WHO raises swine flu alert level

Reported April 27, 2009, GENEVA. By Elizabeth Weise, USA TODAY

The World Health Organization raised its global alert level Monday, signaling the swine flu virus was spreading from human to human in community outbreaks, but it stopped short of declaring a full-blown pandemic.

The organization's emergency committee had been meeting all day in Geneva to discuss the international epidemic which has now appeared in Mexico, the United States, Canada and Spain.

The move to raise the level from a Phase 3 Global Outbreak to a Phase 4 followed a decision by European Union Health Commissioner Androulla Vassiliou urging Europeans to postpone non-essential travel to parts of the United States and Mexico because of the virus.

If the disease turns out to have numerous areas where it is being actively transmitted from person to person, the pandemic would reach Alert Level 5. At Level 5, the virus has become widespread and vaccine production internationally would need to be switched from focusing on the normal flu season schedule to emergency pandemic production, according to WHO.

In addition, stocks of antiviral drugs might be shifted to areas hardest hit, and health care systems would begin to triage cases as the possibility of hospitals being overrun was high.

Phase 6 is the pandemic phase, meaning there are outbreaks in at least two regions of the world.

"We have never reached higher than a Phase 3," said Gregory Hartl, a spokesman for WHO.

WHO and the U.S. Centers for Disease Control said Monday that there are currently 40 confirmed cases in the United States; 26 in Mexico; 6 in Canada; and one in Spain.

President Obama said Monday that the threat of spreading swine flu infections is a cause for concern but "not a cause for alarm."

"We are closely monitoring the emerging cases of swine flu in the United States," Obama said.

Oil prices dipped to about $50 a barrel Monday as a strong dollar and new reports of swine flu threatened to slow summer travel and sent jitters through global markets.

At a news conference in Atlanta on Monday, Richard Besser, the acting head of the U.S. Centers for Disease Control, said the government is going to recommend non-essential travel to Mexico be avoided. The agency is distributing yellow cards outlining swine flu symptoms at U.S. ports of entry so travelers coming into the country can be on alert for potential illness.

Although he hopes the outbreak won't progress, Besser said people need to start thinking about what they would do if it does. Schools, churches and businesses all need to begin planning, he said.

"It's time for people to be thinking about: What would I do if my children's school were closed? What will I do about child care?" Businesses should review business plans, he said. "What would I do if some of my workers couldn't come to work?"

Masks may help people feel better, but except in an actual setting where one is coming face-to-face with someone who is actively ill, it's not actually protective, Besser said. "I would rather people really focus on hand washing," avoid shaking hands and kissing when they meet, he said.

"At this point I would not put a travel restriction or recommendation against coming to the United States," Besser said.

Besser said New York City had 20 more confirmed cases of swine flu, raising the city's total to 28. The additional cases are what brought the national total to 40 on Monday. Some of the students had returned from spring break in Mexico.

The outbreak has also sickened people in Kansas, California and Texas. Health officials in Michigan said they have one suspected case. Many of those people had recently visited Mexico.

A private school in South Carolina was closed Monday because of fears that young people returning from Mexico might have been infected.

South Dakota has two suspected cases of swine flu, state epidemiologist Lon Kightlinger said Monday

Test samples from two adult patients are being sent to the state health lab in Pierre for testing and results should be back Tuesday, Kightlinger said. The two recently traveled to Mexico.

Mexico still appeared to be the epicenter. It has 1,614 suspected swine flu cases and as many as 149 deaths in which the virus is suspected, according to Mexican Health Secretary Jose Angel Cordova. The CDC has confirmed only 26 deaths in Mexico.

Mexico City Health Secretary Armando Ahued Ortega said Monday that the death toll from suspected swine flu cases in the capital is now 22, up from 15. Seven more were confirmed dead on Sunday. At least 17 more people have flu symptoms. Officials said they were closing all schools in the nation.

The CDC is currently working on the creation of a vaccine for the disease. Thus far, the CDC has been able to grow the virus in eggs, the first stage in creating a vaccine. However the process is a long one and it generally takes five to six months for vaccines to be produced in sufficient quantities to be widely available, Hartl said.

Thus far, cases of this form of swine flu have been mild in the United States and Canada. Mexican patients are being hit the hardest. Doctors do not yet know why that is the case, Hartl said.

Although the European Union has called for travelers to avoid the United States and Mexico, WHO is very clear that it does not recommend any travel restrictions, Hartl said.

Contributing: Chris Hawley in Mexico City; Associated Press