Monday, April 27, 2009

Swine Flu Can Not Be Contained - May Move to Stage 5 - WHO (OMS)

Swine-Flu Warning Level Raised as Virus Crosses Continents
2009-04-27 23:14:41.336 GMT


(For related stories, see {EXT3 })

By Tom Randall
April 28 (Bloomberg) -- The World Health Organization,
acknowledging the growing threat of swine flu, raised its global
pandemic alert, saying the disease is no longer containable.

The alarm is at its highest level since the warning system
was adopted in 2005. The emphasis for health officials worldwide
should be treating patients and strengthening preparations for
outbreaks, said Keiji Fukuda, assistant director-general for
health security and environment. The Geneva-based WHO isn’t
recommending travel restrictions.

Swine flu cases in the U.S. doubled to 40, and Mexico’s
toll of flu-related deaths reached 149. Fears among global
health officials about other outbreaks spurred an emergency
meeting of the WHO. U.S. officials yesterday recommended that
nonessential travel to Mexico be avoided, the European Union has
told travelers to avoid outbreak areas, and Australia, Japan,
Singapore and South Korea are screening air passengers.

The increased threat level “signifies that we have taken a
step closer” to pandemic, Fukuda said in a conference call with
reporters yesterday. “It is also possible that as the situation
evolves over the next few days we could move into Stage 5.”

A pandemic is an unexpected outbreak of disease that
spreads from person to person across borders. Pandemics occur
when a new influenza A-type virus, to which almost no one has
natural immunity, emerges and spreads internationally.

Not Inevitable

The raised level indicates health officials need to prepare
for a pandemic, though it’s not inevitable, Fukuda said. This is
the first time pandemic risk has risen above level 3 on the
WHO’s six-step alert system since the United Nations agency
adopted the current scale in 2005.

Production of influenza vaccine for seasonal outbreaks,
which U.S. health officials have said is ineffective against the
new flu, should continue, Fukuda said. WHO is working with
partners to prepare for a swine-flu vaccine, and would help
produce such a vaccine if the outbreak becomes a pandemic, he
said.

You don’t know going into an outbreak what it will look
like in the end,” said Richard Besser, the acting head of the
U.S. Centers for Disease and Prevention. “I wouldn’t rest on
the fact that we have only seen cases in this country that are
less severe. I would expect that the spectrum of disease will
expand.”


No Vaccine

“We don’t think that any of the existing vaccines are
effective,” Besser said.

Homeland Security Secretary Janet Napolitano said 25
percent of “courses of treatments” of drugs, known as
antivirals, were being released from U.S. stockpiles. In all,
there are 50 million courses, she said. Among those are Tamiflu,
sold by Swiss drugmaker Roche Holding AG, and Relenza, from
London-based GlaxoSmithKline Plc.

There are enough stockpiles of Tamiflu around the world to
meet current demand, said Roche spokesman Terrence Hurley. Roche
has the capacity to manufacture, over one year, enough courses
of treatment for 400 million people, Hurley said in a telephone
interview. A fifth of those treatments would be made in the U.S.

The WHO has told Roche that it appears Tamiflu would work
against this strain of the virus, Hurley said.

Glaxo has increased production of its antiviral Relenza and
is in contact with the WHO and CDC, said spokeswoman Sarah
Alspach.

Heightened Concern

President Barack Obama said yesterday the emergence and
spread of swine flu in the U.S. merits heightened concern “but
it’s not a cause for alarm.” He declared a public emergency
after 40 U.S. cases were confirmed in California, Kansas, New
York, Ohio and Texas, according to the CDC.

The U.S. Department of Health and Human Services issued an
emergency declaration as a “precautionary tool” to free
resources to monitor and respond to the spread of the virus,
Obama said yesterday in a speech to the National Academy of
Sciences in Washington.

New York City has 28 confirmed cases of swine flu, all from
St. Francis Preparatory School in Queens, Mayor Michael
Bloomberg said yesterday at a news conference. All the cases
were mild and as many as 100 may ultimately be found at the
school, the mayor said.

The number of confirmed cases in Mexico is 26, said WHO
spokesman Gregory Hartl yesterday on a conference call. Testing
has been limited, and U.S. and international experts are being
sent to help track the disease, WHO and CDC said. Mexico Health
Minister Jose Cordova said as many as 149 people may have died
in Mexico from an outbreak of swine flu, though the cause of the
deaths hasn’t been confirmed.

International Response

Eight people in Canada contracted swine flu, Chan said. New
Zealand officials said as many as 13 students who recently
visited Mexico may have swine flu.

Travel restrictions are unnecessary and based on political,
not medical considerations, said Margaret Chan, World Health
Organization chief.

“By definition, pandemic influenza will move around the
world,” Chan said in the call yesterday. “Does that mean we
are going to close every country? Does that mean we are going to
bring the world’s economy to a standstill?

“We know from past experience that transmission of
influenza or the spread of new influenza disease would not be
stopped by closing borders and would not be stopped by
restricting movement of people or goods,” Chan said.

Potential Shutdown

The Mexican government requested that bars, movie theaters
and churches be closed in Mexico City. It also extended its
school closure to May 6 and may shut down more activities,
Mexico’s Cordova said.

Swine flu results in symptoms similar to regular human
influenza such as fever, lethargy and cough, and may also cause
nausea, vomiting and diarrhea, according to the CDC. Swine-flu
viruses aren’t transmitted by food, and eating properly handled
and cooked pork and pork products is safe, according to the CDC.
There’s no evidence the disease is spread by exposure to “pork
or pigs,” WHO’s Fukada said.

Scientists are trying to determine why the virus has been
more severe in Mexico. In the U.S. only one person has required
hospitalization, said Besser of the CDC.

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