26 April 2009 9:18am, Manila time
No less than the World Health Organization (WHO) has raised the warning that the current swine flu virus could lead to a global pandemic. The virus has been linked to the reported death of 68 people in Mexico and has caused the illness of at least a thousand more prompting the Mexican government to shut down schools, museums, libraries and other public places in Mexico City.
Associated Press is quoting WHO spokesperson Thomas Abraham as saying, "We are very, very concerned. We have what appears to be a novel virus and it has spread from human to human." The report also attributes to Abraham the statement that 'if international spread is confirmed, that meets WHO's criteria for raising the pandemic alert level.'
A news report I saw about an hour ago on BBC News World Report tells of a rare WHO emergency meeting in Geneva to deal with the developing crisis. It showed WHO Director General Dr. Margaret Chan urging nations around the world to "heighten surveillance" to determine whether infection is happening in places other than the United States and Mexico.
Even as I write,
MSNBC is reporting that another two swine flu cases have been confirmed in Kansas and possibly another eight in New York City. This brings to 11 the number of confirmed instances of swine flu virus in the United States: 7 in California, 2 in Texas and 2 in Kansas.
In Canada,
The Toronto Star has quoted Dr. Donald Low of the Mount Sinai Hospital as saying that "it is just a matter of time before we recognize it here":
There was no word today from the Public Health Agency of Canada. On Friday, Canada’s Chief Public Health Officer Dr. David Butler-Jones said there were no cases yet in this country.
With the mounting evidence of efficient person-to-person spread, infectious disease experts suggested Canada is likely to see its first cases soon.
“We now apparently have widespread swine H1N1 throughout the United States which tells us that it is highly infectious, therefore having all the makings of the next pandemic strain,” said Dr. Donald Low, chief microbiologist at Toronto’s Mount Sinai Hospital.
“It is just a matter of time before we recognize it here.”
The paper's
HealthZone was even more anticipatory, saying:
The new strain of swine influenza is likely already in Ontario, said Dr. Michael Gardam, one of Ontario's top infectious disease specialists, because about 60,000 people return to the province from Mexico every month.
"We have to assume that it is circulating in Ontario," he said. "You just have to look at air travel patterns to realize that what goes on in Mexico has to come to Canada."
With the spectre of SARS still looming over the Toronto area, local infectious disease experts are emphasizing the new strain of swine flu should not be compared to the severe acute respiratory syndrome that swept the city in 2003 and killed 44 people.
The present situation has the elements of an explosive sci-fi thriller that might just become true. And it has a precedent in history. We need to head back in time, towards the end of the First World War, to find history's greatest killer, the Spanish influenza pandemic of 1918-1919.
The "Spanish" influenza pandemic of 1918–1919, which caused ≈50 million deaths worldwide, remains an ominous warning to public health. Many questions about its origins, its unusual epidemiologic features, and the basis of its pathogenicity remain unanswered. The public health implications of the pandemic therefore remain in doubt even as we now grapple with the feared emergence of a pandemic caused by H5N1 or other virus. However, new information about the 1918 virus is emerging, for example, sequencing of the entire genome from archival autopsy tissues. But, the viral genome alone is unlikely to provide answers to some critical questions. Understanding the 1918 pandemic and its implications for future pandemics requires careful experimentation and in-depth historical analysis.
An estimated one third of the world's population (or ≈500 million persons) were infected and had clinically apparent illnesses during the 1918–1919 influenza pandemic. The disease was exceptionally severe. Case-fatality rates were>2.5%, compared to <0.1%>). Total deaths were estimated at ≈50 million and were arguably as high as 100 million.
That was ninety-one (91) years ago and the world is now better prepared, hopefully, to deal with this lethal menace.
More when we return.
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