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Influenza pandemic now rates 5/6

Chart of alert levels from World Health Organisation (WHO) This page also contains details of what the chart symbolises and is useful to understanding the situation.

Full Statement by WHO Director-General, Dr Margaret Chan, 29 April 2009, Swine influenza

Original source is

Ladies and gentlemen,

"Based on assessment of all available information, and following several expert consultations, I have decided to raise the current level of influenza pandemic alert from phase 4 to phase 5. Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world."

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Swine influenza - full coverage

Current WHO phase of pandemic alert

International Health Regulations (IHR)

On the positive side, the world is better prepared for an influenza pandemic than at any time in history.

Preparedness measures undertaken because of the threat from H5N1 avian influenza were an investment, and we are now benefitting from this investment.

For the first time in history, we can track the evolution of a pandemic in real-time.

I thank countries who are making the results of their investigations publicly available. This helps us understand the disease.

I am impressed by the work being done by affected countries as they deal with the current outbreaks.

I also want to thank the governments of the USA and Canada for their support to WHO, and to Mexico.

Let me remind you. New diseases are, by definition, poorly understood. Influenza viruses are notorious for their rapid mutation and unpredictable behaviour.

WHO and health authorities in affected countries will not have all the answers immediately, but we will get them.

WHO will be tracking the pandemic at the epidemiological, clinical, and virological levels.

The results of these ongoing assessments will be issued as public health advice, and made publicly available.

All countries should immediately activate their pandemic preparedness plans.

All countries should immediately activate their pandemic preparedness plans. Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.

At this stage, effective and essential measures include heightened surveillance, early detection and treatment of cases, and infection control in all health facilities.

This change to a higher phase of alert is a signal to governments, to ministries of health and other ministries, to the pharmaceutical industry and the business community that certain actions should now be undertaken with increased urgency, and at an accelerated pace.

I have reached out to donor countries, to UNITAID, to the GAVI Alliance, the World Bank and others to mobilize resources.

I have reached out to companies manufacturing antiviral drugs to assess capacity and all options for ramping up production.

I have also reached out to influenza vaccine manufacturers that can contribute to the production of a pandemic vaccine.

The biggest question, right now, is this: how severe will the pandemic be, especially now at the start?

It is possible that the full clinical spectrum of this disease goes from mild illness to severe disease. We need to continue to monitor the evolution of the situation to get the specific information and data we need to answer this question.

From past experience, we also know that influenza may cause mild disease in affluent countries, but more severe disease, with higher mortality, in developing countries.

No matter what the situation is, the international community should treat this as a window of opportunity to ramp up preparedness and response.

Above all, 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.

As I have said, we do not have all the answers right now, but we will get them.

Thank you.

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The European Union advises against travelling to Mexico or to the United States. Brussels advises cancelling any non-indispensable trips to directly affected zones. A meeting of Ministers of Health at the European Union is scheduled for Thursday to consider the threat this type of flu represents.

Contrary to the World Health Organisation, which has not recommended restricting travel, the Spanish authorities have advised their citizens not to go to Mexico.

Source Translation by Sheila Newman
Sheila Newman, population sociologist
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Only 7 swine flu deaths, not 152, says WHO
April 29, 2009

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.
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.

Sydney's swine scared arrivals
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"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 today.

"That figure is not a figure that's come from the World Health Organisation and, I repeat, the death toll is seven and they are all from Mexico."

Ms Allan said WHO had confirmed 40 cases of swine flu in the Americas, 26 in Mexico, six in Canada, two in Spain, two in Britain and three in New Zealand.

Ms Allan said it was difficult to measure how fast the virus was spreading.

She said a real concern would be if the flu virus manifested in a country where a person had had no contact with Mexico, and authorities were watching all countries for signs of that.

"There is no pattern that has emerged at this stage to be able to say that it is spreading in a particular way or it is spreading into a particular country ... the situation is continuing to evolve," she said.

She said the WHO was not recommending against overseas travel, but urged those who felt sick to stay home and others to ensure they kept their hands clean.

No decision had yet been made about vaccinations.

"This virus is not airborne, it's caused by droplets ... so it's not a time for worry. It's a time to be prepared," Ms Allan said.

It is a bit late to panic when the death-rate goes up as the virus morphs.
I went to a restaurant yesterday (in Australia) and infection was at the back of my mind much of the time.
The problem rises geometrically. Seven deaths out of x number of confirmed cases, will still multiply exponentially. Of course that may not seem a big deal until the death is to your child or elderly parent.
Passed largely from hand to face and mouth and nose and from droplets on other surfaces. Humans constantly groom themselves by touching hands to face.
You need an antiviral disinfectant - basically sodium hyperchlorite (bleach). It needs to be of adequate strength. Only way to disinfect the immediate environment, say in an office, is to use sodium hyperchlorite on fomites like door handles, benches, phones, keyboards ... anything that hands often touch and where spray may land ... and wash hands constantly, using something that breaks protein down - like liquid detergent - especially before, after food and not touch other people and stay away from crowds, especially inside closed spaces.

Unfortunately WHO doesn't really tell people how to keep their environment safe. I guess it relies on governments to tell shopkeepers etc, which I don't think they do. Once nurses and doctors had good knowledge about which disinfectants to use and what to disinfect. They have become so reliant on luck and the average basic good health of patients or the ability to use antibiotics to fight secondary infections.

The chart inside the article explains the stages very well. Basically this epidemic has spread REALLY QUICKLY internationally. It has sustained infection so far, but not for a very many days. But, you see, it doesn't take many days, does it? I don't know if we can predict the death-rate on the information we have so far. I can think of a number of factors which would not yet be apparent. One is that it is nearly winter in Australia - that will make our risks higher. Another is the global financial crisis, homelessness, lack of heating, lack of access to hospitals. But also, can we talk about a typical survival curve at this stage, with so few cases confirmed? And, finally, the reason we fear this kind of pandemic is because of the rate that such viruses can change - too fast to keep up with.

(Anonymous for professional & political reasons)