PAHO Urges Southern Hemisphere to Remain Alert for Influenza A(H1N1)

Expert says stigmatization of affected people and countries is unwarranted

Washington, D.C., May 5, 2009 (PAHO/WHO) – While the vast majority of confirmed cases of influenza A(H1N1) have been in the Northern Hemisphere, a top Pan American Health Organization (PAHO) expert today cautioned that Southern Hemisphere countries should remain on high alert, as their winter season is just now beginning.

“There is a strong likelihood that there will be an upsurge of cases in your countries,” said Dr. Jon K. Andrus, PAHO’s lead senior technical advisor in immunizations. “Implementing your pandemic plans is very important. Most countries are already protecting their populations with seasonal vaccination as we speak. In addition, most, if not all, of our Southern Hemisphere countries have already enhanced their surveillance and monitoring procedures. The challenge will be not to drop your guard.”

North America (Mexico, the United States and Canada) currently accounts for all but 7 of the total 1,255 confirmed influenza A(H1N1) cases in the Americas. Three other countries in the PAHO region have reported the 7 additional cases: Colombia (1), Costa Rica (4), and El Salvador (2).

Andrus noted that WHO’s pandemic alert level could be raised from 5 to 6 if sustained community transmission of influenza A(H1N1) were to be found in another WHO region.

“In our region, most countries are already implementing their emergency plans,” said Andrus. “The term phase 6 is more relevant for the rest of the world than it is for us because we are already implementing our emergency plans.”

Andrus emphasized that PAHO and the World Health Organization (WHO) are recommending that countries not impose travel restrictions nor close borders.

“We would also like to emphasize that countries around the world should be fair with individuals. It is not helpful to blame or stigmatize people who happen to be citizens of affected countries or happen to become victims of the disease.”

Andrus also described how Mexico is currently handling suspected cases of influenza A(H1N1).

First, providers decide whether a patient’s symptoms warrant a test for influenza A. If appropriate, treatment is provided. Next, depending upon the facility’s capabilities, the specimen is tested on site or sent to a reference laboratory for analysis. If the result is positive for influenza A, the patient is classified as a probable case, and the specimen is sent to a more specialized lab to determine if it is positive for influenza A(H1N1). If the result is positive, the case is considered confirmed.

Subsequent investigation focuses on when and where the patient may have been infected, and who else might have been exposed. Known contacts are notified and tested as well.

In addition, virologists study the virus’s genetic makeup to better understand it and determine how it may be mutating.

“I hope you can begin to imagine the huge volume of effort that all this work entails,” Andrus said. He added that PAHO, the Public Health Agency of Canada, and the U.S. Centers for Disease Control and Prevention (CDC) are assisting these efforts by mobilizing their own experts as well as others from countries throughout the hemisphere.

“We have never had such close surveillance of the emergence of a new virus such as for this new influenza A(H1N1) virus,” said Andrus, “and so we are learning as we go.”

PAHO, founded in 1902, works with all the countries of the Americas to improve the health and quality of life of their peoples. It also serves as the Regional Office for the Americas of the World Health Organization (WHO).
For more information, please contact Donna Eberwine-Villagran, eberwind@paho.org This e-mail address is being protected from spam bots, you need JavaScript enabled to view it , Tel +1 202 974 3122, fax +1 202 974 3143 or Daniel Epstein, email: epsteind@paho.org This e-mail address is being protected from spam bots, you need JavaScript enabled to view it , Tel +1 202 974 3459 – mobile +1 202 316 5679, fax +1 202 974 3143 – www.paho.org

PAHO Urges Southern Hemisphere to Remain Alert for Influenza A(H1N1)

Expert says stigmatization of affected people and countries is unwarranted

Washington, D.C., May 5, 2009 (PAHO/WHO) – While the vast majority of confirmed cases of influenza A(H1N1) have been in the Northern Hemisphere, a top Pan American Health Organization (PAHO) expert today cautioned that Southern Hemisphere countries should remain on high alert, as their winter season is just now beginning.

“There is a strong likelihood that there will be an upsurge of cases in your countries,” said Dr. Jon K. Andrus, PAHO’s lead senior technical advisor in immunizations. “Implementing your pandemic plans is very important. Most countries are already protecting their populations with seasonal vaccination as we speak. In addition, most, if not all, of our Southern Hemisphere countries have already enhanced their surveillance and monitoring procedures. The challenge will be not to drop your guard.”

North America (Mexico, the United States and Canada) currently accounts for all but 7 of the total 1,255 confirmed influenza A(H1N1) cases in the Americas. Three other countries in the PAHO region have reported the 7 additional cases: Colombia (1), Costa Rica (4), and El Salvador (2).

Andrus noted that WHO’s pandemic alert level could be raised from 5 to 6 if sustained community transmission of influenza A(H1N1) were to be found in another WHO region.

“In our region, most countries are already implementing their emergency plans,” said Andrus. “The term phase 6 is more relevant for the rest of the world than it is for us because we are already implementing our emergency plans.”

Andrus emphasized that PAHO and the World Health Organization (WHO) are recommending that countries not impose travel restrictions nor close borders.

“We would also like to emphasize that countries around the world should be fair with individuals. It is not helpful to blame or stigmatize people who happen to be citizens of affected countries or happen to become victims of the disease.”

Andrus also described how Mexico is currently handling suspected cases of influenza A(H1N1).

First, providers decide whether a patient’s symptoms warrant a test for influenza A. If appropriate, treatment is provided. Next, depending upon the facility’s capabilities, the specimen is tested on site or sent to a reference laboratory for analysis. If the result is positive for influenza A, the patient is classified as a probable case, and the specimen is sent to a more specialized lab to determine if it is positive for influenza A(H1N1). If the result is positive, the case is considered confirmed.

Subsequent investigation focuses on when and where the patient may have been infected, and who else might have been exposed. Known contacts are notified and tested as well.

In addition, virologists study the virus’s genetic makeup to better understand it and determine how it may be mutating.

“I hope you can begin to imagine the huge volume of effort that all this work entails,” Andrus said. He added that PAHO, the Public Health Agency of Canada, and the U.S. Centers for Disease Control and Prevention (CDC) are assisting these efforts by mobilizing their own experts as well as others from countries throughout the hemisphere.

“We have never had such close surveillance of the emergence of a new virus such as for this new influenza A(H1N1) virus,” said Andrus, “and so we are learning as we go.”

PAHO, founded in 1902, works with all the countries of the Americas to improve the health and quality of life of their peoples. It also serves as the Regional Office for the Americas of the World Health Organization (WHO).
For more information, please contact Donna Eberwine-Villagran, eberwind@paho.org This e-mail address is being protected from spam bots, you need JavaScript enabled to view it , Tel +1 202 974 3122, fax +1 202 974 3143 or Daniel Epstein, email: epsteind@paho.org This e-mail address is being protected from spam bots, you need JavaScript enabled to view it , Tel +1 202 974 3459 – mobile +1 202 316 5679, fax +1 202 974 3143 – www.paho.org

Tips for journalists covering swine flu

Nieman Reports, part of the Nieman Foundation for Journalism at Harvard University, has published a comprehensive resource for journalists about coverage of a pandemic flu, available at http://www.nieman.harvard.edu/newsitem.aspx?id=100114. The information comes from a conference held at the Nieman Foundation during the time when the concern about the potential of Avian Flu to evolve into a human flu epidemic was high. In the report, journalists at The Associated Press, Reuters and CNN pass along valuable information about how their newsrooms prepared to cover flu outbreaks and shared insights about their on-the-ground frontline coverage. Also, Al Tompkins at the Poynter Institute has issued a series of tips, which include recommendations from the World Health Organization, available at: http://www.poynter.org/column.asp?id=2&aid=162623. (International Journalists Network)

Colleagues

At this point I think my biggest contribution to the anti-epidemic communication effort is to encourage the KMC team to follow up with the proposal to use RED SALUD to help health journalists to cover this (and other) epidemic.

I understand that Adelaida Trujillo has already been in touch directly with most of you. I am not aware of the current status of the negotiation.

Please find below a "coverage guide" put together by RED SALUD, with critical support of the Fundacion para el Nuevo Periodismo Iberoamericano. It also relies heavily on PAHO and WHO materials.

What is lacking maybe is plan on how to use RED SALUD strategically in this instance. PAHO needs to be part of this discussion. As you know this network of more than 2,000 health journalists was built with PAHO support.

I also spoke to Patria de los Rios regarding forwarding the messages prepared by KMC. In the case of RED SALUD, I kindly ask Patricia, Sonia and other colleagues to include Adelaida, Juana and Diego Fajardo in the mailing. They are copied in this email.

Thanks

Paulo

ORGANIZACIÓN PANAMERICANA DE LA SALUD
ORGANIZACIÓN MUNDIAL DE LA SALUD

Oficina Regional, Organización Mundial de la Salud
Noticias e Información Pública

Comunicado de prensa


La OPS insta a lograr el acceso equitativo a las vacunas antigripales

Washington, D. C., 3 de mayo del 2009 (OPS/OMS) - Garantizar el acceso de los países en desarrollo a las vacunas, incluida una posible vacuna contra el nuevo virus de la gripe A/H1N1, es de gran preocupación para la Organización Panamericana de la Salud (OPS), oficina regional para las Américas de la Organización Mundial de la Salud (OMS), de acuerdo con lo que señaló hoy un experto en vacunas de dicha organización durante una conferencia de prensa.

"La distribución equitativa de las vacunas en los países en desarrollo es una absoluta prioridad para la OPS", dijo el doctor Jon K. Andrus, principal asesor técnico de la OPS en materia de vacunación. "En la actualidad, varios fabricantes tienen contratos de preproducción con algunos países, lo que podría imponer algunas barreras para que los más pobres entre los pobres puedan tener acceso a las vacunas. Debemos mantener en marcha el apoyo y el diálogo para evitar una crisis humanitaria en caso de una insuficiencia de vacunas, particularmente si se agravara el brote actual".

La OPS y la OMS están trabajando activamente con sus centros colaboradores técnicos y con los fabricantes de vacunas para producir las cepas de virus para una eventual vacuna. Andrus, integrante del Grupo de Trabajo de la OPS/OMS para la vacuna contra la gripe por A/H1N1, indicó que se prevé que el suministro de la vacuna será de "entre 1.000 y 2.000 millones de dosis", lo cual no es suficiente para una población mundial de más de 6.000 millones de personas. Por lo tanto, subrayó que las estrategias de vacunación deberán dirigirse a las personas de alto riesgo.

"Los datos procedentes de México que permitan determinar los factores de riesgo de morbilidad y mortalidad serán críticos, no solo para México sino para el resto del mundo."
Andrus indicó también que la OPS y la OMS están trabajando para garantizar que los Estados Miembros tengan acceso equitativo al antivírico oseltamivir, que en estos momentos es eficaz contra el nuevo virus de la gripe A/H1N1. Tanto la OMS como la OPS cuentan con reservas del medicamento.

La OPS ha enviado a 27 expertos en epidemiología, logística, control de infecciones, comunicaciones y virología a México, donde colaboran estrechamente con los funcionarios de salud mexicanos.

"Como dijo el Secretario de Salud de México y como ha dicho la OMS desde Ginebra, todos han hecho lo posible para colaborar y responder a tiempo", dijo Andrus. "Lo que ahora hay que hacer es avanzar con ese mismo espíritu de colaboración".

Andrus explicó que los datos de los que se dispone en este momento indican que el brote de la nueva gripe por A/H1N1 es de "leve a moderado en cuanto a su gravedad". Por ejemplo, de los 160 casos registrados en los Estados Unidos, ha habido solo una defunción y cinco hospitalizaciones.

"No obstante, esto no quiere decir que la situación no pueda cambiar con mucha rapidez y de manera radical. Lo que sabemos de la gripe, y de los virus de ARN en general, es que son predeciblemente impredecibles. La respuesta rápida y resuelta de la OPS y la OMS ha sido apropiada dado que se trata de una cepa completamente nueva del virus de la gripe. Debemos estar alerta pero en calma, para no crear pánico ni perder la confianza pública".

Entre los nuevos países que han notificado casos del nuevo virus de la gripe A/H1N1 se encuentran dos países de América Latina: Colombia, con un caso confirmado, y Costa Rica, también con un caso confirmado. Junto con los Centros de Control y Prevención (CDC) de los Estados Unidos, la OPS está trabajando para asegurar la distribución de estuches de análisis rápido a sus Estados Miembros en América Latina y el Caribe, para que puedan hacer exámenes preliminares de los casos.

Andrus dijo que la OPS está haciendo un llamado a los países de América del Sur para que continúen la vacunación antigripal estacional dado que el hemisferio sur está entrando en estos momentos en el periodo de clima más frío y en la temporada ordinaria de gripe. La composición de la vacuna antigripal estacional actual para el hemisferio sur incluye una cepa de un virus H1N1 diferente (tipo Brisbane) y los datos hasta el momento indican que no ofrece protección cruzada para la nueva cepa A/H1N1.

Los mejores cálculos indican que una posible vacuna contra el nuevo virus de la gripe A/H1N1 estaría disponible en un plazo de entre 4 y 6 meses, antes de que en el hemisferio norte haya comenzado plenamente la temporada ordinaria de gripe. Mientras tanto, las personas deben poner en práctica los consejos de salud pública como cubrirse la boca con un pañuelo desechable cuando tosen o estornudan, lavarse las manos frecuentemente y posponer cualquier viaje si están enfermas. Los viajeros que regresen enfermos deben buscar atención médica. La OPS y la OMS recomiendan que los países no impongan restricciones a los viajes normales ni cierren fronteras. Andrus subrayó que comer carne de cerdo cocinada no conlleva riesgo de infección por el virus de la gripe.

Andrus señaló además que la OPS y sus Estados Miembros en la Región de las Américas han confrontado exitosamente otras grandes epidemias por medio de la colaboración estrecha, como la de poliomielitis, enfermedad que fue erradicada del continente antes que en las demás regiones de la OMS; la epidemia de cólera en los años noventa, que fue controlada satisfactoriamente por medio de una intervención conjunta panamericana de salud pública; y las epidemias de sarampión y rubéola, que están próximas a su erradicación en este continente.
"Cuando uno trabaja en la erradicación de enfermedades, cada día es una emergencia," dijo Andrus. "Cada día que pasa significa que más niños sufren de parálisis. Esto resulta inaceptable y, por eso, cada día ha de ser una emergencia si se trata de hacer el trabajo que se debe hacer. En el continente americano, los países han tenido mucho éxito con estas iniciativas de eliminación de enfermedades".

Se puede consultar el número de casos confirmados, las respuestas a preguntas frecuentes, las recomendaciones de salud pública y otras informaciones sobre los nuevos brotes de gripe por A/H1N1 en el sitio www.paho.org.

Video: http://www.youtube.com/watch?v=ZWQagYhzR5o&feature=PlayList&p=999921988037C964&index=0