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WHO has raised pandemic alert to Level 5
The purpose of this report is to provide our readers with the information you need to know to protect yourselves, your families, and your communities during the developing epidemic. There are already many websites offering a great deal of advice, some better than others. (Please see the end of this document for our recommendations.)
Last update Thursday, 4/30/2009 1:26 PM EDT
The World Health Organization has raised its global pandemic alert to Level 5 — its second highest level — meaning a pandemic is imminent and countries must finalize preparations to deal with the outbreak of swine flu.
“Based on assessments of all available information and several expert consultations, I have decided to raise the current level of influenza pandemic alert from Phase 4 to Phase 5,” WHO director general Margaret Chan said during a briefing from the organization's headquarters in Geneva.
Phase 5 is called when there is human-to-human spread of a virus in at least two countries in one region, according to WHO's pandemic response guidelines.
“It is clear that the virus is spreading and we don't see evidence of it slowing down at this point,” Dr. Keiji Fukuda, WHO acting assistant director-general, told a news briefing. “Things are moving fast.”
First US Victim of Mexican Swine Flu
According to Dr. Richard Besser, acting director of the Center for Disease Control (CDC), the Mexican Swine Flu has claimed its first victim in the US, a 23-month-old Mexican boy who was brought to Texas for medical treatment. The new strain of A/H1N1 swine flu that has already killed 159 people in Mexico has been raising alarms around the world.
- On Sunday, April 26, the US government declared a public health emergency because of the growing number of cases being identified as the new type of swine flu, classified as an A/H1N1 virus.
- At the time of this entry, 109 cases have been confirmed in the US.
- Seven additional countries have officially reported cases of swine influenza A/H1N1 infection.
- On Sunday, the European Union's health commissioner, Andorra Vassiliou, has added the United States to the EU's travel advisory issued earlier for Mexico, urging Europeans to avoid nonessential trips to both Mexico and the United States.
- On Monday, WHO raised the alert to Level 4 (Sustained human to human transmission).
- CDC expects more deaths from the A/H1N1 virus, according to Besser.
- To put this flu in perspective, 36,000 people die in the US each year from complications arising from seasonal flu.
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In Mexico, where the virus first appeared, more than 6,000 are now under observation. All schools, universities, museums and theaters have been closed, and Sunday Masses were also canceled - the first time the churches in this largely Roman Catholic country have been closed since Mexico's religious wars in the 1920s. Medical face masks have been distributed on the streets of Mexico City to try to contain the spread of the disease. North of the border, the number of cases is expected to rise quickly as incubation periods expire and more people are exposed in that critical 24 hour period before symptoms begin to appear. Schools have been closed in fourteen states. In Texas, Gov. Rick Perry has issued a disaster declaration, and the state has suspended all high school sports competitions until May 11. Twelve million doses of Tamiflu from federal stockpile have been released for delivery to states where needed. Around the world, other cases have been confirmed in Austria (1), Britain (6), Canada (13), Costa Rica (2), Germany (3), Israel (2), the Netherlands (1), New Zealand (14), Scotland (2), South Korea (1), Spain (10), and Switzerland (1). About the Mexican Swine Flu The strain of flu that is causing so much concern is a combination of four separate strains - two strains of swine flu, and one strain each of avian flu and human flu. Because one of the two main proteins on its surface is similar to proteins that are usually present in infected pigs, it is considered a swine flu virus. |
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The most interesting thing about this virus is that all the people who have died from this virus so far were in Mexico, while the cases that have been confirmed elsewhere have all presented with mild symptoms that were never life threatening. Moreover, it seems to attack a different population than the more common seasonal flu viruses, which generally attack the very young and the very old. The A/H1N1, which we call the Mexican Swine Flu virus, seems to prefer healthy people between the ages of 15 and 40. For the time being, it seems that if the symptoms are treated early, they can be controlled and recovery is swift.
Nevertheless, countries around the world are rushing to avoid both a pandemic and the possibility of global hysteria that is likely to accompany it. The World Health Organization has declared this event a Public Health Emergency of International Concern. The US government has declared a public health emergency, but no travel restrictions have yet been recommended.
In our business the question naturally arises as to whether such a virus can evolve naturally. It may seem unlikely, but almost no one has yet mentioned the possibility that this virus was engineered. This possibility could affect what we might reasonably expect in terms of the behavior of the virus as it continues to spread - and possibly mutate - around the world. Scientific investigation into this possibility should be an imperative, if for no other reason than to rule it out.
Epidemic, Pandemic, or False Alarm?
The chances that this will turn out to be a false alarm appear increasingly slim. The amount of exposure time between the appearance of this virus and the realization that this was a problem of international proportions, together with the speed with which the virus has traveled and spread once it was identified, has largely precluded its containment in any real sense. Moreover, the way in which the virus can be transmitted through the transfer of molecules in the air and on surfaces is likely to make the further spread of the virus unstoppable.
According to the CDC, the spread of this influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads, from person to person through coughing or sneezing.
- People may become infected by touching something with the flu virus on it and then touching their mouth or nose.
- Droplets from a cough or sneeze of an infected person move through the air.
- Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk and then touches their own eyes, mouth or nose before washing their hands.
Some viruses and bacteria can live for two or more hours on surfaces like cafeteria tables, doorknobs, and desks. Frequent hand washing will help reduce the chance of contamination from these common surfaces.
A person carrying the virus may be able to infect others 24 hours before symptoms develop, and up to seven or more days after becoming ill. That means that the virus can be transmitted to someone else even before a person knows he is sick, as well as while he is sick.
Because the air in an airplane is re-circulated many times during the course of a flight, one affected passenger can theoretically infect all the other passengers. For this reason there is special concern about traveling to areas where the virus has been confirmed.
What Symptoms to Look For
The symptoms for the Mexican Swine Flu are similar to those of other types of flu. According to the CDC, they include fever (over 100 degrees), cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu.
In Mexico, severe illness (pneumonia and respiratory failure) and deaths occurred from this unique type of swine flu infection. As with seasonal flu, swine flu may also cause a worsening of underlying chronic medical conditions.
The Possibility of Quarantine
At the onset of the outbreak in Texas, a family was quarantined after their son contracted the virus. Health officials arrived at their home, drew blood from the whole family, then quarantined them all indefinitely, according to CNN-affiliate KABB.
As the scope of this virus becomes more severe and the number of people who are infected continues to grow, it is highly likely that quarantine may be used to help contain the virus' spread. We therefore highly recommend that our readers prepare for the possibility that they may have to stay at home for an extended period of time. This means not being able to go to work, or to the supermarket for food. We advise our readers to be prepared for this possibility by laying in a supply of food, water, and essential medications that can suffice for two to three weeks.
The Mexican Swine Flu in perspective
It is likely that as this virus increases in speed and scope, it will result in a national emergency in which all efforts will be made to contain it wherever possible. The national agencies are already gearing up to support the effort to control this outbreak.
It is therefore important to keep the situation in perspective. Among the most important things to remember are:
1. The virus appears to be relatively mild and appears to present little danger to those who are infected and treated promptly.
2. Because it was caught fairly early in the process, governments, public agencies and private companies around the world are rising to the challenge to identify and contain the spread of the virus. While this will not contain the spread in any real sense, it will provide a strong support system to treat those who contract the virus and, to some extent, protect those many who have not been exposed from becoming ill.
3. Medicine - specifically Tamiflu and Relenza - is available that can limit the progression of the flu, and ease the symptoms when taken within twenty four hours of the first symptoms. Older medications were proven ineffective against this flu, as are the flu shots which many Americans received in the fall. Tamiful and Relenza are available only with a doctor's prescription.
4. In our view, no time is right for panic. Happily, we have time to prepare ourselves to stay protected from exposure.
While it is not always possible to avoid exposure in a large event such as this, there are many things you can do to protect yourself and your family. They include
- Avoid close contact with others who have shown signs of illness (such as coughing, sneezing, fever, etc.).
- Wash your hands thoroughly and often, particularly after being in a public place, being near someone who is sick, and after sneezing or coughing.
- If the swine flu virus is identified in your area, the use of face masks and surgical gloves will provide some protection against exposure to the virus through contact with infected surfaces.
- In the event that the spread of the flu in your area is significant, or if quarantine may be introduced in your community, be prepared to stay at home with enough food, water, and medicines to last for several weeks.
- If you feel mildly ill, stay home. Do not expose others to your illness. If you are severely ill, with high fever and other flu symptoms, call your doctor immediately. Only a doctor can prescribe the medicine you need to fight this flu, and you must take it within 24 hours of the first symptoms.
The CDC is working very closely with local officials in states where human cases of the A (H1N1) have been identified. Their current efforts include deploying staff to provide guidance and technical support. They are also working with health officials in Mexico, Canada, and the World Health Organization. The CDC has activated its Emergency Operations Center to coordinate the agency's response to this emerging health threat. Sunday's declaration of a public health emergency throughout the country will allow funds to be released to support the public health response, including the distribution of medicine and emergency equipment.
We Americans are very good at rising to meet the challenges that face us. The likelihood that this virus can be contained is very small. But by pulling together the resources that are available to us through the federal and state governments, public agencies, and the private sector, we have the best opportunity to ride out this new virus for the best possible outcome.
Gerard Group has put its team on emergency status, and is ready to assist you as you deal with the issues relating to this incipient epidemic. Please feel free to contact us at info@gerardgroup.com with questions or new information. In order to help you keep up with the latest news on the Mexican Swine Flu, we have added five news feeds to our website at www.gerardgroup.com . These news links give you immediate access to breaking news.
Additional on-line resources:
http://www.cdc.gov/swineflu/general_info.htm
http://www.cdc.gov/swineflu/swineflu_you.htm
http://www.who.int/csr/disease/swineflu/en/index.html
http://www.travel.state.gov/travel/cis_pa_tw/pa/pa_4488.html
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