Pandemic fears grow as flu death toll exceeds 100

Governments around the world are on high alert for a swine flu pandemic as the death toll from the virus in Mexico rose to more than 100 and possible cases were reported as far afield as Israel, New Zealand and Scotland.

A declaration at the weekend by the World Health Organisation (WHO) of an international public health emergency was followed by a call for worldwide surveillance of the spread of the virus.

The illness has rapidly claimed 103 lives, confined hundreds of people to hospital, and brought Mexico City, one of the world’s largest, to a near standstill.

The United States last night separately declared its own emergency after officials said the virus was now so widespread it was unlikely it could be contained. However, White House officials urged people not to panic and pointed out that no case outside Mexico had proved fatal.

Jose Angel Cordova, the Mexican health secretary, said suspected swine flu cases in his country had risen to 1 614 including 103 deaths, 22 of which have been confirmed to be linked to the new virus.
Tests are being carriedcout on the others. A further 1 614 cases of pneumonia under investigation for links to the virus.

The US has found 20 confirmed cases of swine flu: eight students in New York and other sufferers in California, Kansas and Texas.

The US homeland security secretary, Janet Napolitano, ordered the immediate release of 12-million doses of antiviral treatments, such as Tamiflu, collected over five years in response to fears about the spread of avian flu.

In the United Kingdom Health Protection Agency chief executive Justin McCracken told BBC News it was better to assume the UK would be affected by some cases.

“I think probably we should expect cases given the way this has spread across the US. It is sensible that we plan in the assumption that there will be cases,” he said. “We are already mobilising things in the UK in case the virus comes over here. I definitely think we have enough of the drugs.”

He added: “I don’t think at this stage there is any need to declare an emergency.”

Some governments issued travel warnings as suspected infections were reported in Spain, Israel and Canada. In New Zealand, 10 pupils at an Auckland school who had visited Mexico were treated for symptoms similar to swine flu. Four suspected cases have been found in France.

In Scotland the health secretary, Nicola Sturgeon, said that two people in Lanarkshire had been admitted to hospital on their return from Mexico; however, their flu-like symptoms were mild and the couple’s condition was causing little concern, she said.

China and Russia took quarantine measures at airports to prevent entry by anyone infected. The US said it would begin testing suspect arrivals from infected areas.

Keiji Fukuda, the WHO’s assistant director general for health security, said it had convened an emergency committee. “We have asked all countries to increase their surveillance,” he said.

But Fukuda said the committee had held off raising its pandemic crisis alert system from phase three to four, which would ratchet up the response, until after more information about the disease had been gathered.

He said that past experience with avian flu had laid the ground for officials to deal with this crisis. “I believe that the world is much, much better prepared than we have ever been for dealing with this kind of situation,” he said.

In Mexico City, the centre of the outbreak, schools, many public buildings and most restaurants remain closed.

The government is warning citizens not to shake hands or to stand close to each other. Many people stayed at home, or only ventured out wearing masks. Some stored water and food. Others left the city altogether.

Across Mexico, more than 1 300 people were tested for suspected swine flu infection and 400 were taken to hospital for checks. Health officials believe that tens of thousands, and possibly more, have been infected but have since recovered. “[We are] monitoring, minute by minute, the evolution of this problem across the whole country,” said the Mexican president, Felipe Calderón. The World Bank on Sunday approved $205-million in loans to the country to fight the outbreak.

Although confirmed infections outside Mexico remain few, the head of the US Centres for Disease Control, Richard Besser, said he expected the flu to spread in the US. “I would expect that over time we are going to see more severe disease in this country,” he said. “This will continue to spread, but we are taking aggressive actions to minimise the spread.”

Another CDC official, Anne Schuchat, went further and said the virus had spread widely and could not be contained.

The US has begun work on a vaccine, but that is unlikely to be available for months and CDC officials say schools may be closed and large gatherings banned in the most affected areas.

In New York, health officials confirmed that eight pupils at a high school in Queens had been infected. The mayor, Michael Bloomberg, said all the cases were mild and there was no evidence that the disease had spread. “So far there does not seem to be any outbreak,” he said. “We don’t know if the spread will be sustained. What’s heartening is the people who tested positive have only mild illnesses.”

Of particular concern to health officials is that those most at risk from death are healthy adults whose immune systems are strong and over-react to the virus.

The WHO is likely to raise its pandemic alert level within days if more cases are confirmed. It will go to phase four if the virus shows sustained ability to pass from human to human, and to phase five if it is confirmed in two countries in the same region.“Declaration of phase five is a strong signal a pandemic is imminent and that the time to finalise the organisation, communication, and implementation of the planned mitigation measures is short,” the WHO said. Phase six is the declaration of a global pandemic.—