WORLD: Flu pandemic alert level raised amid warning of 'imminent' emergency

. LONDON, England / The Times / World News / April 30, 2009 By David Rose and Sam Lister The world was put on the second highest possible alert of a flu pandemic last night as countries were warned that a global health emergency was imminent. Margaret Chan, director-general of the World Health Organisation (WHO), raised the official global alert level to phase five out of six, after the new strain of Mexican swine flu was transmitted between humans in Mexico and the United States. It had spread to at least nine countries, four of them in Europe. Dr Chan said: “Influenza viruses are notorious for their rapid mutations and unpredictable behaviour. We do not have all the answers immediately, but we will get them.” Phase five, one step short of a full pandemic, is defined by the WHO as a strong signal that a pandemic is imminent, “and that the time to finalise . . . planned mitigation measures is short”. Phase six declares a global pandemic, or sustained community-level illness on more than one continent. Britain is considered one of the countries best prepared for such an event. Ministers pledged yesterday to increase stockpiles of medicines, including antiviral treatments, and announced a public health campaign. The Government had indicated earlier that no big events in Britain were likely to be cancelled or borders closed as a result of the decision to raise the alert level. The announcement came late last night after all-day emergency meetings with leading scientists, convened by the WHO. By 9pm a total of 140 cases were confirmed around the world of the viral strain of swine flu that is spreading from Mexico, including three new cases in Britain. Up to a million doses of antiviral drugs will be delivered to frontline NHS workers by next week. Doctors and nurses will receive medication to use as a precaution if they come into contact with anyone suspected of carrying the swine flu strain. Gordon Brown said that three new cases had been confirmed yesterday in England, including a 12-year-old girl, whose school was closed and her classmates given antiviral drugs. A 41-year-old woman from Birmingham and a 22-year-old man from London were also confirmed as having been infected. It takes the total number of confirmed cases in Britain to five, although all had recently returned from Mexico and were understood to be responding well to treatment at home, the Prime Minister said. Keiji Fukuda, assistant directorgeneral of the WHO, said yesterday afternoon that the agency was moving closer to increasing its pandemic alert level. “It’s clear that the virus is spreading, and we don’t see any evidence that it is slowing down at this point,” he said. “Phase five is a significant milestone in terms of countries and warnings. We are dealing with sustained transmission in at least two or more countries.” Hours later Dr Chan raised the alert level and said that the world was better prepared than ever for a pandemic. “For the first time in history we can track the infections, in real time,” she said. All countries should immediately “activate their pandemic preparedness plans”. The Spanish Health Ministry had reported earlier that a person who had not travelled to Mexico was infected, raising fears that the H1N1 viral strain could spread between people throughout several countries if not contained. As Germany and Austria confirmed their first cases yesterday, Mr Brown told MPs that a schoolgirl from Paignton, Devon, was among the three new cases in England. The girl, later named as Amy Whitehouse, 12, had flown back from a holiday in Mexico last week on the same aircraft as two Scottish honeymooners identified on Monday as Britain’s first swine flu cases. Her school, Paignton Community and Sports College, has been closed for a week and 230 children given precautionary doses of Tamiflu, which appears to be successful in treating the new strain. The Scottish government said that tests on the initial eight people who came into contact with the first two Britons to be confirmed with the virus were negative. Iain and Dawn Askham, of Polmont, near Falkirk, are recovering well in an isolation ward at Monklands Hospital in Airdrie, Lanarkshire. The Government said that it was increasing its stockpiles of antiviral drugs, face masks and antibiotics. It has already stockpiled more than 33 million doses of the drugs Tamiflu (oseltamivir) and Relenza (zanamivir) but has ordered enough to have 50 million doses ready within a few weeks, at a estimated total cost of £750 million. Leaflets will be sent to every British household on Tuesday, advising people to use tissues and good hygiene to contain the spread of the virus. The “catch it, kill it, bin it” message and a national telephone hotline for advice will feature on television, press and radio adverts from this morning. “We’ll make sure that we are as well prepared as any country in the world,” Alan Johnson, the Health Secretary, added. Sir Liam Donaldson, the Chief Medical Officer, said that it may be weeks before the virus — thought to be a combination of animal and human flu strains — was sufficiently understood for a vaccine to be researched. He added that millions of surgical facemasks had been ordered for NHS staff who have close contact with infected patients, but the wearing of masks by the public was not necessary. “It could even be counter-productive, as they get moist, which increases risk of virus transmission . . . and provides a false sense of security,” he said. Anyone who had returned from affected countries and had flu-like symptoms was to contact NHS Direct, or their doctor by phone, he said. NHS Direct released figures last night on the number of people visiting its website to find out more about swine flu. A spokesman said more than 63,000 people visited the site on Tuesday compared with about 39,000 on Tuesday last week. Of those, 16,638 people inquired about flu. US officials reported the first swine flu fatality outside Mexico yesterday, although it later emerged that the 23-month-old girl who died in Texas was a Mexican who had been taken to the US for treatment. President Obama raised the prospect of widespread school closures to prevent the virus spreading, saying that “utmost precautions” were needed to contain the spreading outbreak. Several schools in New York, where 51 of the 91 confirmed swine flu cases in the US have been recorded, have already closed their doors and some parents kept their children away. At an emergency meeting of the European Union today, health officials will discuss the possibility of a Europe-wide travel advisory to avoid Mexico, where as many as 159 people are suspected to have been been killed by the new virus. Another 2,500 are thought to have been infected, with the majority making quick recoveries. EU experts believe that swine flu could claim thousands of lives. “Yes, people will die from this. It is not a question of whether people will die, but more a question of how many. Will it be hundreds, thousands or tens of thousands?” Robert Madelin, director-general for health and consumer policy at the European Commission, said. However, the Mayor of Mexico City, the metropolis of 20 million people that has been virtually shut down because of the outbreak, said that cases of serious illness appeared to be levelling out. Marcelo Ebrard said that if the number of reported deaths kept falling, he would consider easing the citywide closures of schools, restaurants, gyms and other public places. Apart from closing down its capital, Mexico has taken other measures to contain the outbreak: all archaeological sites have been closed; a regional beach football championship has been postponed; and all first division football games this weekend will be played with no spectators. Cruise ships are avoiding Mexican ports, and holiday tour groups are cancelling charter flights to the country, in line with the Foreign and Commonwealth Office’s advice to postpone all non-essential travel to affected areas. Copyright 2009 Times Newspapers Ltd.