WHO admits shortcomings in handling flu pandemic
An epidemiologist examines the sample taken from a patient thought to be infected with influenza A (H1N1) virus, formerly referred to as swine flu, in a government laboratory in Leon Guanajuato, some 320 km (200 miles) northwest of Mexico City, April 30, 2009.
Credit: Reuters/Mario Armas
GENEVA (Reuters) - The World Health Organization conceded shortcomings on Monday in its handling of the H1N1 swine flu pandemic, including a failure to communicate uncertainties about the new virus as it swept around the globe.
Keiji Fukuda, the WHO's top influenza expert, said the U.N. agency's six-phase system for declaring a pandemic had sown confusion about the flu bug which was ultimately not as deadly as the widely-feared avian influenza.
"The reality is there is a huge amount of uncertainty (in a pandemic). I think we did not convey the uncertainty. That was interpreted by many as a non-transparent process," Fukuda said.
He was addressing a three-day meeting of 29 external flu experts called to review WHO's handling of the first influenza pandemic in 40 years.
LINKS TO DRUG COMPANIES
Critics have said the WHO created panic about the swine flu virus, which turned out to be moderate in its effect, and caused governments to stockpile vaccines which went unused.
Some questioned its links to the pharmaceutical industry after companies like GlaxoSmithKline and Sanofi-Aventis profited from producing H1N1 vaccine.
Kenya's delegation criticized the United Nations agency for failing to ensure that developing countries received a fair share of vaccines developed against the virus.
"It is not fair to have new vaccines and medicines and then they are so expensive that most poor people in developing countries can't access them," Kenya's delegate said. "This is not a situation that should be tolerated at all."
To date, 31 poorer countries including Afghanistan, Cuba, Kenya and Myanmar have received limited supplies of vaccine donated by drug companies and Western countries, via the WHO.
India's delegation suggested that in public health emergencies, patents on vital drugs should be lifted in line with the World Trade Organization's TRIPS agreement on intellectual property.
H1N1, which emerged in Mexico and the United States almost exactly a year ago, has killed 17,770 people in 213 countries, according to WHO, which declared a pandemic under way in June.
The WHO will need another year or two after the pandemic is declared over to determine a final death rate from the virus, which is certain to be much higher. The pandemic is still officially under way.
FEAR AND CONFUSION
The World Bank has estimated that countries have spent $4 billion to prepare pandemic preparedness plans and respond to the outbreaks, according to the U.S. delegation to the talks.
"Influenza is a formidable and unpredictable opponent. The threat of a severe pandemic has not decreased," the U.S. delegate said.
The separate but highly lethal H5N1 bird flu virus -- which has killed 60 percent of those infected since 2003 -- "injected a high level of fear about the next pandemic," Fukuda said.
It had been difficult to meet public demands for advice as the H1N1 virus spread quickly across borders and blogs generated speculation and criticism, according to the WHO official.
One big surprise had been that only one dose of vaccine was needed to provide immunity, whereas most planning had been built around two doses being required, he said.
This meant that some countries were left struggling with an oversupply of unused vaccines while poorer ones had little or no access to supplies.
"Confusion about phases and level of severity remains a very vexing issue," Fukuda said, referring to the WHO's six-level scale for pandemics which takes into account the geographic spread of a virus but not its severity.
(Editing by Jonathan Lynn and Michael Roddy)
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Monday, April 12, 2010
WHO admits shortcomings in handling flu pandemic | Reuters
Sunday, May 3, 2009
Swine flu implications for travel
Here is an attempt to separate some of the facts from fiction.
Flu, including swine flu, is transmitted by droplets. Unless you are within about three feet of an infected and contagious individual, the risk is relatively small. The primary guidance for managing a suspected sick passenger on an airplane is to try to move other passengers so that there is nobody within 3-6 feet of the individual, to provide a surgical mask for the ill passenger (to prevent their sneezes or coughs from infecting others), and for flight crews to use disposable gloves when handling possibly infected materials from the passenger. The crew also has to alert U.S. health officials prior to landing, who are to make the appropriate arrangements for medical personnel to meet the plane on arrival. The CDC has traveler quarantine stations in about 20 cities, so diverting an aircraft would seem to be an unlikely -- and very costly -- event.
The CDC also has very specific recommendations for cleaning airplanes, trains, cabs, and other transit vehicles during an outbreak. The cleaning focuses on areas where a suspected ill passenger or crew member was located. On airplanes, cleaning with a disinfectant is recommended for all surfaces such as seat belt latches, armrests, tray tables, windowshades, and passenger controls such as lighting and audio.
The flu virus can survive outside the human body for more than 24 hours, but the CDC says that it is highly doubtful that sufficient amounts to be infectious would be present on any surfaces on an airplane or other conveyance after many hours.
If you are traveling, the most practical advice from the CDC is to carry a pocket-sized alcohol gel so that you can keep your hands clean throughout your flight or other travel. Although this does not take the place of thorough hand washing with hot water and soap, it is a very effective interim measure.
For more information, visit the CDC's Travel Notices page, which is frequently updated.
Thursday, April 30, 2009
Spreading facts, common sense instead of germs
Here are a few flyers that I think convey clear messages:
- Swine (H1N1) influenza and you - CDC
- San Francisco Dept. of Public Health - Is it a cold or the swine flu?
- Stopping the Spread of Flu Germs at Work - CDC
Wednesday, April 29, 2009
Good blog post: Swine flu: I beat a dead horse
Posted using ShareThis.
Pandemic near, now what?
The precautions being taken -- like closing a school at the first sign of infection -- may seem severe, but keeping possibly infected individuals isolated (such as at their home) is the most effective and practical way to thwart person-to-person spread. Some communities in Texas and a few schools in Northern California have canceled classes already while suspected or confirmed cases are investigated and the schools can be disinfected.
Should things get much worse in any community, major public events may be curtailed and many people will be urged to work from their homes temporarily. This is why having a supply of food and other essential supplies is a good idea.
Do you need to wear a mask? Probably not. If you are sick, wearing a handkerchief or surgical mask is probably a good idea to keep from spreading your germs. If a family member gets sick, the CDC recommends that the individual stay in one room and that only one family member enters to provide care. Surgical masks do not provide sufficient protection from the flu for a non-infected person, by the way.
Can I get swine flu on an airplane? Maybe, but probably not. Contrary to popular belief, the flu virus doesn't circulate very well, especially through many air conditioner filters. Although airplane air may be stale, it is not likely to carry the flu. However, if you are seated next to someone with the flu, your risk is considerably higher. The flu is transmitted through little fluid droplets that don't travel far, but airplane seats are pretty tight. Best advice: carry some alcohol wipes and swab your audio-video controls, your tray table and other surfaces before touching them. Use a tissue to open and close lavatory doors. And, wash your hands frequently.
-- Post From My iPhone
Tuesday, April 28, 2009
Swine flu in Marin: The facts and the questions
The Marin woman, 60, and a 20-month old grandaughter, both of whom recently returned from Mexico, had confirmed cases of swine flu. The child is no longer sick, and the woman has only mild symptoms. Nobody else in the family appears to have gotten the illness, according to health authorities.
The rapid spread of the disease in Mexico, and its growing death toll, poses a number of questions for epidemiologists. So does the relative mildness of the illnesses within the United States. One possible explanation is that the swine flu virus may be losing potency as it is transmitted from one person to the next. Over the next few days and weeks, we will learn much more as physicians report more cases and their sources can be traced.
Because the virus is so easily transmitted, the CDC has recommended steps such as school closures at the first indication that a student has become infected. Keeping an infected individual away from other people is the single most important thing that can be done to reduce risk of spreading disease. Until we know how infectious the strain of swine flu in Marin actually is, people should do what ought to be done all the time: wash hands frequently, cover your mouth with a tissue when you cough, and stay home if you have any signs of illness.
Richard Besser, MD, acting director of the CDC, was quite definitive Tuesday when asked what people should do:
Hand washing. We say it every day. People will get tired of hearing it because we are always going to say that. Hand washing, use of alcohol hand gels can reduce the spread of viruses. And if people take that step, that can reduce the risk that they're going to get an infection. Covering your cough. Not with your hand, but with your arm or your shoulder. That can reduce the likelihood that you are going to transmit a virus.My earlier post has good sources of updated information. Please email or add comments with questions that you want me to pursue. Let's all stay healthy.
What you need to know about swine flu
- Swine flu, like other flu bugs, is a virus that is transmitted by tiny droplets usually found in mucus. Most flu is transmitted from one human to another, although infections like this are thought to originate in animals with human contact.
- There is no evidence of risk of catching swine flu from eating pork or other animal products.
- Most of the cases of swine flu that have been reported so far in the United States have been relatively mild and with typical flu symptoms (fever, muscle aches, nausea.)
We do not yet know enough about why so many fatalities in Mexico have occurred, but the flu is one of the biggest killers worldwide every year, so some deaths are to be expected.
- Everyday precautions -- like thoroughly washing hands -- will do more to protect each of us from any kind of flu than most of the other steps being touted by supposed media experts or concerned neighbors.
The World Health Organization currently calls the swine flu a "pandemic risk," not a "pandemic." This is an important distinction. Right now, there is no evidence that the flu is spreading rapidly beyond the initial outbreak communities. If that were to change, the level of precautions would, too.
For example, if there is evidence that these two people in Marin have in turn infected others, and then we have evidence that those individuals passed the infection along again, health officials would likely order a cancellation of large group events and potentially ask employers to allow workers to stay home. This "isolation in place" technique is critical for anyone who has flu symptoms, but if the outbreak spreads, it also keeps healthy people from contracting the disease.
Meantime, this is a good opportunity to make sure you or your families have appropriate emergency supplies on hand. This means nonperishable foods, a good supply of water, extra supplies of any necessary prescription medicines, and things to help pass the time like a deck of cards. And since we are in earthquake country, don't forget things like a flashlight and a wrench to turn gas valves off.
What you do not need: I've heard people rushing to buy surgical masks or "N95" protective masks. If you get the flu and must go out in public, wearing a surgical mask will help protect others around you, but you are better off staying home. The N95 masks are really only suitable for health care workers who are taking care of sick people. These masks are not very comfortable, are often worn incorrectly, and are not very useful for widespread use except in the most extreme circumstances. (For more information on protective measures, visit the CDC web site.)
And while disinfectants may be a good idea, plain old soap and hot water works just fine. Antibacterial gels may be convenient to keep in the pocket when a sink and soap aren't handy, but it's the alcohol in them that protects you -- not the antibacterial characteristics. (There's actually some evidence that widespread use of antibacterial gels and soaps promotes resistant bacteria, too.)
For Marin County's recommendations, visit the county Health Department web site and download its flyer on family precautions. The county has also created an RSS feed for swine flu news.
The San Francisco Department of Public Health also has compiled many excellent resources and links on its swine flu web site.