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WHO sees swine flu tailing off in northern summer

Tunisia suspends Mecca pilgrimages due to swine flu
Tunisia suspended Saturday lesser pilgrimages to Mecca for fear of swine flu infection, but reserved judgment on whether the main hajj pilgrimage should be undertaken in November. As well as the annual hajj, which all Muslims are required to make once in a lifetime if they have the means, the faithful can also make a lesser pilgrimage to the holy places, known as omra, at any time of the year. The suspension of omra trips was "a necessary decision" which does not contradict Muslim doctrine, said Tunisian religious affairs minister Boubaker El Akhzouri. He was speaking to a crisis cell set up by Tunisia's health ministry, and said the rapid spread of the A(H1N1) pandemic meant that officials should "reflect on whether or not to postpone the hajj" later this year. In the meantime, Tunisia has toughened selection criteria for hajj candidates, doubling medical checks and ruling out the elderly or chronically sick on the grounds they would be "more exposed" to infection. Some 30,000 Tunisians complete the omra pilgrimages, with peak numbers making the journey during the Holy month of Ramadan, which is this year due to begin some time in late August. The suspension of the omra will affect travel agencies who specialise in pilgrimage trips, with BusinessNews website estimating the loss of revenue to the industry at around 150 million dinars (more than 80 million euros or 120 million dollars). Tunisia has announced just three infections to-date, but with millions of Muslims preparing to converge on Mecca, the whole Islamic world is concerned about the pilgrimage season's potential to make the pandemic far worse.
by Staff Writers
Geneva (AFP) July 3, 2009
The World Health Organisation still expects the swine flu pandemic to subside in the northern hemisphere over the summer, despite its persistence in the likes of the United States and Britain.

Sylvie Briand, interim head of the WHO's influenza programme, said that cases of flu should still be expected but transmission would slow down thanks to the combined impact of the heat and school holidays.

"First of all there's a climactic aspect, knowing that flu viruses survive better in the cold than in the heat," Briand told AFP.

"The other important element is the density of contact between people. Children are on holiday and we don't have the outbreaks in schools like we had in the United States at the beginning of the epidemic," she added.

Even if the influenza A(H1N1) virus is new, "I think we will nonetheless have the same seasonal nature and transmission will decline in the northern hemisphere this summer, with a weak proportion of severe cases," Briand said.

England's Health Secretary Andy Burnham said Tuesday that 100,000 cases a day could occur across England, Northern Ireland, Scotland and Wales by the end of August if the current infection rate is maintained, stressing it was a projection.

In Washington, the White House said it would hold a high-level meeting next week bringing together top government officials to prepare for the possibility of a more severe outbreak of A(H1N1) influenza.

The meeting was called after the US Centers for Disease Control and Prevention (CDC) estimated that at least one million people in the United States have had swine flu, basing the projection partly on computer models.

British authorities have indicated that officially reported infections may fall well short of the true number of cases.

At the WHO Briand suggested this was largely expected.

"Of course, because there are already a lot of cases where people have few symptoms where they just have a light cough and don't go to the doctor," she said.

"There are even asymptomatic cases of people who are carrying the virus and do not even know it."

Briand said the WHO was thinking of ending its global reporting of laboratory-confirmed cases of swine flu in each country, because it had become "almost unmanageable" to confirm all the cases.

"This data does account for a certain reality and especially the number of countries infected, which shows that most of the earth is now infected," said Briand.

However, "after a certain moment, counting is of little interest and represents just a considerable loss of time for countries," she explained.

The latest data released by the WHO Friday showed that 125 countries and territories have been infected since the new A(H1N1) influenza virus was uncovered in Mexico and the United States last April

Some 89,921 cases were confirmed by laboratory tests, including 382 deaths, at-pac/rt

related report
Tamiflu resistant swine flu case found in Hong Kong: govt
Hong Kong on Friday detected a strain of swine flu that was resistant to Tamiflu, the main anti-viral flu drug, the health department reported on its website.

The statement said the resistant strain of influenza A (H1N1) was detected during routine tests of its sensitivity to anti-virals.

"This is the first time Tamiflu resistance in HSI virus (has been) found in Hong Kong," a spokesman said.

The case came as the Japanese health ministry said doctors had detected the second case worldwide of a patient resistant to Tamiflu, widely used to treat the illness.

In the Hong Kong case the resistant virus was isolated from a specimen taken from a 16-year-old girl who arrived in the southern Chinese city from San Francisco last month.

She was admitted to hospital and opted not to take Tamiflu, the spokesman said, but was discharged after a week.

The strain is not resistant to the other anti-viral drug, Relenza, the health department said.

A spokeswoman for Swiss pharmaceuticals giant Roche, which makes Tamiflu, said the company had been informed of the case and called it "normal."

"It is absolutely normal," she said, adding that "0.4 percent of adults develop resistance" to Tamiflu.

Last month, authorities ordered all primary schools in Hong Kong to be closed for two weeks after the first cluster of local swine flu cases was found.

When Hong Kong discovered its first case, in early May, health authorities quarantined around 300 guests and staff at a hotel where the carrier, a Mexican, had briefly stayed.

Hong Kong is particularly nervous about infectious diseases following the outbreak of the SARS virus in 2003, which killed 300 people here and a further 500 around the world.

The latest numbers from the World Health Organization, released on Wednesday, showed 77,201 reported swine flu cases, with 332 deaths.

In Japan, the health ministry said doctors in Osaka prefecture had identified a woman who was resistant to Tamiflu -- the second such case, after one found in Denmark.

The Japanese woman had since been treated with Relenza and was recovering, Kyodo news agency reported Thursday, citing the health ministry.

In China, furious relatives of a woman who died while being treated for suspected swine flu stoned an ambulance in a rampage at a hospital in the eastern city of Hangzhou, state news agency Xinhua reported.

Initial reports stoked fears she might be the first person in China to die from swine flu, but police said on Friday that an autopsy had shown she died of an electric shock.

Xinhua reported that the woman had shown no symptoms of swine flu at the time of death, barring an occasional cough.

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WHO, poor nations urge global access to swine flu vaccine
Cancun (AFP) July 3, 2009
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