Number of Flu Cases Rising, 13 Countries Now Involved

Worldwide, cases of the virus rose from 236 yesterday, with Mexico reporting 156 infections and nine deaths, one more death than yesterday.

As of 11 am EDT, the Centers for Disease Control and Prevention in Atlanta confirmed 141 cases of the virus in 19 U.S. states, with one death, which occurred Monday. That number is up from yesterday's figures of 109 confirmed cases in 11 states.

In Canada, as of 1 pm EDT the Public Health Agency of Canada confirmed a total of 51 cases of the virus, up from 34 reported yesterday. "With increased surveillance," the agency said, "we fully expect that new cases will be identified. It is too soon to say whether we will see an escalation in severity of illness."

Health workers wearing protective clothing outside a Hong Kong hotel , after a guest from Mexico was confirmed to be suffering from swine flu. May 1, 2009. (Photo by H.L. Tam)

Since yesterday, cases of the virus have emerged in two new countries - in China, where one case was reported in Hong Kong in a man visiting from Mexico; and in Denmark, where one case was confirmed.

According to WHO, the other countries reporting laboratory confirmed infections with no deaths are Austria (1), Germany (3), Israel (2), Netherlands (1), New Zealand (3), Spain (13), Switzerland (1) and the United Kingdom (8).

Although the World Health Organization stressed that it is "prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention," the agency considers the imposition of travel restrictions or border closures to be ineffective in halting the spread of the virus.

"The focus now is on minimizing the impact of the virus through the rapid identification of cases and providing patients with appropriate medical care, rather than on stopping its spread internationally," WHO said in its latest update concerning the outbreak.

For the third consecutive day, WHO places its pandemic alert at Phase 5 on a six-level warning scale. This means that sustained human to human transmission has been confirmed, with widespread community outbreaks in at least two regions.

Today, in a news teleconference with reporters from around the world, Marie-Paule Kieny, director of WHO's Initiative for Vaccine Research, said there is very little chance that current vaccines used against seasonal influenza could be effective against the new flu strain. She said that the agency is in discussion with manufacturers to produce an inoculation as soon as possible.

"We have no doubt that making a successful vaccine is possible within a relatively short period of time," said Kieny. However, the first dosage to leave factories available for immunizing people will take four to six months.

The capacity of manufacturers to make flu vaccines has increased a lot from a few years ago, said Kieny.

The production of seasonal vaccine for the normal flu season of 2009-2010 has been going on already for weeks, she said, and production of the bulk material to make the seasonal vaccine is well advanced.

Manufacturers are expected to make 700 million doses of seasonal flu vaccine this year.

It is too early to say how this capacity would translate to the H1N1 virus, as "We don't know which of various technologies will be used by the industry," said Kieny, but she estimates "there would be around one to two billion doses minimum available in one year."

Initial steps have already been made to start prod of A/H1N1 vaccine. The bulk starting material to begin production will be available in mid-May at the earliest, Kieny said. It will be shipped to manufacturers who will adapt it to their individual production technologies.

Vaccine in a test tube (Photo Bema Biotech courtesy IFPMA)

"Within a few weeks," she said, some of the larger manufacturers will switch from producing the seasonal vaccine to making the A/H1N1 vaccine.

"There is no uncertainty" that a successful vaccine for the new flu strain can be produced "because there is lots of experience in the vaccine industry and also because the industry has succeeded in making a vaccine against H5N1 avian influenza," she said.

Kieny said WHO is in discussion with manufacturers to reserve some of the H1N1 vaccine to distribute in poor countries that could not otherwise afford the vaccine.

President Barack Obama said in a news conference today that while his administration is focused on what needs to be done immediately, "we also need to prepare for the long term, since we know that these kinds of threats can emerge at any moment."

The regular flu season now is ending across the Northern Hemisphere even as it is starting south of the Equator. While the A/H1N1 may ease off in the Northern Hemisphere in the near future, the President warned that it could return next winter.

"Even if it turns out that the H1N1 is relatively mild on the front end, it could come back in a more virulent form during the actual flu season," he said. "And that's why we are investing in our public health infrastructure."

President Obama said, "We've had discussions about the production of vaccines in anticipation of the flu season. And we've made sure that all our agencies here are coordinating, that they have appropriate action plans; that we, for example, are working with the Department of Education to provide clear guidelines for school closures; that we are working with the U.S. Chamber of Commerce, for example, to ensure that businesses are supportive of their hourly workers who need to stay home but may be worried about losing their jobs because they don't have sick leave."

The President said he is having discussions with Secretary of State Hillary Clinton as well as the U.S. Ambassador to the United Nations Susan Rice about how the country will respond to potential requests from other countries for assistance in dealing with this issue.

The H1N1 flu, also called human swine flu, is a respiratory disease of pigs caused by type A influenza virus that regularly causes outbreaks of flu in pigs.

Symptoms in people can be similar to the symptoms of regular human seasonal influenza infection and include fever, cough, headache, general aches and fatigue. Some people with this new strain of flu have also reported runny nose, sore throat, nausea, vomiting and diarrhea.

Health officials advise ill people to cover the nose and mouth when sneezing or coughing and wash hands often with soap and water. People with symptoms should stay home from work or school to avoid spreading the infection.

Copyright Environment News Service (ENS) 2009. All rights reserved.