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Hundreds in flu testing

Fri May 1st, 2009

Hundreds of tests were under way world-wide last night to establish if travellers from Mexico have passed on the swine flu virus.

According to the World Health Organisation, the number of infections confirmed world-wide is fewer than 300, the bulk of them in Mexico and the USA.

Spain has confirmed 13 cases, Britain eight and Canada 19.

British officials confirmed that another 230 people had undergone tests for suspected flu and results are awaited.

In the USA health secretary Kathleen Sebelius placed an order for some 13 million courses of treatment with anti-flu drugs, promising to send some 400,000 to Mexico - topping up a national reserve of some 73 million courses in federal and state stockpiles.

As WHO repeated it would not recommend restrictions on travel, experts debated whether drastic measures would work.

The British Medical Journal yesterday argued that they will not - and that handling the effects of infection will be more important.

Professor Richard Coker from the London School of Hygiene and Tropical Medicine, UK, says that "efforts need to focus increasingly on mitigation" rather than containment, as the swine flu virus is now widespread across many countries.

In an editorial on the website of the British Medical Journal yesterday, he warns that: "Fragile health systems will make surveillance and mitigation a challenge."

New probable and confirmed cases are reported daily, but almost all by developed countries with robust surveillance systems, writes Professor Coker. He suggests that cases in other countries are not coming to international attention. "Are we seeing only part of the global picture?" he asks.

Many countries, especially developing countries, have limited health system resources to call on in the event of a pandemic. Furthermore, there is a risk that the threat still posed by H5N1 ("bird flu") and other strains of flu may be forgotten.

"The economic crisis of the past year has shown how interconnected we are, and it has also highlighted challenges that arise when countries whose interests are at variance have to act together for the common global good," Professor Coker warns.

"If swine flu becomes a pandemic and is associated with high mortality and morbidity, notions of global solidarity may be tested as never before."

But an Australian expert argues that dramatic measures taken rapidly can have a big impact.

Professor George Milne, of the University of Western Australia, says school closures and quarantine measures could hold back a pandemic - but only if they are put into place rapidly.

Writing in BMC Public Health, Professor Milne says: "While such draconian measures seem unlikely to be mandated given their impact on personal freedom, they appear to have a key role to play in delaying the development of a ‘worst case’ influenza epidemic.

"They may be critical in holding back an epidemic until vaccines are deployed on a sufficient scale that subsequent relaxation of these rigorous measures will not result in a consequential acceleration in the scale of the outbreak."

Coker, R. Editorial: Swine flu. The British Medical Journal, 2009;338:b1791.
BMC Public Health 2009, 9:117

Discuss this report here

Tags: Flu & Viruses | World Health | North America | Travel | UK News | Europe | Australia

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