As it raised the pandemic alert to phase 4, the World Health Organization (WHO) said yesterday that it was now too late to try and contain the spread of swine flu and countries must focus on reducing the impact; however this does not mean that a global pandemic is inevitable.

Director General Dr Margaret Chan, announced that on the advice of the Emergency Committee, the WHO raised the pandemic alert status from phase 3 to phase 4. She emphasized that while this means it is more likely that a global pandemic will occur, it is not inevitable. Phase 4 means the virus is showing ability to spread from human to human and sustain community-level outbreaks.

She said the WHO does not recommend closing borders and restricting international travel, although people who are ill should delay any international travel plans and anyone who has become ill following international travel should see a doctor.

WHO Assistant Director General Keiji Fukuda told the press that the virus was now beyond containment and countries should now concentrate on protecting their people, reported the BBC.

Fukuda stressed that closing borders or restricting travel would now have little effect on stopping the spread.

As further information becomes available, the WHO may decide to return to phase 3 or raise the level to phase 5, which is still one level below full scale global pandemic.

Although there is evidence that this is a new strain of swine flu, containing elements of bird, human and pig flu virus, it is still too early to predict how it might spread and change.

In the meantime, countries should continue with plans to produce seasonal flu vaccines, although this advice may change as the situation evolves. WHO will help with developing vaccines against A/H1N1, the flu type that swine flu belongs to.

Fukuda said while the first batches of a vaccine for swine flu could be ready in 4 to 6 months, it will take another several months to make enough for large scale use.

Chen said that in arriving at its decision, the Emergency Committee looked at the available data on confirmed outbreaks of A/H1N1 swine flu in the US, Mexico and Canada, and also at reports of suspected cases in other countries.

Meanwhile, in Mexico, Employment Minister Javier Lozano said the move to pandemic alert phase 4 did not affect the measures the government was already taking throughout the country, reported the leading daily newspaper, El Universal, who also reported that the Secretary for Health, José Ángel Córdova, said the death toll of suspected swine flu cases is now 152, which is three more deaths since the last announcement yesterday.

Córdova said he will be presenting a report on state by state figures over the next 24 hours.

According to reports in the media yesterday, it is still thought that so far only 20 of the deaths in Mexico have been confirmed as swine flu.

The US, Canada, Spain and Britain have confirmed their patients had milder versions of swine flu, prompting suggestions that perhaps the fatal cases in Mexico resulted from swine flu mixed with another virus.

Despite the WHO advice that travel should not be restricted, the situation is affecting international travel, and to and from Mexico and the US especially.

CNN News reported early this morning that the US State Department and the Centers for Disease Control and Prevention (CDC) have warned against any non-essential travel to Mexico, a move that could “potentially devastate an already struggling tourism industry in the country”, especially as other countries follow suit.

Yesterday, European Union Health Commissioner Androulla Vassiliou said European citizens should avoid going travelling to Mexico and the US unless it is very urgent.

“Personally, I would try to avoid non-essential travel to the areas which are reported to be in the centre of the cluster,” she said in a video statement released in Brussels, according to EUobserver.

The UK Foreign Office have also warned against all but essential travel to Mexico, and for Britons visiting or living in Mexico to consider leaving.

The UK’s first confirmed swine flu cases, a couple who returned from a holiday in Mexico with the illness, are now recovering in a hospital in Lanarkshire, Scotland, said the BBC.

According to information on its website, the UK Foreign Office refers to the cases in Mexico and says people travelling should see a doctor at once if they start having flu-like symptoms and any British nationals should follow local advice on what precautions they should take to avoid exposure to the virus.

The BBC also reported that the Foreign Office has suspended visa and routine services at the embassy in Mexico City.

In the UK people who think they may have the flu are being asked not to go to their GP surgery or clinic but to stay home and call their health provider for advice.

In Hong Kong, where memories of the SARS outbreak are still fresh, Health Secretary York Chow said earlier today that the city had gone onto its serious level of response and was “geared towards managing escalating risk”, said Reuters.

The Czech EU Presidency has called an emergency meeting of Europe’s health ministers to take place this Thursday to discuss how best to minimize the impact of the virus in the EU.

Director General for Health and Consumer Protection in the European Commission, Robert Madelin, said it was not possible to catch this virus from eating pig meat and people should continue to enjoy eating pork as before.

Meanwhile, the American Public Health Association (APHA) said the current swine flu outbreak is an opportunity to get ready for potential pandemics and that people should take the following sensible precautions to avoid infection:

  • Stay healthy and stop infection spreading by washing your hands often.
  • Avoid close contact with people who are sick.
  • Cover your nose and mouth when you sneeze.
  • Stay at home and don’t go to work or school if you are ill.
  • Get ready a kit with food, water, medical supplies and anything else you might need incase you have to stay home for a while.
  • Talk to your bosses about their plans for dealing with a situation where many people may not be able to go to work or will have to work from home.

In Mexico the government is urging employers to show leniency in cases of absence or lateness because many parents will now have childcare problems due to closed schools and nurseries.

Around the world, countries are increasing border surveillance.

In many Asian countries, officials are heat scanning passengers coming off planes to spot people with high temperatures and sending them for testing.

In Australia, before a plane coming from the Americas is allowed to land, the Captain will be required to report on the health status of all passengers and anyone suspected of having flu will be assessed on landing by a quarantine officer to see if they need medical attention.

In the US, border patrol staff have been trained to ask questions and spot signs of illness in order to alert the authorities about potential cases of people with swine flu coming into the country.

Sources: CNN, Reuters, BBC, EUobserver, WHO, El Universal, APHA.