Monday, May 4, 2009

WHO warns against flu complacency

It is no longer possible to contain the deadly swine flu virus first found in Mexico, the World Health Organization (WHO) says. Governments around the world have been stepping up precautions against its spread.

AFRICA

Ghana

The authorities have banned imports of pork and pork products. The country has drugs available and a quarantine system in place should any cases be identified.

Kenya

Officials are monitoring visitors who have come from infected areas such as the US, Canada, Israel, Spain and the UK.

Morocco

Official stocks of Tamiflu are sufficient for 1m of the 34m people who live there. Health and airport workers are being issued with gloves, surgical boots and masks.

Nigeria

In Africa's most populous state, health minister Babatunde Osotimehin told the BBC his government was increasing surveillance, providing information about the disease to the public and medical centres, and making sure there were sufficient supplies of anti-viral drugs. Nigeria was badly hit by bird flu three years ago.

South Africa

Response teams have been mobilised outbreak in all provinces. Tests on two women who became sick after returning from Mexico have both proved negative.

Sudan

The government has banned any person arriving directly from Mexico from entering the country. Transit passengers arriving from countries where problems relating to the disease were reported are kept in a room at the airport for 4 - 7 days. If a passenger shows symptoms then we will deal with all the passengers on the plane, local media reported a health official said. Sudan says it has the capability to treat 45,000 cases.

Uganda

The avian flu National Taskforce has been revived to deal with the new threat. Officials say they have 10,000 doses of Oseltamivir, a cheap generic version of Tamiflu, in stock.

Zambia

The authorities have formed an emergency task force to deal with a possible outbreak of swine flu.

Zimbabwe

Teams have been deployed at ports of entry to check for suspected flu cases. But Zimbabwe does not have enough drugs in stock to treat a swine flu outbreak. It is asking the regional WHO office for supplies.

AMERICAS

Argentina

The health authorities have been ordered to watch for an increase in respiratory illnesses and to promote vaccinations and preventative hygiene habits among health workers and the public. Flight crews have been urged to tell the authorities immediately if they or passengers experience any flu-like symptoms on flights from Mexico. The immigration authorities have been asked to provide information about passengers who arrived from Mexico in the last 15 days. The health ministry has said the stocks of Tamiflu are enough to provide 500,000 treatments, the Argentine press reported.

Belize

This country on the Mexico's south-eastern border has ordered the cancellation of all major events which involve big public gatherings. These range from a reggae concert to the national agriculture and trade show, and performances by a visiting circus from neighbouring Guatemala.

Bolivia

The government has declared a "state of health alert". National director of epidemiology Eddy Martinez said the control mechanisms for swine flu are based on what was done to prevent bird flu. If a case of swine flu were found in Bolivia, health-service workers would be transferred to all airports and border areas, he said.

Brazil

Monitoring of passengers, initially restricted to those arriving from Mexico and US, has been extended to all international flights. The health ministry says it has the ability to handle 12,500 patients immediately; it has started to distribute medication giving priority to Rio de Janeiro and Sao Paulo, states which receive the highest number of passengers from abroad. The authorities are also building stockpiles of medicines in other cities such as Recife, where international flights also arrive.

Travellers arriving from the US and Mexico are being advised to avoid close contact with other people for the first 48 hours after their arrival. Arrivals from Mexico are having their luggage sterilised.

Canada

After cases were confirmed in Canada - all involving only mild illness - the government said it was stepping up surveillance for possible new cases and urged people to take precautions like frequent hand-washing.

AMERICAS

Argentina

The health authorities have been ordered to watch for an increase in respiratory illnesses and to promote vaccinations and preventative hygiene habits among health workers and the public. Flight crews have been urged to tell the authorities immediately if they or passengers experience any flu-like symptoms on flights from Mexico. The immigration authorities have been asked to provide information about passengers who arrived from Mexico in the last 15 days. The health ministry has said the stocks of Tamiflu are enough to provide 500,000 treatments, the Argentine press reported.

Belize

This country on the Mexico's south-eastern border has ordered the cancellation of all major events which involve big public gatherings. These range from a reggae concert to the national agriculture and trade show, and performances by a visiting circus from neighbouring Guatemala.

Bolivia

The government has declared a "state of health alert". National director of epidemiology Eddy Martinez said the control mechanisms for swine flu are based on what was done to prevent bird flu. If a case of swine flu were found in Bolivia, health-service workers would be transferred to all airports and border areas, he said.

Brazil

Monitoring of passengers, initially restricted to those arriving from Mexico and US, has been extended to all international flights. The health ministry says it has the ability to handle 12,500 patients immediately; it has started to distribute medication giving priority to Rio de Janeiro and Sao Paulo, states which receive the highest number of passengers from abroad. The authorities are also building stockpiles of medicines in other cities such as Recife, where international flights also arrive.

Travellers arriving from the US and Mexico are being advised to avoid close contact with other people for the first 48 hours after their arrival. Arrivals from Mexico are having their luggage sterilised.

Canada

After cases were confirmed in Canada - all involving only mild illness - the government said it was stepping up surveillance for possible new cases and urged people to take precautions like frequent hand-washing.

AMERICAS

Argentina

The health authorities have been ordered to watch for an increase in respiratory illnesses and to promote vaccinations and preventative hygiene habits among health workers and the public. Flight crews have been urged to tell the authorities immediately if they or passengers experience any flu-like symptoms on flights from Mexico. The immigration authorities have been asked to provide information about passengers who arrived from Mexico in the last 15 days. The health ministry has said the stocks of Tamiflu are enough to provide 500,000 treatments, the Argentine press reported.

Belize

This country on the Mexico's south-eastern border has ordered the cancellation of all major events which involve big public gatherings. These range from a reggae concert to the national agriculture and trade show, and performances by a visiting circus from neighbouring Guatemala.

Bolivia

The government has declared a "state of health alert". National director of epidemiology Eddy Martinez said the control mechanisms for swine flu are based on what was done to prevent bird flu. If a case of swine flu were found in Bolivia, health-service workers would be transferred to all airports and border areas, he said.

Brazil

Monitoring of passengers, initially restricted to those arriving from Mexico and US, has been extended to all international flights. The health ministry says it has the ability to handle 12,500 patients immediately; it has started to distribute medication giving priority to Rio de Janeiro and Sao Paulo, states which receive the highest number of passengers from abroad. The authorities are also building stockpiles of medicines in other cities such as Recife, where international flights also arrive.

Travellers arriving from the US and Mexico are being advised to avoid close contact with other people for the first 48 hours after their arrival. Arrivals from Mexico are having their luggage sterilised.

Canada

After cases were confirmed in Canada - all involving only mild illness - the government said it was stepping up surveillance for possible new cases and urged people to take precautions like frequent hand-washing.

ASIA-PACIFIC

Australia

Ministers have approved new powers to detain and disinfect people suspected of carrying swine flu. All incoming flights have to declare any suspected flu cases on arrival. Thermal scanners and extra medical staff are also being sent to airports for screening of incoming passengers. With 8.7 million doses of Tamiflu and Relenza drugs stockpiled, Australia has enough anti-viral drugs to cover about 41% of its 21m population. It also has large stores of surgical masks.

Cambodia

The authorities have taken protective measures including setting up thermal scanners at airports to check arriving passengers for possible swine flu cases. Prime Minster Hun Sen has made a personal plea for Cambodians to continue to eat pork as usual. "The infection does not come by eating pork," he said.

China

The authorities appear to have learned the lessons of previous deadly virus outbreaks such as the H5N1 avian flu and Sars (Severe Acute Respiratory Syndrome), and this time around have been quick to share information with the WHO. The central government has put in place a joint prevention and control system and hospitals have been told to report any suspected cases of swine flu swiftly. The official press is primed to report swiftly on cases of infection.

Citizens have been advised not to make tourist trips to Mexico and body temperature checks on passengers and crew at ports of entry have been re-introduced. Stockpiles of disease control equipment, anti-viral drugs and clinical equipment have been increased. China has also banned imports of pork and pork products from Mexico and the US states of Texas, Kansas and California. The quarantining of up to 70 Mexicans who did not show any flu symptoms prompted complaints from the Mexican ambassador in China.

Hong Kong

Hong Kong authorities have 20m doses of Tamiflu and other anti-flu medication, media reports say. Port health protection measures have been increased, including body temperature screening machines at all checkpoints. About 400 guests and staff at a hotel were quarantined for a week following the diagnosis of a guest with swine flu.

Indonesia

Temperature scanners have been installed at 10 airports and ports with immediate effect. At least 3m Tamiflu capsules are in stock. Imports of pigs and pork products have been completely banned.

Japan

Passengers from Mexico, Canada and the US are being checked at international airports. Officials are inspecting all imported pigs across the country (about 420 pigs were imported in 2008). The central government has Tamiflu and Relenza combined stockpiles which would cover nearly 20% of the population. New supplies of anti-viral drugs to treat 8.3m people have been ordered. Local governments have their own stockpiles but figures are not available.

Kyrgyzstan

The import of meat products from the US and Mexico has been temporarily banned.

Malaysia

Tamiflu stockpile covering more than 2m people out of a population of 27m. It does not have a stockpile of personal protection equipment such as masks for the general population yet, but has a supply for health staff who will be dealing with any outbreak.

New Zealand

With the first confirmed cases in the region, public health officials say they have "ample stocks" of anti-flu drugs. The country built up a stockpile after the bird flu scare sufficient to cover 25-30% of the 4.3m population.

Philippines

Airports are equipped with thermal scanners, and additional medical staff have been hired. The government says it has enough Tamiflu for 60,000 possible cases and is buying 10m pesos ($206,000) worth of additional Tamiflu. This covers a fraction of the Philippine population of 90 million. Government says there are sufficient masks in stock.

Singapore

Anyone who has visited Mexico in the past seven days has been instructed to remain at home in self imposed quarantine for a week and to keep in contact by telephone with officials monitoring flu symptoms.

Thermal scanners are set up at airports and isolation units at hospitals, where staff at some emergency departments are wearing full protective clothing. Asean has 500,000 courses of anti-virals stockpiled in Singapore (and a similar amount distributed among member states).

South Korea

The agriculture ministry has suspended imports of live pigs from North America and recommended its nationals leave Mexico unless on urgent business. Health authorities have a Tamiflu stockpile for 2.5 million people and are working to increase that to 10% of the population of about 49 million.

Taiwan

Taiwan currently has supplies of swine flu treatment to cover 10% of its 23m population. More than 1m facemasks for emergency use are available.

Thailand

The government has 320,000 courses of Tamiflu stockpiled. GPO, a state-owned drug-maker, can produce 1m capsules of generic Tamiflu if needed. Temperature screening checkpoints are in place at international airports in Bangkok, Chiang Mai and Phuket. The main targets for the thermal scanners were passengers on eight routes - from France, Tokyo, Dubai, Frankfurt, London, Chicago, Los Angeles and Texas - which had connecting flights from Mexico. Suspected cases of new arrivals will be put under close surveillance for three to five days during their stay in Thailand.

Vietnam

Ho Chi Minh City, Vietnam's largest city of more than 8m people, has stocks of Tamiflu sufficient for a million people.

EUROPE

Austria

The authorities have stocks of anti-viral drugs sufficient to treat 4m people (half the population), and have secured production capacity for prophylactic vaccines for the entire population. They have also stockpiled 8m protective masks.

Belgium

The country has 500,000 anti-viral treatments and the capacity to make 2m more. In addition, it has 32m masks for patients and 6m for healthcare professionals.

Bulgaria

Customs officers are checking the luggage of passengers arriving from Mexico, the US, Canada and Japan to ensure they are not importing pork products. Two thermal scanners have been installed at Sofia airport.

Czech Republic

The country has stocks of 2m doses of Tamiflu, enough to treat 20% of the population. General information on the viral strain has been circulated to hospitals, doctors and GPs. At Prague Airport, information boards on swine flu have been put up and medical examinations are available.

Denmark

A general pandemic plan has been in place since the bird flu scare. Denmark has stockpiled Tamiflu.

Finland

More than 90,000 doses of anti-viral medication have already been stockpiled. An additional 880,000 doses of the Relenza are to be acquired.

France

French nationals have been advised not to travel to Mexico. A national information campaign will be launched next week. Passengers arriving from Mexico will be tracked and their health checked. France has a stock of more than 30m anti-viral treatments, composed of 24m doses of Tamiflu and 9m doses of Relenza.

Germany

Nationals have been advised against non-vital travel to Mexico.

Greece

Passengers coming from countries where swine flu has occurred are being tracked and doctors at the airport will carry out checks. The country has "strategic stocks" of Tamiflu and other anti-viral medication.

Hungary

Medical imaging cameras have been installed in Budapest's main Ferihegy airport. The cameras are linked to computers which analyse the electromagnetic radiation of the human body to screen passengers for signs of the flu infection.

Italy

Pamphlets are being handed out to passengers at Rome's international airport, although there are no restrictions on travel. Italy has 10m doses of Zanamivir (Relenza) and 60,000 doses of Tamiflu, as well as enough Tamiflu powder to make 30m doses.

The Netherlands

The Dutch government is acquiring 19m doses of anti-viral medication.

Norway

A "pandemic committee" will be assembled this week. Authorities have stored flu medicine covering one-third of the 4.7m population.

Portugal

Has stocks of 2.5m doses of Tamiflu - enough for a quarter of the population.

Russia

Air crew arriving from the Americas have been told to look out for passengers with flu-like symptoms. Planes with suspected cases are sent to special airport zones, where passengers and crew can be examined by medics. Curbs have been imposed on meat imports from Mexico, a number of US states and the Caribbean.

Slovakia

With population of 5.4 million, it has around 700,000 doses of Tamiflu in official reserves.

Slovenia

The authorities have 500,000 doses of Tamiflu, which is sufficient to treat a quarter of the population.

Spain

The first European country to confirm a case of the virus, in a man who had recently returned from Mexico, Spain is distributing leaflets to other passengers arriving from there, advising them to report to a health centre if they suffer symptoms. Spain has a stockpile of 10m doses of Tamiflu. Flights to Mexico are being supplied with masks and gloves.

UK

Health ministry launches "Catch it, Bin it, Kill it!" campaign on tv, radio and internet to urge people to use tissues when they sneeze, dispose of them and then wash their hands. Leaflets giving advice about the new H1N1 swine flu virus are to be sent to every home in Britain. But health authorities are not advising the general public to wear masks.

A Scottish couple who spent their honeymoon in Mexico were the UK's first confirmed case of swine flu. The British government stresses it has enough anti-viral drugs to treat more than half the population if necessary.

Ukraine

Imports of live pigs and pork meat from countries where cases of swine flu have been recorded, including Mexico, the US, Canada and New Zealand, have been banned. All shipments received after 21 April will be subject to the ban.

MIDDLE EAST

Egypt

A cull has been ordered of all pigs in the country. The animals are mainly eaten by members of the Coptic Christian minority in the largely Muslim state.

Experts say the flu cannot be caught from eating pig meat, and there is no scientific rationale for slaughtering pigs or banning pork.

The authorities have increased numbers of medical staff at Cairo airport to check passengers arriving from Mexico and will monitor them during their stay.

Israel

The Israeli government has stepped up preventive measures ordering travellers returning from Mexico to undergo medical checks at airports or other points of entry. A "crisis cell" has been formed in the defence ministry to deal with the outbreak were the disease to spread inside the country. Israel, Jordan and the Palestinian Authority will hold a joint meeting "to discuss ways to prevent the spreading of the epidemic," Israel's foreign ministry announced.

Jordan

The health ministry has set up a telephone advice line to answer question about the disease and its symptoms; a pamphlet on the disease will be distributed in hospitals and health centres. A medical team is screening air travellers arriving from flu-infected areas.

Kuwait

The government has 10m capsules of Tamiflu, enough for 1m flu patients, roughly the number of Kuwaitis. Of the 3.44m people who live in the state 2.35m are foreigners.

Lebanon

Among the reported measures to prevent contagion, Health Minister Mohammad Khalifeh has issued advice for schools and employers and suggested people should avoid "social kissing".

SOUTH ASIA

Bangladesh

Travellers, particularly those coming from countries already hit by swine flu, are to be screened by teams comprising medical officers, epidemiologists and representatives from the WHO and the International Centre for Diarrhoeal Diseases Research in Bangladesh.

India

Preventative measures such as surveillance at ports and nine international airports have been taken, and people have been advised to defer non-essential travel to the affected areas. About 50,000 passengers who have come from countries affected by swine flu have been traced and checks would be carried out on them, a senior health official Vineet Chaudhary said.

The states within India have been advised to review their preparedness to investigate and contain any suspected cluster of swine flu cases, with central government providing expert, logistics and laboratory support. A toll-free call centre number has been set up for the public to report incidents of illness.

An Indian newspaper reports that the drug company Cipla has received orders from Latin America, Mexico and Israel for the anti-viral Tamiflu. India has stockpiles of 1m Tamiflu doses and is taking steps to stockpile up to 10m doses.

Nepal

Visitors from the US and Mexico will be screened, local media report. A team of health professionals will be stationed at Tribhuvan International Airport with a health-related questionnaire and take immediate action if anyone is suspected to have contracted the flu.

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