After human cases of a new H1N1 swine influenza A virus were first reported in Mexico and then quickly spread around the world, the World Health Organization (WHO) raised its pandemic alert level from phase 3 to phase 4, on April 27. The virus is a fusion of human, pig and avian influenza. There was growing international concern a week ago, after outbreaks of illnesses similar to influenza were reported in Mexico and in other countries. The WHO (World Health Organization) reports that as of April 28, Mexican health institutions confirmed 26 laboratory human cases of swine influenza A (H1N1) and seven confirmed deaths. Other countries with confirmed cases are Canada, UK, Spain, New Zealand, Israel, and the United States with 40 cases.

The Unite States reported twelve cases of human infection with swine influenza- a porcine respiratory disease rarely infecting humans- between December 2005 and February 2009. Mexican authorities started to detect an increase in influenza-like illnesses as early as March 18, but at first considered them cases of seasonal influenza. Two isolated cases of a new swine influenza virus in California were reported by the US Center for Disease Control and Prevention on April 21. Mexico declared on April 24, that the same virus had been detected in the country´s epidemic outbreak.

In an attempt to control the outbreak, as of April 24 the Mexican Government quickly put into action health measures as radical as the closing of schools, museums, libraries and theatres in the capital, and the cancellation of public events. Health authorities also distributed six million face masks and recommendations to prevent the infection. In the United States, twelve million doses of oseltamivir are prepared for delivery from federal stockpiles while a public health emergency was declared. Tests on the new virus revealed it is sensitive to oseltamivir and zanamivir. On April 24, the World Health Organization placed into effect its twenty four hour emergency response room through which the agency is able to be in worldwide contact with institutions, partners and appropriate health authorities to coordinate responsive action. In addition, the agency convoked an emergency committee in order to inform the Director-General on the outbreak.

The recommendations of the committee on its second reunion raised the influenza pandemic alert level when the epidemiological pattern of the outbreak indicated there was human-to-human transmission. The risk of a worldwide pandemic is expected. It is essential that countries prepare to moderate the effects of the virus on their populations, as containment is no longer a viable alternative.

In response to the danger from the H5N1 avian influenza, the international community has been getting ready for the past five years. There are variations on the national and regional levels but transparency and communication between the World Health Organization, governments, health officials, the public and the media is crucial.

Because some countries are better prepared than others, there is special concern for low and middle income countries in their expertise to identify and control the effects of this new virus. In the past, developing countries have suffered a disproportionate impact by influenza pandemics. In 2006, The Lancet published the study of Christopher Murray and his collaborators in which by using data from the 1918-20 Spanish influenza pandemic, they predicted the next global influenza pandemic would cause 62 million deaths with 96 percent of them taking place in low and middle income conditions. There is a higher threat for populations in exile and refugees.

More loss of life should be anticipated from this swine influenza outbreak. Without any doubt, The Lancet predicts the infection will expand and the number of infected will rise. Consequently, the current recommendations should be considered as temporary. The evolution of this outbreak is an unstable period. Each and every member of the community has a duty in preventing the risk of a full-blown pandemic. One should be ready to self-isolate at home with caution and no panic if an influenza-like illness should develop. Social distancing and home isolation are helpful in preventing the spread of swine influenza. Such actions could be useful in making time to increase the supply of antivirals and develop a vaccine against this virus. Certainly, this will require months of work to prepare and distribute. Up to now, the quick reactions by governments and international agencies have set in motion efficient mechanisms to defend the general population. However, the fundamental role and responsibility of each individual is essential.

http://www.thelancet.com

Written by Stephanie Brunner (B.A.)