Chan hits back at WHO critics

The head of the World Health Organisation hit back at critics who have accused it of over-reaction to the swine flu crisis, warning it may comeback “with a vengeance” in the months ahead.

In her first extensive media interview since alerting the world to a possible flu epidemic 9 days ago, Margaret Chan, the agency’s director-general, told the Financial Times that the end of the flu season in the northern hemisphere meant an initial outbreak could be milder but then a second wave more lethal, as happened in 1918.

New information from Mexico indicated the affect of the flu could be less than at first believed. José Angel Cordova, health minister said the flu virus epidemic had passed its peak and was waning. “The evolution of the epidemic is now in its phase of decline,” he said.

The Mexican government, which had already scaled back its first count of 176 deaths, said 19 of the suspected 100 deaths from the H1N1 virus had been confirmed.

But Ms Chan warned that an apparent decline in mortality rates outside and within Mexico didn't intend the pandemic was ending.

“We hope the virus fizzles out, because if it doesn’t we are heading for a big outbreak.” But she said: “I’m not anticipating the pandemic will amplify, but if I miss it and we don’t prepare, I fail. I’d rather over-prepare than not prepare.”

She emphasized that a likely increase to the agency’s maximum “level 6” pandemic alert didn't needfully mean “every country and all humans will be affected” with many more deaths.

Instead “it is a sign to public health agencies to take suitable steps” such as intensified disease surveillance.

Ms Chan admitted frustration with slow release of information on the threat posed by the virus. But she defended Mexico as very co-operative but overwhelmed by extending treatment and limiting the spread of infection as well as analyzing cases. She added: “The data is starting to roll in.”

“These countries are so overwhelmed. Other countries may anticipate a lot of information now. But people need to allow time for the epidemiology, laboratory and clinical data. ”

She repeated the WHO’s perspective based on “the evidence and science available to us” that travel limitations were counterproductive. Although countries had the right under international health regulations to take different measures, they would need to justify them publicly.

But she supported recent decisions such as that of Hong Kong and New Zealand to quarantine travellers arriving with suspected flu.

Ms Chan called on pharmaceutical companies to increase their contributions, praising their efforts so far but asking for fresh donations and for larger numbers of drugs and vaccines at lower costs to help care for and protect the poor.

She had released most of the WHO’s stockpile of the antiviral medicine Tamiflu provided by Roche, its manufacturer, which had already agreed to provide more and to propose lower costs.

She suggested new methods to encourage generic companies to develop inexpensive variations of Tamiflu to expand capacity.

First US death from Swine Flu

A 23-month-old toddler passed away in Texas from the swine flu virus as agencies in the U.S. and around the global scrambled to contain a raising global health imperil that has also dragged Germany onto the roster of afflicted nations.

"Even though we've been expecting this, it is very, very sad," said Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention. "As a pediatrician and a parent, my heart goes out to the family."

Learn how you can protect yourself from Swine Flu.

In what has become standard procedure in this widening health crisis, Besser went from network to network Wednesday morning to give an update on what the Obama administration is doing. He said agencies in essence are still "trying to learn more about this strain of the flu." His appearances as Germany reported its first cases of swine flu infection, with three victims.

"It's very crucial that people take their concern and channel it into action," Besser said, adding that "it is crucial that people understand what they need to do if symptoms appear.

"I don't think it (the reported death in Texas) indicates any change in the strain," he said. "We see with any flu virus a spectrum of disease symptoms."
66 infections had been reported in the U.S. before the report of the toddler's death in Texas.

The world has no vaccine to prevent infection but United States health officials aim to have a key ingredient for one ready in early May, the big step that vaccine manufacturing business are awaiting. But even if the World Health Organization ordered up emergency vaccine supplies — and that decision hasn't been made yet — it would take at least two more months to produce the initial shots needed for human safety testing.

"We're working together at 100 miles an hour to get material that will be useful," Dr. Jesse Goodman, who oversees the FDA swine flu work, told The Associated Press.

The United States is transporting to states not only enough anti-flu medication for a million people, but also masks, hospital supplies and flu test kits. President Barack Obama asked Congress for $1.5 billion in emergency funds to help build more drug stockpiles and monitor future cases, as well as facilitate global efforts to avoid a full-fledged epidemic.

"It's a very serious possibility, but it is still too early to say that this is inevitable," the WHO's flu chief, Dr. Keiji Fukuda, told a telephone news conference.

Cuba and Argentina banned flights to Mexico, where swine flu is suspected of killing more than 150 people and sickening well over 2,000. In a bit of good news, Mexico's health secretary, Jose Cordova, late Tuesday called the death toll there "more or less stable."

Mexico City, one of the world's largest cities, has taken forceful steps to curb the virus' spread, starting with closing down schools and on Tues expanding closures to gyms and swimming pools and even telling restaurants to limit service to takeout. People who venture out tend to wear masks in hopes of protection.

The number of confirmed swine flu cases in the U.S. rose to sixty-six in 6 states, with forty-five in NY, eleven in Calif., six in TX, two in KS and one each in Indiana and Ohio, but cities and states suspected more. In NY, the city's health commissioner said "many hundreds" of school children were sick at a school where a few students had confirmed cases.

New Zealand, Australia, Israel, Britain, Canada and now Germany have also reported cases.
But only in Mexico so far are there confirmed deaths, and scientists remain baffled as to why.

The WHO argues against closing down borders to halt the spread, and the United States — although checking arriving travelers for the ill who may need care — agrees it's too late for that tactic.

"Sealing off a border as an approach to containment is something that has been talked over and it was our planning assumption should an outbreak of a new strain of flu occur overseas. We had plans for trying to swoop in and knockout or quench an outbreak if it were occurring far from our borders. That's not the case here," Besser told a telephone briefing of Nevada-based health providers and reporters. "The idea of trying to confine the spread to Mexico is not possible at all."

"Border controls do not work. Travel restrictions do not work," WHO spokesman Gregory Hartl said in Geneva, recalling the SARS epidemic earlier in the decade that wiped out 774 people, mostly in Asia, and slowed the global economy.

Authorities sought to keep the crisis in context: Flu deaths are common around the world. In the United States alone, the Center for Disease Control and Prevention says about 36,000 people a year die of flu-related causes. Still, the CDC calls the new strain a combining of pig, bird and human viruses for which people may have limited natural immunity.

Therefore the need for a vaccine. Using samples of the flu taken from people who fell ill in Mexico and the United States, scientists are engineering a strain that could trigger the immune system without causing illness. The desire is to get that element — called a "reference strain" in vaccine jargon — to manufacturers around the second week of May, so they can begin their own laborious production work, said CDC's Dr. Ruben Donis, who is directing that effort.

Vaccine manufacturers are just beginning production for next winter's regular influenza vaccine, which protects against 3 human flu strains. The WHO wants them to stay with that course of action for now — it won't call for mass output of a swine flu vaccine unless the outbreak worsens globally.

But sometimes new flu strains pop up briefly at the end of one flu season and disappear only to reappear the next autumn, and at the very least there should be a vaccine in time for next winter's flu season, Dr. Anthony Fauci, the National Institutes of Health's infectious diseases chief, said Tuesday.