The H1N1 flu is still spreading in North Africa, parts of eastern and southeastern Europe and areas of Asia, but is generally declining, the World Health Organisation (WHO) said last week.

The pandemic virus is still the predominant influenza virus circulating worldwide, posing an increased risk to pregnant women and people with underlying medical conditions such as asthma, it said.

“Activity in general is decreasing,” WHO spokesman Gregory Hartl told a news briefing.

Flu peaked in North

Much of the temperate northern hemisphere passed a peak of influenza transmission between late October and late November, the WHO said in a weekly update.

But the H1N1 virus continues to transmit actively in North Africa, including Egypt, limited areas of eastern and southern Europe, and in parts of South and East Asia, including western India, according to the United Nations agency.

In China, the H1N1 pandemic virus has declined substantially since peaking last November, but other influenza viruses have been detected increasingly in recent weeks, the WHO said.

The virus has killed at least 14,711 people worldwide since emerging last April, it said.

The WHO has said it will take a year or two after the pandemic ends to establish the true number of fatalities. – (Reuters Health, February 2010)

As per the latest report of the Ministry of Health and Family Welfare, death from swine flu has reached to 1235. Also 28,861 cases I have been tested positive for swine flu in India. Around 123397 people have been tested in India as on Feb 1, 2010. In India, 23.3 per cent of people who have tested for swine flu are found suffering from swine flu. Also around 4 per cent of people who have tested positive for Swine flu, have died and could not be saved in India.

Maharashtra with 317 deaths has seen maximum deaths from swine flu in India. Gujarat also has 242 deaths from swine flu till February 1, 2010. Interestingly Gujarat is the only state where Chief Minister has been tested positive for swine flu. Other Indian states suffering from are Rajasthan (176 deaths from swine flu), Karnataka (141 deaths from swine flu), Delhi (93 deaths from swine flu).

Delhi has highest no. of patients who are tested positive for swine flu. In Delhi 9,652 people have been tested positive for Swine flu so far. Maharshtra has 5116 case of swine flu affected patients and Rjasthan has 2101 patients who were tested positive for swine flu till February 1, 2010.

In the states which are severely affected by swine flu, have high exposure to foreigners. Also people from these states make more foreign visits. However the trend is changing now. On Feb 1, 2010 from the 51 patients who tested positive for swine flu, only one has traveled outside India and remaining 50 have infected in the country only.

(AP) — LEXINGTON, Ky. – Doctors applied the paddles to Maddy Kidwell’s little body over and over and over and over.

Four times in 10 minutes.

Four times before her heart began to beat again.

Her parents, Harold and Edith Kidwell, knew something had gone badly wrong because the nurses wouldn’t even let them near the room she was in.

It was just another unreal moment in a string of unreal moments that had led them from watching their almost 3-year-old daughter play happily on the floor to waiting while she fought for her life.

The H1N1 flu virus that hit Maddy so hard “wasn’t even really on my radar,” her mom said. She’d told her kids to keep their hands washed and had bought some hand sanitizer. But she didn’t get them vaccinated. It didn’t seem necessary, she said.

“You never realize how easy it could happen to you.”

Maddy’s case is extreme, but 229 children have died from H1N1 since August, according to the Centers for Disease Control and Prevention. State health officials reported that four of the 39 people in Kentucky who died of H1N1 have been children.

The number of cases overall has waned in recent weeks, but CDC officials expect another surge as the nation enters what is typically flu season.

Dr. Philip Bernard, who treated Maddy at Kentucky Children’s Hospital, said H1N1 is “a completely preventable disease because there is vaccine available.”

As the crisis response is scaled down, and vaccines go unused, a number of people are asking what happened to the swine flu pandemic.

Last week the Council of Europe launched an inquiry into the handling of swine flu.

Some claim that it was never really a pandemic at all and that the World Heath Organization may have been overly influenced by the pharmaceutical industry.

The BBC’s Imogen Foulkes reports.

(MYFOX NATIONAL) – The widely publicized swine flu pandemic of the past few years may have been largely over-hyped, according to recent reports.

While the swine flu scare may have cost panicked citizens lots of time, money and quality of life, the anxiety made some people very wealthy. For many who believed the hype, stockpiles of unused pharmaceuticals now translate to a big waste of money — particularly undesirable in this down economy.

“The panic leading up to the anticipated pandemic was a multibillion-dollar windfall for big drug companies like GlaxoSmithKline Plc, Novartis AG, and Sanofi-Aventis SA,”Portfolio.com reports. “But some countries are now negotiating with the companies to cancel part of their orders.”

A Jan. 26 article from Time magazine speculates on the issue and asks not only who raised the alarm, but why.

“By the summer of 2009, shortly after the H1N1 flu pandemic had first emerged, there was a waiting list for the first several million doses of the forthcoming new flu vaccine. At the head of the line, naturally, were the world’s richest nations,” reads the Time article.

The Time article notes that admonitions against rich nations’ greed from World Health Organization head Margaret Chan may have prompted a ramp up of production and buying.

A Wall Street Journal article from April 2009 noted that an H1N1 scare not only causes people to stay home from work out of fear, but also damages tourism, while strengthening healthcare and drug company stock portfolios.

“Flu concerns were helping pharmaceutical and health-care stocks,” the WSJ article said.

A voluntary, non-safety related recall is underway of  six lots of Sanofi Pasteur H1N1 influenza vaccine.

The recalled lots are:

The Centers for Disease Control and Prevention says the recalled vaccines have a lower strength than what is required.

More than 28,000 doses of the affected vaccine lots were distributed to approximately 169 medical facilities in New York City between November 2009 and January 2010.

Reviewing the swine flu response will help in future emergencies

Hawaii has been lucky so far to get through the H1N1 pandemic with one wave of “mild to moderate severity,” but flu is unpredictable, cautions Dr. Sarah Park, the state epidemiologist.

“We’re certainly not saying we’re over it yet,” she said in an interview. “Hawaii has not, and hopefully will not, see a second wave, but recent deaths highlight that vaccinations can do something for you, even with a low level of disease.”

Park, chief of the state Health Department’s Disease Outbreak Control Division, urges residents who have not been vaccinated for H1N1 or swine flu to take that step to protect themselves and those around them.

Although flu activity has waned on the mainland, the pandemic is worldwide, with a lot of activity in some areas with travel potential to and from Hawaii, she said. The first cases here were travelers, she pointed out.

Thirteen deaths associated with H1N1 — most with underlying medical conditions — have been reported in Hawaii since the first three cases of the virus were confirmed here May 5. The latest two deaths were in December and the week of Jan. 10.

Bill Gallo, with U.S. Centers for Disease Control and Prevention, says he is concerned about a potential new wave hitting the state with “a lot of vaccine unused.”

“I think maybe a lot of people struggled to get vaccinated early on when the supply was limited and gave up,” he said in an interview. “While we’re having a lull in flu activity, we all know there could still be a wave in store.”

Because of the delay by manufacturers in getting vaccine out, said Gallo, Hawaii and other states “dealt with a lot of challenges just trying to manage the flow and everything. We’re hoping next time it will go quicker. The best solution is improving vaccine technology.”

Gallo, the CDC’s senior management official for Hawaii and the U.S.-affiliated Pacific islands, said “there is a lot to be learned” from the pandemic, “and hopefully all states and counterparts” will share stories and learn from each other. For example, he said, Hawaii can teach other states about school-based flu vaccination clinics.

Meanwhile, the Department of Health staff is gathering data and working on “after-action” reports to better prepare for other potential vaccine-preventable or food-borne diseases or disasters, Park said.

“Our response doesn’t end when the pandemic is on the decline and vaccine distribution is over,” she emphasized. “Part of it is understanding who got vaccine; where did it go? Are there more areas or parts of the state that have more people vaccinated than others? Which age groups were vaccinated?

“SARS (severe acute respiratory syndrome) is still out there, and we don’t know what this (H1N1) virus may do,” she added. “If we’re lucky, it will remain quiet into spring and summer, but we don’t know what the next season will hold.”

Hawaii’s H1N1 wave started a little later than on the mainland and seemed to last longer, Park said.

“When mainland states were revving up in mid-August and beginning September (with a second H1N1 wave), we were waiting for the other shoe to drop, and we got lucky.”

There were “a few close calls,” she said, with a school cluster and a little rise in activity at the end of September and beginning of October. But even during the H1N1 wave, she said, “We saw a lot of morbidity but not the mortality I heard about from colleagues on the mainland.”

Health officials repeatedly emphasized the importance of prevention and good hygiene, and Park said she has noticed more people washing hands and covering coughs and sneezes.

“The vaccine did arrive just in time, and we were able to vaccinate a big portion of our population, especially with our school program,” she said.

Three years’ experience with seasonal flu vaccination clinics at schools enabled the department and partners to add H1N1 school clinics to the anti-flu campaign despite the economic situation and state and school furloughs, she said.

Hawaii and other states would have had a tough time dealing with the pandemic if extra federal funds had not been available, Park said.

“We were all prepared, but still it’s a huge struggle for all of the labs because of the volume hitting us at a time of economic crisis. The staff here, not just mine and the lab, but a lot of folks here, go above and beyond because public health means something to them beyond the job, but it is a struggle. You only have so much resource support.”

H1N1 medical alerts and advisories were posted for the first time on the department Web site, and the pandemic strengthened relationships between the health agency and various partners, Park said.

It also highlighted some issues, she said. For instance, a lot of people did not understand why priorities for limited vaccine included workers in the state’s critical infrastructure, she said.

“There needs to be more discussion and better identification … who needs to be protected so our society doesn’t collapse,” she said. “The biggest issue is the challenge of public messaging, trying to get the word out and insure that everyone understood what was going on.”

A LOOK AT THE H1N1 INFLUENZA A (SWINE FLU) PANDEMIC IN HAWAII

April 21: The first 2009 H1N1 pandemic influenza (swine flu) cases are reported in the United States by the Centers for Disease Control and Prevention, and the state Department of Health implements its pandemic influenza response plan. The department works with physicians and clinical laboratories to enhance surveillance to identify suspect cases quickly.

April 27: » The department receives first reports of suspect H1N1 pandemic cases in Hawaii, begins multiple investigations and sends health care providers medical advisories and alerts about the swine flu virus infection. » Health officials ask people with symptoms to seek medical care and health care providers to collect samples from patients for laboratory testing. The public is advised to stay home from school or work for seven days or 24 hours after a fever ends without needing medicines or whichever is longer.

May 5: The first three H1N1 cases are confirmed in Hawaii residents, including a Maui resident who was hospitalized with the illness on the mainland.

May 12: » The state Laboratories Division receives federal approval to confirm specimens for influenza A (H1N1) instead of sending them to the mainland. » The department confirms two H1N1 cases at Anuenue School on Oahu — an eighth-grade student and a third-grade teacher — and 16 cases are identified within three weeks. All recover with no hospitalizations or deaths. The school remains open, and the outbreak ends after 19 days. It is the first documented community transmission of swine flu virus in Hawaii.

May 18: The department prioritizes diagnostic flu testing for severe cases, those with high-risk conditions, those in high-risk occupations such as health care workers in direct patient care, out-of-state travelers, people identified in an outbreak investigation and children and teens under age 19.

May 26: The department informs the public about vaccine availability and how to protect against flu via Aloha United Way 211 and the department’s Web site.

June 19: An Oahu woman in her late 60s at Tripler Army Medical Center with underlying medical conditions is Hawaii’s first confirmed death tied to the flu strain.

June 29: » An outbreak is confirmed among several Molokai firefighters and related staff, requiring backup from Maui. » The department confirms 545 cases of H1N1 infection since May 5.

July 10: Hawaii allocates $1,478,835 in federal grants to help prepare for the H1N1 virus and fall flu season.

July 13: The department announces the second death associated with the virus: an Oahu man in his late 40s who died at the Queen’s Medical Center July 10.

July 17: The third related death is confirmed in a woman who died July 7 at Kona Community Hospital; she was in her early 50s with chronic underlying health conditions.

July 19: State testing data shows the “vast majority” of flu illness statewide is H1N1 influenza with a small mix of seasonal flu. State Epidemiologist Sarah Park implores people to stay home when sick.

July 25: The fourth death is reported: a man in his 50s who died July 19 at a Hawaii island hospital because of influenza pneumonia and underlying factors.

July 30: The department confirms the death of a man in his early 20s with H1N1 July 21 at an Oahu home and a man in early 30s July 22 shortly after being transported to an Oahu hospital. Both had underlying conditions.

Sept. 5: Four more deaths associated with H1N1 are reported June through August: three adults in their 40s and a child under 5. Two adults had underlying conditions. Deaths now total 10.

Oct. 5: The first batch of H1N1 vaccine arrives — 4,400 doses of nasal spray.

Oct. 8: A department Twitter page (twitter.com/HIGov_health) provides immediate notices about vaccine availability.

Oct. 13: Annual Stop Flu at School clinics begin with seasonal flu vaccine for children in grades K-8 at 342 public and private schools statewide. About 71,000 children and more than 10,000 staff and faculty are vaccinated.

Oct. 27: The department reports a man in his 50s with underlying conditions at Tripler Army Hospital is the 11th death associated with swine flu in Hawaii.

Nov. 13: Using the Stop Flu at School Clinics framework, H1N1 vaccination clinics begin in schools statewide.

Dec. 17: The department opens H1N1 nasal spray vaccinations to the general public.

Jan. 11: H1N1 shots are offered to the public along with nasal spray.

Jan. 20: » The department confirms two more swine flu deaths for a total of 13 — a woman in her 20s who died while hospitalized for pneumonia in late December, and a a man in his 50s who died the week of Jan. 10 after being admitted to a hospital and did not appear to have underling medical problems. » The H1N1 school vaccination program ends with more than 55,000 K-eighth-grade children and more than 10,000 faculty and staff from 328 schools vaccinated.

Jan. 27: At least 538,000 doses of vaccine are reported shipped or in transit to Hawaii; 651,000 doses are allocated to Hawaii.

Boston (DbTechNo) – The government of Rwanda has announced that there are no more swine flu cases in their country.

This news was made public by an official in the Ministry of Health, Dr. Justin Wane.

He said that following 4 months in which the country was dealing with numerous cases of the virus, as of last week there are no reported cases, and all who developed the swine flu have recovered.

“Since last week, we have not received any reports about emerging cases and certainly the situation is under control now. We mainly attribute the success of this fight to increased hygiene among all Rwandans,” he said.

“It is also important to note that those who contracted the flu made it a point not to infect others. Behavioral change also contributed a great deal to this achievement and we hope that the situation will remain as it is,” Wane added.

Swine flu first hit the country of Rwanda back in October, and since then more than 400 cases have been reported.

Swine flu has taken the world by storm since April of last year, prompting the World Health Organization to label it as a pandemic.

The virus first emerged in April in the country of Mexico and since then has swept across the globe, infecting hundreds of thousands and killing thousands.

Six more people have died of influenza A (H1N1) in Gujarat, taking the toll due to the swine flu pandemic in the country so far to 1235, an official statement said here today.

Three of the deaths were reported during the day, while reports of three deaths that occurred earlier were also conveyed by the health authorities of the state to the Union Ministry of Health & Family Welfare today, it said.

Of the total swine flu deaths in the country so far, Maharashtra now accounts for 317, while 242 lives have been lost in Gujarat, 176 in Rajasthan, 141 in Karnataka, 93 in Delhi, 52 in Andhra Pradesh, 38 in Punjab, 36 each in Kerala and Haryana, 22 in Madhya Pradesh, 18 in Uttar Pradesh, 13 in Uttarakhand, 8 each in Chandigarh and Himachal Pradesh, 7 in Tamil Nadu, 6 each in Chhattisgarh and Puducherry, 5 in Goa, 4 in Jammu & Kashmir, 3 in Orissa, 2 in Assam and 1 each in Mizoram and Dadra & Nagar Haveli.

The statement said 51 new cases of swine flu were reported from different parts of India today, including 28 in Maharashtra, 5 in Delhi, 4 in Rajasthan, 3 in Haryana, 2 each in Karnataka, Kerala, Punjab and Gujarat, and 1 each in Tamil Nadu, Uttar Pradesh and Jammu & Kashmir.

With these, the total number of laboratory-confirmed cases of the virus reported in the country so far has gone up to 28,861, the statement added.

A north Shropshire woman who works for the NHS and had the swine flu vaccination has been left unable to walk properly after the jab triggered a rare medical condition.

But married mother-of-two Alison Dygnas today urged others not to be put off having the jab themselves after she developed myasthenia gravis – a neurological condition which has left her with limited mobility and unable to lead the active life she led before.

In the space of three months she has been forced to give up work, an active lifestyle and many of the things she loved doing.

She said: “It’s entirely a personal choice and I wouldn’t want people to die because they never got the jab.

“It’s a rare side effect of the jab and there’s a one in a million chance of this happening.”

Mrs Dygnas was urged to have the jab because she works in the NHS.

Not for the first time, the World Health Organization is under fire for its handling of the current H1N1 influenza pandemic. Initially, it was criticized for being too slow to alert the world when the disease, often called swine flu, first broke out in Mexico. Now, the organization faces a diametrically opposite charge: that it was influenced by the pharmaceutical industry to create a false pandemic when none existed, so that drug companies could sell more vaccines. The W.H.O.’s critics are barking up the wrong tree. This is a real influenza pandemic, not an imaginary disease cooked up by public health agencies around the world and the pharmaceutical industry. Though for the vast majority of people the disease has been mild, it has killed small children, pregnant mothers and otherwise healthy teenagers. This is not an innocuous disease. Take a look at the lungs of those whom it as killed: The virus has turned them into a wasteland of devastated tissue, in a way that the normal flu virus never can.

The world has been fortunate that this virus has not mutated to cause more severe illness in larger numbers of people. This could still happen. In China, in less than a month’s time, one of the world’s great annual movements of people will take place as millions travel to their home towns and villages during the Chinese lunar new year holidays. Travel and the movement of people provides opportunities for the virus to spread to new environments and change to a more lethal form in the process. The changing flu seasons that see the focus of outbreaks move from the northern to the southern hemisphere, and then back again to the northern hemisphere later in the year, also bring risks of the virus changing to a more severe form.

The non-debate over whether there is a new type of flu sweeping the world has detracted from a real issue: The world’s poorest countries have yet to receive the vaccine they were promised, while many of the world’s rich countries are wondering what to do with vaccine supplies their citizens do not want. Ninety percent of the world’s influenza vaccine production is concentrated in Europe and North America. With production well short of demand, governments in these countries had contracts in place to buy the bulk of the first year’s production. Most poor and middle income countries (with the exception of countries like China, which has built up its vaccine production capacity) would have had to wait for at least a year for their first supplies.

If this pandemic had rapidly gained lethality and killed several millions of people, the imbalance in the supply of vaccine would have caused a major rift in society between those who had access to vaccines and those who did not. While those who lived in the world’s rich countries would have been largely protected, the majority of the world’s population would have borne the brunt of the pandemic , exposing the fault lines that divide the haves from the have nots in today’s globalized world.

To try and bring fairness to vaccine distribution, the U.N. secretary general, Ban Ki-moon, and the W.H.O. director general, Margaret Chan, met with the heads of major vaccine manufacturers last June, and received a pledge that they would devote 10 percent of their first year’s production for distribution to countries that would otherwise not have any supplies.

The W.H.O. put together a list of 95 countries that should have received emergency supplies of vaccines, beginning late last autumn. But it was only in January that supplies trickled through to the first three countries — Mongolia, Azerbaijan and Afghanistan.

Legal and administrative hurdles, regulatory issues and logistic problems have meant that the W.H.O. has been unable to deliver vaccines to developing countries at the time they most needed them, when the disease was peaking. Even had they received vaccine supplies, many countries were ill-equipped and ill-prepared to distribute the vaccines, revealing the weaknesses in health systems across the world.

The Council of Europe’s parliamentary assembly has held an emergency debate into the “false pandemic” that the W.H.O. declared ostensibly under the influence of the pharmaceutical industry. Wolfgang Wodarg, the chairman of the subcommittee on health in the council’s parliamentary assembly, has described the declaration of the pandemic as one of the greatest medical scandals of the century. The real scandal that should be investigated is the inequity in pandemic vaccine distribution.

Thomas Abraham heads the public health communication program at the University of Hong Kong’s Journalism and Media Studies Center, and was working at the W.H.O. when the pandemic was declared last year.

According to a recent statement by Dr. Justin Wane, an official in the Ministry of Health, all the cases of the infectious influenza A, H1N1 virus– or swine flu – have recovered; and, as of now, there are no more cases of the disease in the country.

Nonetheless, the situation is being constantly and closely monitored by theMinistry of Health, via TRAC Plus, the National Reference Laboratory and other organs.

Noting that Rwanda has been relentlessly battling with the H1N1 virus for the past four months, Wane – the head of the Swine Flu response team – said that even the Kigali Central Prison’s most recent confirmed swine flu cases recovered completely last week.

Saying that thus far nearly 400 “severe but rather very mild” cases of swine flu have been treated and fully recovered in Rwanda, Wane added: “Since last week, we have not received any reports about emerging cases and certainly the situation is under control now.”

Giving the Rwandans credit for the “truly commendable” turnaround in the swineflu situation, Wane added: “We mainly attribute the success of this fight to increased hygiene among all Rwandans. It is also important to note that those who contracted the flu made it a point not to infect others. Behavioral change also contributed a great deal to this achievement and we hope that the situation will remain as it is.”

Mumbai: Swine flu kills one more in Egypt: After confirming its first case of H1N1 death on July 19, 2009, Egypt registered one more death on Sunday.

Now the swine flu death toll of the nation has reached 258. A 53-year-old man from Assiut governorate succumbed to the deadly flu.

The first victim was a 28-year-old Egyptianwoman coming back from Saudi Arabia after her pilgrimage to Mecca.

According to a Yuma Country news release, residents can still receive flu shots for both the H1N1 virus or swine flu as it is also known, and for seasonal flu, as well.

Vaccines will be offered by workers from the Yuma County Public Health District from 8:00 a. m. to Noon and 1:00 p. m. to 4:30 p. m. Monday through Thursday for the month of February. For receiving the vaccines you will have to visit Room 256, the Nursing Division, at 2200 W. 28th St. in Yuma.

According to the release, the H1N1 vaccine is being provided at no cost, though the seasonal flu shots come at a cost of $25 for adults and $10 for children, with cash, Medicare and AHCCCS (Arizona Health Care Cost Containment System) accepted.

Clinics will be open to people of all ages having a physical address in Yuma County, with shots given on a first come, first serve basis.

As per the county news release, so far, area physicians, Fry’s, Mollen clinics, Walgreens and Healthwaves have received the distributed vaccines, and will continue to receive them for the rest of the flu season.

Call the 2009-2010 Flu Season phone line with recorded information at (928) 373-1025 for more information on both kinds of flu vaccines.

And while, pharmacies across the stateline continue to offer vaccinations, a free flu clinic is being set up in Ogle County tomorrow, from 9:00 a. m. to Noon at the Oregon Health Department. It is completely free.

Dispute is over $106 million alleged ‘personal services’ contract

The Health and Human Services Department’s inspector general has accused the Centers for Disease Control and Prevention of violating federal contracting rules  in CDC’s administration of a $106 million professional services contract, according to a new report.

The case involves a CDC contract that HHS IG Daniel Levinson alleges was a personal services pact prohibited by the Federal Acquisition Regulation. CDC officials are disputing the allegation and defending their handling of the contract.

Under the federal rule, “personal services” are defined as those in which an employer-employee relationship is created between the government and contractor personnel. Factors to be considered include whether the contract worker is subject to relatively continuous supervision by agency personnel, whether the contractor performs the work on site, whether the government furnishes the equipment and tools, whether the work carries out the agency’s mission, and whether the need for the service can be expected to last beyond one year.

Under federal rules, agencies that hire contractors for personal services are circumventing federal civil service hiring. Such contracts are prohibited except in special cases.

Levinson audited a 2003 CDC contract for management and consulting services awarded to an unidentified minority- and woman-owned professional services certified small business contractor. The contractor subsequently received 149 task orders totaling $106 million from 2003 to 2008.

The IG’s audit covered eight task orders valued at $18.9 million, which required an estimated 110 contractor personnel.

Levinson concluded that CDC inappropriately administered all eight task orders as personal service contracts. “By using contractor personnel for personal services, CDC violated the Federal Acquisition Regulation,” Levinson wrote. The Jan. 11 IG report recommends that CDC further evaluate its contracts for compliance and institute additional policies and procedures.

However, in written comments to the draft report, CDC Director Dr. Thomas Frieden said the contract in question was not a personal service contract.

“The contract in question was neither structured nor administered as a personal services contract by the CDC,” Frieden wrote. “We recognize that there may be instances where the actions of federal employees may have contributed to creating the appearance of one or more personal services indicators. But the totality of these circumstances do not rise to the level of the contract relationship being for personal services, and we do not believe the contracts were regularly administered as personal services.”

Levinson, in a response to Frieden, maintains that the CDC violated federal rules.

The CDC did not address the key elements identified in the audit, Levinson wrote. “Most significantly, CDC did not address our finding that its employees had provided relatively continuous supervision and control of on-site contractor personnel. CDC also did not address our findings on on-site contractor performance, equipment and supplies furnished to contractor personnel, services necessary to accomplish CDC’s mission, and services needed beyond one year. When considered together, these findings demonstrate that CDC violated the Federal Acquisition Regulation,” Levinson wrote.

The CDC is responsible for the federal public health education and response. In recent months, the agency has been awarding contracts for surveillance of swine flu infections.