outpacing championship leader Briton Jenson Button.

Australian Mark Webber topped the times in Friday morning's opening free practice for Sunday's German Grand Prix, narrowly outpacing championship leader Briton Jenson Button.

The 32-year-old Red Bull driver maintained the impressive form shown by his team at last month's British Grand Prix with a fastest lap in one minute and 32.082 seconds.

Button, in his Brawn GP car, was three-tenths of a second slower with Brazilian Felipe Massa of Ferrari third, a further three-tenths adrift of Webber's top time on a cool, damp and overcast morning in the Eiffel mountains.

The conditions were similar to those at Silverstone three weeks ago and once again appeared to favour Webber and Red Bull as Brawn battled to bring the best out of their car.

But while Webber shone again, it was a difficult morning for his young team-mate German Sebastian Vettel who came to a halt after at the first corner after only 10 laps.

His Red Bull car needed repairs and he rejoined later on only to wind up eighth-fastest as he struggled to find the form that brought him victory at the British race.

Half of the session was virtually lost to the wet conditions during early drizzle before Webber took command and began setting the benchmark times for the rest to chase.

Italian veteran Jarno Trulli of Toyota wound up fourth ahead of compatriot Giancarlo Fisichella of Force India, a team showing rapid improvements as the season continues.

But Fisichella's promising young team-mate German Adrian Sutil was forced to stop early in the session and had to return to the pits and sit out the practice.

Button's Brawn team-mate Brazilian veteran Rubens Barrichello endured a troubled morning and ended up 12th.

Finn Kimi Raikkonen in the second Ferrari was sixth, two-times champion Spaniard Fernando Alonso of Renault was 10th and defending champion Briton lewis Hamilton was 13th for McLaren Mercedes while his team-mate Finn Heikki Kovalainen struggled to take 18th place.

(MY085) Guatemalan court rules in favor of tweet author

GUATEMALA CITY – An appeals court found insufficient evidence to warrant the trial of a Guatemalan whose Twitter message led to his arrest on charges of inciting financial panic.

Jean Anleu was arrested and charged in May after sending a 96-character tweet that urged depositors to withdraw funds from a bank involved in a political-murder scandal. The message earned him the unfortunate distinction of becoming one of the first people in the world to be arrested for a tweet.

The new ruling means charges will be dropped Friday if prosecutors don't appeal first. Prosecutor Genaro Pacheco told The Associated Press that he has not been officially informed of the appeals court's decision and has not considered dropping the case.

Anleu found the court's ruling to be "very Twitter-like."

"It's a long legal document but there is a very short sentence that sums it up, like a tweet: The appeals court orders the judge to rule the case lacks merit," Anleu told the Associated press by instant message. "A huge weight has been lifted off my shoulders. We still have to see what the prosecution does."

Incensed by reports of a political scandal at Guatemala's rural development bank, Anleu sent the offending tweet under the Internet alias "jeanfer," urging depositors to pull their money from the bank. Written in Spanish, it said: "First concrete action should be take cash out of Banrural and bankrupt the bank of the corrupt."

Pacheco contends the tweet illegally undermined public trust in Guatemala's banking system, and authorities proved Anleu sent the message by searching his Guatemala City home. He was jailed for a day and a half and released on bail.