‘All humanity’ urged to fight imminent swine flu pandemic

Saying global outbreak is imminent, WHO raises alert level and calls on all countries to activate preparedness plans.

GLORIA GALLOWAY and CAROLINE ALPHONSO

From Thursday’s Globe and Mail

April 30, 2009 at 12:11 AM EDT

OTTAWA and TORONTO — Global health authorities raised the alert level for a virulent new strain of swine flu Wednesday, saying a pandemic is now imminent and “all of humanity” must join in an urgent battle against the infection.

The World Health Organization declared that the spread of the virus had reached Phase 5, meaning there has been sustained human-to-human transmission in at least two countries in a WHO region – Mexico and the United States – and there are strong signals that a worldwide outbreak is about to occur.

“All countries should immediately now activate their pandemic preparedness plans. Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia,” WHO Director-General Margaret Chan said in a conference call from Geneva.

“This is an opportunity for global solidarity as we look for responses and solutions that benefit all countries, all of humanity. After all, it really is all of humanity that is under threat during a pandemic.”

Canadian authorities say Canada’s pandemic plan is already in effect. It includes, among other things, vaccine production, an anti-viral stockpile, and a citizen-readiness campaign for each phase of a pandemic.

“We already have cases [of the virus] in Canada and as we continue our surveillance, we will find more and more cases,” said David Butler-Jones, Canada’s Chief Public Health Officer. “As for any form of influenza, some will be more severe and, unfortunately, we may see some deaths as well.”

The outbreak in Canada has so far been mild. Six new cases were confirmed Wednesday – three in Ontario and three in British Columbia – bringing the total in this country to 19. That breaks down to six in B.C., seven in Ontario, four in Nova Scotia and two in Alberta.

In one of the Ontario cases it was unclear whether the person had travelled outside Canada.

In one B.C. case, it was confirmed the young woman had not been to Mexico but had been around people who had, raising the spectre of human-to-human transmission.

But the H1N1 virus is a new disease and human beings have not yet developed immunity. So, unlike a normal influenza season when 10 per cent of the population is typically infected, Dr. Butler-Jones said, “you could have 20 to 30 per cent, and potentially even more, of the population ill and large numbers of people sick at any given time.”

And while there are between 2,000 and 8,000 deaths in a given flu year, a pandemic could multiply those numbers many times, he said.

Internationally, as of Wednesday, there were 185 confirmed cases and eight deaths positively linked to the virus. Seven of those deaths were in Mexico and the eighth – a 26-month-old Mexican child who had travelled to Texas – occurred in the United States.

But the number of Mexicans who are suspected to have died of the swine flu is much higher than the confirmed toll. And, although just 26 people have tested positive in that country, the actual number is expected to be closer to 1,500 or 2,000.

Mexican health authorities sent 200 suspected virus samples to Canada’s National Microbiology laboratory for analysis Wednesday.

Symptoms of the virus can be similar to a seasonal flu, which includes fever and joint aches. In more severe cases, patients suffer from pneumonia and, at its most severe, death.

Stopping the spread of the virus may not be possible, health officials warned, but individuals can protect themselves by staying home if sick.

Early tests have shown that it is sensitive to anti-viral drugs such as Tamiflu.

The WHO has 3.5 million donated doses of anti-virals, but Dr. Chan said it’s not nearly enough as it will look to support developing countries which are not nearly as prepared for a pandemic. She said companies and the World Bank have expressed a willingness to deal with this crisis.

Canada has sufficient stockpiles of anti-virals. But Dr. Butler-Jones warns that healthy people should not take them because they could cause the virus to become resistant – and then they would be useless if the disease hits hard.

He also advises against wearing face masks except in a hospital setting because they provide little protection from the disease and could give wearers a false sense of security.

David Patrick, the director of epidemiology services with the B.C. Centre for Disease Control, said that two of newly confirmed infected individuals in that province had travelled to Mexico, while the third had had extensive contact with infected persons.

“What this means for B.C. is that five out of six cases we have had to date have had direct contact with Mexico,” Dr. Patrick said. “It’s also important that you know that all of these people are okay, it’s quite correct to say that people are sick when they have influenza and one person was in hospital overnight, but everybody’s at home right now.”

In Ontario, the number of cases has grown to seven, as three women in their 20s tested positive Wednesday.

“It’s not surprising at all,” David Williams, Ontario’s Acting Chief Medical Officer of Health , told reporters Wednesday. “I expect some more as the days go on.”

All seven individuals experienced mild symptoms of the flu and are now resting at their homes in the suburbs surrounding Toronto. They all recently travelled to Mexico.

Vivek Goel, chief executive officer of the Ontario Agency for Health Protection and Promotion , said it is puzzling that Canadians are suffering mild symptoms from the same virus that has left several Mexicans dead.

But “there’s some speculation that there may be tens of thousands of cases, or perhaps even hundreds of thousands of [additional] cases” in Mexico, Dr. Goel said. “If you put that in context, the death rate in Mexico is actually very low.”

Four schools in New York have been closed and a fifth is being watched closely as students have fallen ill with suspected cases of the swine flu.

They include the Good Shepherd School, where nine students were displaying symptoms, and St. Brigid where one student showed signs of the disease. The St. Brigid student has a sibling at St. Francis Preparatory in Queens where there are more than two dozen confirmed cases of the virus.

U.S. President Barack Obama offered an immediate $1.5-billion cash injection to fight swine flu Wednesday and said U.S. health officials recommend that schools close in the event of a local outbreak.

Mr. Obama said last night that it would be pointless to close the U.S. border with Mexico over swine flu because the illness is already in the United States. He likened the move to closing the barn door after the horses are out. In this country, Dr. Butler-Jones said officials are leery of closing schools when one or more students gets infected. There is a certain amount of control that can be exercised in a school setting, he said, but, when the schools are not open, children are likely to be in malls or other places where they can transmit infection.

With reports from Kate Hammer and Karen Howlett in Toronto and the Associated Press

(globeandmail.com)