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USA/Mexico/worldwide: Swine influenza - update 30.4.2009
The situation continues to evolve rapidly. 9 countries have officially reported cases of swine influenza A/H1N1 infection. The United States Government has reported 91 laboratory confirmed human cases, with one death. Mexico has reported 26 confirmed human cases of infection including 7 deaths.
The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (13), Germany (3), Israel (2), New Zealand (3), Spain (4) and the United Kingdom (5). In Mexico unlike the other affected countries the virus seems to be more virulent and causes a higher mortality; up to now, no explanation has been found for this discrepancy.
The reported cases from Germany had all a travel history to Mexico. The German Ministery of Foreign Affairs to date does therefore not recommend travels to Mexico.
The World Health Organisation has raised the influenza pandemic level from phase 4 to phase 5. Phase 5 is characterized by human-to-human spread of the virus into at least 2 countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short. At present, there are cases in Canada and the United States who do not have a history of travel to Mexico, so there are now 3 countries (USA, Canada and Mexico) that are reporting human to human spread of the virus. At present, the definition of a suspected case in many countries includes a history of travel to Mexico or another country (such as the USA or Canada) that has confirmed cases. This may bias towards a later recognition of indigenous transmission of the novel H1N1 virus in countries not presently known to have local cases.
The antiviral drugs oseltamivir and zanamivir have shown some effect. It si not known to date whether the seasonal influenza vaccination gives some protection against the swine influenza.
Recommendations are rules of general hygiene (washing hands with soap, avoid close contact to sick people, avoid mass gatherings). The virus is transmissible via droplet infection but not with the foodchain; heating pork over 72° will definitely kill the swine influenza virus.
Sources:
http://www.auswaertiges-amt.de/diplo/de/Laenderinformationen/01-Reisewarnungen-Liste.html
CDC: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5815a5.htm?s_cid=mm5815a5_e
CDC: http://www.cdc.gov/swineflu/general_info.htm
ProMED: http://www.promedmail.org/pls/otn/f?p=2400:1001:2383300242861030::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,77203
RKI: http://www.rki.de/cln_100/nn_200120/DE/Content/InfAZ/I/Influenza/IPV/Schweineinfluenza__Situation.html