The UK Is One Of The Best Prepared Countries

The UK is one of the best prepared countries to deal with swine flu and “all action necessary” will be taken to stop its spread, Gordon Brown has said. The prime minister took part in a meeting of the government’s emergency committee Cobra by phone from Poland. The Foreign Office is advising against all but essential travel to Mexico. Three tour firms have stopped flights. Following the confirmation of two cases in Scotland, the health secretary said there would undoubtedly be more. The first UK cases are Iain and Dawn Askham, of Polmont, near Falkirk, who had been on honeymoon in Mexico. The prime minister said: “I understand the very real concern that people have in Britain and across the world. “As you know there have been two confirmed cases and I believe that both patients are in better health.”   Iain and Dawn Askham had been on honeymoon in Mexico “Let me reassure you that we have been preparing for this kind of scenario for many years.” Health Secretary Alan Johnson said: “There are no more confirmed cases at this stage, although undoubtedly there will be. “But all the cases, anywhere other than Mexico, have been very mild symptoms, from which people have recovered.” Justin McCracken, of the Health Protection Agency, said his organisation was ensuring that each suspect case in the UK would receive “very careful treatment and screening”. This is so that “we can do everything possible to increase our understanding of the virus as quickly as possible, and of course to minimise its spread”, he added. The World Health Organization (WHO) has raised its alert level to four – two steps short of declaring a pandemic. Level four means the virus is showing a sustained ability to pass from human to human, and is able to cause community-level outbreaks. Following the raising of this alert level, a statement on the Foreign Office website said: “Cases of swine influenza have been reported in Mexico City and a number of other locations across the country. “Travellers should consult a doctor immediately if they show signs of flu-like symptoms.” The department has suspended routine consular and visa services at the Mexico City embassy. Swine flu: mapping the outbreak The statement said: “British nationals should continue to follow local advice on precautions to take to avoid exposure to the influenza.” Holiday firms Thomson and First Choice cancelled flights to the Mexican resort of Cancun on Tuesday morning – one from Manchester and the other from Gatwick – and are reviewing future flights. A spokesman said: “While we do appreciate that the new news may be a great disappointment to customers, we hope they will also understand that their health and safety is of paramount importance to us.” The company said it would start repatriation flights for British holidaymakers already in Mexico. Thomas Cook said all Thomas Cook and Airtours holidays to Cancun have been cancelled for the next seven days. Passengers flying back into the UK from Mexico saw airport staff wearing masks British Airways, which has four flights a week to Mexico City, said it would not be cancelling any flights. Johnson said UK preparations had been going on for the last five years to cope with a flu pandemic. He said the government proposed to use its stockpile of anti-viral drugs to treat patients showing symptoms of the disease, should the virus start spreading in the UK. England’s Chief Medical Officer Sir Liam Donaldson said: “If a new pandemic does start as a result of this outbreak in Mexico and the United States, we can’t make it go away, but what we can do through our plans, particularly our stockpiles of anti-virals, is mitigate its effect.” But the Conservatives have criticised the government for falling behind with plans to set up a national flu helpline. The telephone service was supposed to be ready in early 2009 but is not expected to be operational until the autumn. Shadow health minister Stephen O’Brien has called on the government to “take action quickly”. “The national flu line will be crucial if a pandemic were to happen in Britain, by allowing people to get the information and the anti-virals they will need to fight the flu without having to go to GP surgeries or hospitals,” he said. NHS Direct has stopped call centre staff from booking any new periods of time off until further notice in response to the high expected demand for the service. There were 57% more visits to the NHS Direct website on Monday afternoon and Tuesday morning compared with the same period last week. Mr and Mrs Askham are continuing to improve at Monklands Hospital in Airdrie, Lanarkshire, where they are being treated following their return from honeymoon in Cancun. Scottish Health Secretary Nicola Sturgeon said the couple were “doing well” but no decision had been taken on when they would be discharged. SWINE FLU Swine flu is a respiratory disease thought to spread through coughing and sneezing Symptoms mimic those of normal flu. In Mexico more than 150 people are thought to have died from the virus Good hygiene like using a tissue and washing hands thoroughly can help reduce transmission She said 23 other people were displaying symptoms across Scotland, but swine flu had not been confirmed. Nine of those people had been in contact with the Askhams. The other 14 had “travel connections” to Mexico, she said. The chief medical officer for Wales, Tony Jewell, said there were eight suspected cases under investigation in the nation. All were linked to travel in Mexico, he added. The Health Protection Agency said it was not releasing details about any suspected cases in England until swine flu is confirmed. In Northern Ireland the chief medical officer, Dr Liz Mitchell, said it was likely that there would be cases, although there were none currently under investigation. The Department of Health (DoH) said surveillance arrangements were being “stepped up” in the UK, without revealing details. It added the outbreak was “unusual and of concern”. Professor Steve Field, chairman of the Royal College of General Practitioners, said people in the UK were “perfectly safe at the moment”, and did not need to start wearing facemasks or stop eating pork. “I don’t think people in this country need to be worried at the moment, the focus needs to be on people coming in from Mexico and other areas where this infection has taken hold,” he said. Sir Liam Donaldson’s advice on concerns over swine flu Official UK guidance is that anyone with flu-like symptoms who might have been in contact with the virus – such as those living or travelling in the affected areas of Mexico – should seek medical advice. But patients are being asked not to go into GP surgeries in order to minimise the risk of spreading the disease to others. Instead, they should stay at home and call their healthcare provider for advice. Swine flu is usually found in pigs and contracted only by people in contact with the animals.

More Countries Confirm Swine Flu

New cases of the deadly swine flu virus have been confirmed as far afield as New Zealand and Israel, as the UN warns it cannot be contained.

The US, Canada, Spain and Britain confirmed cases earlier but no deaths have been reported outside Mexico, where the virus was first reported.

Mexico has raised the number of probable deaths to 152, with 1,614 suspected sufferers under observation.

UN inspectors are to examine reports that pig farms spread the virus.

The UN’s health agency, the World Health Organization, confirmed that the flu had spread between humans.

CONFIRMED & SUSPECTED CASES Mexico: 152 suspected deaths – 20 confirmed cases US: 51 confirmed cases Canada: 6 confirmed cases New Zealand: 3 confirmed cases UK, Spain, Israel: 2 confirmed cases each Countries with suspected cases: Brazil, Guatemala, Peru, Australia, and South Korea, and seven EU states

Several countries have issued warnings against travelling to Mexico, but the WHO and the EU’s health chief, Androulla Vassiliou, said such measures would do little to combat the flu’s spread.

WHO spokesman Gregory Hartl said experts were working on a vaccine, but said it could take five or six months to develop.

Health experts say the virus comes from the same strain that causes seasonal outbreaks in humans, but also contains genetic material from versions of flu which usually affect pigs and birds.

In New Zealand, Health Minister Tony Ryall said at least three students who had travelled to Mexico had swine flu.

Israeli health officials confirmed on Tuesday that the country now had two people infected with the virus. Both sufferers had recently been to Mexico.

UN alert raised

Fifty-one cases have been confirmed in the US, six in Canada, two in the UK and two in Spain

The EU said patients were also under observation in Denmark, Sweden, Greece, the Czech Republic, Germany, Italy and Ireland.

Tests are being carried out on individuals or groups in Brazil, Guatemala, Peru, Australia and South Korea.

A number of countries in Asia, Latin America and Europe have begun screening airport passengers for symptoms, while Germany’s biggest tour operator has suspended trips to Mexico.

The UN’s Food and Agriculture Organisation (FAO) is sending a team to Mexico to investigate rumours that people had been falling ill last month near some intensive pig farms.

The WHO raised its pandemic (global epidemic) alert status to level four on Monday – two levels from a full pandemic – after concluding there had been sustained transmission between humans.

Levels five and six are reserved for when there is widespread human infection.

WHO spokesman Mr Hartl said there are a number of cases in New York “which appear to be human-to-human transmission”.

SWINE FLU Swine flu is a respiratory disease thought to spread through coughing and sneezing Symptoms mimic those of normal flu Good hygiene like using a tissue and washing hands thoroughly can help reduce transmission

He said if the New York cases were confirmed, the WHO was likely to raise its alert to level five.

The UN body is encouraging countries to begin intensive surveillance of possible infection.

The WHO said this would help to identify where the virus is, who has it, what its source was and what kind of illness it produced.

In Mexico, swine flu has been confirmed in 20 of the 152 known deaths.

In almost all cases outside Mexico, people have been only mildly ill and have made a full recovery.

How Swine Flu Outbreak Emerged

Infection control experts are scrambling to respond to outbreaks of swine flu in Mexico and the US, and suspected cases elsewhere.

What is swine flu?

Swine flu is a respiratory disease, caused by influenza type A which infects pigs.

There are many types, and the infection is constantly changing.

Until now it has not normally infected humans, but the latest form clearly does, and can be spread from person to person – probably through coughing and sneezing.

What is new about this type of swine flu?

The World Health Organization has confirmed that at least some of the human cases are a never-before-seen version of the H1N1 strain of influenza type A.

 

SWINE FLU Symptoms usually similar to seasonal flu – but deaths recorded in Mexico It is a new version of the H1N1 strain which caused the 1918 flu pandemic Too early to say whether it will lead to a pandemic Current treatments do work, but there is no vaccine Good personal hygiene, such as washing hands, covering nose when sneezing advised

H1N1 is the same strain which causes seasonal outbreaks of flu in humans on a regular basis.

But this latest version of H1N1 is different: it contains genetic material that is typically found in strains of the virus that affect humans, birds and swine.

Flu viruses have the ability to swap genetic components with each other, and it seems likely that the new version of H1N1 resulted from a mixing of different versions of the virus, which may usually affect different species, in the same animal host.

Pigs provide an excellent ‘melting pot’ for these viruses to mix and match with each other.

How dangerous is it?

Symptoms of swine flu in humans appear to be similar to those produced by standard, seasonal flu.

These include fever, cough, sore throat, body aches, chills and fatigue.

Most cases so far reported around the world appear to be mild, but in Mexico lives have been lost.

How worried should people be?

When any new strain of flu emerges that acquires the ability to pass from person to person, it is monitored very closely in case it has the potential to spark a global epidemic, or pandemic.

 

FLU PANDEMICS 1918: The Spanish flu pandemic remains the most devastating outbreak of modern times. Caused by a form of the H1N1 strain of flu, it is estimated that up to 40% of the world’s population were infected, and more than 50 million people died, with young adults particularly badly affected 1957: Asian flu killed two million people. Caused by a human form of the virus, H2N2, combining with a mutated strain found in wild ducks. The impact of the pandemic was minimised by rapid action by health authorities, who identified the virus, and made vaccine available speedily. The elderly were particularly vulnerable 1968: An outbreak first detected in Hong Kong, and caused by a strain known as H3N2, killed up to one million people globally, with those over 65 most likely to die

The World Health Organization has warned that taken together the Mexican and US cases could potentially trigger a global pandemic, and stress that the situation is serious.

However, experts say it is still too early to accurately assess the situation fully.

Currently, they say the world is closer to a flu pandemic than at any point since 1968 – rating the threat at four on a six-point scale.

Nobody knows the full potential impact of a pandemic, but experts have warned that it could cost millions of lives worldwide. The Spanish flu pandemic, which began in 1918, and was also caused by an H1N1 strain, killed millions of people.

The fact that all the cases in the US and elsewhere have so far produced mild symptoms is encouraging. It suggests that the severity of the Mexican outbreak may be due to an unusual geographically-specific factor – possibly a second unrelated virus circulating in the community – which would be unlikely to come into play in the rest of the world.

Alternatively, people infected in Mexico may have sought treatment at a much later stage than those in other countries.

It may also be the case that the form of the virus circulating in Mexico is subtly different to that elsewhere – although that will only be confirmed by laboratory analysis.

There is also hope that, as humans are often exposed to forms of H1N1 through seasonal flu, our immune systems may have something of a head start in fighting infection.

However, the fact that many of the victims are young does point to something unusual. Normal, seasonal flu tends to affect the elderly disproportionately.

Can the virus be contained?

The virus appears already to have started to spread around the world, and most experts believe that containment of the virus in the era of readily available air travel will be extremely difficult.

Can it be treated?

The US authorities say that two drugs commonly used to treat flu, Tamiflu and Relenza, seem to be effective at treating cases that have occurred there so far. However, the drugs must be administered at an early stage to be effective.

Use of these drugs may also make it less likely that infected people will pass the virus on to others.

The UK Government already has a stockpile of Tamiflu, ordered as a precaution against a pandemic.

It is unclear how effective currently available flu vaccines would be at offering protection against the new strain, as it is genetically distinct from other flu strains.

US scientists are already developing a bespoke new vaccine, but it may take some time to perfect it, and manufacture enough supplies to meet what could be huge demand.

A vaccine was used to protect humans from a version of swine flu in the US in 1976.

However, it caused serious side effects, including an estimated 500 cases of Guillain-Barré syndrome. There were more deaths from the vaccine than the outbreak.

What should I do to stay safe?

Anyone with flu-like symptoms who might have been in contact with the swine virus – such as those living or travelling in the areas of Mexico that have been affected – should seek medical advice.

But patients are being asked not to go into GP surgeries in order to minimise the risk of spreading the disease to others. Instead, they should stay at home and call their healthcare provider for advice.

After the WHO raised its alert level over swine flu, the Foreign and Commonwealth Office began advising against all but essential travel to Mexico.

What measures can I take to prevent infection?

Avoid close contact with people who appear unwell and who have fever and cough.

General infection control practices and good hygiene can help to reduce transmission of all viruses, including the human swine influenza. This includes covering your nose and mouth when coughing or sneezing, using a tissue when possible and disposing of it promptly.

It is also important to wash your hands frequently with soap and water to reduce the spread of the virus from your hands to face or to other people and cleaning hard surfaces like door handles frequently using a normal cleaning product.

If caring for someone with a flu-like illness, a mask can be worn to cover the nose and mouth to reduce the risk of transmission. The UK is looking at increasing its stockpile of masks for healthcare workers for this reason.

But experts say there is no scientific evidence to support more general wearing of masks to guard against infections.

Is it safe to eat pig meat?

Yes. There is no evidence that swine flu can be transmitted through eating meat from infected animals.

However, it is essential to cook meat properly. A temperature of 70C (158F) would be sure to kill the virus.

What about bird flu?

The strain of bird flu which has caused scores of human deaths in South East Asia in recent years is a different strain to that responsible for the current outbreak of swine flu.

The latest form of swine flu is a new type of the H1N1 strain, while bird, or avian flu, is H5N1.

Experts fear H5N1 hold the potential to trigger a pandemic because of its ability to mutate rapidly.

However, up until now it has remained very much a disease of birds.

Those humans who have been infected have, without exception, worked closely with birds, and cases of human-to-human transmission are extremely rare – there is no suggestion that H5N1 has gained the ability to pass easily from person to person.

‘Too Late’ To Contain Swine Flu

A deadly swine flu virus first detected in Mexico can no longer be contained, a World Health Organization (WHO) official has said.

WHO Assistant Director General Keiji Fukuda said countries should now focus on mitigating the effects of the virus.

The WHO has raised its alert level from three to four, two steps short of declaring a full pandemic.

The number of probable deaths from the virus in Mexico has officially risen to 152 though only 20 cases are confirmed.

The US, Canada, Spain and Britain have confirmed milder versions.

‘Not inevitable’

The WHO’s decision to raise the alert level to four came after an emergency meeting of experts, brought forward by a day because of concerns over the outbreak.

WHO PANDEMIC ALERT PHASES Phase 1: No viruses circulating among animals causing infections in humans Phase 2: Animal influenza virus causes infection in humans, and is considered potential pandemic threat Phase 3: Influenza causes sporadic cases in people, but no significant human-to-human transmission Phase 4: Verified human-to-human transmission able to cause community-level outbreaks. Significant increase in risk of a pandemic Phase 5: Human-to-human transmission in at least two countries. Strong signal pandemic imminent Phase 6: Virus spreads to another country in a different region. Global pandemic under way

Level four means the virus is showing a sustained ability to pass from human to human, and is able to cause community-level outbreaks.

“What this can really be interpreted as is a significant step towards pandemic influenza. But also, it is a phase that says we are not there yet,” Mr Fukuda said.

“In other words, at this time we think we have taken a step in that direction, but a pandemic is not considered inevitable.”

He said the virus had become too widespread to make containment a feasible option, and said countries must focus on trying to put measures in place to protect the population.

He also stressed that the experts did not recommend closing borders or restricting travel. “With the virus being widespread… closing borders or restricting travel really has very little effects in stopping the movement of this virus,” he said.

The first batches of a swine flu vaccine could be ready in four to six months’ time, but it will take several more months to produce large quantities of it, Mr Fukuda said.

Health experts say the virus comes from the same strain that causes seasonal outbreaks in humans. But they say this newly detected version contains genetic material from versions of flu which usually affect pigs and birds.

‘Decline in cases’

Mexican Health Minister Jose Angel Cordova said the suspected death toll from swine flu had risen to 152. Of that number, 20 have been confirmed as swine flu.

SPREAD OF VIRUS Mexico: 20 confirmed cases (152 suspected deaths) United States: 50 confirmed cases Canada: 6 confirmed cases UK: 2 confirmed cases Spain: 1 confirmed case Israel, Brazil, Guatemala, Peru, Australia, New Zealand, and South Korea: Suspected cases being tested

Reporting earlier, he said that all of those who had died were aged between 20 and 50. Infections among young healthy adults were a characteristic of past pandemics.

He said the first suspected case of swine flu had occurred in the southern state of Oaxaca but stressed that nobody knew “the point of origin or dissemination” of the virus.

Nearly 2,000 people had been hospitalised since the first case of swine flu was reported on 13 April, he added, but half had now been allowed home.

Mr Cordova noted that the number of new cases reported by Mexico’s largest government hospitals had declined during the past three days: from 141 on Saturday to 119 on Sunday and 110 on Monday.

Schools nationwide are to remain closed until 6 May as the country grapples with the outbreak.

In almost all swine flu cases outside Mexico, people have been only mildly ill and have made a full recovery.

Travel advice

In the US, a further 20 cases of swine flu were confirmed in New York. Cases have also been reported in Ohio, Kansas, Texas and California, bringing the total across the country to 50.

SWINE FLU Swine flu is a respiratory disease thought to spread through coughing and sneezing Symptoms mimic those of normal flu Good hygiene like using a tissue and washing hands thoroughly can help reduce transmission

Dr Richard Besser, acting director of the US Centers of Disease Control and Prevention (CDC), warned that a new US travel advisory was being prepared suggesting non-essential travel to Mexico should be avoided.

US Secretary of State Hillary Clinton and EU Health Commissioner Androulla Vassiliou have separately urged caution for those considering travelling to Mexico.

In Canada, six cases have been recorded at opposite ends of the country, in British Columbia and in Nova Scotia.

Swine flu officially arrived in Europe on Monday, when tests confirmed that a young man in Spain and two people in Scotland – all of whom had recently returned from Mexico – had the virus. They were said to be recovering well.

Tests are also being carried out on individuals or groups in New Zealand, Australia, Brazil, Israel and South Korea who fell ill following travel to Mexico.

A number of countries in Asia, Latin America and Europe have begun screening airport passengers for symptoms, while Germany’s biggest tour operator has suspended trips to Mexico.

Taiwan has announced it will quarantine any visitors showing symptoms of swine flu.

Several countries have banned imports of raw pork and pork products from Mexico and parts of the US, although experts say there is no evidence to link exposure to pork with infection.

Shares in airlines have fallen sharply on fears about the economic impact of the outbreak.