Swine flu: No cause for alarm, not considered a pandemic so far

With increasing numbers of people contracting the deadly swine flu virus, various governments and organizations are swiftly reacting by putting in place precautionary measures.

Among such organizations taking actions, the United Nations health agency on Monday elevated the international pandemic alert to phase 4, on a six-point scale, for the first time since the current warning system was introduced in 2005 in response to the avian influenza crisis.

The increase in the alert level signals an outbreak of human-to-human transmission in at least one country, which increases the risk of a global epidemic but does not mean a pandemic is inevitable.

“Given the rapidly-evolving situation [it was felt] that it was important to give a strong signal to countries that now is a good time to strengthen preparations for possible pandemic influenza,” United Nations World Health Organization (WHO) assistant director-general Keiji Fukuda told reporters in Geneva.

Mr. Fukuda explained that the emergency committee of health experts, set up to deal with the recent outbreak of the swine flu virus, raised the alert level because the virus had already spread to the United States, Mexico, and Canada, with a verified case in Spain.

He underscored the importance for authorities to protect the health of individuals and to focus their efforts on mitigating the disease rather than attempting to stop its spread, stressing that “containment is not a feasible consideration.”

WHO would not recommend the closing of borders or the restriction of travel, which would have little to no effect in stopping the movement of the virus, Mr. Fukuda said.

Phase 5 of the WHO pandemic alert levels is characterized by human-to-human spread of the virus into at least two countries in one WHO region. “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,” says the agency’s website.

Noting that flu season is now kicking into gear in the southern hemisphere, Mr. Fukuda said it is prudent to continue production of general influenza vaccines that prevent severe illness and death from seasonal influenza.

However, the emergency committee also advised WHO to “take all steps to facilitate production and development of a swine flu influenza vaccine that would be effective in [treating] people against this new virus.”

A new vaccine would normally take four to six months to develop and for the production of initial batches. The manufacture of significant amounts of the vaccine would require further months, by which time the threat of pandemic could be over, warned Mr. Fukuda.

In an unscheduled address to the press Monday afternoon, secretary-general Ban Ki-moon told reporters “The UN system is responding, quickly and effectively, with the director general of the WHO, Dr. Margaret Chan, taking the lead.”

Announcing that the World Bank and other UN development and humanitarian agencies will provide funding to countries needing additional resources to combat an epidemic, Mr. Ban said that the poorer nations must not be hit disproportionately hard by a potential health crisis.

“So far, our response has been an example of multilateral cooperation at its best. I am confident that it will continue to be so,” he added.

Meanwhile, a team of experts from the UN Food and Agriculture Organization (FAO) is helping to determine if the new virus strain has a direct connection to pigs.

FAO will also dispatch a team of animal health experts to Mexico this week to help the government assess the origin and transmission of the infection in the pig production sector.

So far, the spread seems to be solely human-to-human. Evidence that the virus entered the human population directly from pigs has not yet been established. “There is no evidence of a threat to the food chain; at this stage it is a human crisis and not an animal crisis, but we have to be alert and prepared,” said FAO chief veterinary officer Joseph Domenech.

He added that FAO and others must first “ascertain if the new strain is circulating in pigs, establish if there are any direct linkages between the illness in the human population and animals, and explain how this new virus has obtained genetic materials from human, bird, and pig influenza strains.”

With 40 human cases of swine influenza A (H1N1) virus infections in the United States, top officials declared a national health emergency Sunday. White House Homeland Security advisor John Brennan said that US President Barack Obama has ordered a “very active, aggressive, and coordinated response.”

“Nobody is taking any chances,” said Fran Lessans, CEO of Passport Health, a provider of travel medical services and immunizations in the US. “We are warning travelers to postpone their trips to Mexico City and, if they must go, we are counseling them on the use of antivirals to prevent and treat this type of influenza.”

According to published reports, 12 million doses of flu-fighting medications are being mobilized from a federal stockpile in the event they are needed. The Belfast Telegraph reported early this Monday morning that Scotland has also reported two cases of swine influenza; the travelers having just returned from Mexico.

“We have influenza immunizations and some of our offices have antivirals,” added Lessans. “But this is not your typical influenza strain. The influenza vaccine does not specifically protect against the swine flu, but it does help boost an immune response since the swine Influenza strain is also A (H1N1).”

According to Passport Health, Antivirals Tamiflu (Oseltamiviror) or Relenza (Zanamivir) are used for treatment when exposure is suspected. The antivirals, which are available at some of Passport Health’s nationwide offices, have proven to be effective against the swine influenza virus in laboratory tests. To be effective, the antiviral regiment must be started within 48 hours of exposure, added Lessans.

Meanwhile, Tourism Fiji CEO Josefa Tuamoto has advised that while Fiji remains free of the swine flu virus, the Fijian government is taking all necessary action to combat an outbreak of the virus within the destination.

Mr. Tuamoto said currently there are no international restrictions on travelers arriving in Fiji from affected areas in Mexico, US, and Canada. However, and as per newly-implemented policy in several other countries, airlines flying into the destination have been requested to advise of any passengers with flu-like symptoms before they arrive in the country.

Mr. Tuamoto said Fiji’s Ministry of Health has been swift to react to the situation, establishing a national task force with its stakeholders in order to closely monitor the situation.

Part of the task force’s activity will be to implement influenza surveillance and identify the virus in the population as quickly as possible.

Fiji’s health ministry, Tuamoto said, has advised that any travelers returning from affected areas who develop respiratory symptoms (fever, cough, sore throat, body aches, headache, chills, etc.) within seven days should report immediately to their nearest hospital for tests and treatment.

In addition, the Tourism Fiji CEO said, the health ministry is urging the general public and all visitors to take simple precautions to protect themselves from influenza viral infections.

Mr. Tuamoto stressed that the swift reaction from the Fijian health authorities fully underlined the government’s intention of doing everything within its power to ensure the health and well being of the Fijian people and the country’s international visitors.

Hong Kong and South Korea have warned against travel to the Mexican capital and three affected provinces. Italy, Poland, and Venezuela also advised their citizens to postpone travel to affected areas of Mexico and the United States.

Coincidentally, the Centers for Disease Control and Prevention (CDC) will be hosting a conference call today from 2:00 pm to 4:00 pm Eastern Standard Time on “Federal Public Health Emergency Law – Implications for State and Local Preparedness and Response.”
The Clinician Outreach and Communication Activity (COCA) conference call is being sponsored by the CDC Public Health Law Program and the CDC Coordinating Office for Terrorism Preparedness and Emergency Response and will offer a comprehensive overview of the principal federal laws that frame responses to all-hazards public health emergencies, according to the Federal Emergency Management Agency (FEMA).

FEMA added that these laws are directly relevant to federal, state, tribal, local, and territorial agencies’ emergency preparedness and response efforts. “This call will present an overview of the federal authorities for public health emergency preparedness and response under the Public Health Service (PHS) Act and related provisions of the Social Security Act and the Food, Drug, and Cosmetic Act. The Stafford Act and quarantine authorities under the PHS Act will also be discussed.”

Speakers will include Susan Sherman and Jennifer Ray from the US Department of Health and Human Services (HHS), Diane Donley from FEMA, and Kim Dammers from the US Department of Justice.

The call-in number is 888-283-2960 and the passcode:3986978.