Swine Flu - India On High Alert

India has increased surveillance at international airports and ports as part of global measures to check the spread of swine flu.

Passengers arriving on flights from the US, Canada and Mexico are being checked for the virus, health officials say.

In Goa, officials are trying to track down British tourists who arrived there after the deadly outbreak.

The virus is thought to have killed nearly 160 people in Mexico, where it was first found.

The number of swine flu cases globally is rising and the US has confirmed that the death of a 23-month-old child there is the first fatality outside Mexico.

Swine flu is usually found in pigs and contracted only by people in contact with the animals.

It can also spread from person to person - probably through coughing and sneezing.

As a potential pandemic edges closer, governments around the world have been stepping up precautions against its spread.

Officials in India have also decided to increase the country's reserves of the antiviral drug Tamiflu.

Swine Flu Infected Countires All Over So Far

Within a day, the swine flu death toll in Mexico climbed to 152, prompting the World Health Organization (WHO) to raise its global pandemic flu alert level to phase four. Confirmed cases in other parts of the world — 50 in the US, six in Canada, two in the UK and one in Spain — have been linked to travel to Mexico.

Brazil, Australia, Israel and New Zealand have suspected swine flu cases, but three of the four people tested for the virus tested negative in France. While the WHO has not advised restriction of international travel, it has asked people with symptoms following international travel to get tested and treated. Swine flu symptoms include fever, lethargy, lack of appetite, cough, runny nose, sore throat, nausea, vomiting and/or diarrhoea. There is no risk of infection from eating well-cooked pork and pork products, says the WHO.

How prepared is India to tackle swine flu? Not as much as the Health Ministry would have us believe. A reality check of the government’s contingency plan to stop swine flu from entering India showed that nothing is in place at Delhi and Mumbai airports that get the most flights from the affected countries.

On Monday afternoon, the health ministry informed the media that it has issued an advisory asking travellers to India from affected countries to report flu symptoms to the airport health authority or call 1075 or 011-23921401.

Ministry officials, however, were still to inform airport authorities, who had got no information till late Tuesday evening. “We have yet to get a notification from the health ministry telling us about what steps need to be taken, but we are planning to add more counters to screen passengers for symptoms of cough, cold and fever,” said a spokesman of the Delhi International Airports Limited. “Usually travel advisories are issued by the WHO, but we have not heard from them or the Indian government,” the Air India spokesperson told HT.

The anti-flu drug oseltamivir (brandname Tamiflu) is very effective against the H1N1 virus that causes swine flu and India has stockpiled 1 million doses, with plans to add another 1 million for an emergency.

Oseltamivir is manufactured in India by several companies, including Cipla and Hetero Drugs. “W are in talks with Mexico, Israel and Latin American countries for oseltamivir and can manufacture 1.5 million doses within four to six weeks. We, however, don’t supply to the Indian government, which I beleive has already stockpiled it,” Cipla’s chief executive Amar Lulla told HT.

Is Swine Flu Infection Causing deaths?

Swine flu spreads, India falters

Within 24 hours, the swine flu death toll in Mexico climbed to 152, putting Indian holiday plans in jeopardy and forcing many frequent fliers to choose conference calls over business travel.

While the World Health Organization (WHO) has not advised restrictions on food (eating pork) or international travel, it has asked all people with flu symptoms travelling through affected countries (see box) to get tested and treated.

Swine flu symptoms include fever, lack of appetite, cough, runny nose, sore throat, nausea, vomiting and/or diarrhoea.

The advisories are expected to affect outbound travel to Europe and US.

“Governments have started issuing advisories and travellers are being asked to take adequate precautions. There could be an estimated 20 per cent fall in overseas travel if infection spreads across continents,” said H.K. Singh, general secretary, Travel Agents Association of India.

Though an advisory has been issued in India, a reality check of the government’s contingency plan showed that nothing is in place at Delhi and Mumbai airports that get the maximum flights from affected countries.

On Monday afternoon, the health ministry announced its travel advisory.

Airport authorities in Delhi were asked to put up health counters late on Tuesday evening. "We haven't got a notification from the health ministry on steps to be taken. We did get a call asking us to set up eight special counters to screen passengers on flights from Mexico, US and Canada from Tuesday midnight," said a Delhi International Airports Limited spokesman.

The health ministry had announced they would assign 32 health officials to Delhi airport and a similar number to Mumbai, who would work in four shifts in groups of eight.

Airlines, however, have still not been informed. "Usually travel advisories are issued by the WHO, but we have not heard from them or the Indian government," the Air India spokesperson told HT.

The situation is no better at Chhattrapati Shivaji International Airport, with the Mumbai International Airport Limited (MIAL) being asked to provide only three counters at the country's busiest airport. "We have been asked to provide facilities by Wednesday noon. They may start screening in the afternoon," said an MIAL spokesperson.

Checking every passenger for symptoms could result in delays and long queues at immigration, fear airport officials. "These counters are located before the immigration counters. It could cause chaos," said an airport official requesting anonymity, as he is not authorised to speak to the media.

Swine Flu Update In India

Santa Clara County Public Health Department
Swine Flu Update: April 27, 2009

Local Situation
At this time there are no reported cases in Santa Clara County. But since it is the role of the Santa Clara County Public Health Department to inform the public, medical community and other local agencies about a potential health emergency, and the current outbreak of swine flu poses a potential risk to the residents of this community, the Public Health Department has taken the following actions:

Activated the Public Health Department Medical/Health Emergency Operations Center, with the Health Officer and at least one Deputy Health Officer on-call at all times.
Has the Public Health Laboratory on alert over the weekend, making resources available to take specimens from local hospitals and physicians.
Participating in regular updates and conference calls with the CDC and the California Department of Public Health.
Conducting interviews with the news media to provide updated information to the general public.
Sent a Health Alert to Santa Clara County Hospitals, Emergency Departments and community physicians providing instructions for surveillance, collecting lab samples and procedures for sending in their samples.
Continues to monitor the situation locally, state-wide, nationally and internationally.

We know people are concerned about swine flu situation and we share that concern. At this early stage of this outbreak, there is a lot of uncertainty and the situation remains very fluid.

National Situation
The Centers for Disease Control and Prevention (CDC) today provided the following update on the 20 confirmed cases of swine flu in the United States:
California: seven (7) confirmed cases
Kansas two (2) confirmed cases
New York City, eight (8) confirmed cases
Ohio, one (1) confirmed case
Texas, two (2) confirmed cases

At this time, the cases in the United State have had mild symptoms, with the exception of one case that was hospitalized. All of these people have or are recovering.

Also today, the US Department of Health declared a Public Health Emergency in the United States. This means they have the ability to release resources, including the national stockpile of Tamiflu for treatment of confirmed swine flu cases. The US Department of Health emphasized that this declaration should be viewed as an early preparedness alert so that local jurisdictions and states can review their plans and put early preparedness efforts in place.

Currently, there are no travel restrictions to or from Mexico but it is anticipated that within the next 24 hour this will change and travel to and from Mexico will be restricted.

California Situation
The seven (7) California cases are located in Southern California:
Five (5) in San Diego County
Two (2 ) in Imperial County

All local California Public Health Departments are conducting active surveillance and continue to remain in communication with each other and the California Department of Public Health. Because of the release of the national stockpile of Tamiflu, California will be receiving 25% of our 5 million courses of treatment, which means 1.25 million courses.

International Situation
The international situation remains fluid. Currently, three nations have confirmed cases of swine flu: Mexico, Canada and the United States. Nations from New Zealand to Spain have also reported suspected cases. The numbers being reported for the situation in Mexico range from 943 to 1,300 swine flu cases, with anywhere from 20 possible deaths due to swine flu to 71 possible deaths.

Next Steps
With the growing concern about this situation, the Public Health Department is planning on taking the following actions this week.

Increase Active Surveillance by placing Public Health Department nurses at all SCC hospitals to assist the infection control staff and report findings quickly to the Public Health Department. We will also develop recommendations and guidance for SCC school districts and the San Jose International Airport specifically, and work with the Mexican Consulate to provide information to the farm worker community and others that may particularly at-risk.

Additionally, the Public Health Laboratory will continue to accept specimens and conduct preliminary tests on these specimens.

In the area of Public Information, we will continue to provide information to members of the news media. Key messages will include:
There is not any specific swine flu action people need to take
What you should do if you have flu symptoms
The importance of limiting the spread of disease and germs and what you should do (wash hands, cover cough, go to sccphd.org or ready.gov for more preparedness information).

Background
These cases of swine flu in humans raises concerns since it is a new flu virus for which people have little or no immunity. Since this is a new flu virus there is no vaccine. Swine flu virus regularly causes outbreaks in pigs but rarely affects humans. Occasionally there have been human infections of swine flu and there have been documented cases of a person spreading swine flu to others.

The symptoms of swine flu are very similar to regular seasonal flu symptoms. These symptoms include fever, coughing, runny nose, sore throat, head and body aches, lack of appetite and lethargy. With swine flu there may be additional gastrointestinal symptoms such as of nausea, vomiting and diarrhea.

For more information about swine flu see the attached flyer or , visit www.cdc.gov/flu/swine

For information in Spanish, visit http://www.cdc.gov/flu/swine/espanol/swine_espanol.htm

Swine Flu Latest News Worldwide

Cases of swine flu have been reported in several U.S. states, Mexico, and a growing number of other countries. While the U.S. government has declared this a “public health emergency,” Homeland Security Secretary Janet Napolitano emphasized that this signifies a “declaration of emergency preparedness,” meaning that national, state, and local health organizations are closely monitoring new cases and taking steps to contain the spread of the virus.

On April 27, 2009, the U.S. Centers for Disease Control and Prevention (CDC) issued a travel advisory recommending that people avoid “non-essential travel to Mexico” (e.g., that they postpone Mexican vacations or other non-necessary trips to the country). For up-to-date CDC travel warnings, advisories, and other notices for Mexico and other destinations, visit the CDC’s travelers’ health page.

Members of the MIT community are urged to follow the same strategies they would ordinarily use to protect themselves and others during a normal cold and flu season:

Wash your hands frequently and thoroughly with soap and warm water or use an alcohol-based hand sanitizer

Cover coughs and sneezes

Avoid touching your eyes, nose, and mouth

Stay home if you are feeling sick

MIT Medical and the Massachusetts Department of Public Health continue to monitor the situation closely. The most up-to-date national and local information is available from the CDC and the state's public health blog.

Statement by WHO Director-General, Dr Margaret Chan

Swine influenza
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.

Related links


Watch the video [wmv, 7min 13 sec]

Listen to the audio [mp3 57 Mb]

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. 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.

courtesy:WHO website

Swine influenza Latest Update News

29 April 2009 -- The situation continues to evolve rapidly. As of 18:00 GMT, 29 April 2009, nine countries have officially reported 148 cases of swine influenza A/H1N1 infection. The United States Government has reported 91 laboratory confirmed human cases, with one death. Mexico has reported 26 confirmed human cases of infection including seven deaths.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (13), Germany (3), Israel (2), New Zealand (3), Spain (4) and the United Kingdom (5).

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

source:WHO