The Stockpiling Dilemma

 

 

# 3102

 

 

Roughly a year ago, when the pandemic threat seemed distant to all but public health officials and a few disease geeks blogging on the subject, the CDC began to recommend that Americans consider stockpiling a small quantity of facemasks and respirators in the event they might be needed during an outbreak.

 

 

In an  Interim guidance on the use and purchase of facemasks and respirators by individuals and families for pandemic influenza preparedness  the American public was given a much stronger recommendation for the home stockpiling, and use, of facemasks and respirators than we'd seen before. 

 

Some excerpts from this guidance:

 

Although not all households will have someone who becomes ill with influenza during a pandemic, because one cannot predict in which households an infection will occur, it would be reasonable for each household to stockpile some respirators that can be used, if needed, when caring for an ill family member.

 

With proper precautions, a single caregiver can use the same respirator several times over a day for brief care visits with the same ill person in the household,[2] so a stockpile of 20 respirators per household would be reasonable.

 

<snip>

 

Pandemic outbreaks in communities may last 6 to 12 weeks.[3]  Persons who cannot avoid commuting on public transit may choose to purchase 100 facemasks for use when going to and from work.

 

An additional supply of facemasks also could be purchased for other times when exposure in a crowded setting is unavoidable or for use by an ill person in the home when they come in close contact with others.[4]

 

 

Ideally, that is when you want to encourage people to stock up; before a crisis begins.

 

The same was true for encouraging Americans to stockpile at least 2-weeks of food in their pantry.  Something that has been part of the pandemicflu.gov family planning advice for nearly 3 years.

 

 

Before a crisis, authorities knew that too few people would heed that advice to make much of an impact on the supply chain.

 

AFTER a crisis has become high profile for a large segment of society, urging people to go out and stockpile masks or food can cause huge runs on the just-in-time inventory kept by most stores.

 

And that poses a genuine dilemma for governments and emergency planners.   

 

A public call to `stock up’ now, would probably result in a mad rush to the stores by millions of people.   Those who were slow to act, or who didn’t have the financial resources to stock up, could find that the shelves would be bare for them and their families.

 

If you doubt the impact of such a statement, consider the infamous Toilet Paper Shortage of 1973.

 

In December of 1973, the United States was suffering through the first of the oil shocks, and gas prices had tripled. Americans were understandably nervous.

 

Johnny Carson, the King of Late nite TV made an offhand joke, a week before Christmas that the next shortage congress was worried about was of Toilet Paper. It got a small laugh.

 

The next morning, millions of Tonight Show fans ran out and cleaned the shelves of all of the available toilet paper. Some people bought shopping cart's full. By noon, there wasn't a roll to be had in most major cities. The supplies were, err, wiped out, so to speak.

 

That night, Johnny Carson went on the air to explain, and apologize. There was no shortage, it was all a joke. Only one problem: Now there was a shortage. As soon as new supplies were delivered and put on the shelves, they were snapped up by worried buyers. People were hoarding toilet paper out of fear, and the shortage continued.

 

Even though the supply chain was unbroken, it took 3 weeks before normalcy returned. And all of this took place back when stores actually had stockrooms, and didn't rely on just-in-time inventory restocking.

 

 

Multiply this scenario a hundred times, and you'd have some idea of what would happen now if the President, or some other high profile official suggested everyone lay in a 2-week supply of food, medicine, and  . . .you guessed it . .. toilet paper.

 

 

The supply of facemasks and respirators is finite, and quite frankly, we need as many of those to go to Health Care Workers (HCWs)  and first responders as possible.   

 

They are going to be most at risk for exposure to the virus. And without protective gear (PPE’s) many will probably elect not to work.  

 

 

If you were smart, and listened to the sage advice of the HHS, FEMA, and Ready.gov, and have laid in a reasonable amount of supplies. 

 

Congratulations.

 

You are ahead of the curve, and will be in a better position to care for your family, and hopefully help your friends and neighbors.  

 

There still exists a window of opportunity for people to make reasonable and modest additions to their preparedness level.  To acquire a small stockpile of basic foods, medicines, and emergency supplies.

 

But don’t expect many public officials to stress these actions, now that a pandemic alert has been issued.  Doing so could cause panic buying, and immediate shortages.

 

And that could make matters worse for everyone.

 

 

This advice remains on the HHS site:

 

Be Prepared

Stock a supply of water and food. During a pandemic you may not be able to get to a store. Even if you can get to a store, it may be out of supplies. Public waterworks services may also be interrupted. Stocking supplies can be useful in other types of emergencies, such as power outages and disasters. Store foods that:

• are nonperishable (will keep for a long time) and don't require refrigeration
• are easy to prepare in case you are unable to cook
• require little or no water, so you can conserve water for drinking

See a checklist of items to have on hand for an extended stay at home.

 

To plan for a pandemic:

• Store a two week supply of water and food. During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand. This can be useful in other types of emergencies, such as power outages and disasters.
• Periodically check your regular prescription drugs to ensure a continuous supply in your home.
• Have any nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
• Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.
• Volunteer with local groups to prepare and assist with emergency response.
• Get involved in your community as it works to prepare for an influenza pandemic.

 

 

These recommendations are sensible ones to prepare for any disaster, not just a pandemic.  

 

Each year we see floods and hurricanes, and tornadoes. Some regions are prone to earthquakes.  Disasters happen.

 

Being prepared can not only ensure that you and your family have the resources you need to deal with an emergency, it can free up public resources to help those who were less prepared.

HHS Sends 400K Courses Of Tamiflu To Mexico

 

 

# 3101

 

 

The new HHS Secretary, Kathleen Sebelius, announced two new actions this evening regarding our strategic national stockpile of Tamiflu. 

 

First, just a few days after authorizing the release of 25% of our national antiviral stockpile to the States, the HHS has announced they will order 13 million replacement courses of Tamiflu & Relenza.

 

Second, the HHS is sending 400,000 10-pill courses of Tamiflu to Mexico to help that country deal with their novel H1N1 flu outbreak. 

 

The Strategic National Stockpile (SNS) has roughly 6 million courses of antivirals earmarked for possible early containment attempts in other countries.

 

In this case, containment is obviously impossible since the virus is no longer circulating just in Mexico, but there apparently remains some hope that these resources might slow the spread of the virus.

 

 

 

 

 

 

FOR IMMEDIATE RELEASE
Thursday, April 30, 2009

Contact: HHS Press Office
(202)-690-6343

Secretary Sebelius Takes Two Key Actions On Strategic National Stockpile

13 Million Treatment Courses Purchased to Replenish Stocks Sent to the States, 400,000 Treatment Courses Deployed to Mexico

Health and Human Services Secretary Kathleen Sebelius announced today that the Federal government will purchase an additional 13 million treatment courses to help fight influenza, including the 2009 H1N1 flu virus. The additional treatment courses will be added to the Strategic National Stockpile. The Secretary also announced that HHS began moving 400,000 treatment courses to Mexico to help slow the spread of the H1N1 virus.

 

"As this flu virus outbreak expands across the country, we have been taking necessary steps to ensure states have the resources they need," said Sebelius. "The 13 million additional treatment courses that we will purchase will allow us to replenish our national stockpile and further ensure we are prepared to provide the American people with the treatments they may need to stay healthy."

 

HHS has stockpiled approximately 50 million courses of antiviral drugs in the Strategic National Stockpile, and state stockpiles across the country include an additional 23 million more treatment courses. Earlier this week, HHS released a total of 11 million treatment courses to help all 50 states. Today HHS began moving 400,000 treatment courses to Mexico to help stop the spread of the virus. The 400,000 courses represent less than 1 percent of the total American stockpile.

 

As a result of today's action by the Secretary, HHS will spend an estimated $251 million to refill the Strategic National Stockpile and replace the 11 million treatment courses offered to states and to purchase an additional two million treatment courses. These additional two million treatment courses will be used to replace those that have been provided to Mexico or could also be available to respond to other outbreak needs.

 

"Flu viruses don't stop at the border, and it is imperative we do whatever we can to slow the spread of the virus and help stop this outbreak," said Sebelius.

 

HHS will make Strategic National Stockpile experts available on a background briefing call at 7:15 PM to answer questions about today's actions.

 

A Flu By Any Other Name . . .

 

# 3100

 

 

Who knew the pig lobby was so powerful?

 

Actually, WHO didn’t know. 

 

Until today, that is, when they finally relented and officially announced that from this day forward `Swine Flu’ will be called Influenza A(H1N1).

 

(aka “The Virus Formerly Known As Swine”).

 

It just sorta rolls off the tongue, doesn’t it?

 

Influenza A(H1N1) . . . not to be confused, of course, with the other Influena A/H1N1 . . . which has been circulating as a seasonal flu since it's return in 1977.

 

Minor detail.

 

Of course, getting the public to make the switch may not be as easy.  But at least at the World Health Organization `Swine’ is out.

 

 

Screenshot from today’s WHO Update.   

 

Of course, the URL to get to this update is still:

 

 

I’m sure they are working on that.

 

Whether this change in nomenclature is picked up by average person on the street remains to be seen.  

 

I wouldn’t put a lot of money on it, however.

 

It’s a minor point, I suppose. And I can live with it. I’d only really been  upset if they’d named it after a country or region.  

 

We’ve seen too much of that in the past.

 

Still, it’s sorta a shame. 

 

`Swine Flu’ was catchy. 

 

It lent itself to some humor, something we all could use a little more of during a crisis.  On twitter, some people have been using #piggyflu to mark their A(H1N1) posts (see, I’m trying). 

 

When I first saw that, it made me smile.

 

A(H1N1) sounds worse, somehow. 

 

 

 

 

 

 

WHO changes flu virus strain name from swine flu

Thu Apr 30, 2009 6:33pm BST

GENEVA (Reuters) - The World Health Organisation (WHO), bowing to pressure from meat industry producers and concerned governments, said on Thursday it would refer to a deadly new virus strain as influenza A (H1N1) not swine flu.

 

"From today, WHO will refer to the new influenza virus as 'influenza A (H1N1)'," it said in a brief announcement posted on its www.who.int/en/ website.

 

The new strain has infected 257 people, of whom 8 have died.

 

It derives from a swine influenza virus but the new strain has been found only in people. No pigs have been confirmed to be sick with it.

 

WHO has consistently said the disease cannot be caught from eating pork if it is prepared properly.

 

 

Where possible, I’ll attempt to use the H1N1 FLU (CDC’s version), or A(H1N1) (WHO’s version).  

 

But I’m not going to promise not to use the term `Swine Flu’. 

 

Not, at least, until I get a lucrative offer from the Global Pig Cartel.

Today’s CDC Briefing

 

 

# 3099

 

 

Today’s CDC briefing just ended.

At 1 PM, the HHS will begin a live Online Telecast of their PlanFirst series of webinars, with newly sworn HHS Secretary Kathleen Sebelius,  Director of Homeland Security Janet Napolitano, and Dr. Rich Besser of the CDC.

 

 

The subject will be the H1N1 `swine’ flu outbreak and you can watch it HERE.

 

Today’s briefing, which lasted about 45 minutes, reiterated a number of points we’ve heard before.  The `new daily numbers’ were updated, now with 109 confirmed cases in 11 states.

Dr. Besser indicated that at some point testing of every case probably won’t continue, and that the numbers will become murkier.   Localities being affected will be the focus, more than numbers, at that point.

 

The CDC Swine Flu website is getting between 6 and 8 million hits a day, and the toll-free information hotline about 4,000 calls each day.  

 

1-800-CDC-INFO

 

The CDC  has put on extra staff to  handle the telephone and email inquiries.   The average wait for an operator is down to only about 90 seconds now.

 

We should be getting more details on the course of illness in Mexico later today when the CDC releases a new MMWR Report.

 

And finally, Dr. Besser stressed once again the importance of Shared Responsibility.  That means practicing safe, and sensible flu hygiene (stay home if sick, cover coughs, wash hands, etc.) and he said it is TIME TO PULL OUT YOUR PANDEMIC PLAN.

 

You need to be deciding what will do when it reaches your community.

 

The audio and transcript will be posted later today on the CDC PRESS BRIEFINGS page.

 

Today’s CDC status update is as follows:

 

Swine Influenza (Flu)

Swine Flu website last updated April 30, 2009, 10:30 AM ET

In response to an intensifying outbreak in the United States and internationally caused by a new influenza virus of swine origin, the World Health Organization raised the worldwide pandemic alert level to Phase 5  on April 29, 2009.

 

A Phase 5 alert 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.”

 

The United States Government has declared a public health emergency in the United States. CDC’s response goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by this emergency.

CDC is issuing and updating interim guidance daily in response to the rapidly evolving situation. CDC’s Division of the Strategic National Stockpile (SNS) continues to send antiviral drugs, personal protective equipment, and respiratory protection devices to all 50 states and U.S. territories to help them respond to the outbreak.

 

The swine influenza A (H1N1) virus is susceptible to the prescription antiviral drugs oseltamivir and zanamivir. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against this new virus.

It Isn’t Just `Swine Flu’

 

# 3098

 

 

More than two years ago I wrote a blog entitled  It isn’t Just Bird Flu, where I echoed the sentiments of a number of scientists that bird flu wasn’t the only pandemic threat.  

 

That has been a familiar theme of many of the flu bloggers, even though the mainstream media has focused almost entirely (when they’ve discussed it at all) on `bird flu’.

 

Now the media pretends that nobody saw this new virus coming, but that isn’t really true.  The truth is, this virus was discovered because scientists were looking for it, or one like it.  

 

And they will continue to look for more, novel, emerging viruses. 

 

Because this won’t be the last one. 

 

In my blog of two years ago, I wrote of `Pathogen X’, the one we don’t know about, that could suddenly appear and spark a pandemic.

 

One could certainly argue that Swine flu fits that description.

 

While our attention is (rightfully) placed on the current pandemic threat, it is important to remember that there are other pathogens out there, and we could end up fighting back-to-back pandemics, or worse, end up fighting a pandemic on two viral fronts.

 

The Bird Flu (H5N1) threat has not gone away.  There are other viruses (avian and otherwise) out there that have pandemic potential as well.

 

While we cover the Swine Flu outbreak, we can’t afford to ignore these other viral threats.   Funding intended to control and contain H5N1 in places like Indonesia and India are likely to be diverted now to control H1N1.

 

So I intend to continue to blog on the H5N1 virus, and other emerging disease threats, even while we deal with the current crisis.

 

And now, as a reminder of some of those threats, I’ll reprint my blog from April of 2007.

 

 

 

 

 

 

It Isn't Just Bird Flu

 

#662

In this increasingly crowded world of ours, where there are large areas of poverty and poor medical care, there are literally scores of deadly pathogens that could spark the next epidemic, or pandemic.    Bird flu, or the H5N1 virus, is high on the list of diseases we watch, but it is by no means the only one out there.

 

When we prepare for a bird flu pandemic, we are also preparing for any other disease outbreak.

 

We worry most about influenza viruses because they spread so rapidly.  In 1918 the Spanish Flu managed to traverse the globe in 5 months without the benefit of air travel.   What took months back then could well take only weeks today.   The next pandemic may strike with little or no warning.

 

Among the influenza's, H5N1 is currently our main focus.  It is a novel virus, it has become endemic in birds in many countries, and it has shown that it can jump species and infect humans.  It has all of the criteria needed to spark a pandemic, save one;  it hasn't developed the ability to be easily transmitted from human-to-human. 

 

But influenza viruses mutate rapidly, and with each human infection there is a chance that the virus may acquire the ability to become easily transmissible.   Whether that will ever happen with the H5N1 virus is unknown, but many scientists strongly believe it could happen.

 

Other influenza viruses with pandemic potential exist out there, among them are H9N2, which infected two children in Hong Kong in 1999 and another in 2003, H7N7 which infected 89 people (1 death) in the Netherlands in 2003, and H10N7 which infected two infants in Egypt in 2004. 

 

Beyond Influenza we also watch for SARS, which broke out of China in 2003, and infected 8000 people worldwide, killing roughly 800.  SARS wasn't as easily transmitted as influenza, but it does have pandemic potential.   We hear very little about it today, but there is nothing to say that it couldn't jump back into the headlines tomorrow.

 

XDR-TB,  a form of tuberculosis that is highly drug resistant, worries many health officials.  It wouldn't spread at the speed of an influenza outbreak, but it could become another slow moving epidemic, like AIDS.   TB was a scourge when I was a child, my grandmother had it and was in a TB hospital before I was born, but has been largely controlled over the past 40 years.  No longer, TB is on the rise again, and it is deadlier than ever.

 

Viral fevers, now mostly seen in tropical developing countries, have the potential to end up anywhere in the world because of modern air travel. Lhassa fever, Rift Valley Fever, and even Ebola could end up in New York or London someday.

 

Old favorites, like polio, smallpox, yersinia (plague), and measles could return.  We've seen outbreaks of pneumonic plague and polio in the last year in equatorial Africa.  Measles and mumps have broken out both in the United States and Europe in recent months despite mass vaccinations of the populace.

 

Chikungunya, which is spread by mosquitos, has ravaged nations in and around the Indian Ocean over the past year.  Yellow Fever is endemic in large areas of South America and Africa.  Dengue fever is spreading in tropical countries like Indonesia, and of course Malaria kills millions every year.   Those who live in developed nations would like to believe they are immune from these disease outbreaks, but they are not.

 

While some of these diseases are controllable, and not all of them have pandemic potential, they all would require a well mounted public health response to contain them. 

 

And then there is always the possibility of pathogen X, the one we don't know about, that will suddenly pop up somewhere in the world and begin to spread, just as SARS did a few short years ago.   

 

Pathogen X will most likely be a zoonotic disease, one that normally resides in animals, but jumps to humans.  Over the past thirty years, more than two dozen of these zoonotic disease have been identified.  There is a strong possibility that one of these zoonotic diseases will someday pose a major health threat.

If you think that's unlikely, I'd remind my readers that Lyme Disease is one of the fast growing emerging infectious diseases in the country. Each year more than 20,000 new cases are reported to the CDC, although they admit that the real number of infected is likely many times higher.  Testing is woefully inadequate, and it is frequently misdiagnosed.

 

As a Lymie, I can attest to the damage that disease can do when it is not properly diagnosed and treated. 

 

The next pandemic may come out of left field, and be completely unexpected.  Our only defense is to have a strong global public health system that can monitor these diseases, and hopefully detect and contain them before they can spread. 

 

The WHO, FAO, and our own CDC are at the forefront of this daily battle against emerging infectious diseases.   They are limited, of course, by a finite budget, global politics, and the fact that many of these diseases come out of remote areas of the world where surveillance is poor.   But despite these constraints, they are our best hope in preventing the next pandemic.

 

The focus of this blog will remain Avian Flu as long as that remains a threat.  But from time to time, when conditions warrant, I'll bring you information on other emerging infectious diseases.  

 

We don't know when the next pandemic will occur, or what pathogen it will spring from. 

 

We just know that their are many emerging threats out there, and every day that passes brings us closer to the next global health crisis. 

Referral: Next Steps On H1N1 Flu (Swine Flu)

 

# 3097

 

 

DemFromCt (who is an M.D. in his `other’ life) is the editor of the Flu Wiki, and writes for the Daily Kos.    He has been an outspoken proponent for preparing for the next pandemic for many years.

 

Today he has a blog entitled:

 

Next Steps On H1N1 Flu (Swine Flu)

 

Follow the link to read the whole thing.  But I’d like to excerpt one particularly well stated paragraph here.

 

Get used to the word pandemic. It's not a dirty word, or alarmist, or hype. It's a description of a novel virus that can spread human to human and causes disease. Right now, the disease seems relatively mild outside of Mexico, but all of the above effort is not based on where we are now, it's anticipating where we might be in two weeks or four. Or longer. people aren't used to thinking longer, but for now, just accept that things can possibly get worse before getting better, even though things can very well stay mild. Uncertainly is driving prudent precaution. Rather than rail against "hype", take some prudent steps to prepare yourself and your family, and that includes reviewing the above, covering your cough, and planning for school closures.

 

Now . . . go read the rest of it.

Videos: Two From The CDC

 

# 3096

 

 

The CDC has produced a couple of videos in the past two days and they are now available on YouTube.

 

First, we get the CDC’s Dr. Bresee talking about the symptoms of Swine Flu,  then some instruction on the proper use of N95 respirators.

 

As new videos and podcasts are produced, I’ll highlight them in this blog.

 

 

 

 

 

 

(Note: Dbl click to go to the video’s Youtube Page)

Mexico Shuts Down

 

# 3095

 

 

 

It is hard to believe that it is just over a week since the first word of a new influenza virus began to filter across the news wires.  

 

In a week we’ve gone from watching the H5N1 bird flu virus (which is still out there, and still percolating) to a Level 5 Pandemic Alert for `Swine Flu’.

 

While the virulence (severity of illness) of this virus appears to be relatively mild, it has been cited as the cause of a number of deaths in Mexico, and at least one death in the  United States.

 

It is too soon to know whether we see a mild pandemic, or a severe one  (or something in between) from this virus. 

 

The virus we deal with today will no doubt mutate over the coming weeks and months.  We may see pockets of more severe illness even if the virus remains `generally mild’. 

 

But even a `relatively mild’ virus has the ability to severely disrupt society.   

 

Case in point, Mexico is all but shut down this morning due to the outbreak.

 

 

 

Mexico Plans Shutdown as World Flu Alert Raised

Mexico to shut all but essential services as world health officials ratchet up swine flu alert

By MARK STEVENSON and ANDREW O. SELSKY Associated Press Writers
MEXICO CITY April 30, 2009 (AP)

Mexico readied a "temporarily closed" sign — taking the drastic step of ordering a suspension of nonessential federal government and private business activity as it tried to squelch a swine flu epidemic. The World Health Organization ratcheted up an alert and warned that "all of humanity" is threatened.

 

<snip>

 

In a televised address, Mexican President Felipe Calderon praised "the heroic work" of doctors and nurses and asked his countrymen to literally stay in their homes between May 1 and May 5, saying "there is no safer place to protect yourself against catching swine flu, than in your house."

 

In recent days, Mexico has faced one of the most serious problems in recent years," Calderon said Wednesday night. He brushed aside criticisms that his government's response was slow, stressing several times that authorities had reacted "immediately."

Commuters, wearing protective face masks to prevent infection from swine flu, ride in the subway in Mexico City Wednesday April 29, 2009. (AP Photo/Rodrigo Abd)

 

School in Mexico has already been canceled until May 6. During the shutdown, essential services like transport, supermarkets, trash collection and hospitals will remain open.

 

Calderon said authorities would use the partial shutdown to weigh whether to extend the emergency measures, or "if it is possible to phase out some" restrictions.

 

(Continue . . .)

 

 

Restaurants, pool halls, movie theatres, sporting events, even taco stands are closed or are being closed in Mexico city.

 

Millions of people are unable to work. 

 

Many countries have stopped, or have reduced airline flights to and from Mexico.  Tourism is all but dead there right now, and may remain so for some time.

 

The economy, on many levels in Mexico, is taking a terrible hit.

 

The question comes: How long can any nation sustain this sort of reaction?

 

And a week from now, if they try to lift some of these restrictions, will the virus simply pick up steam again?

 

Unanswered questions at this point.

 

The secondary effects of a pandemic – on the economy and on society – may exceed the health related impact.   And in the long run, could have a profound effect on peoples lives.

 

Over the coming days and weeks we are going to have to find ways to live, and work, as safely as possible under `pandemic conditions’. 

 

Because, like it or not, we really haven’t much choice.

HHS/CDC/DHS Webcast On Pandemic Flu

 

 

 

# 3094

 

 

Sebelius, Napolitano, Besser to Host Webcast on 2009 H1N1 Flu, Answers Questions from the American People

Health and Human Services Secretary Kathleen Sebelius, Homeland Security Secretary Janet Napolitano and Acting Director of the Centers for Disease Control and Prevention, Dr. Rich Besser will host a webcast to answer questions and provide information directly to the American people regarding the 2009 H1N1 flu on Thursday at 1:00 PM EDT. The webcast can be viewed at www.hhs.gov and www.cdc.gov.

 

“At times like this, clear accurate information is one of the most powerful tools we have and we look forward to answering questions and speaking directly to the American people,” said Secretary Sebelius. “Our administration believes in using new methods to engage the American people and ensure they can speak directly to their public officials. This webcast is an important part of that effort.”

 

“It’s imperative that the American people know exactly what their government is doing, and exactly what they can do themselves to mitigate the spread of this virus,” said Secretary Napolitano. “Everyone has a part to play in this, and it’s important that the lines of communications are open.” 

 

Questions for the officials can be submitted by emailing hhsstudio@hhs.gov. Additional information regarding the Webcast is included below.

 

WHAT:          Webcast regarding 2009 H1N1 flu virus

WHEN:          Thursday, April 30

                        1:00 p.m. EDT

WHERE:       Watch the Webcast live at www.hhs.gov or www.cdc.gov. Submit questions for the Webcast by emailing hhsstudio@hhs.gov. Registration for the Webcast is not required.

 

Please note, you will need Flash (http://www.adobe.com) installed on your computer in order to view the live video stream.  You can test your ability to view the Flash video stream starting at 10 am EDT on Thursday by visiting www.hhs.gov or www.cdc.gov.

 

NOTE:            Networks can access the Webcast via outbound fiber from VYVX: 100355

 

What Pandemic Level 5 Means To You

 

 

# 3093

 

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

 

 

 

No doubt, today’s declaration of a Global Pandemic Emergency (Level 5) by the World Health Organization (WHO) will drive a lot of people to this site, and others looking for information about what all of this really means.

 

There are a lot of things we don’t know yet, and may not know for months, about this virus.   

 

While some early reports have suggested that this virus may not produce a lot of severe illness, viruses mutate, and the pandemic we start out with may not be the pandemic we end up with.

 

Unfortunately, it does produce severe symptoms in some people.  And some people have died.

 

But we should remember that every year, 30,000+ Americans die from complications of influenza – and globally that number is in the hundreds of thousands. 

 

Even seasonal influenza is a serious illness.

 

A pandemic will probably mean an escalation of that death toll – but by how much . . . we can’t say.  

 

We may be talking double, triple . . . or maybe more.  And a pandemic could linger on for months, or even a year or longer.

 

Right now, before the virus really begins to move through our communities, you need to be making sure that your family, your neighborhood, and your business are prepared to deal with it.

 

You have time to act, but not time to procrastinate.

 

First, you need to get and stay informed. 

 

The CDC has a Swine Flu website at http://www.cdc.gov/swineflu/ and that is your best source of accurate information.

 

For analysis and advice, without hype and sensationalism, I can heartily recommend the bloggers in my blog roll on my sidebar.  They aren’t trying to sell advertisement, or run up the number of hits on their sites, and most are uniquely qualified to write about pandemic influenza.

 

Crof's H5N1

Scott McPherson's Blog

Preparedness and Response

SophiaZoe's Pandemic Chronicle

Maryn McKenna's Superbug

Effect Measure (Public Health Blog)

 

Second, you need to be instructing your family on good `flu hygiene’.   

 

With no vaccine for months, and the possibility that antivirals may lose their effectiveness over time, things like handwashing, covering coughs, social distancing, and staying home if you are sick become all the more important.

 

You should be ensuring that you have sufficient emergency supplies on hand to stay at home, without making a grocery store run, for at least 2-weeks.

 

That means food, medicine, and essential supplies.

 

If you haven’t downloaded Dr. Grattan Woodson's Home Treatment of Influenza  booklet on treating influenza, you need to do so now, and lay in the supplies he recommends.

 

 

 

You should plan to visit the HHS’s excellent pandemicflu.gov site, and spend some time going over their recommendations for Individual and Family Preparedness.  

If you own or run a business, you need to be working immediately to implement a pandemic plan.   Two important resources are:

 

HHS Workplace Planning Page

Guidance on Preparing Workplaces For an Influenza Pandemic

 

 

 

 

My colleagues and I will continue to provide you with the most up to date news, and sensible advice, possible.   This is serious, but it isn’t the end of the world . . .

 

What does a Pandemic Level 5 really mean to you?

 

It means it’s time to get prepared.

 

Now . . . take a deep breath.  Formulate a plan.  And get started.

Media: WHO To Raise Pandemic Alert Level

 

 

# 3092

 

 

UPDATE: 1600hrs EDT 

WHO Raises Pandemic Level to 5

 

Pandemic Imminent as Swine Flu Cases Spread, WHO’s Chan Says

 

By Naomi Kresge and Dermot Doherty

April 29 (Bloomberg) -- The World Health Organization said the first pandemic since 1968 is imminent after an outbreak of swine flu spread to eight nations and 11 U.S. states.

 

The WHO’s Director-General Margaret Chan raised the agency’s six-phase pandemic alert to 5 from 4, the second jump in three days, at a news conference in Geneva today. Level 5 means a pandemic, or a global outbreak of a new virus, is near.

 

“The biggest question right now is this: how severe will the pandemic be,” Chan said. World nations “should treat this as an opportunity to ramp up preparedness.”

 

 

Reuters reported a few minutes ago that the WHO will announce that they are declaring a Global Pandemic Emergency, and raising the Pandemic Alert Level to a 5.

 

 

WHO set to raise pandemic alert within hours-sources

 

Wed Apr 29, 2009 2:38pm EDTGENEVA, April 29 (Reuters) - The World Health Organisation is set to increase its pandemic flu alert level to 5 -- its second-highest level -- within hours, sources said on Wednesday.

"Things are moving fast," said one well-informed source. Another said the WHO was likely to increase the alert by one step, from 4 to 5, in response to the spreading swine flu virus, saying: "I don't think it will be 6." (Reporting by Laura MacInnis and Stephanie Nebehay)

The WHO has stated that they will make an announcement of some sort at 4 pm EDT today. 

Stay tuned. . .

Adopt An Essential Worker's Family

 

 

# 3091

 

 

 

This is a repost (slightly updated) of an article I first wrote in 2006.  I run it once or twice a year because it is a personal cause of mine, and I believe it is important - not only for the essential workers - but for the community as a whole.

 

The bad news is that the Swine Flu virus currently spreading around the world threatens to become a pandemic.   The Good News is, it doesn’t appear to be nearly as virulent as the H5N1 bird flu virus.

 

Still, even in a mild or moderate pandemic, many members of our society will be asked to work on the front lines, and make the sacrifice of being away from their families at a time when they fear their families could need them most.

 

Your local LEO’s (law enforcement officers), firefighters, EMT’s, nurses, utility workers, National Guard troops, and even mortuary workers won't be able to hunker down and wait out a crisis.

  

They will be on the front lines.

 

It will be a tough job. For some, possibly, the last job they will ever do. Some may fall in the line of duty. And they know that.

 

 

For most emergency workers, it’s something they think about every time they put on their uniform. Most of the time, the risks are relatively small, but during a pandemic, they will be at much greater risk.

 

 

The hardest part for them will be leaving their families behind to fend for themselves. Some may decide not to do so, and will refuse to report for work. But most will answer the call.

 

 

There is something you can do for these folks, now, before a pandemic strikes, that can make their job, and their decision easier. You, and your neighborhood can adopt an essential worker.

 

Not so much the worker themselves, but their family.

 

Think about finding a nurse, or an EMT, or a cop in your neighborhood, and introducing yourself. Find ways to support their families during a crisis. 

 

And no, it needn't be just for  a pandemic.  These folks go into harm's way during hurricanes, floods, tornadoes . . . or any other crisis that threatens the community.

These folks will be out there, putting their lives on the line. Knowing their neighbors are watching out for their spouses and kids would mean a great deal to them.

 

It doesn’t have be a lot. A phone call each day, to check on them. A casserole passed over the fence. A security check of their home. An assurance that, if they run short of supplies, their neighbors will pitch in and donate something.

 

There are a thousand ways, large and small, that you can help support these folks, so they can go out and protect your lives and property.

 

And you won’t have to expose yourself to the virus to do it. A gift of food or water left on their doorstep. Extending your security perimeter to include your neighbor’s house. Or just a reassuring daily conversation with family members who will be terrified about what their loved ones are going thru in the pursuit of duty.

 

Your reward will be twofold. You will have done something good for someone, and your community as a whole. And likely, you will receive a certain amount of protection from the people you help. They will know who you are, and will keep an eye out for you and yours, while you help out taking care of theirs.

 

Think of it as a way to attract a little extra security. Believe me, it never hurts to have a friend on the police force or in the fire department.

 

Don’t have a neighbor who qualifies?

 

During a prolonged crisis call your local firehouse, police station, or ambulance service every couple of days (use their non-emergency number)  and let them know you’ve got a casserole, or a couple of pies, or a thermos of hot coffee waiting for them on your front porch. I can assure you, they will appreciate it.

 

Maybe one person can’t make much of a dent. But every little bit will help. And hopefully you can lead your neighbors by example.

 

You don’t have to put on a uniform to be a hero to your community. You just need to think like one. And act like one.

 

Pretty soon. You’ll be one.

WHO Mulls Raising Pandemic Alert Level

 

 

# 3090

 

 

The worst kept secret in cyberspace this morning was that the WHO (World Health Organization) was meeting in Geneva to discuss whether or not to raise the current Pandemic Alert Level from 4 (pre-pandemic) to 5 (Pandemic Emergency Declaration).

 

Pandemic Level 5 is described as:

 

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

 

As this AP article tells us, the WHO is moving closer to making that decision.

 

 

WHO considers raising alert level

LAURAN NEERGAARD AND MIKE STOBBE

Associated Press

April 29, 2009 at 12:01 PM EDT

GENEVA — The World Health Organization says the swine flu outbreak is moving closer to becoming a pandemic.

 

WHO flu chief Dr. Keiji Fukuda told reporters in Geneva today that developments in the disease are moving the agency closer to raising its pandemic alert to phase 5, indicating widespread human-to-human transmission.

 

He said the health body was monitoring the situation but was not yet ready to move the pandemic alert level up from its current 4, which means it is being passed among people. Phase 6 is the highest on the scale and is for a full-scale pandemic.

 

Mr. Fukuda said there was no evidence the virus was slowing down.

 

(Continue . . .)

 

 

The fact that Phase 5 is `on the table’ should be enough to convince anybody that now is the time to make sure you, your family, and your business are prepared to deal with a pandemic.

 

If you have a pandemic plan, now is the time to review it.  If you don’t have one, get cracking.  Much can be accomplished even on short notice.

 

I’ll be discussing specific preparations later today (and in the future), but for now, please visit www.pandemicflu.gov and check out the government’s advice on preparing for a pandemic.

The Latest Numbers From The CDC

 

 

# 3089

 

 

 

As Dr. Besser pointed out in the televised press conference from the HHS this morning, these numbers are almost obsolete by the time they post them.

 

But, the official count is 91 cases (1 fatality) in 10 states.

 

 

 

 

 

 

The HHS also announced plans to move forward with the development and testing of a Swine Flu Vaccine. 

 

The creation of a new vaccine takes time. 

 

Questions as to safety and the lowest effective dose must be answered.  And of course, a decision must be made whether (and how) to distribute it.

 

It is hoped that `some quantity’ of vaccine will be available in the Fall . . . but when it will be available to the public is unknowable right now.  

 

Everything we’ve been told to date about the process would indicate that any significant quantity of vaccine is probably at least 6 months away.

Revised Interim Guidance On Swine Flu Case Definitions

 

# 3088

 

 

 

As promised, the CDC continues to post, and revise, guidance documents on their Swine Flu website as new information is acquired and analyzed.

 

Many of these documents are of most interest to clinicians, or public officials, but all are available for you to view.

 

We hear a lot about Suspected, Probable, and Confirmed cases.  Here are the revised case definitions.

 

 

Interim Guidance on Case Definitions to be Used For Investigations of Swine Influenza A (H1N1) Cases*

April 29, 2009 2:00 AM ET

This document provides interim guidance for state and local health departments conducting investigations of human cases of swine-origin influenza A (H1N1) virus (S-OIV). The following case definitions are for the purpose of investigations of suspected, probable, and confirmed cases of S-OIV infection.

 

Acute febrile respiratory illness is defined as a measured temperature of 37.8 degrees Celsius (100.4 degrees Fahrenheit) and recent onset of at least one of the following: rhinorrhea or nasal congestion, sore throat, or cough.

Case Definitions for Infection with Swine-origin Influenza A (H1N1) Virus (S-OIV)

A confirmed case of S-OIV infection is defined as a person with an acute febrile respiratory illness with laboratory confirmed S-OIV infection at CDC by one or more of the following tests:

1. real-time RT-PCR
2. viral culture

A probable case of S-OIV infection is defined as a person with an acute febrile respiratory illness who is positive for influenza A, but negative for H1 and H3 by influenza RT-PCR

 

A suspected case of S-OIV infection is defined as a person with acute febrile respiratory illness with onset

• within 7 days of close contact with a person who is a confirmed case of S-OIV infection, or
• within 7 days of travel to community either within the United States or internationally where there are one or more confirmed cases of S-OIV infection, or
• resides in a community where there are one or more confirmed cases of S-OIV infection.

 

 

This is a fluid situation, and we should expect revisions and updates as a matter of course. 

 

Here are the changes/additions to the CDC’s Swine Flu site so far today.  You can visit the What’s New page to see the latest updates.

 

 

Wed, 29 Apr 2009 06:30:00 EST
Interim Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public Safety Answering Points (PSAPs) for Management of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection
This document provides interim guidance for 9-1-1 Public Safety Answering Points (PSAPs), the Emergency Medical Services (EMS) system and medical first-responders and will be updated as needed at http://www.cdc.gov/swineflu/guidance/.The information contained in this document is intended to complement existing guidance for healthcare personnel, “Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting” at http://www.cdc.gov/swineflu/guidelines_infection_control.htm.

 

Wed, 29 Apr 2009 03:30:00 EST
CDC Health Update: Interim Guidance--Children and Pregnant Women who may be Infected with Swine-Origin Influenza Virus: Considerations for Clinicians
Health Alert NetworkApril 28, 2009

 

Wed, 29 Apr 2009 02:00:00 EST
UPDATED Interim Guidance on Case Definitions for Swine Influenza A (H1N1) Human Case Investigations
This document provides interim guidance for state and local health departments conducting investigations of human cases of swine-origin influenza A (H1N1) virus (S-OIV). The following case definitions are for the purpose of investigations of investigation of suspected, probable, and confirmed cases of S-OIV infection.

 

Wed, 29 Apr 2009 01:45:00 EST
Swine Flu: Emergency Use Authorization (EUA) of Medical Products and Devices
The U.S. Food and Drug Administration, in response to requests from the U.S. Centers for Disease Control and Prevention, has issued Emergency Use Authorizations (EUAs) to make available to public health and medical personnel important diagnostic and therapeutic tools to identify and respond to the swine flu virus under certain circumstances. The agency issued these EUAs for the use of certain Relenza and Tamiflu antiviral products, and for the rRT-PCR Swine Flu Panel diagnostic test.

 

Wed, 29 Apr 2009 00:00:00 EST
Interim Guidance for Clinicians on Identifying and Caring for Patients with Swine-origin Influenza A (H1N1) Virus Infection
This document provides interim guidance for clinicians who might provide care for patients with swine-origin influenza A (H1N1) or suspected swine-origin influenza A (H1N1) virus infection. It will be periodically updated as information becomes available.

 

Obama: Flu Is `Serious Situation’

 

 

# 3087

 

 

President Obama, in a statement this morning, expressed his concerns over the growing Swine Flu outbreak.  He urged schools where there are confirmed or suspected cases to strongly consider closing to protect the students.

 

This from Reuters.

 

 

 

Obama: time for 'utmost' precautions on swine flu

29 Apr 2009 12:27:11 GMT

Source: Reuters

WASHINGTON, April 29 (Reuters) - President Barack Obama said on Wednesday that the first U.S. death from a new strain of swine flu showed it was time to take "utmost precautions" against its possible spread.

 

"We are closely and continuously monitoring the emergent cases of this virus throughout the United States," Obama said in remarks at the White House before leaving on a one-day trip to Missouri.

 

"This is obviously a serious situation. Serious enough to take the utmost precautions," Obama said.

 

He urged state and local health authorities to be vigilant in detecting and reporting possible new cases and asked schools to consider closing if they have confirmed or suspected cases of the virus.

 

U.S. officials said on Wednesday that a 23-month-old Texas child had died from the H1N1 virus, the first confirmed death outside Mexico. U.S. officials have confirmed 65 cases of swine flu, most of them mild.

US Confirms First Swine Flu Fatality

 

 

# 3086

 

 

 

Health officials have been warning that this was inevitable for several days.  

 

Still, it is a very sad milestone.   

 

A 23-month old child has died in Texas from the Swine Flu virus.

 

This report from Maggie Fox, of Reuters News.

 

 

U.S. has first death from swine flu

By Maggie Fox, Health and Science Editor Maggie Fox, Health And Science Editor – 9 mins ago

WASHINGTON (Reuters) – A baby in Texas has died from the new H1N1 swine flu, the first U.S. death from the virus, a CDC official said on Wednesday.

 

It is the first death from swine flu reported outside Mexico, the country hardest hit by the influenza outbreak. The official gave no other details on the case. U.S. officials have confirmed 65 cases of swine flu, most of them mild but with five hospitalizations in California and Texas.

 

"I can confirm very sad news coming out of Texas -- that a child has died from the H1N1 virus," Dr. Richard Besser, acting director of the U.S. Centers for Disease Control and Prevention, told CNN.

(Continue . . .)

Audio: NPR Interview With Dr. Michael Osterholm

 

 

# 3085

 

 

 

Minnesota Public Radio’s Mid-Morning program has an extended interview with Dr. Michael Osterholm, director of CIDRAP (Center for Infectious Disease Research & Policy) of the University of Minnesota, along with two other experts.

 

Dr. Osterholm, who is perhaps the best public speaker on influenza in the world, is always worth listening to.   

 

 

The entire show runs an hour, and is worth listening to in its entirety.  But if your time is limited, please listen to the first 30 minutes.

 

Highly recommended.

 

 

 

 

Officials assess dangers of swine flu

 

Broadcast: Midmorning, 04/28/2009, 9:06 a.m.

The rising number of deaths caused by swine flu in Mexico has health workers, the Department of Homeland Security, and even Wall Street concerned about the impacts of a global pandemic. Midmorning gets the latest on the swine flu outbreak.

 

Guests

Michael Osterholm: Director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Frank Rhame, MD: Infectious disease specialist with Allina Medical Clinic. He is also research director of Abott Northwestern's Infectious Disease and Travel Clinic.

Gerald Callahan: Associate professor of Immunology and the Public Understanding of Science at Colorado State University, author of "Infection: the Uninvited Universe."

The Testing Gap

 

 

# 3084

 

 

AIDigest Interactive Map of Suspected/Confirmed Swine Flu Cases – Current as of 0500 hrs EDT Apr 29th

 

 

As the number of suspected, probable, and confirmed cases of Swine Flu escalate around the world we are seeing the inevitable haggling over `the numbers’ that occurs when different sources apply different criteria for their reporting.

 

Depending upon who you ask, Mexico has either 7, 20, 159, or more than 300 Swine Flu Fatalities.

 

No, I’m not kidding.

 

After all of the hoopla of the past 6 days, with every  news agency shouting 100+ fatalities . . . how do we get back to 7?

 

 

 

Only seven confirmed swine flu deaths - WHO

Last updated 14:20 29/04/2009

NUMBERS: While there have been more than 150 reported deaths from swine flu, the World Health Organisation has officially recorded only seven.

A member of the World Health Organisation (WHO) has dismissed claims that more than 150 people have died from swine flu, saying it has officially recorded only seven deaths around the world.

 

Reports have put the likely death toll from the virus at 152, with Mexican officials confirming 20 deaths.

 

The number of cases under observation in Mexico alone has reportedly reached 1,614.

 

But Vivienne Allan, from WHO's patient safety program, said the body had confirmed that worldwide there had been just seven deaths - all in Mexico – and 79 confirmed cases of the disease.

 

"Unfortunately that (150-plus deaths) is incorrect information and it does happen, but that's not information that's come from the World Health Organisation," Ms Allan told ABC Radio on Wednesday morning.

 

If you read my post yesterday, Fluing Beneath The Radar, you saw this graphic from the CDC showing how few cases get laboratory confirmation during a disease outbreak.

 

 

As you can see, epidemiologists know that the total number of cases in any community is  likely to be much higher than those that can be laboratory confirmed.   

 

The question is always, how much higher?

 

And right now, we don’t know.

 

Testing for this new flu is still in its infancy.  The CDC is working to get new test kits out to improve the `testing gap’, but these are custom made kits with new reagents.  

 

It isn’t as if they could pull them off the shelf.

 

Testing in Mexico is, quite frankly, running days behind the media reports and government `estimates’.

 

Last night, in a news conference out of Mexico City, the Mexican Health Minister reportedly stated that they now had nearly 2,500 cases of severe pneumonia with 159 suspected deaths (but only 7 laboratory confirmed) and they are investigating another 150.

 

For now, I don’t think we can put much reliance on any of the numbers we are seeing.  

 

None are likely to be correct.

 

Sure, the numbers give us some idea of how things are `trending’ . . . but that’s about all they do.

 

Even here in the United States, where the testing situation is much better, the numbers are lagging behind the reality (or at least, the perception).

 

In New York City yesterday we learned that there were `many hundreds’ of  suspected swine flu cases, but at last count there were only 45 `confirmed cases’.

 

 

Swine flu in NY: Two hospitalised, 'many hundreds' of schoolchildren sick

Two people in New York City have been hospitalised and "many hundreds" of schoolchildren were said to be sick with suspected swine flu as officials gave warning that deaths are likely.

 

While it is likely that some (perhaps many) of the ill children have the Swine Flu, without testing, we can’t know for sure.

 

For now, while I’m reporting the numbers as they are released by the press, I’m encouraging people not to put a lot of stock in them. 

 

They are a moving target, constantly changing.   

 

Press reports, even government announcements, are likely to be wrong or out of date by the time they appear.   And as the number of suspected cases rises, our ability to test them all declines. 

 

That is simply a reality that we must accept.

Three New Swine Flu PSA’s From The CDC

 

# 3083

 

 

The CDC has released three short audio Public Service Announcements (PSA’s) that I imagine will start playing on radio stations around the country.

 

You can beat them to the punch, however, by downloading them and sending them to your friends and family as email attachments.

 

I don’t think the CDC would mind a bit. 

 

 

 

Swine Flu Public Service Announcements (PSAs)

April 28, 2009 6:45 PM ET

CDC PSAs provide timely messages about what you can do to protect yourself and your family.

Swine Flu Preparedness

April 28, 2009 6:45 PM ET

Audio

Audio - Download MP3 file

Script

Health officials are concerned about a new influenza virus of swine origin that’s spreading from person to person. Officials are acting to combat this threat, but the outbreak could grow. Prepare now.

Check with local leaders, schools, employers, and other community groups about their plans regarding an outbreak in your community. It’s important for everyone to know what to do about swine flu.

For details, visit www.cdc.gov/swineflu or call 1-800-CDC-INFO.

A message from HHS.

 

 

Community Planning for Swine Flu

April 28, 2009 6:45 PM ET

Audio

Audio - Download MP3 file

Script

Health officials are concerned about a new influenza virus of swine origin that’s spreading from person to person. Officials are acting to combat this threat, but the outbreak might grow. So be prepared.

Store a two-week supply of food and water. Have two weeks of your regular prescription drugs at home. Keep health supplies on hand, including pain relievers and cold medicines.

For more details, visit www.cdc.gov/swineflu or call 1-800-CDC-INFO.

A message from HHS.

 

 

 

Hygiene Habits to Help Fight Swine Flu

April 28, 2009 6:45 PM ET

Audio

Audio - Download MP3 file

Script

Health officials are concerned about a new flu virus of swine origin spreading from person to person. To help fight swine flu, cover your nose and mouth with a tissue when you cough or sneeze, then throw the tissue away. Wash your hands often with soap and water, especially after coughing or sneezing. Stay home if you’re sick and limit contact with others to keep from infecting them.

To learn more, visit www.cdc.gov/swineflu or call 1-800-CDC-INFO.

A message from HHS.

WHO Swine Influenza Update 4

 

 

# 3082

 

 

Not a lot of new information here, other than the confirmation that Swine Influenza has now been confirmed in 7 countries.

 

• Mexico
• United States
• Canada
• New Zealand
• Israel
• United Kingdom
• Spain

 

That list will undoubtedly grow.

 

 

 

Swine influenza - update 4

28 April 2009--The situation continues to evolve rapidly. As of 19:15 GMT, 28 April 2009, seven countries have officially reported cases of swine influenza A/H1N1 infection. The United States Government has reported 64 laboratory confirmed human cases, with no deaths. Mexico has reported 26 confirmed human cases of infection including seven deaths.

 

The following countries have reported laboratory confirmed cases with no deaths - Canada (6), New Zealand (3), the United Kingdom (2), Israel (2) and Spain (2).

 

Further information on the situation will be available on the WHO website on a regular basis.

 

WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

 

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.