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Swine flu spreading at 'unbelievable' rate: WHO chief

Mexico could have one million swine flu cases: minister
Up to one million people in Mexico could be infected with swine flu in the coming months, Mexico's health minister said Friday in announcing five new deaths from the A(H1N1) virus. The new deaths bring Mexico's toll from the swine flu to 184, with 21,264 confirmed cases of infection, Health Minister Jose Angel Cordova said in a statement. But he warned that "we predict the number of infections will rise to one million this winter." The virus first emerged in Mexico in late April, and quickly developed into a global pandemic that has killed close to 2,200 people in 177 countries, according to the most recent figures released Friday by the World Health Organization (WHO). With 209,438 cases of infection globally, according to the WHO's lowest estimate, the virus has overtaken seasonal influenza to become the most prevalent strain of flu worldwide.

Swine flu death toll surpasses 2,100: WHO
The World Health Organisation said Friday that 2,185 people have died from swine flu, with some tropical countries reporting "moderate strains" on their healthcare systems amid surges in infections. "Many countries in tropical regions -- represented by central America and tropial regions of Asia, continue to see increasing or sustained high levels of influenza activity with some countries reporting moderate strains ont he healthcare system," it said in a statement. Most countries in the southern hemisphere have passed their peak, and in the northern hemisphere, flu activity was law, added the UN health agency. The latest death toll posted on the WHO's website was an increase from the 1,799 deaths posted over a week ago. Most deaths were recorded in the Americas region, where 1,876 people have died from their influenza A(H1N1) infection. In Asia-Pacific, 203 deaths were recorded. This was followed by Europe, with at least 85 deaths. Middle East recorded 10 deaths, while Africa posted 11. Cameroon, Madagascar and Mozambique also recorded their first infections since the last update. In all 209,438 laboratory confirmed swine flu infections have been reported to the global health watchdog. However, the WHO says that figure vastly understates the full number of infections since individual cases no longer have to be tested or reported in each country. Photo courtesy AFP.
by Staff Writers
Paris (AFP) Aug 28, 2009
Swine flu spreads four times faster than other viruses and 40 percent of the fatalities are young adults in good health, the world's top health official warned in an interview appearing Saturday.

"This virus travels at an unbelievable, almost unheard of speed," World Health Organisation Director General Margaret Chan told France's Le Monde daily in an interview.

"In six weeks it travels the same distance that other viruses take six months to cover," Chan said.

"Sixty percent of the deaths cover those who have underlying health problems," Chan said. "This means that 40 percent of the fatalities concern young adults -- in good health -- who die of a viral fever in five to seven days.

"This is the most worrying fact," she said, adding that "up to 30 percent of people in densely populated countries risked getting infected."

Chan's warning came a day after the WHO said the virus had overtaken others to become the most prevalent flu strain.

"Evidence from multiple outbreak sites demonstrates that the A(H1N1) pandemic virus has rapidly established itself and is now the dominant influenza strain in most parts of the world," the UN agency said in a statement.

"The pandemic will persist in the coming months as the virus continues to move through susceptible populations," it added.

Chan underlined that emergency and healthcare services in several countries had come under strain and stressed that resources allocated for cancer patients and those suffering from heart disease should not be diverted.

"One must not rob Peter to pay Paul," she said. "All governments must prepare for the worst."

She said the most important thing in the battle against the virus was "political leadership."

More than 2,180 people around the world have died from the virus since it emerged in April, according to the latest WHO figures.

Chan also said that it could be months before sufficient vaccine is available to combat the pandemic.

She put world production capacity at 900 million doses a year, for a global population of 6.8 billion people.

Even if this was an unprecedented effort, and authorities were speeding up procedures for getting vaccines to the market, there should be no question of compromises on their safety and effectiveness, Chan said.

Britain and France received their first batches of swine flu vaccine this week. Australia on Friday said a massive swine flu vaccination programme would start in October and Turkey hopes the first supplies of the vaccine will come by that time.

While 90 percent of severe and fatal cases occur in people aged above 65 in seasonal flu, most of those who die from swine flu are under the age of 50.

A "very severe form of disease" affecting the lungs and causing severe respiratory failure among young and healthy people was being reported, WHO said Friday, adding that highly specialised care was required.

Large numbers of such patients could therefore "overwhelm" intensive care units and disrupt the provision of care for other diseases, it warned.

In the southern hemisphere where the flu-prone winter season is tailing off, the WHO said cities in several countries had reported that nearly 15 percent of hospitalised cases required intensive care.

earlier related report
When flu viruses 'shift and drift', how many vaccines?
The World Health Organisation's announcement Friday that the 2009 H1N1 virus has become the dominant strain of flu worldwide fits a historical pattern, but the impact on vaccine policy remains unclear, a top expert said.

"This was one of the big questions, whether we would finish up with three types of strains, or whether one would replace the others," said Nigel Dimmock, a virologist and emeritus professor at the University of Warwick.

Dimmock said it was surprising that the WHO had decided so rapidly that the pandemic strain -- which surfaced in Mexico four months ago -- had elbowed out other flu strains.

The northern hemisphere flu season has not yet begun, so the determination must have been based mainly on what has happened in southern hemisphere countries such as Australia, New Zealand, Argentina and Brazil, he said.

The WHO said in a communique: "Evidence from multiple outbreak sites demonstrates that the H1N1 pandemic virus has rapidly established itself and is now the dominant influenza strain in most parts of the world."

Human flu viruses are identified by a surface-lying protein called hemagglutinin -- the "H" of A(H1N1).

There are 16 subtypes of the "H" protein that circulate in birds and swine, but so far only three have become easily transmissible among humans.

"Flu viruses go through 'shift and drift', explained Mark Miller, an epidemiologist at the US National Institutes of Health's Fogarty International Center.

"In previous pandemics we had a shift in the type of virus that is dominant," and then a process of 'drift' and it changed slightly from year-to-year.

The deadly 1918 "Spanish flu" -- which left some 40 million dead -- was an H1 virus, and dominated unchallenged until 1956 when a new "H2" variant swept across the globe.

"It pretty much at a stroke replaced the H1N1. It is still amazing how that happened -- nobody really knows why," Dimmock said.

The same thing happened a dozen years later, when the "H3" knocked its predecessor off the world stage. This led scientists to conclude that any new pandemic strain replaces the seasonal one descendent from the previous pandemic.

"But then the H1N1 reappeared in 1977, very similar to the strains circulating in the mid-1950s, and it has been co-circulating with the H3N2 up until the start of this year," Dimmock said.

It was unclear based on the WHO's statement, he added, whether people would need to vaccinate against only the new swine flu virus, or against the two strains that have been around for decades as well.

"If the pandemic H1N1 has replaced the other strains, as happened in 1957 and 1968, then you don't need the old vaccine," Dimmock said by phone.

"But if they continue to co-circulate, even if it is dominant, then you are going to need a vaccine with three type-A components -- and a seasonal B."

The vaccines can be combined into a single shot, or given separately he said.

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Britain, France get first batches of swine flu vaccine
London (AFP) Aug 27, 2009
Britain and France have received their first batches of swine flu vaccine, officials said Thursday, as governments began to arm themselves against a second wave of the pandemic in the northern winter. The World Health Organization has been warning governments for months to brace for a resurgence of the A(H1N1) virus when the cold season hits the northern hemisphere. The doses to combat ... read more

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