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From the news: Roundup and analysis.

Giuseppe

Emeritus
Swine Flu Emergency Caused By New Variant of Old Bug (Update2) - Bloomberg.com

Swine Flu Emergency Caused By New Variant of Old Bug (Update2)

By John Lauerman and Jason Gale
April 26 (Bloomberg) --

International health officials are wrestling with how to respond to a swine flu from Mexico that?s infecting people, causing a range of illnesses, and even death.


The World Health Organization called the outbreak a ?public health emergency of international concern? yesterday, and as many as 81 deaths in Mexico were linked to the virus, normally transmitted among pigs. Eleven cases in California, Kansas and Texas, all of them mild, have been connected as well, and at least eight students in New York are being tested for whether they match the Mexico strain, health officials said.

Fears of a lethal pandemic lie in the nature of flu germs, which mutate readily and can become virulent by exchanging genes with related influenza viruses. While the H5N1 bird virus that spread across Asia in the last few years, killing millions of fowl and several hundred people, never gained genes to spread easily among humans, the Mexican swine flu already has, said Malik Peiris, a microbiologist from the University of Hong Kong.

?The concern is that this virus has the ability to transmit from humans to humans because a number of the cases who got infection have had no direct exposure to swine,? said Peiris, who has studied the SARS and avian flu viruses. ?That is certainly a cause for concern.?

Health officials said they are trying to determine how the virus gained its ability to infect and spread among humans.

Swine-Flu Emergency
Mexican President Felipe Calderon declared a swine-flu emergency, giving him powers to order quarantines and suspend public events in the nation, where 1,324 patients are hospitalized with flu-like symptoms.

Authorities closed schools until May 6 in Mexico City and the states of Mexico and San Luis Potosi, where infections have been concentrated, and canceled most public and official activities.

The U.S. Centers for Disease Control and Prevention, an Atlanta-based agency, is leading the search for more cases than the 11 it has confirmed as of yesterday.

The latest U.S. tally includes two adults residing at the same address in Dickinson County, Kansas. Neither of the patients was hospitalized, the state?s health department said in a statement on its Web site yesterday. One is still ill and being treated, and one is recovering, it said. One of the patients had recently traveled to Mexico, flying in and out of Wichita, according to the statement.

New Zealand Students
Three teachers and 22 students from Auckland?s Rangitoto high school are being tested for swine flu after returning to New Zealand?s most populous city from Los Angeles following a three week trip to Mexico, Stuff.co.nz reported on its Web site. Some of the travelers had symptoms of flu-like illness and were being isolated as a precaution pending test results, it said, citing Auckland?s public health service.Japan began screening for fever in travelers returning from Mexico fevers, the country?s health ministry said in a statement yesterday. A British Airways Plc crewmember was hospitalized in north London with suspected swine flu after arriving yesterday on a flight from Mexico City. Tests showed he doesn?t have the bug, Agence France-Presse said, citing a hospital spokesman.

Outbreaks in Mexico and the U.S. warrant an urgent assessment of its potential to spark the first influenza pandemic in 41 years, the WHO said yesterday. The Geneva-based United Nations agency held an emergency meeting and found that more evidence is needed to determine whether the level of pandemic alert should be increased, it said.

Pandemic Threat
The WHO?s pandemic threat level, a six-stage measure, is currently at 3. Evidence of increased human-to-human spread of a new virus would move it to level 4, according to the WHO Web site.

Health officials in the U.S. are asking both doctors and patients to be on the lookout for suspicious cases of flu. The lung virus normally causes symptoms such as coughing and sneezing, and can also bring on muscle and joint aches, headaches, and even diarrhea and vomiting, according to the CDC.

At a time when scientists can tailor drugs to match a patient?s genetic profile and people live longer than ever, the flu, first described by Hippocrates 2,400 years ago, still has the power to make millions bed-bound for a week and kill the very young, the elderly and those weakened by chronic disease.

The CDC estimates the germ is linked to more than 30,000 U.S. deaths annually.

In most cases, adults can resist succumbing to flu viruses that are identical or very similar to those they?ve been exposed to before. ?New? viruses that the human immune system hasn?t seen earlier are the most dangerous, because they can overwhelm the body?s defenses.

1918 Pandemic
Flu germs are classified by two proteins, one known by the letter H, for hemagglutinin, and the other N, for neuraminidase. The Mexican swine flu is an H1N1 flu, the same subtype that caused the pandemic of 1918. Many less-dangerous descendants of that virus are seasonal H1N1 viruses circulating worldwide today, scientists said.

The dominant form of flu circulating in the U.S. in the most recent flu season was an H1N1, said Frederick Hayden, professor of clinical virology at the University of Virginia Health Sciences Center in Charlottesville. That suggests that people who got this year?s flu vaccine, which gave protection against the H1N1 virus, might also have some protection against the swine flu, he said.

?We need to take the [blood] of individuals who got last season?s vaccine and see whether there?s any evidence of cross- reactivity for this new strain,? he said in a telephone interview. ?We need to do the same thing with patients who have had recent infection with the human H1N1 strain.?

1976 Swine Flu
The CDC is conducting studies now that might show whether seasonal vaccination might protect people against swine flu. It?s also possible that people who were vaccinated in the 1976 swine flu outbreak, which many flu experts believed was the beginning of a pandemic at the time, are protected, he said.

Vaccine makers are taking the initial steps toward making shots against swine flu. Baxter International Inc., a maker of both seasonal and pandemic vaccines, has requested samples of the swine virus for laboratory testing, said Christopher Bona, a spokesman for Deerfield, Illinois-based Baxter. GlaxoSmithKline Plc, based in London, has had conversations with WHO?s flu division that?s responsible for distributing flu virus samples to drugmakers, said Deborah Alspach, a spokeswoman.

Other companies that make flu vaccine include Novartis AG, of Basel, Switzerland, and Sanofi-Aventis SA, of Paris.

Roche?s TamifluRoche Holding AG, of Basel, has an ample supply of Tamiflu, which can reduce the symptoms of swine flu. Roche has donated a ?Rapid Response Stockpile? of 5 million treatment courses to the WHO that?s on 24-hour stand-by to be sent around the world, said Terence Hurley, a spokesman for the company. No request has been made to deploy the stockpile, he said in an email.

Glaxo also has ample supplies of its inhaled Relenza antiviral, which also appears to be effective against the swine flu in CDC tests, Alspach said.

The virus has already evaded the first line of defense that health officials had hoped to use against a pandemic. International flu experts preparing for a pandemic had planned to contain the initial outbreak of a new, lethal strain of flu. The swine flu virus has already spread so far in Mexico and the U.S. that the containment strategy is out of the question, said Anne Schuchat, interim deputy director for science and public health programs at the Centers for Disease Control and Prevention, the Atlanta-based U.S. agency.

?We don?t think we can contain the spread of this virus,? she said yesterday in a conference call with reporters.

To contact the reporter on this story: John Lauerman in Boston at jlauerman@bloomberg.net; Jason Gale in Singapore at j.gale@bloomberg.net
Last Updated: April 26, 2009 04:27 EDT
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<cite cite="http://www.bloomberg.com/apps/news?pid=newsarchive&sid=aD0VK0_oNmw4">Swine Flu Emergency Caused By New Variant of Old Bug (Update2) - Bloomberg.com</cite>
 
Re: From the news: Roundup and analysis.

Reuters AlertNet - ANALYSIS-Swine flu cases raise more questions than answers

ANALYSIS-Swine flu cases raise more questions than answers

26 Apr 2009 20:07:52 GMT
Source: Reuters

(Refiles to fix date)

* Flu behaves unpredictably
* Officials confused because many infections look alike
* Influenza can spread quietly and undetected

By Maggie Fox, Health and Science Editor
WASHINGTON, April 26 (Reuters) -

How widespread is this new swine flu that has killed as many as 81 people in Mexico? How can a swine flu be infecting people? Why has it killed some people and caused only mild symptoms in others?


The new strain of H1N1 influenza is behaving just as public health experts expect it to -- that is, unpredictably.

"It's very hard to predict exactly," Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention told reporters in a conference call. "We all need to all be prepared for change."

Within hours on Sunday, officials learned of new cases across the United States and in Canada, for a total of 26, in addition to more than 1,300 suspected cases in Mexico.

Influenza can spread quietly, and people who are infected can spread the virus before they even start showing symptoms. One of the biggest problems with flu is that it causes flu-like symptoms -- just like dozens of other viruses and bacteria do.

Fever, headache, muscle aches, dry cough, extreme tiredness -- all these can be caused by numerous other infections from the rhinoviruses that cause the common cold to the less-known but also common adenoviruses.

"The syndrome that we are hearing about in Mexico is relatively non-specific," Schuchat noted. "There are many different causes of respiratory illnesses."

And people die of these common infections every day. Even during the height of the flu season, only 10 percent or less of deaths from "influenza-like illness" are ever confirmed to be influenza.

So tracking it is difficult.

Health officials all over the world are now testing people with influenza-like symptoms for the new strain of swine flu. It requires DNA tests because it is an influenza A virus -- like two of the strains now causing very common seasonal flu. It is also an H1N1 virus -- one of the seasonal strains.

DNA TESTING
Not until the DNA is sequenced does it become clear whether a person with influenza has this new and unusual strain of swine flu.

"It could be all over the place and they just haven't tested for it," said Mike Osterholm, a former Minnesota state health official who is now director of the Minnesota-based Center for Infectious Disease Research and Policy.

It already has turned up in Mexico, Canada and the United States, and among people who have nothing else apparent in common. That suggests the connection is an as-yet unseen chain of human infections.

"It is clear that this is widespread. And that is why we have let you know that we cannot contain the spread of this virus," Schuchat said.

This new strain is just what flu experts have worried about. It has DNA from four different strains of flu. While genetically it most closely resembles a swine H1N1 virus, it contains avian flu and human flu sequences as well.

While most cases in the United States, Canada and Mexico have been mild, it has killed up to 81 people in Mexico, including some young adults. This is disturbing because flu usually kills the very young, the very old and those with other underlying conditions.

"It may look different because we don't have good enough information. It may look different because the virus is different," Schuchat said.

Acting CDC director Richard Besser said this virus could itself disappear and reappear. "It's very hard to say," he told a White House briefing on Sunday. "We are nearing the end of the season in which flu viruses tend to transmit easily."

Besser said he would expect the number of cases to decline in the northern hemisphere's summer. Other pandemics have come in waves months apart and Besser said this virus could do that.

Pandemics hit in 1918 -- killing anywhere between 40 million and 100 million people globally -- and in 1957 and 1968. The 1968 pandemic was relatively mild, with 1 million deaths -- perhaps because the case, an H3N2 virus, was similar to the H3N2 that caused the 1957 pandemic and people had some immunity.

H1N1 has been around since the 1918 pandemic, in various forms but no one knows if this strain is different enough to cause widespread and severe disease. Health experts say the world is overdue for another pandemic but have stressed that no one can predict which strain would cause the next one.

(Editing by Philip Barbara)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/N26492325.htm">Reuters AlertNet - ANALYSIS-Swine flu cases raise more questions than answers</cite>
 
Re: From the news: Roundup and analysis.

Reuters AlertNet - U.S. acts swiftly to contain swine flu outbreak
U.S. acts swiftly to contain swine flu outbreak

26 Apr 2009 19:42:53 GMT
Source: Reuters

* US to release 25 percent of anti-viral stockpile
* Health chief recommends planning for school closures
* Too early to determine impact on economy

By Ross Colvin
WASHINGTON, April 26 (Reuters) -

The United States declared a public health emergency on Sunday because of an outbreak of swine flu that has been diagnosed in 20 people in this country -- the same strain suspected of killing 81 people in Mexico.


The outbreak is yet another distraction for President Barack Obama, who is focused on rescuing the economy from its worst crisis in decades. His administration will also be mindful of the lasting damage to former President George W. Bush over his government's inept handling of Hurricane Katrina in 2005.

"At this point, a top priority is to ensure that communication is robust and that medical surveillance efforts are fully activated," John Brennan, assistant to the president for Homeland Security, told a White House briefing.

Health and Homeland Security officials announced steps to release some of the country's stockpiles of anti-flu drugs, Tamiflu and Relenza. They recommended that local authorities plan for possible school closures and for people with flu-like symptoms to stay at home to reduce the possibility of transmission.

White House spokesman Robert Gibbs said it was too early to say what impact the outbreak could have on efforts to get the economy back on its feet. Spiraling health-care costs are already a huge drain on the economy.

Homeland Security Secretary Janet Napolitano said the declaration of the public health emergency was necessary to free up federal, state and local agencies' resources and authorize the release of funds to buy more antivirals.

"This is standard operating procedure," Napolitano stressed, adding that similar declarations had been issued in the past to help states cope with flooding or to help them prepare for approaching hurricanes.

WHY NOT AS DEADLY?
The acting director of the Centers for Disease Control and Prevention, Dr Richard Besser, told the briefing there were 20 confirmed cases of swine flu in the United States. All patients had recovered and only one person had to be hospitalized.

It appeared to be the same strain as the virus that has killed scores in Mexico, he said, although it was not yet clear why it had not proven as deadly in the United States. Health officials from the United States and Canada were now in Mexico to try to answer this "critical question," he said.

"We expect to see more cases of swine flu. As we continue to look for cases, we expect that we will find them," he said.

Besser said the closure of two schools in New York City, where there had been a cluster of swine flu cases, and in Texas had been the right way to go.

"If there are other communities where we saw cases in a school, we would be recommending they take those actions as well," he said.

Napolitano said the United States would release 25 percent of the 50 million anti-flu drugs from the strategic national stockpile. The Department of Defense has also bought 7 million courses of Tamiflu for for defense personnel, she said.

Tamiflu, a pill made by Roche AG <rog.x> and Gilead Sciences Inc <gild.o>, and GlaxoSmithKline's <gsk.l> <gsk.n> and Biota's <bta.ax> Relenza, an inhaled drug, can treat influenza if given quickly. They have been shown to work against this new flu strain.

Gibbs said Obama, who recently returned from a trip to Mexico, had shown no symptoms of the virus and had therefore not been tested.

(Additional reporting by Kim Dixon; editing by Chris Wilson)
(For full coverage of the flu outbreak, click on [nFLU])
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Reuters AlertNet - U.S. acts swiftly to contain swine flu outbreak
 
Re: From the news: Roundup and analysis.

FACTBOX-Making a flu vaccine can take months
26 Apr 2009 21:06:29 GMT
Source: Reuters


April 26 (Reuters) -

The U.N. World Health Organization and U.S. Centers for Disease Control and Prevention have been collecting samples of the new H1N1 swine flu virus to make a new vaccine in case it is needed. Following are some facts about influenza vaccines.

* The WHO and CDC prepare samples of virus to give to industrial makers. * These samples must be grown in specially produced chicken eggs. The virus is then purified and made into vaccines, a process that takes months. * At least 20 companies make flu vaccines including Sanofi Pasteur <sasy.pa>, Australia's CSL Ltd <csl.ax>, GlaxoSmithKline Plc <gsk.l>, Novartis AG <novn.vx>, Baxter <bax.n> and nasal spray maker MedImmune, acquired by AstraZeneca Plc <azn.l>.
* Experts agree the current process for making vaccines is clumsy and outdated, but new and more efficient technologies are still a few years away.
* WHO and CDC experts are trying to decide if a new vaccine for the H1N1 swine flu strain is needed, or perhaps if a fourth element could be added to the seasonal flu vaccine mix for next September.
* The health agencies also had been considering adding some vaccines against H5N1 avian influenza, which occasionally infects people and is also considered a major pandemic threat.
* Tests show the H1N1 component of the current seasonal flu vaccine does not protect against the new strain.
* Consulting firm Oliver Wyman found that drug companies would need four years to meet global demand for vaccines if a pandemic broke out today, but new technology could significantly boost production by 2014.
* Currently, drug makers could make up to 2.5 billion doses of pandemic vaccines in one year, meaning it would take four years to meet global demand, Oliver Wyman found. In a best-case scenario, they could make 7.7 billion doses in 1.5 years.
* Compounds called adjuvants can be used to boost a vaccine's effectiveness, so it could be diluted and used in more people.
* Current global demand for seasonal influenza vaccine is about 500 million doses a year.
* The CDC recommends that 261 million Americans -- 85 percent of the population -- should be vaccinated against flu. A RAND Corp. study in December showed that only about a third of those who should have did get the vaccine.

(Reporting by Maggie Fox; Editing by Will Dunham)
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http://www.alertnet.org/thenews/newsdesk/N26495217.htm
 
Re: From the news: Roundup and analysis.

Swine flu: Experts warned in February that new strain could cause pandemic - Telegraph

Swine flu: Experts warned in February that new strain could cause pandemic

Experts warned months ago that a pandemic could be sparked by a different strain to the feared bird flu.

By Rebecca Smith, Medical Editor
Last Updated: 7:05AM BST 27 Apr 2009

In February, scientists at the International Meeting on Emerging Disease and Surveillance in Vienna, Austria, said so much attention had been focused on H5N1 that the medical and scientific community risked missing the start of an outbreak caused by another strain.


Prof Thomas Monath from Harvard University said that another strain could trigger a pandemic and then "we would be screwed".

He warned vaccine manufacturing capacity is insufficient, meaning that if a pandemic strain of flu emerged now it would be impossible to make enough for the world's population in time.

The scientific community had become "complacent" about a new flu pandemic because the avian influenza strain H5N1 has been around for 13 years without spreading around the world.

Prof Monath said: "If it's a new strain of flu it will be nine months to a year before we have got really good geared up vaccine production. We will rely on antiviral drugs first and then it is a crash effort to make a vaccine. In the meantime there will be clearly an emerging uncontained problem," he said.

"To detect it early and try to contain it in the early stages is the best chance we have got," Prof Monath added.

Other experts at the meeting also believed the scientific community was "betting on the wrong horse" by continuing to focus solely on H5N1.

Influenza expert Ilaria Capua said a pandemic could come from a number of flu strains.

"H5N1 may become a new pandemic but we are taking our eye of other avian flu strains which have infected humans such as H7 and H9 and historically humans have been infected with H1, H2 and H3," she said.

Ms Capua, who is director of the National Reference Library for Avian Influenza in Italy, warned that other strains such as H9 could cause a pandemic, although it is not as lethal but could still cause major disruption.

"If one in four of your population fell ill in cycles of four to six weeks then the could slow down the economy, swamp the hospitals and have major implications for day-to-day life," she said.
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<cite cite="http://www.telegraph.co.uk/health/healthnews/5225533/Swine-flu-Experts-warned-in-February-that-new-strain-could-cause-pandemic.html">Swine flu: Experts warned in February that new strain could cause pandemic - Telegraph</cite>
 
Re: From the news: Roundup and analysis.

Reuters AlertNet - EU Commission calls urgent meeting on swine flu

EU Commission calls urgent meeting on swine flu

27 Apr 2009 07:13:19 GMT
Source: Reuters
ATHENS, April 27 (Reuters) -

The European Commission has called an urgent meeting of health ministers as fears grew of a swine flu pandemic after a virus killed 103 people in Mexico and spread to the United States.


"The Commissioner in charge of public health has already asked for an urgent meeting of health ministers," EU Commission President Jose Manuel Barroso told reporters in Athens.

"It's too soon to speculate about the situation. We are following the situation very closely, together with the member states," he said.

(Reporting by Ingrid Melander; Editing by Richard Balmforth)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/ATH001720.htm">Reuters AlertNet - EU Commission calls urgent meeting on swine flu</cite>
 
Re: From the news: Roundup and analysis.

Hong Kong, Minding SARS, Announces Tough Measures in Response to Swine Flu - NYTimes.com

Hong Kong, Minding SARS, Announces Tough Measures in Response to Swine Flu

By KEITH BRADSHER
Published: April 26, 2009
HONG KONG ?

Hong Kong, the epicenter of a SARS outbreak six years ago, announced some of the toughest measures anywhere on Sunday in response to a swine flu outbreak in Mexico and the United States.


Officials urged residents not to travel to Mexico, and they ordered the immediate detention at a hospital of anyone who arrived with a fever and symptoms of a respiratory illness after traveling in the previous seven days through a city with a laboratory-confirmed outbreak.

At least 20 cases have been confirmed in New York, Ohio, California, Kansas and Texas, according to the Centers for Disease Control and Prevention in Atlanta.

The new policy has the potential to dampen air travel across the Pacific. Hong Kong has Asia?s busiest airport hub for international travel, with Boeing 747s arriving around the clock from cities all over the United States and Canada, though not from Mexico.

Ever since the 2003 outbreak of SARS, or severe acute respiratory syndrome, Hong Kong has used infrared scanners to measure the facial temperatures of all arrivals at its airport and at its border crossings with mainland China.

Dr. Thomas Tsang, the controller of the Hong Kong government?s Center for Health Protection, said Sunday afternoon at a news conference that any traveler who had passed through a city with laboratory-confirmed cases and who arrived in Hong Kong with a fever and respiratory symptoms would be intercepted by officials and sent to a hospital to await testing.

?Until that test is negative, we won?t allow him out,? he said.

An aide later said that the cutoff for having a fever would be 100.4 degrees, and that it would take two or three days to obtain test results.

Dr. York Chow, Hong Kong?s secretary for health and food, asked residents to watch the news for reports of which American states had outbreaks and discouraged travel to those states, but he reserved his strongest warning for travel to Mexico.

?Do not travel to Mexico unless it is absolutely necessary,? he said.

The Hong Kong government will also amend its health regulations in the next couple days to make it mandatory for any health professional to alert the government of any suspected cases of swine flu, he said.

Hong Kong should ?prepare for the worst? if the swine flu virus develops a clear ability to pass from person to person, Dr. Chow said, adding that the risk from the virus was low if this did not happen.

One legacy of SARS is that Hong Kong may now be better prepared for a flu pandemic than practically anywhere else in the world. Fearing that SARS might recur each winter, the city embarked on a building program to enlarge its capacity to isolate and treat those infected with communicable respiratory diseases.

The city has also expanded its flu research labs, already among the best in the world and leaders in tracking the H5N1 avian flu virus. The so-called bird flu virus, which kills an unusually high share of its victims, has periodically triggered fears over the past decade about a possible pandemic. It is different, though, from the H1N1 swine flu virus now causing illnesses in Mexico and the United States.
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<cite cite="http://www.nytimes.com/2009/04/27/world/asia/27kong.html?_r=1&emc=tnt&tntemail1=y">Hong Kong, Minding SARS, Announces Tough Measures in Response to Swine Flu - NYTimes.com</cite>
 
Re: From the news: Roundup and analysis.

BBC NEWS - World moves to contain flu spread

World moves to contain flu spread

Governments around the world have been hurrying to contain the spread of a new swine flu virus after outbreaks were reported in Mexico, the US and Canada.


At least 100 people are now suspected to have died of the disease in Mexico.

The UN has warned the virus has the potential to become a pandemic, but said the world was better prepared than ever to deal with the threat.

Stocks of anti-viral medicines are being readied and travellers are being screened at some airports for symptoms.

Mexican Health Secretary Jose Angel Cordova said suspected swine flu cases in his country had risen to 1,614 including 103 deaths.


Of those, 20 deaths are confirmed to have been caused by the new virus.

The US, where 20 people are confirmed to have caught the virus, has declared a public health emergency.

There are also confirmed cases in Canada, and investigations are being carried out on suspected cases in Spain, Israel and New Zealand.

In most cases outside Mexico, people have been only mildly ill and have made a full recovery.

Vigilance urged
The World Health Organization (WHO), the UN's health agency, has said the swine flu virus could be capable of mutating into a more dangerous strain. The BBC talks to people in Mexico City about the flu outbreak.

But officials say they need more information on the virus before deciding whether to raise the global pandemic alert phase.The WHO is advising all countries to be vigilant for seasonally unusual flu or pneumonia-like symptoms among their populations - particularly among young healthy adults, a characteristic of past pandemics.

Only a handful of the Mexican cases have so far been laboratory-confirmed as swine flu, while in the US confirmed cases had only mild symptoms.

Health experts want to know why some people become so seriously ill, while others just develop a cold, the BBC's Imogen Foulkes reports from Switzerland.

Dr Keiji Fukuda, WHO's assistant director-general in charge of health security, said all countries were "looking at the situation seriously" but that a true picture of the extent of the virus was still emerging.

FLU PANDEMICS

1918: The Spanish flu pandemic remains the most devastating outbreak of modern times - infecting up to 40% of the world's population and killing more than 50m people, with young adults particularly badly affected
1957: Asian flu killed two million people. Caused by a human form of the virus, H2N2, combining with a mutated strain found in wild ducks. The elderly were particularly vulnerable
1968: An outbreak first detected in Hong Kong, and caused by a strain known as H3N2, killed up to one million people globally, with those over 65 most likely to die

H1N1 is the same strain that causes seasonal flu outbreaks in humans but the newly detected version contains genetic material from versions of flu which usually affect pigs and birds.

It is spread mainly through coughs and sneezes.Officials said most of those killed so far in Mexico were young adults - rather than more vulnerable children and the elderly.

There is currently no vaccine for the new strain of flu but severe cases can be treated with antiviral medication.

Dr Fukuda said years of preparing for bird flu had boosted world stocks of antivirals.

It is unclear how effective currently available flu vaccines would be at offering protection against the new strain, as it is genetically distinct from other flu strains.

WHO experts will meet again in Geneva on Tuesday to discuss whether to raise the pandemic alert phase.

Widespread cases
In the US, eight cases have been confirmed among New York students, seven in California, two in Texas, two in Kansas and one in Ohio.

SWINE FLU

Swine flu is a respiratory disease found in pigsHuman cases usually occur in those who have contact with pigsHuman-to-human transmission is rare and such cases are closely monitored'I couldn't get out of bed'Keeping a distance in Mexico City

"I do fear that we will have deaths," Dr Anne Schuchat of the US Centers for Disease Control and Prevention (CDC) told reporters.

The Canadian cases were recorded at opposite ends of the country: two in British Columbia in the west, and four in the Atlantic province of Nova Scotia.

Several countries in Asia and Latin America have begun screening airport passengers for symptoms.

Suspected cases have been detected beyond Mexico, the US and Canada:

* In New Zealand, two school groups that recently visited Mexico have reported illnesses - ten students from one school tested positive for Influenza A, making it "likely" they are infected with swine flu, and three in the other school were being tested
* France and Spain have both reported cases of people becoming ill after returning from Mexico and are carrying out tests
* In Israel, medics are testing a 26-year-old man who has been taken to hospital with flu-like symptoms after returning from a trip to Mexico
* Two people in Queensland, Australia, are being tested after developing flu-like symptoms on returning from Mexico
* The Brazilian authorities say one man was taken into hospital as a precaution after he became ill following a visit to Mexico

Economic worries
With Mexico City apparently the centre of infection, many people are choosing to leave the city, the BBC's Stephen Gibbs reports.Schools, universities and even most bars and restaurants will remain closed for several days and though Sunday church services went ahead, priests were asked to place Communion wafers in people's hands rather than on their tongues.

Some people are beginning to worry about the effects swine flu is having on their livelihoods and the Mexican economy in general, our correspondent says. Not knowing exactly how the virus works and how it can be killed off creates a horrible uncertainty

The World Bank is providing Mexico with more than $200m in loans to help it deal with the outbreak.Fear of the virus is expected to lead to many tourists cancelling their holidays and Mexican exports are already beginning to be affected.

Russia has banned imports of raw pork and pork products from Mexico and the US states of California, Texas and Kansas until further notice as a precaution.

Dr Fukuda said on Sunday there was no proof that eating pork would lead to infection.

"Right now we have no evidence to suggest that people are getting exposed, or getting infected, from exposure to pork or to pigs, and so right now we have zero evidence to suspect that exposure to meat leads to infections," he said.
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<cite cite="http://news.bbc.co.uk/2/hi/americas/8019882.stm">BBC NEWS | Americas | World moves to contain flu spread</cite>
 
Re: From the news: Roundup and analysis.

Reuters AlertNet - ANALYSIS-Has globalisation made us more catastrophe-prone?

ANALYSIS-Has globalisation made us more catastrophe-prone?

27 Apr 2009 07:40:32 GMT
Source: Reuters
By Andrew Marshall, Asia Political Risk Correspondent
SINGAPORE, April 27 (Reuters) -

As the world grapples with the worst economic downturn in decades and the possibility of a flu pandemic, a growing body of research suggests the complexity of the modern global economy may make us more vulnerable than ever to catastrophe.


The financial crisis began as turmoil in one small segment of the U.S. mortgage market. Within months it had morphed into a global meltdown affecting almost everyone on earth.

"The speed at which these events unfolded was unprecedented," said the World Economic Forum's 2009 report on global risk.

"It has demonstrated just how tightly interconnected globalisation has made the world and its systems."

Disease, too, can spread faster than ever before. Modern air travel means that any contagious outbreak can be worldwide in a matter of days. In the past, it would have taken months or years.

The more complex and efficient a system, the faster and wider any contagion can spread. Yet this interdependence is by no means always negative. The complexity of the world economy means risk can be more easily distributed, and often more easily mitigated.

Complex systems can often be adaptable -- if one part fails, other parts of the network can assume the burden.

Network theory suggests that complex diversified systems can often bring greater stability. But only to a point.

"While this helps the system diversify across small shocks, it also exposes the system to large systemic shocks," Raghuram Rajan, who has been an IMF chief economist and adviser to Indian Prime Minister Manmohan Singh, wrote in a 2005 research paper.

"It is possible that these developments...create a greater (albeit still small) probability of a catastrophic meltdown."


BUTTERFLIES, BLACK SWANS AND SWINE FLU

One key issue is the so-called "butterfly effect" -- in highly complex systems, even a small event can be magnified and transmitted with highly unpredictable results. Edward Lorenz, a pioneer of chaos theory, noted that a butterfly flapping its wings in one corner of the world could cause a tornado far away.

Benoit Mandelbrot, a French mathematician and the father of fractal geometry, applied the theory to markets to show how "wild variability" is intrinsic to the system.

In network theory, one key finding is that complex interconnected systems organise themselves around key nodes. If one of these is hit, the whole house of cards can collapse.

This is one reason the damage done by the subprime crisis to major global investment banks had such a devastating impact.

And while specialisation in global supply chains has brought significant efficiency gains, it has also brought vulnerability. Disruption to a key node in the supply chain can cause dramatic and unpredictable turbulence in the whole system.

This was why global semiconductor prices nearly doubled following an earthquake that hit Taiwan in 1999, and why Hurricane Katrina spread turbulence throughout world markets.

Security analysts also worry that even a single terrorist attack could have a magnified impact if it targets a key point in global supply chains -- for example, a major port.

In his book "The Black Swan", which examines the impact of major unexpected events, Nassim Nicholas Taleb noted that the appearance of stability in complex systems can be illusory: "Random insults to most parts of the network will not be consequential since they are likely to hit a poorly connected spot. But it also makes networks more vulnerable... Just consider what would happen if there is a problem with a major node."

True, we have fewer failures," he wrote. "But when they occur... I shiver at the thought..."


DECLINE AND FALL OF ROMAN EMPIRE

The complexity that makes financial shocks more potentially dangerous also means that pandemics can wreak greater havoc.

Analysts point out that when the Black Death plague hit Europe in the 14th century, killing around a third of the population, society did not collapse, because economic and social systems were relatively simple and so insulated from shocks.

By contrast, a plague that hit the Roman empire in the 2nd century, with a similar death rate, caused chaos -- Roman society was much more complex and economically advanced.

In modern society, if key nodes are taken out by disease, the impact could be magnified exponentially. The "nodes" could be people essential to the functioning of society and the economy -- doctors, truck drivers, engineers, port workers.

And just as with financial crisis, herd behaviour, panic and the spread of inaccurate or incomplete information could provide negative feedback loops, making the catastrophe even worse.

"Economic disruptions on the supply side would come directly from high absenteeism... There may also be disruptions to transportation, trade, payment systems and major utilities," the IMF said in a 2006 report on the impact of a global flu pandemic.

And beyond the immediate catastrophe, an overriding risk from both the financial crisis and any pandemic is that it causes a worldwide retreat from globalisation, with profound long-term consequences for the world economy.

In its 2007 report on global risks, the World Economic Forum imagined the consequences of a simultaneous pandemic and global liquidity crisis -- a scenario that was purely speculative then but which now seems eerily prescient.

The result, it said, would be "a backlash against globalisation, which in turn compounds the hit on global demand". Across the world, it said, increased militarism and authoritarian tendencies would reshape global geopolitics.

The events of the next few months may show just how accurate such a scenario could be.

(Editing by Bill Tarrant)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/SP446696.htm">Reuters AlertNet - ANALYSIS-Has globalisation made us more catastrophe-prone?</cite>
 
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TheStar.com | News & Features | Swine flu lands in Canada

Swine flu lands in Canada

Apr 27, 2009 04:30 AM

Iain Marlow
IN TORONTO

Richard J. Brennan
IN OTTAWA

Ontario health officials are maintaining a vigilant watch for cases of confirmed swine flu in the province but, as fears of a possible global pandemic continue to spread, the only cases to emerge so far in Canada are in Nova Scotia and British Columbia.


All six Canadian cases ? four at a Windsor, N.S., school, two in B.C.'s Lower Mainland ? were linked to Mexican travel. Unlike Mexico, where the flu is believed to have killed more than 100 people and sparked fears of a pandemic, the Canadian cases were so mild they did not require hospitalization.


But as Canadian health officials tried to ease fears yesterday, they also warned against complacency.

"The swine flu symptoms seen in Canada have thankfully been relatively mild and the patients are recovering. These are Canada's first confirmed cases but ... these cases are likely not the last we'll see in Canada," federal Health Minister Leona Aglukkaq told an Ottawa press conference yesterday.

Passengers returning from Mexico at Toronto's Pearson airport yesterday wore masks during their flights. Canadian border guards who greeted them wore masks and latex gloves.

"We were just afraid that maybe people, if they were carrying the disease, might sneeze or cough or anything," said Emerson Abrego, 45, who returned from his homeland on a Mexicana flight from Mexico City.

He called the mood in Mexico "scary" and said nightclubs and other public places have been closed until the flu threat passes. "The police and military, they are on the street over there stopping everybody to give them a mask."

David Butler-Jones, Canada's chief public health officer, said the fact only mild cases have been confirmed so far means little. "Simply because we are having milder cases nobody should take this for granted in any way. That's why we are paying very close attention," he said.

"It's too soon to say where this will lead us," Butler-Jones said. "It doesn't mean we won't see more severe illness or potentially deaths."

To protect yourself, Butler-Jones advises washing your hands often and thoroughly, using a hand sanitizer, coughing or sneezing into an arm or sleeve rather than your hands, staying at home if you have flu-like symptoms and getting a flu vaccine, which he says may offer limited protection.

So far the only deaths have been in Mexico, where officials last night said there were 1,614 possible cases of swine flu, including 103 suspected deaths. People are staying inside or wearing masks in public.

There have been 20 confirmed infections in the U.S., which declared swine flu a public health emergency yesterday; six in Canada; and possible cases in New Zealand, Israel and Europe. But while Canadian and international health officials grow more concerned, a Toronto expert warned against panic.

Any flu has a wide range of symptoms and the severe, complicated cases get the most attention, said Dr. Andrew Simor, head of microbiology and infectious diseases at Sunnybrook Health Sciences Centre. "But they're not all like that and certainly the (cases) we've seen in the U.S. and Canada have been much milder," he said.

Canada's experience with SARS ? Severe Acute Respiratory Syndrome ? in 2003 gave health professionals a unique expertise in handling outbreaks like this, and Ontario health officials say the province's emergency departments and clinics are well prepared and have protocols in place for handling any flu outbreak.

As well, some doctors noted, warm weather will help curb person-to person transmission.

Dr. Frank Plummer, scientific director general for the federal public health agency, said the outbreak is only beginning "and there is a lot more unknown than is known."

Plummer noted Canada has done much of the testing of the virus for Mexico because of a prior relationship between the two countries with respect to infectious disease.

In Hong Kong, the government has taken drastic measures ? urging its populace to avoid Mexico and ordering the detention at hospital of anyone arriving with symptoms of a respiratory illness after travelling through a region with confirmed cases.

Yesterday afternoon, Ontario health officials were investigating 11 possible cases across Ontario, said Steve Erwin, spokesperson for Minister of Health David Caplan. By yesterday evening, however, provincial public health officials said no cases had been confirmed.

The process of confirmation is complicated because flu-like symptoms can be caused by a variety of other, non-fatal viruses.

Canadian officials have not yet warned against travel to Mexico, but several airlines, including Air Canada and WestJet, were waiving cancellation fees for passengers wishing to postpone or change flights to Mexico City.

Patrick Chuidian, who returned from Mexico on Friday after a one-week visit, greeted his wife and daughter yesterday after their three-month stay there.

"Of course we're worried, but I've been checking around with the family doctor, so we're okay," Lourdes Chuidian said in Spanish through her husband. She said schools and universities in Mexico have been closed for a week and concerts and movies have been suspended for 10 days. "Traffic is very good now because people are scared and they're staying at home," she said. "Driving around Mexico City is perfect ? no traffic."

Patrick Chuidian, a nurse at St. Joseph's Health Centre, said he had to be cleared by occupational health and safety inspectors before returning to work. He was warned to stay home if cold symptoms develop within two weeks.

With files from Tess Kalinowski, Jim Wilkes and Star wire services
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<cite cite="http://www.thestar.com/article/624840">TheStar.com | News & Features | Swine flu lands in Canada</cite>
 
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Reuters AlertNet - Mexican swine flu spreads to Europe, markets edgy

Mexican swine flu spreads to Europe, markets edgy

27 Apr 2009 14:52:27 GMT
Source: Reuters

(For full coverage of flu outbreak, click [nFLU])

* First European case confirmed in Spain
* U.S. to urge Americans not to travel to Mexico
* Governments step up health checks at airports
* Stock markets and oil fall

(Recasts, adds details)

By Catherine Bremer
MEXICO CITY, April 27 (Reuters) -

Governments around the world rushed to reduce the impact of a possible flu pandemic on Monday, as a virus that has killed 103 people in Mexico and spread to the United States and Canada also reached Europe.


While the swine flu virus has so far killed no one outside Mexico, the fact that it has proved able to spread quickly between humans has raised fears that the world may be facing the flu pandemic that scientists say is long overdue.

Shares and oil prices fell in Asia and Europe, as investors feared a further shock to an already fragile global economy, if trade flows are curbed and manufacturing is hit. [MKTS/GLOB]

The MSCI world equity index <.MIWD00000PUS> fell 0.5 percent, although U.S. stocks bounced back from early losses and the Dow Jones industrial average turned higher.

The U.S. government has declared a public health emergency and an official said it will also urge Americans to avoid all "non-essential" travel to Mexico, which relies heavily on tourism. [nN27526139]

Spain became the first country in Europe to confirm a case of swine flu when a man who returned from a trip to Mexico last week was found to have the virus.


But his condition, like that of 20 cases identified in the United States and six in Canada, was not serious.

A New Zealand teacher and around a dozen students who recently returned from Mexico were also being treated as likely mild swine flu cases.


President Barack Obama said U.S. officials were closely monitoring cases of swine flu, but he also tried to ease fears.

"This is obviously a cause for concern and requires a heightened state of alert. But it is not a cause for alarm," Obama told a meeting of the National Academy of Sciences.

Cases of the flu, which has components of classic avian, human and swine flu viruses but has not actually been seen in pigs, were also suspected in Britain, France, Italy and Israel.

Many countries have stepped up surveillance at airports and ports, using thermal cameras and sensors to identify people with fever, and the World Health Organisation has opened its 24-hour "war room" command centre. [nLP310187]

The European Union's health chief urged citizens to avoid non-essential travel to areas affected by swine flu, and the European Commission called an urgent meeting of health ministers.


HEALTH EMERGENCY

Although most cases outside Mexico were relatively mild, a top official at the Centers for Disease Control and Prevention said she feared there might be U.S. fatalities.

The WHO has declared the flu a "public health emergency of international concern" that could become a pandemic, or global outbreak of a serious disease. [ID:nHKG369044]

Its emergency committee was due to decide on Monday whether to raise its pandemic alert level, currently at 3 on a scale of 1 to 6. [nLR529911]

"If we go to phase 4 because of the swine flu virus, it basically means that we believe that a potential pandemic virus has potentially shown it can transmit from person to person and cause large outbreaks," WHO Acting Assistant Director-General Keiji Fukuda said on Sunday.

In the financial markets, travel and leisure stocks such as Hong Kong's Cathay Pacific Airways <0293.HK> and British Airways <bay.l> nevertheless fell sharply, whereas makers of drugs and vaccines, such as Roche <rog.vx>, were higher. [nLR144642]

"The threat of the pandemic will add further weakness to global trade," said Justin Urquhart Stewart, investment director at Seven Investment Management in London. "We saw with SARS tangible percentage points knocked off the index, and that was in a buoyant time. Put that in a weaker time and it is likely to be more unpleasant."

An outbreak of the SARS respiratory virus in 2003 was largely limited to Southeast Asia and cost the region's economy around 0.6 percent of GDP. [nSP408177]

The World Bank estimated last year that a global flu pandemic could cost $3 trillion and cut world GDP by 5 percent.

Oil prices fell more than 4 percent to below $50 a barrel on Monday, pressured partly by expectations the world economy could suffer if a pandemic materializes. <clc1>Mexico's peso fell more than 3 percent on Monday and its stock market <.MXX> fell more than 4 percent.


MEXICO SLOWS TO A HALT

In Mexico, the centre of the swine flu outbreak, life has slowed dramatically in cities as schools have been closed and public events called off to slow the spread of the virus.

Many in Mexico City spent the weekend hunkered at home or wore blue surgical face masks handed out by truckloads of soldiers to venture out onto strangely hushed streets. The city government considered halting public transport.

Health Minister Jose Angel Cordova said on Sunday that the flu had killed 103 people in Mexico, and about 400 people had been admitted hospital. But he noted that a majority of infected patients had recovered.

Health authorities across Asia tried to give reassurance, saying they had enough stockpiles of anti-flu drugs to handle an outbreak. [nSP393424]

Guan Yi, a virology professor at the University of Hong Kong who helped to fight SARS and bird flu, said a pandemic looked inevitable. "I think the spread of this virus in humans cannot possibly be contained within a short time ... We are counting down to a pandemic." [nHKG364159]

(Additional reporting by Stephanie Nebehay in Geneva, Maggie Fox, Emily Kaiser and Lesley Wroughton in Washington, Helen Popper, Miguel Gutierrez and Alistair Bell in Mexico City and Tan Ee Lyn in Hong Kong; Writing by Kevin Liffey; Editing by Kieran Murray)
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</clc1></rog.vx></bay.l>​
<cite cite="http://www.alertnet.org/thenews/newsdesk/N27484099.htm">Reuters AlertNet - Mexican swine flu spreads to Europe, markets edgy</cite>
 
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Reuters AlertNet - Guatemala tests patient for suspected swine flu

Guatemala tests patient for suspected swine flu

27 Apr 2009 15:04:30 GMT
Source: Reuters
GUATEMALA CITY, April 27 (Reuters) -

Authorities in Guatemala are testing a patient for a suspected case of swine flu on Monday, a hospital director in the capital said.


Dr. Hector Font told local radio a 29-year-old, who had been in Mexico recently, had symptoms similar to those seen in hundreds of patients in the neighboring country, where the virus has killed 103 people.

Guatemala is checking all travelers arriving from Mexico for signs of flu and stopping anyone with symptoms of the virus at border crossings.

(Reporting by Sarah Grainger; editing by Mohammad Zargham)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/N27528938.htm">Reuters AlertNet - Guatemala tests patient for suspected swine flu</cite>
 
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Reuters AlertNet - Peru says investigating possible swine flu case

Peru says investigating possible swine flu case

27 Apr 2009 15:08:21 GMT
Source: Reuters
LIMA, April 27 (Reuters) -

Peru is investigating its first suspected swine flu case after an airline passenger arrived in Lima from Mexico with flu-like symptoms, Health Minister Oscar Ugarte said on Monday.


"There is a case with suspicious symptoms, which is to say general discomfort and a fever above 39 degrees Celsius," Ugarte said on RPP radio.

Peruvian health officials have been checking passengers at Lima's airport since Friday in response to a possible flu pandemic that has killed 103 people in Mexico.

Swine flu has also popped up in the United States and Europe, though so far only Mexico has reported deaths.

(Reporting by Marco Aquino; writing by Dana Ford; editing by Terry Wade and Mohammad Zargham)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/N27497404.htm">Reuters AlertNet - Peru says investigating possible swine flu case</cite>
 
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Reuters AlertNet - Cuba to limit Mexico flights amid swine flu fears

Cuba to limit Mexico flights amid swine flu fears

27 Apr 2009 15:08:33 GMT
Source: Reuters

(Adds one Havana to Mexico City flight suspended, details)

HAVANA, April 27 (Reuters) -

The Cuban government said on Monday it would limit flights to and from Mexico as one of its measures to prevent an outbreak of swine flu on the island nation.


Representatives of Cubana Airlines said the state-owned carrier had canceled its Havana-to-Mexico City flight for Tuesday, but not yet for the days beyond that.

One official with the airline said the flight was suspended due to swine flu precautions.

But another said it was canceled for other reasons and that it had nothing to do with the illness that has killed 103 people so far in Mexico.

There usually are at least four flights daily between the two countries, which are separated by the 115-mile-wide (185 km) Yucatan Channel.

The government announcement, published on the front page of Granma, the newspaper of the ruling Communist Party, did not mention whether any swine flu cases had been detected in Cuba.

Government sources told Reuters that medical teams would question passengers arriving on flights from Mexico and check them during their visit to Cuba to see if they showed signs of illness.

Medical personnel throughout the island were to be briefed on what to look for and how to deal with any cases of swine flu they found.

Sources also said pigs throughout Cuba were being monitored for symptoms.

The government advised Cubans to wash their hands frequently, and to cover their mouths and nose when they sneeze or cough to help limit the spread of germs.

(Reporting by Jeff Franks; editing by Pascal Fletcher and Will Dunham)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/N27367775.htm">Reuters AlertNet - Cuba to limit Mexico flights amid swine flu fears</cite>
 
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Reuters AlertNet - Poor countries could face swine flu drug shortages

Poor countries could face swine flu drug shortages

27 Apr 2009 15:51:42 GMT
Source: Reuters

* Global antiviral supply to be strained in pandemic
* Poor countries may face shortages as swine flu spreads

By Laura MacInnis
GENEVA, April 27 (Reuters) -

Developing countries could struggle to access the antiviral drugs they need to combat a fast-spreading outbreak of swine flu, which has killed 103 people in Mexico, health activists said on Monday.

"It is going to become a problem," said Sangeeta Shashikant of the Third World Network, which campaigns for better drug access for the poor.

She said "advance purchase agreements" and other deals securing medicines for wealthy governments could drain the global supply chain of effective medicines.

The antiviral drugs Tamiflu made by Swiss drugmaker Roche Holding AG <rog.vx> and Relenza, made by GlaxoSmithKline <gsk.l>, have been shown to be effective against the swine flu strain that has infected people in Mexico, the United States, Canada and Spain.

But there are not likely to be enough doses to treat the whole world in a pandemic, and production is limited.

"Many countries have stockpiled antivirals, although how to deliver them within a maximum of 48 hours remains a huge challenge," the London School of Hygiene and Tropical Medicine said in a statement.

"Preparedness levels in middle income and lower income countries remain low. Therefore it is likely that this flu outbreak will also be a test for global solidarity," it said.

The international health community must work to ensure that drugs reach those who truly need them to avoid needless deaths, said Mike Palmedo, research coordinator at American University's programme on information justice and intellectual property.

"I suspect that in the event of an epidemic, many countries would find their supplies inadequate," he said, suggesting that increased generic production could help ease shortfalls.

"Whatever the amount of drugs currently available, more generic competition would drive prices down further, making access available to more countries."

India's Cipla <cipl.bo> began to manufacture generic oseltamivir, or Tamiflu, in 2006, and Ranbaxy <ranb.bo> and Hetero also make the drug in India. Shanghai Pharmaceuticals <600849.SS> and HEC also make it in China, according to Palmedo.

Roche said the World Health Organisation had not yet asked it to deploy 3 million treatment courses being held as a "fire blanket" to use wherever a pandemic breaks out. The WHO also has an additional 2 million packs that Roche donated in the past for use in countries which are not so well prepared for a pandemic.

Shares in Roche and Glaxo rose 4 and 5 percent in European trading on Monday on expectations those companies would benefit as governments and corporations set up orders for their drugs.

Efforts to create a swine flu vaccine could also create strains for poorer states, especially if manufacturers who take virus samples offer them at a high price, Shashikant warned.

"You need production for developing countries and access to technology," she said.

Indonesia created diplomatic uproar at the height of the world's bird flu pandemic fears three years ago when it refused to share virus samples without a guarantee that poor states would later be able to afford the vaccines developed.

Developing a vaccine against the variety of swine flu circulating will take several months.

Despite its shorthand name, the disease is spread person-to-person and has never been seen in pigs. It has components of classic avian, human and swine flu viruses.

(For more stories on swine flu, click on [nFLU])
(For WHO information on swine flu, go to: http://www.who.int/csr/disease/swineflu/en/index.html )
(Additional reporting by Ben Hirschler in London; Editing by Janet Lawrence)
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</ranb.bo></cipl.bo></gsk.l></rog.vx>​
<cite cite="http://www.alertnet.org/thenews/newsdesk/LR672817.htm">Reuters AlertNet - Poor countries could face swine flu drug shortages</cite>
 
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Reuters AlertNet - "Swine flu" name is wrong -world animal health body

"Swine flu" name is wrong -world animal health body

27 Apr 2009 15:28:48 GMT
Source: Reuters
(Adds comment from European Commission, Denmark)
PARIS/BRUSSELS, April 27 (Reuters) -

The virus spreading around the world should not be called "swine flu" as it contains avian and human components and no pig has so far been found ill with the disease, the world animal health body said on Monday.


It would be more logical to call the virus "North American influenza", a name based on its geographic origin like the Spanish influenza, a human flu pandemic with animal origin that killed more than 50 million people in 1918-1919.

"The virus has not been isolated in animals to date. Therefore it is not justified to name this disease swine influenza," the Paris-based World Organisation for Animal Health, also known as the OIE, said in a statement.

The European Commission said that the virus was not linked with pork.

Robert Madelin, director-general of the Commission's health and food safety department, said in Brussels that no European Union trade restrictions on imports were planned since swine flu had nothing to do with the food chain.

The EU only imports insignificant numbers of live pigs and pigmeat products are not seen as a disease threat. The World Health Organization has ruled out any risk of infection from consuming pork, saying swine flu has not been shown to be transmissible to people through eating properly handled and prepared pork, or other products derived from pigs.

Fears of a global flu pandemic grew after 103 people were killed in Mexico and new infections were found in the United States and Canada and possible cases as far afield as Europe, Israel and New Zealand. [ID:nN26482522]

The OIE, an intergovernmental organisation, warned that if the virus was shown to cause disease in animals, this could worsen the regional and global public health situation.

Denmark, a major pork producer that exported nearly 2 million tonnes of pigmeat in 2008, said on Monday it was not putting any extra controls in place on pigs or introducing extra measures relating to pork production as a result of the flu threat.

The Danish food and agriculture ministry also said it had not received any information from the industry suggesting pork demand had been hit by concerns arising from the virus. It said it would monitor the situation closely in coming days.

Fears there could be a global flu pandemic which would hurt fragile world economies led to a broad-based decline in stocks, oil and other commodity markets on Monday.

Grain and oilseed markets fells sharply on concern that the outbreak could reduce feed demand for pigs. [ID:nLR350048]

For a Take a Look on the latest flu outbreak double-click on [ID:nFLU]
For a factbox of past flu pandemics double-click on [ID:nN24440477]
(Reporting by Sybille de La Hamaide in Paris, additional reporting by Jeremy Smith in Brussels and Anna Ringstrom in Copenhagen, editing by Anthony Barker)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/LR748260.htm">Reuters AlertNet - "Swine flu" name is wrong -world animal health body</cite>
 
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Reuters AlertNet - WHO may raise pandemic threat level over swine flu

WHO may raise pandemic threat level over swine flu

27 Apr 2009 15:25:08 GMT
Source: Reuters
GENEVA, April 27 (Reuters) -

A World Health Organisation emergency committee could raise its pandemic alert level to phase 4 or 5 as a deadly swine flu outbreak shows no signs of slowing, a spokesman for the agency said on Monday.


Going to phase 4 would mean the WHO believes that a potential pandemic virus has shown it could transmit from person to person and cause large outbreaks.

WHO spokesman Gregory Hartl also told a telephone briefing that U.S. health officials have taken the first steps toward producing a vaccine against the virus that has killed more than 100 people in Mexico and spread to North America and Europe.

(Reporting by Jonathan Lynn and Robert Evans; Writing by Michael Kahn; Editing by Charles Dick)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/LR751485.htm">Reuters AlertNet - WHO may raise pandemic threat level over swine flu</cite>
 
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Swine flu: twenty-five possible cases reported in Britain - Telegraph

Swine flu: twenty-five possible cases reported in Britain

Twenty-five cases of possible swine flu have been reported in Britain, the Health Secretary has disclosed.

Last Updated: 5:20PM BST
27 Apr 2009

In a statement to the Commons, Alan Johnson said that three patients were undergoing specialist testing and another 14 were being monitored at home. None has yet been confirmed as suffering from the virus.


Eight people who came forward with swine flu-like symptoms have been shown not to have the condition, which is believed to have killed more than 100 people in Mexico.

Earlier today it emerged that a Canadian woman is being treated for suspected swine flu at an undisclosed hospital in Manchester.

The World Health Organisation's emergency committee said it could raise its pandemic alert level to phase 4 or 5, which would indicate it believed the virus was now capable of passing from person to person, rather than just from animals.

Health Secretary told MPs said that Britain was - with France - one of the two best prepared countries in the world to deal with a potential flu pandemic.

"The UK has been preparing for a flu pandemic for the last five years. We have established a stockpile of enough anti-virals to treat more than 33 million people, that is to say half of the UK population," he said.

He said that the Government had imposed ?enhanced? port health checks to identify passengers arriving in the UK with symptoms of the illness, and said that measures were in place to allow the swift nationwide distribution of the drug Tamiflu.

People who suspect they may have been infected should stay at home and seek medical advice over the telephone, Mr Johnson added.

"Everywhere outside Mexico the symptoms have been mild and all the victims have made a full recovery," he said.

Sir Liam Donaldson, the Government?s chief medical officer, has said it is ?inevitable? that the infection will reach Britain at some point.His warning came as the first case was confirmed in Spain and 10 people were being monitored for a suspected outbreak in Denmark and Sweden.

Speaking about the Manchester health alert an NHS North West spokeswoman said: "We are aware that an overseas visitor to the Sale area is being tested for possible swine flu."

The person concerned has been taken to hospital for further tests, in keeping with recommendations, and purely as a precaution.

"More information will be released as soon as possible."

In a radio interview Sir Liam Donaldson said plans were in place to prevent the spread of the disease if it reached the UK.

"I think it is inevitable that at some point we will have cases in the United Kingdom," he told BBC Radio 4's The World At One.

"Hopefully, if we identify those early and treat people and their contacts, we might be able to reduce the spread."

Sir Liam said the Government was well-prepared if there was an outbreak in the UK, with large stockpiles of antiviral drugs in place.

"We have been told on many occasions by the WHO (World Health Organisation) that we are one of the best prepared countries in the world but we are not complacent," he said.

"This a virus which can go through many twists and turns and can threaten the health of the population in all sorts of different ways.
"So, if a new pandemic does start as a result of this outbreak in Mexico and the United States, we can't make it go away, but what we can do through our plans, particularly our stockpiles of anti-virals, is mitigate its effect."

He said there was still only limited information about the disease although the picture should become clearer in the coming days.

"The problem at the moment is that there is so much uncertainty about this particular virus ? the information coming out of Mexico is very unclear," he said.

"There have been some cases in the United States and in some other countries, but so far there isn't a lot evidence of extensive spread outside Mexico from those other cases ? so-called secondary spread.

"It may develop in due course. It is a very uncertain position."

Anyone who feels unwell and suspects they have flu is advised to visit the NHS Direct website at www.nhsdirect.nhs.uk
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<cite cite="http://www.telegraph.co.uk/health/swine-flu/5231229/Swine-flu-twenty-five-possible-cases-reported-in-Britain.html">Swine flu: twenty-five possible cases reported in Britain - Telegraph</cite>
 
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Second suspected case of swine flu reported in Israel

Last update - 19:50 27/04/2009

Second suspected case of swine flu reported in Israel

By Ran Reznick, Anshel Pfeffer, Zohar Blumenkrantz and Barak Ravid, Haaretz Correspondents
Tags: Israel News, Swine Flu

A second case of suspected swine flu has been reported in Israel, after a man who returned recently from Mexico checked himself into a Kfar Sava hospital complaining of a sore throat.


The 47-year-old patient will remain in quarantine until his test results are released in the coming days. Hospital officials say, nevertheless, that chances are low that he has actually contracted the disease.

The first suspected case of swine flu in Israel was reported on Sunday, when a Netanya man Mexico was hospitalized under quarantine with flu-like symptoms upon his return from Mexico.

After that hospitalization, Israel began to take measures to combat a potential outbreak of the disease, which has already struck across two continents.

Magen David Adom representatives said on Sunday they would not take blood donations from individuals who had visited Mexico, California or Texas in the past week.

The Israel Embassy in Mexico has also decided to cancel Memorial Day events honoring fallen Israel Defense Forces soldiers, to avoid "taking any unnecessary risks" posed by public gathering, Israeli media quoted an embassy spokesman as saying.

Health Ministry Director-General Professor Avi Israeli on Sunday issued directives to health care institutions, which he described as "temporary instructions intended to be on the side of caution until we learn more details."

According to the ministry's instructions, a patient may be considered a potential carrier of the swine flu virus if his or her breathing system becomes compromised without apparent reason and the patient shows symptoms such as respiratory malfunction, high fever, congestion, throat pain, coughing or shortness of breath.

In addition, the patient, in order to be considered a potential carrier, must have visited Mexico in the week before falling ill or have been in close contact with someone who had visited the country, or been in contact with an individual who had treated somebody with the virus. The instructions also require anyone meeting these criteria to report for medical treatment immediately.

The dangerous viral strain has killed up to 103 people and infected 1,614 in Mexico. 20 cases have also been discovered in the United States.

New York official said Monday the city has 20 more cases of swine flu, and an additional 17 probable cases.

Tomer Vajim, a 26-year-old Israeli, checked himself into Netanya's Laniado Hospital on Sunday after returning Friday from Mexico with minor flu-like symptoms. Vajim, of Moshav Geulim, is currently being treated in quarantine, and the Health Ministry said laboratory results pointing to whether he was carrying swine flu would be ready in three days.

The Health Ministry said it had not issued special instructions to the public on the matter, nor adopted extraordinary measures for monitoring those returning from Mexico. Ministry officials said the disease had potential to snowball into a global pandemic, but the chances of that happening remain unclear at this point. The World Health Organization has yet to issue instructions on preparing for such an eventuality, and has yet to change the global alert level for the disease, currently at 3, meaning predominantly animal infections; few human infections.

Sharon Sa'ar, the partner of the Israeli patient hospitalized after returning from Mexico, said Vajim had returned Friday from a one-week trip to Mexico City for work purposes complaining of flu-like symptoms. After friends told him they had read about swine flu on the Internet, he sought medical care.

Sa'ar said her partner "feels slightly better, and his temperature dropped a little. We're hoping this will end up just being regular flu, and that everything will be okay."

"Tomer has agreed to expose this so that others won't be harmed. That's why he's calling on everyone who was with him on the flight or in contact with him during the trip or after and has flu-like symptoms to be examined," she said.

Defense Ministry may be put in charge if alert level raised
The World Health Organization convened an emergency meeting on Saturday, but the panel adjourned without raising the pandemic alert level, stating it was still waiting for more information. Some experts believe the Mexico outbreak meets the definition of a Level 4 alert sustained human-to-human transmission.

Raising the alert level to 4, one below that of "pandemic," would likely obligate the government to transfer responsibility for containing the disease from the Health Ministry to the Defense Ministry, the only state body with the necessary logistical resources to handle a public health emergency on such a massive scale. Defense sources said at this point the ministry is making due with "updating procedures" and continuously briefing Defense Minister Ehud Barak and other senior ministry officials.

Should a global pandemic be declared, the Health Ministry would likely receive authorization to close both air and sea ports. The discovery of the virus in Israel would also likely lead to certain regions of the country being closed to visitors.

Still, senior medical officials believe even if the flu strain develops into a global epidemic, there will be no need for mass immunization in Israel, as the treatment Tamiflu is highly effective when administered in the disease's earliest stages.

The Israel Airports Authority told Haaretz Sunday, "We're preparing for all possibilities of an epidemic, but we are waiting to receive the Health Ministry's instructions. It is those instructions which will determine how we will deal with travelers returning from abroad."

The Foreign Ministry has urged Israelis living or traveling in Mexico to maintain high standards of personal hygiene and avoid crowded places. It urged travelers to keep abreast of instructions issued by global medical organizations, and to check the ministry's Web site regularly.
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<cite cite="http://www.haaretz.com/hasen/spages/1081434.html">Second suspected case of swine flu reported in Israel - Haaretz - Israel News</cite>
 
Re: From the news: Roundup and analysis.

WHO may raise pandemic threat level over swine flu

WHO may raise pandemic threat level over swine flu

27 Apr 2009 17:19:25 GMT
Source: Reuters

* WHO may raise pandemic alert level to phase 4 or 5
* Bringing meeting forward underlines urgency
* U.S. CDC growing vaccine strain
* U.S. confirmed cases double to 40

(Adds confirmed cases, byline)

By Jonathan Lynn
GENEVA, April 27 (Reuters) -

The World Health Organisation could raise its pandemic alert level to phase 4 or even to phase 5 -- indicating a deadly swine flu was spreading significantly among humans, a WHO spokesman said on Monday.


Gregory Hartl, speaking on a teleconference as experts met to review the alert level, also said work to produce a vaccine against the virus had begun.

Going to phase 4 on the WHO's 6-point scale would mean the WHO believes that a potential pandemic virus has shown it could transmit easily from person to person.

Moving it directly to phase 5 would indicate that the disease was already spreading significantly among humans.

Hartl said the disease, confirmed in Mexico, the United States, Canada and Spain, had gone beyond one single location, enough to raise the alert beyond phase 4.

But more information was needed to see how the disease was spreading, for instance whether cases in other countries had been imported from Mexico, he said.

"I think there will be judgments made because of that whether phase 4 or 5 is appropriate," Hartl said.

It was possible the experts would decide it was too soon to raise the level from phase 3, where it was set in 2005 when the WHO introduced the system to monitor bird flu, he said. The pandemic alert level has never before been raised.

"The fact that we have called this meeting a day early would certainly seem to indicate that this is an event and an evolving situation that needs to be addressed urgently," he said.

Hartl said the U.S. Centers for Disease Control and Prevention (CDC) had taken a sample of the H1N1 virus causing the disease, produced a vaccine virus strain and was now growing it in eggs, the first stage in a vaccine production process.

"We certainly know that the work has begun to produce a vaccine," Hartl said, adding that it would typically be 5-6 months from this initial development before a vaccine was commercially available.

The number of confirmed cases is changing rapidly as more information comes in. Hartl said the WHO now counted 40 confirmed swine flu cases in the United States. There are 26 confirmed cases in Mexico, 6 in Canada and 1 in Spain, he said.

Mexico has reported 1,600 suspected cases and says 149 people have died, possibly because of the disease. There are also suspected cases in Britain, France, Israel and New Zealand.

(For a FACTBOX on the WHO pandemic alert phases, click on: ID:nLP283081]
(For more stories on swine flu, click on [nFLU])
(For more Reuters swine flu coverage, please click here: http://www.reuters.com/news/globalcoverage/swineflu (For WHO information on swine flu, go to: http://www.who.int/csr/disease/swineflu/en/index.html )
(Reporting by Jonathan Lynn and Michael Kahn)
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<cite cite="http://www.alertnet.org/thenews/newsdesk/LR596004.htm">Reuters AlertNet - WHO may raise pandemic threat level over swine flu</cite>
 
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