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Pandemic Fears As Mexican Swine Flu Spreads And Kills


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Deadly swine flu outbreak 'can't be contained'

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Updated 20 minutes ago

The US Centres for Disease Control and Prevention (CDC) says an unusual new flu virus has spread widely and cannot be contained, as the World Health Organisation urges governments to be on the alert.

"It is clear that this is widespread," the CDC's Dr Anne Schuchat told reporters.

"And that is why we have let you know that we cannot contain the spread of this virus."

The strain of swine flu is suspected of killing as many as 60 people in Mexico and infecting thousands more.

It is a new strain, and therefore poorly understood. The World Health Organisation (WHO) says it does not know the full risk yet.

The organisation has held an emergency meeting to discuss the outbreak.

Its director-general, Margaret Chan, says the deadly new form is serious and does have pandemic potential.

"It has pandemic potential because it is infecting people," WHO Director-General Margaret Chan said in Geneva.

"However, we cannot say on the basis of currently available laboratory, epidemiological and clinical evidence whether or not it will indeed cause a pandemic."

The WHO is advising all countries to be vigilant for seasonally unusual flu or pneumonia like symptoms among their populations, particularly among young, healthy adults who seem to be the most affected in Mexico.

The CDC's acting director, Dr Richard Besser, says it seems humans are transmitting the virus.

"There are things that we see that suggest that containment is not very likely, in that we are seeing cases in Texas and we're seeing cases in San Diego without any connection between them, which makes us think that there's been transmission from person to person," he said.

The Mexican government says there will be a mass vaccination campaign, and in the meantime it has closed all schools and universities.

CDC officials are assisting public health authorities in Mexico to test additional specimens and providing epidemiological support as part of a WHO team.

The centres have also dispatched teams in southern California, where several cases were reported.

Health leaders in the US, Mexico, Canada and at the WHO say they are communicating frequently, and state and local US health authorities are conducting investigations.

There is no vaccine to protect humans from swine flu, only to protect pigs, according to the CDC.

Dr Schuchat says measures are being taken to produce a vaccine against the virus if necessary, but cautions that it usually takes "months" to produce a vaccine.

"We're not going to have large amounts of vaccine tomorrow," she warned.


Mexico swine flu has 'pandemic potential'

WHO holds emergency meeting

Last Updated: Saturday, April 25, 2009 | 11:36 AM ET

CBC News

The World Health Organization held an emergency meeting in Geneva on Saturday amid fears that Mexico's outbreak of swine flu may become a worldwide pandemic.

WHO director-general Margaret Chan, who broke off a visit to Washington to return to the organization's headquarters in Switzerland, said the outbreak involves "an animal strain of the H1N1 virus, and it has pandemic potential."

Chan said it's too early to say whether a pandemic will actually occur, but she referred to the outbreak as a "serious situation" that needed to be followed closely.

The new flu strain — combining genetic material typical of avian, swine and human viruses — has killed as many as 68 people among 1,004 suspected cases reported countrywide in Mexico.

Tests confirm 20 people have died of the H1N1 virus, and 48 other deaths were probably due to the same strain.

The WHO convened an expert panel to determine whether to issue any travel advisories or raise the global pandemic alert level.

The organization uses six phases to categorize the risks of such an outbreak and its pandemic alert level is currently at Phase 3 (none or very limited human-to-human transmission).

Phase 6 is "pandemic" — efficient and sustained human-to-human transmission of disease.

Public venues remain closed

On Friday, Mexican authorities closed all schools and other public buildings in the capital in an attempt to contain the outbreak.

The mayor of Mexico City announced on Saturday that all public events would be cancelled for the next 10 days.

Human-to-human transmission of swine flu is thought to spread in the same way as seasonal influenza — through coughing and sneezing, or touching contaminated surfaces.

Officials in Mexico have advised people to avoid customary greetings such as shaking hands or kissing cheeks.

As an added precaution, soldiers have been distributing surgical masks to motorists and pedestrians in downtown Mexico City.

A similar swine flu virus is blamed for causing illness in eight people in Texas and California since last Tuesday. Authorities said all of the U.S. patients are expected to recover.

"This is a particular kind of swine flu and it's actually no longer swine flu, although it came from pigs. It's a new human influenza virus," Allison McGeer, director of infection control at Mount Sinai Hospital in Toronto told CBC News.

McGeer said it's important to keep the outbreak in perspective.

"We still don't have really good sense of how many people have been infected in Mexico. When people talk about 1,000 people ill and 20 deaths, it sounds like a lot, but in truth for influenza, that's a very small number.

"You need to remember that in Canada alone, which is not that much bigger than Mexico City actually in population terms, 4,000 people die of seasonal flu every year."

Pandemic preparation: dealing with infectious disease outbreaks

Last Updated: Friday, April 24, 2009 | 2:48 PM ET

CBC News

If you lived in Toronto during the height of the 2003 SARS outbreak, you probably:

* Saw lots of people wearing protective masks.

* Bought or thought about buying masks for your family.

Since that outbreak of severe acute respiratory syndrome, Canada has been a world leader in preparing for the next pandemic — whether it's a new strain of flu or some other infectious disease not yet on the World Health Organization's (WHO) radar.

The WHO believes that the world is currently closer to another influenza pandemic than it has been any time since 1968, when the last of the 20th century's three pandemics swept the globe. It has developed an global influenza preparedness plan outlining the role of the WHO and recommendations for national measures before and during pandemics.

The organization uses six phases to categorize the risks facing the globe.

Phase one is low risk of human cases. Phase six is "pandemic" — efficient and sustained human-to-human transmission of disease.

Phase three — the one the WHO says the world has been in for several years — is classified as "pandemic alert with no or limited human-to-human transmission." We're there because a new influenza virus subtype — H5N1 or bird flu — is causing disease in humans, but is not yet spreading efficiently and sustainably among humans.

The Public Health Agency of Canada follows the WHO's categories — but has expanded them somewhat.

Dr. Danielle Grondin, the acting assistant deputy minister for the infectious disease branch at the agency, told reporters on April 23, 2009, that officials had upgraded the surveillance alert level from phase one to phase two.

Phase one is routine monitoring, while phase two involves increased vigilance and getting information out to the public.

"At this stage, yes, it is serious," Grondin said. "[The outbreak's in] another country, but we're monitoring it and are collaborating with Mexico to identify quickly what's happening."

Dr. Allison McGeer, the director of infection control at Mount Sinai Hospital in Toronto, told CBC News that before SARS, the Mexican outbreak likely would not have been on the radar screens at all.

"When any jurisdiction now has an outbreak of any significance in their population, they report it immediately. Before SARS Mexico probably wouldn't have reported it — not because they were deliberately trying to be difficult, but because it didn't occur to us how quickly these viruses can travel."

The downside of getting the word out quickly, McGeer said, is that you're reporting before your investigation is complete: "You have a lot of lab tests pending and we all have to wait together to see what's going on."

What happens next in any outbreak that spreads to Canada depends on what scientists determine they're dealing with.

During SARS, infected people were quarantined in an attempt to keep the disease from spreading. A provincial public health emergency was declared, restricting hospital-based services to urgent cases, limiting access by visitors, and mandating the use of protective equipment such as masks for health-care workers.

There was no vaccine to protect the uninfected. When it comes to flu, there are vaccines.

"If it's influenza we're not going to quarantine," McGeer said. "We can't stop the spread. We'll put programs in place to reduce the spread as much as possible and try to make sure we have our care organized in the best way."

In the United States, the Centers for Disease Control and Prevention (CDC) identifies medical emergencies and gets the word out on how people should react.

The CDC — like the Public Health Agency of Canada — doesn't necessarily wait for the WHO to declare an emergency. The WHO set up the Centre for Strategic Health Operations in 2004 to provide a single point of co-ordination for response to acute public health crises including infectious disease outbreaks, natural disasters and chemical emergencies. Its first major task was to assist with emergency co-ordination during the tsunami that hit south Asia on Dec. 26, 2004.

Among the facilities the WHO relies on for its information is PHAC's national microbiology lab in Winnipeg. It is one of 15 laboratories around the world designed to accommodate the most basic to the most deadly infectious organisms. The lab tested samples from the Mexican outbreak and confirmed that it was a new mutation of swine flu.

Dr. Michael Gardham of the Ontario Agency for Health Protection and Promotion, says influenza is very different from SARS.

"We've been preparing for years for influenza … A virus like this may spread more widely than your usual flu virus. It doesn't however necessarily mean it's more dangerous than your regular flu virus. Flu viruses mutate all the time."

On April 24, 2009, the World Health Organization said it would convene an emergency committee to advise whether the outbreaks of swine flu in Mexico and the United States were something the rest of the world should worry about. A WHO official said the committee would meet "in the very near future."

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I work as a resident doctor in one of the biggest hospitals in Mexico City and sadly, the situation is far from "under control". As a doctor, I realise that the media does not report the truth. Authorities distributed vaccines among all the medical personnel with no results, because two of my partners who worked in this hospital (interns) were killed by this new virus in less than six days even though they were vaccinated as all of us were. The official number of deaths is 20, nevertheless, the true number of victims are more than 200. I understand that we must avoid to panic, but telling the truth it might be better now to prevent and avoid more deaths.

Yeny Gregorio Dávila, Mexico City

The situation in Mexico City is really not normal. There is a sense of uncertainty that borders on paranoid behaviour in some cases. At this very moment, Mexican TV is showing how military forces are giving masks to the people in the streets. Moreover the news is sending alarming messages for the audience. Really, the atmosphere in the city is unsettling, a good example: pubs and concerts are being closed or cancelled and people don't haven thorough information. In this city (and country) there is an urgent need for assertive information, no paranoid messages from the government or the Mexican media.

Patricio Barrientos and Aranzazu Nuñez, Mexico City

Massive events have been cancelled at the National Auditorium - Mexico City's largest indoor venue with capacity of 10,000 - which has been closed. Two soccer games have been cancelled at the Olympic Stadium. A sold out game with 70,000 expected attendance will be played behind closed doors. Another game at the famous Azteca Stadium that would draw an attendance of 50,000 will also be played behind closed doors.

Juan Carlos Leon Calderon, Mexico City

It's eerily quiet here in the capital. Lots of people with masks, Facebook communities exchanging gallows humour, everybody waiting to see if schools and universities will stay closed for ten days (as goes the rumour). All masks have been used up, and we are waiting for new supplies.

Dr Duncan Wood, Mexico City

Yesterday in my office it was a bit surreal walking in to see all in blue masks with deep cleansing of computer equipment and surfaces going on. Let's hope it is contained and does not escalate. The local news is reporting 200 fatalities and reports of flu spreading from areas outside of Mexico City. Given the volume of daily commuter traffic on cramped busses and trains, this may not have to be too virulent to be disastrous in human terms. I wonder what controls there will be on flights in and out.

Will Shea, Mexico City

I work for the government as a head of a computer infrastructure operations department. At work we are doing several actions to try not to expose workers. We sent several home. I support the Pumas football team and the very important match with the Guadalajara team will be played behind closed doors. My family and I are going to stay home all weekend. We feel a little scared and confused with the feeling that we are not given being told the truth. Many people think the numbers of dead people is higher than we are being told.

Marcos, Mexico City

The whole city is affected, I have a very bad feeling about this. Two of my friends at work are sick, they were sick for a couple of days, they went to the hospital and they sent them back to work. The doctor told them it was just a flu until Friday when the alarm was spread, then they were allowed to go home. I work in a call centre and I'm worried because there are no windows in the building so it cannot be ventilated and around 400 people work there.

We all have talked to our supervisor but no one has done anything not even sterilise or disinfect the area. We will be sick soon and, well, do the math - 400 can infect at least another two per day. The authorities say there's nothing they can do since it's a private company and I can assure you, the company I work for is not the only one like this in the whole city. Us workers don't have much protection from our government and if we want to keep our jobs we have to go anyway.

Adriana, Mexico City

My sister got influenza like symptoms two weeks ago. She is fine now, thank god, but similar cases have been showing up since two weeks ago. I work for a bank and we were told to take our laptops because there is a high possibility to work from home. I have gone out to buy some face masks.

Ruben Farfan, Mexico City

I'm a college student in Mexico City, and I can only say that the information that the media has provided doesn't seem to be enough, we do not now how serious it is because they have failed to mention it. There have been two ways of responding to this event, the ones that have entered themselves into quarantine claiming that the government is hiding something much more serious, and those who take this as a joke saying that everyone is overreacting. To put a cherry on top all kind of crazy rumours are flying around - that they are going to quarantine Mexico City, that a school and some specific branches of offices and jobs are going to be suspended for days to come, and so on. I wish more info was available, for example how to prevent it? Have there been many deaths? Is there a threat of an epidemic?

Mari A, Mexico City

I didn't hear about the flu epidemic until last night at 2330. Yesterday the streets were almost empty compared to a normal Friday afternoon. The media is bombarding the same information over and over again, but the authorities haven't said anything new yet, only that they have enough vaccines for those with the flu and that we should avoid public spaces.

Paulina, Mexico City

This is another blow to the tourism industry in Mexico, even though non of the events that is taken place is anywhere near the tourist areas of Cancun, Playa del Carmen or Puerto Vallarta, the news comes across as all of Mexico is affected! After wrong reports of drug related violence, military presence etc. in Cancun, which hurt the industry tremendously, now people think that all of Mexico is affected by a virus that is mostly present in the capital. I guess the problem is that this is a country where the capital carries the same name as the country, thus when people hear news about Mexico, albeit it refers to Mexico City, they assume it is affecting the whole country.

Rainer, Cancun

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Swine flu concerns spread nationwide

This from stuff.co.nz

Otago, Nelson, Waikato, Auckland outbreak fears

At least four district health boards are battling a suspected swine flu outbreak, as the Prime Minister warns Kiwis to think very carefully before travelling to Mexico.

Health Minister Tony Ryall said this afternoon that Otago District Health Board was also dealing with suspected cases of swine flu - adding to two possible cases reported in Waikato and further cases in the Nelson-Tasman region.

Cases of Influenza A were confirmed in Auckland yesterday in 10 Rangitoto College pupils who had been staying in Mexico. Officials say it is "likely" they have contracted swine flu.

The college group had originally thought they might be having a bad reaction to Mexican food, Rangitoto College principal David Hodge said.

At least three students from a second school group, Northcote College - which also returned from Mexico on Saturday - have also exhibited flu-like symptoms. Officials are likely to find out today if those pupils have also contracted Influenza A.

Mr Ryall said officials were treating all cases as if they had swine flu and administering Tamiflu. There are currently 1.25 million Tamiflu treatment courses in New Zealand, though some of the stock would expire later this year.

Prime Minister John Key said this afternoon that while there was not a travel ban in place for Mexico "people should think very cautiously about visiting."

He said there was some suggestion that if visitors became unwell they may be stopped from leaving Mexico.

It has emerged this afternoon that a number of passengers on board Air New Zealand Los Angeles flight NZ1 - carrying the 10 influenza-infected Rangitoto College students - are now in isolation.

Mr Ryall said this afternoon that two thirds of the passengers on NZ1 had been contacted by health officials for follow-up checks.

A team of 25 was making contact with the passengers. Once completed passengers on board NZ5 - the flight carrying the Northcote College pupils - would also be contacted, Mr Ryall said.

Mexican officials today put the death toll from the new swine flu strain at over 100, with about 1600 sick, while cases have also been reported in the United States, Canada, Spain and France.

Nelson Marlborough Public Health Service said this evening they were following up 10 people from flight NZ1 as well as eight people from flight NZ5.

District manager Peter Bassett said 20 people had so far been identified across the Nelson-Marlborough district "and are in home quarantine until further notice."

Waikato District Health Board said this afternoon it was investigating two possible cases of swine flu. In both cases the patients had been isolated within their homes until test results for Influenza A come back within the next 24 hours.


A Christchurch father onboard NZ1 from Los Angeles, who did not want to be named, said he was disappointed with the response from health officials. "I'm a bit hacked off with the Department of Health."

Since visiting an emergency 24-hour doctor surgery he had had no contact with health officials.

He had purchased two courses of Tamiflu at a cost of $160, which he planned to take as a precaution.

"I just want to eliminate any risks," he told Stuff.co.nz this afternoon.

He believed Tamiflu treatment for the 360-odd passengers on board NZ1 should be mandatory, particularly as there was a stockpile of 1.2 million Tamiflu treatments following the 2003 Sars outbreak.

"They could stamp it out for the [nearly] 400 people onboard. But potentially by now they could have tens-of-thousands of people exposed to it."

He had not been sitting near the 22 Rangitoto College pupils and three teachers on flight NZ1, but had checked-in alongside the sombrero-wearing group, returning from a language trip to Mexico.


Director of Public Health Dr Mark Jacobs said it was possible the virus could be spread through toilet contamination on board the flight if the affected party members had not washed their hands, but overall the risk of infection spread was relatively low.

Testing on the Influenza A-positive results from Rangitoto pupils will begin in Melbourne today with officials poised to upgrade infection control measures, if needed. "We're going to continue dealing with it as if it's swine flu until we're told it's not," Dr Jacobs said.

"Additional measures may involve greater surveillance," Mr Ryall said.

Influenza A-positive tests results were being sent to Melbourne as that was where laboratories that meet World Health Organisation testing standards were based.

He stressed however that New Zealand was heading into the flu season and the great majority of Kiwis who may have flu symptoms "have just got a cold".

"This [advice] is specifically about people who have been in Mexico and the US in the past couple of weeks and they've developed symptoms."

Dr Jacobs said the situation was very different in Mexico compared with the US. "We still don't know if the deaths in Mexico are related to this particularly type of infection [swine flu] or not." He said only 19 tests had been carried out on the many suspected cases of swine flu in Mexico.

The situation in the US was encouraging with patients mainly suffering "a mild flu-like illness," Dr Jacobs said.

Director-General of Health Stephen McKernan said New Zealand was one of the first to identify the potential swine flu outbreak and he predicted other countries would also discover such cases in the coming days.

Dr Jacobs said there were two main factors that lead health officials to believe swine flu was "likely". "Firstly, the fact that it's Influenza A... The second is the link to Mexico and the fact they are coming out of their influenza season." If the flu had been contracted while the pupils were visiting in winter - Mexico is currently moving into summer - it would be of less concern, he said.


One of the sick Rangitoto high school students, who has tested negative for the deadly flu, spoke with Radio New Zealand this morning.

The unnamed girl - who is currently in quarantine at her home – told how the group were in homestays for the last few days of their trip to Mexico.

"We were at the school with them and living with them for about three or four days of the trip but we were out and about basically every minute of the day."

"Some of us were getting coughs and stuff within the last few days of our trip," she said.

The student said while she had been suffering a cough and the occasional headache the flu was "not really bothering" her.

The Department of Health had told her she could be in quarantine for up to a week.

"It is pretty surreal. It's sort of movie like, but it's alright. My mum is with me so we'll be all good amusing ourselves."

The situation didn’t really feel real, she said.

"I think that it's pretty freaky... some people might be freaking out about who they've been in contact with and whether their kid has it or not and it's a fair worry."

Rangitoto College principal David Hodge said the positive tests were a shock. "Naturally we are very anxious for the students and staff affected and their families.

"But our fears are tempered by the fact they are getting the best medical care possible. The response from the health authorities has been amazing. From the start, we erred on the side of caution."

Mr Hodge told Radio New Zealand this morning the school was open today after being given the all clear by health authorities.

The 22 students and three teachers affected were being closely monitored, he said.


Health authorities have instituted a "Code Yellow", with district health boards on alert and airport surveillance beefed up.

Travellers arriving into Auckland Airport from North America this morning were issued with a public health warning.

If the situation deteriorated, the ministry would "ramp up" its response, moving into the code red phase.

This would involve far more intensive work at border entry points, ring-fencing outbreaks within New Zealand, and continuing to treat patients with Tamiflu.

The Foreign Affairs and Trade Ministry has also issued a travel notice for people returning from Mexico, California and Texas.


- Stay at home and away from others if you are sick

- Cover coughs and sneezes with a tissue and put used tissues in the bin

- Wash and dry hands frequently, even when you start to feel better

* Anyone who has travelled to Mexico or North America in the last fortnight should contact Healthline (0800 611 116) for information. They should seek medical advice if they are displaying flu-like symptoms.


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I had a friend and his grilfriend go to Acamal (outside Cancun) on April 22 for a week. So like 24 hours before word broke. I emailed him yesterday; haven't heard back. I wonder what's happening with him?

BTW, there was a swine flu vaccine like 25 years ago. That's when I started getting the annual flu shot.

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I got my annual flu shot today.

New Zealand officials are investigating a further 56 suspected cases of swine flu as the World Health Organisation said there was now a significantly increased risk of an influenza pandemic.

The new cases all involve people who have visited Mexico or the United States in the last few weeks and who have presented with flu-like symptoms.

This is just breaking news in New Zealand.

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How bout Tamiflu tables ? Will that help against the flu ? I heard those Irish and Swiss has enough doses for their whole population.

That seems to have worked with the young New York CIty students who came down with it.

But what about the young Tamils in Sri Lanka -- when they come down with their flu; what do they take? :blink:

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We've all been joking at work now that we have the swine flu. I somehow find it funny that Mexico has given us swine flu.

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I wonder if muslims get it, they will kill themselves??

Just wondering.

Meanwhile, in Israel:

Israel deems 'swine flu' kosher after all

JERUSALEM (AFP) — Swine flu hasn't skipped the Jewish state. And despite some attempts, neither has its non-kosher name.

Deputy health minister, Yakov Litzman, a member of an ultra-religious party, said earlier this week that the name "swine flu" should not be used as it contains the name of the animal banned by Judaism.

Instead he said the authorities should call the virus sweeping the globe "Mexican flu."

That, however, did not sit well with either Mexico's ambassador to Israel nor the Jewish state's envoy to Mexico.

Mexico's ambassador Frederico Salas and the Israeli envoy to Mexico Yosef Livne both lodged official complaints at the foreign ministry on Tuesday protesting at the new term.

"The ambassador (Salas) said he was offended when the deputy health minister called it the Mexican flu," a foreign ministry official told AFP.

"Israel has no intention of giving the flu any new names. It was nothing more than a slip of the tongue," the official said.

Eating of pork is prohibited by Judaism, the religion practised by the majority of Israelis. Islam, adhered to by most of Israel's Arab minority, likewise bans consumption of pork.

Israel confirmed on Tuesday that two nationals who recently returned from Mexico had contracted swine flu in the first such cases in the Middle East.

US officials also said on Tuesday they were reviewing whether to change the name of the outbreak, complaining that a slew of countries were misguidedly banning pork exports from North America.

"This is not a food-borne crisis. It's important to not refer to swine flu. It's important to convey the message that consuming pork will not cause this illness," Agriculture Secretary Tom Vilsack told reporters.

The World Organisation for Animal Health said on Monday that the name swine flu is a misnomer as the deadly virus has origins among birds and humans as well as pigs.

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Here we are five suspects cases.

And don't pay attention to sensacionalist news, because the swine flu is not mortal, but one trouble is that there arent' vaccines and if you don't go to the doctor, you could have pneumonia.

The real matter is that million of people get sick like in 1918, if 100 million people get sick and the mortality rate is 2%, it would mean that 2 million people would die, and knowing that in the world the people who die for flu is between 500 and 800 thoundsand, hospitals suddenly get crowed of people with symptoms and people who imagine that they have them. It would create panic and it'd make that hospitals get collapsed.

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We have some suspect cases in 11 states here but nothing confirmed so far. Other previous suspect were cases of normal flu and dengue fever, which shares some symptoms with swine flu. And yes, the media here is acting like Mexico City is doomed.

I don't believe this "lethal" virus will spread and kill worldwide. The cases are poping up everywhere but the mortality rate isn't that big comparing to previous flu outbreaks. And the available medicine is working fine so I'm confident it will be controlled in a couple weeks.

BTW, Brazil developed a national contigency plan for global flu outbreaks following SARS, I think most countries are ready to deal with flu these days. It's not like a deadly hemorragic fever outbreak, it's a new type of a disease we know how to treat, right?

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  • 1 year later...

Reports accuse WHO of exaggerating H1N1 threat, possible ties to drug makers

By Rob Stein Washington Post Staff Writer

Friday, June 4, 2010; 3:52 PM

European criticism of the World Health Organization's handling of the H1N1 pandemic intensified Friday with the release of two reports that accused the agency of exaggerating the threat posed by the virus and failing to disclose possible influence by the pharmaceutical industry on its recommendations for how countries should respond.

The WHO's response caused widespread, unnecessary fear and prompted countries around the world to waste millions of dollars, according to one report. At the same time, the Geneva-based arm of the United Nations relied on advice from experts with ties to drug makers in developing the guidelines it used to encourage countries to stockpile millions of doses of antiviral medications, according to the second report.


The first report, released in Paris, came from the Social, Health and Family Affairs Committee of the Parliamentary Assembly of the Council of Europe, which launched an investigation in response to allegations that the WHO's response to the pandemic was influenced by drug companies who make antiviral drugs and vaccines.


The second report, a joint investigation by the BMJ and the Bureau of Investigative Journalism, which is based in London, criticized 2004 guidelines the WHO developed based in part on the advice of three experts who received consulting fees from the two leading manufacturers of antiviral drugs used against the virus, Roche and GlaxoSmithKline.


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