As yet another day goes by with the World Health Organization (WHO) not declaring that the swine flu outbreak is a full-scale pandemic, more questions are surfacing about why this novel H1N1 has not spread as easily in European and Asian communities as it has in the United States, Mexico, and perhaps Canada. At press conferences held today by WHO and the U.S. Centers for Disease Control and Prevention (CDC), officials suggested that the virus had spread widely in the Americas before it was detected, making containment near impossible. Europe and Asia, by contrast, had a heads-up, and countries have closely monitored travelers returning from North America, putting many infected people and their close contacts on antiviral drugs, as well as forcing some patients to remain in isolation.
Both WHO and CDC stress that the daily case counts they have been providing have many limitations, as they tend to pick up the most severe cases first. CDC added that it is now more interested in trends than specific case counts. But numbers are still being tallied, and as of today, WHO reported that there were more than 5200 confirmed cases in 30 countries, nearly 90% of which were in Mexico and the United States.
Nikki Shindo, who heads the clinical team at the WHO Global Influenza Programme, said each country responds according to its own plan and resources. “European countries, which are mainly importing the cases, have been using antivirals very aggressively,” says Shindo. “Maybe in Asia, because of the experience with SARS and avian H5N1 infection, they would like to stick to a higher level of security and preparedness and prevention with regard to this outbreak of H1N1.” In North America, Shindo noted, treatment with antiviral drugs is largely reserved for severe cases and people who are at greater risk from the virus because of other underlying health problems or pregnancy.
Shindo said no data can yet prove that antivirals work against this novel H1N1 virus to lessen the severity and spread of the disease, but test tube studies have shown that the virus is not resistant to the drugs.
Anne Schuchat, CDC’s interim deputy director for science and public health, particularly highlighted the need for pregnant women to receive antivirals, noting that there have been 20 confirmed cases and one death in that group. Schuchat said CDC’s Morbidity and Mortality Weekly Report will publish data about these cases in pregnant women “fairly soon.”
—Jon Cohen
Jon - you are one a few allowed questions when WHO holds briefings. After reading the following article
http://www.voanews.com/english/Africa/2009-06-02-voa35.cfm
and noting that Egypt has its first confirmed case of H1N1, please look into the level of concern that WHO and PAHO have on the reassortment of H5N1 & H1N1.
I am amazed everyday at the level of complacency in the US over this potentially lethal issue, I work with people who say “I do not want to know more, I do not want to get all upset over this”, and I work in healthcare – go figure.
dk