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Swine Flu Update 28-04-09

Posted by feww on April 28, 2009

World Health Organization (WHO) flu expert, Dr Keiji Fukuda:

“Containment is not a feasible operation”

WHO has raised its swine flu alert level from three to four – two levels short of a full pandemic.

There has been  a “significant step towards pandemic influenza”, but “we are not there yet,” Dr Keiji Fukuda, WHO Assistant Director General said.

“What this can really be interpreted as is a significant step towards pandemic influenza. But also, it is a phase that says we are not there yet,” Fukuda said.

“In other words, at this time we think we have taken a step in that direction, but a pandemic is not considered inevitable.”

Because  the virus has become too widespread, containment is no longer a feasible option, he said, adding that the countries must focus measures that mitigate circumstances.

Alert level four means the virus is showing a sustained ability to pass from human to human, and is capable of causing community-level outbreaks.

In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans.

In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.

In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.

Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.

In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required. —WHO

Confirmed and suspected cases

  • In Mexico the death toll from swine flu outbreak rose to 149 , but the authorities have only confirmed 20 cases.
  • The victims are all aged between 20 and 50.
  • A total of about 2,000 people had been hospitalized since April 13, when the first case of swine flu was reported, but a half had been released.
  • Cases are confirmed in the US, Canada, Spain and Britain.
  • In New Zealand a total of about 80 suspected cases were reported.
  • The first batches of a swine flu vaccine could be ready in about four to six months, but it would take several more months to produce it in large quantities, Fukuda said. [But is it guaranteed to work? And more importantly, is it safe?]
  • The newly-detected virus contains genetic material from previous versions of swine flu and avian flu viruses, experts say.
  • Schools nationwide will remain closed until  May 6, as a precautionary measure to mitigate the outbreak.

The U.S. Cases

  • A further 20 cases of swine flu were confirmed in New York, with other cases reported in  California,  Kansas, Ohio, Texas reaching a total of about 40 nationwide.
  • Patients with swine flu outside Mexico are said to be making a full recovery, so far.
  • It is thought that only person in the US had been hospitalised as a result of contracting the virus, and all had recovered.
  • The US Centers for Disease Control and Prevention (CDC) is advising that  “non-essential travel to Mexico be avoided”.

New Zealand, Australia, Brazil, Canada, Israel, Scotland  South Korea, Spain

  • At least six cases have been recorded in British Columbia and in Nova Scotia.
  • Two people in Scotland and a young man in Spain who returned from Mexico were tested positive for the virus.
  • Suspected cases of swine flu infection are being reported in New Zealand, Australia, Brazil, Israel and South Korea among visitors who returned from Mexico.
  • Many countries have banned imports of raw pork and pork products from Mexico and the US.
  • Shares in airlines have nosedived amid fears of the economic impact of the virus outbreak.
  • Oil futures fell 5% in early trading Monday because of concerns over global economic recovery.

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6 Responses to “Swine Flu Update 28-04-09”

  1. […] Swine Flu Update 28-04-09 Posted by feww on April 28, 2009 […]

  2. […] Swine Flu Update 28-04-09 […]

  3. feww said

    Breaking News
    Swine Flu Death in Texas

  4. feww said

    Israel, New Zealand latest countries hit by swine flu

    By Catherine Bremer

    MEXICO CITY (Reuters) – New Zealand and Israel confirmed cases of swine flu on Tuesday, the latest countries hit by a new strain that has killed up to 149 people in Mexico and which threatens to become a pandemic.

    The World Health Organization has raised its alert level to phase 4, indicating a significantly increased risk of pandemic. Global markets tumbled for a second day on Tuesday on fears the outbreak could snuff out fragile signs of economic recovery.

    No one has died outside Mexico but more than 50 infected people have been found in the United States, six in Canada and two each across the Atlantic in Spain and Scotland. Possible cases were being tested in South Korea and Australia.

    New Zealand said three of 11 people in a school group that visited Mexico had tested positive and it expected the others would also turn out to be positive when tests were completed.

    Health Minister Tony Ryall said all those affected appeared to have only mild symptoms and had been responding to treatment.

    Authorities have tracked down most of the 356 people on the same flight from Los Angeles as the infected students.

    The Israeli carrier, a 26-year-old man, had also recently returned from Mexico.

    “His condition is good but he is being kept hospitalized for observation,” health ministry spokeswoman Einav Shimron said.

    One of the mysteries of the current outbreak is why all cases outside Mexico have so far been relatively mild.

    The WHO said the flu was being spread by human-to-human transmission but it did not advise any travel restrictions or border closures.

    Asian and European stock markets retreated, with airline stocks taking another hit and drug makers posting gains. The yen climbed to a seven-week high against the euro and a one-month high versus the dollar as investors cut their exposure to riskier currencies.

    Oil dropped 2 percent, sinking below $50 a barrel.


    Britain, France, Germany and the United States issued travel alerts for Mexico, which relies on tourism as a main source of foreign currency. Japan advised its citizens in Mexico to consider returning home soon.

    China promised to disclose any cases promptly. State-run newspapers urged officials to be open and avoid the kind of cover-up that brought panic during the SARS epidemic in 2003.

    Asian companies stepped up precautions, restricting travel and advising staff on how to protect themselves.

    “We’re limiting all non-essential travel to places that have seen cases of swine flu, and staff members returning from those areas will be quarantined for a period of time before being allowed to enter our factories and facilities,” said Edmund Ding, spokesman for Taiwanese electronics parts firm Hon Hai, which has several factories in Mexico.

    Experts say that while it is impossible to stop the spread of the disease, efforts to slow its progression around the world could buy crucial time for countries to procure essential drugs.

    The last flu pandemic, a Hong Kong flu outbreak in 1968, killed about one million people around the world.


    In Mexico, epicenter of the latest outbreak, people from company directors to couriers wore face masks while airlines checked passengers for flu symptoms.

    “We will defeat this threat,” Mexico City Mayor Marcelo Ebrard said as several hundred people suspected to be suffering from the flu were treated in hospitals and life in the normally hectic capital took on an eerie hush.

    Mexico City shut restaurants, bars, cinemas, stadiums and some government offices to stop the infection from spreading.

    Unsure how worried they should be, people stocked up on food, drinking water, rental movies and surgical masks. Some opted to work from home. Schools were closed until May 6.

    Facing damage to tourism and trade — motors of an economy that is already tipping into recession from the global downturn — Mexico said it would not order a mass closure of businesses to try to contain the infection.

    “Economic activity must continue,” Labor Minister Javier Lozano told a news conference.

    Danske Research said worries over the outbreak weighed on global markets but they were not panicking. The swine flu could be used as an excuse to reduce risk after a period of increased appetite, it said.

    If the WHO raises its pandemic alert level, it could have a further negative impact.

    “The impact would obviously be biggest for countries involved and for emerging markets with weak medical infrastructure and lack of contingency plans for fighting pandemics,” Danske said.

    Worldwide, seasonal flu kills between 250,000 and 500,000 people in an average year. The new strain is worrying as it spreads rapidly between humans and there is no vaccine for it.

    Most of the fatalities have been people aged between 20 and 50, an ominous sign because a hallmark of past pandemics has been the high rate of fatalities among young adults.

    Mexican media have speculated the flu may have originated at a pig farm in the southeastern state of Veracruz.

    But Health Minister Jose Angel Cordova said the first case that alerted authorities to a possible rogue flu strain was in the southern state of Oaxaca. It was too early to identify the cause or geographical source of the virus.

    WHO also did not know where the outbreak started.

    The first victims may not have recognized they were infected with a new type of flu requiring different treatment than normal flu, they may not have received the medicines until late, or they may have been infected with other diseases reducing their immunity to the virus, WHO spokesman Gregory Hartl said ina Geneva.

    Officials say the virus is not caught from eating pig meat products but several countries banned U.S. pork imports.

    The heavy volume of visitors to Mexico only underscores the risk of contagion. Airlines fly more than 1 million passengers in and out of Mexico City’s international airport each week.
    © Thomson Reuters 2009 All rights reserved

  5. terres said

    Swine flu in New Zealand – cases confirmed
    BREAKING The Director of Public Health tonight announced that three of the Rangitoto College party have tested positive for swine flu H1N1.

    Results from three of the samples were received earlier this evening by World Health Organisation’s Melbourne laboratory and all tested positive for the same swine flu strain.

    Testing continues on a fourth sample.

    “Unfortunately tonight we can confirm New Zealanders have tested positive to swine flu,” Health Minister Tony Ryall said.

    On the basis of these results the Ministry is assuming all of the people in the group who tested positive for influenza A have swine flu.
    © 2009 Fairfax New Zealand Limited

  6. […] Swine Flu Update 28-04-09 […]

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