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WHO warns of swine flu pandemic's second wave

India should brace for swine flu pandemic: minister
India's health minister warned Friday that the country of nearly 1.2 billion people must brace for a "large-scale" swine flu pandemic. Given the South Asian nation's size "we shall have to be prepared much more than any other country in the world", Ghulam Nabi Azad told a gathering of state health ministers in New Delhi. "Until very recently, ours were imported cases, now we are reporting most cases which are indigenous cases," Azad said. India must get ready "for a large scale pandemic", he said, accusing state governments of "forgetting their duty" and failing to do enough to combat the virus. Blanket media coverage and a growing number of victims since the first Indian death from the A(H1N1) virus on August 3 has caused increasing panic in the country. Azad said there had been 36 deaths so far in India. About 1,800 people have died worldwide since the influenza was first detected in April, according to the latest update from the World Health Organization (WHO) this week. The vast majority of those deaths have been recorded in the Americas. The minister's warning came as WHO chief Margaret Chan on Friday urged governments to prepare for a likely second wave of swine flu cases. Azad, who warned earlier in the week that swine flu was spreading in India "on a vast scale", has said private laboratories will be allowed to test for the virus to ease the strain on already overloaded government hospitals. Swine flu concerns have led to the closure of many schools, fewer shoppers at malls, disruption of festivals and even delays in Bollywood movie screening debuts. Sales of face masks have soared. Some experts have said the government has not done enough to reassure people and explain the dangers posed by the virus. Swine flu deaths and infections are small in comparison to other diseases endemic in India where 1,173 people died from malaria in 2007. In the same year, 31,268 people died from tuberculosis.

Zimbabwe PM urges emergency funding to halt swine flu
Zimbabwe's Prime Minister Morgan Tsvangirai on Friday called for emergency funding to help the nation combat swine flu, after five students contracted the disease in the eastern town of Mutare. "The recent outbreak of swine flu calls for national emergency funding to respond," Tsvangirai told a doctors conference in Harare. "We don't want a repeat of the cholera experience of last year," Tsvangirai said, but did not indicate how the cash-strapped government would find the additional money. More than 2,400 people died of cholera over the last year, and UN officials have warned that the deadly but preventable disease is likely to erupt again. The confirmation of the A(H1N1) virus has heightened fears about Zimbabwe's health system, which has been decimated by a decade of economic free-fall. Doctors at state hospitals have been on strike for the last week demanding better salaries and the restoration of US dollar allowances that were withdrawn last month by the government and aid agencies. Tsvangirai urged doctors to return to work, saying the government was trying to address their concerns. "I also urge those health professionals who have embarked on industrial action to recognise the efforts of the ministry of health and the Health Service Board," he said. "I am confident that, as Zimbabwe gets back on its feet, we will all benefit." Doctors receive a salary of 170 US dollars, but are demanding a basic salary of up to 3,000 US dollars and to be paid according to their level of experience. Last month, the government increased salaries of civil servants from 100 US dollars to 150 US dollars, while giving doctors 170 US dollars.
by Staff Writers
Geneva (AFP) Aug 23, 2009
The World Health Organisation is urging the planet to brace for a second wave of the swine flu pandemic as the heavily populated northern hemisphere edges towards the cooler season when flu thrives.

"The WHO is still mobilised and worried," spokesman Gregory Hartl said as the global health watchdog kept an anxious eye on some "mysterious" patterns of illness associated with the new A (H1N1) virus that appeared in April.

Influenza traditionally surges to its peak during the northern autumn and winter.

WHO Director General Margaret Chan warned on Friday that there had been second and third waves in previous pandemics.

"We cannot say for certain whether the worst is over or the worst is yet to come," Chan said in a videotaped address to a symposium on flu in the Asia-Pacific region.

"We need to be prepared for whatever surprises this capricious new virus delivers next," she added.

Some 1,799 people have died since the A(H1N1) was uncovered in Mexico and the United States nearly six months ago, according to the UN health agency.

By comparison, an estimated 250,000 to 500,000 people die around the world every year from seasonal flu, and overall the symptoms of the new pandemic virus have proved to be mild in the great majority of known cases.

However, it has spread swiftly into 177 countries, proving to be more infectious than seasonal flu and more durable through warmer months.

Through a full season in the southern hemisphere, the pandemic strain gradually became dominant.

WHO monitoring showed that it was now on the decline there, except in South Africa, and in some later affected areas of Argentina, Australia and Chile.

Some 182,000 people worldwide are known to have caught swine flu based on laboratory confirmed cases, but the WHO has long advised countries to give up counting; the true number may in the millions, according to some experts.

It is also striking those in a more physically fragile phase of life, such as pregnant women or the chronically ill, as well as those who are obese and younger age groups than usual.

Many of the most severe cases are among 30 to 50 year-olds.

WHO officials are also mystified at the "most worrying" characteristic of this flu virus, Hartl explained.

About 40 percent of the most severe or fatal cases occur in people who are in perfect health, he told AFP.

However, he was unable to say how many severe cases had occurred, although they are generally regarded as a small proportion of the outbreak so far.

With autumn approaching, northern countries have set emergency flu plans into motion, in some instances before the WHO's long heralded formal declaration of a pandemic on June 11 that marked global spread of the virus.

While that includes many of the wealthiest nations -- with the most medicines, access to key antiviral drugs and vaccine development, as well as the best health care -- Hartl pointed out that the hemisphere also includes five-sixths of the world's population.

More than one billion doses of preventive vaccine have been ordered by those countries.

But the vaccine is not expected to be ready for use until October and will only be available gradually, for the most vulnerable groups and health workers first.

The WHO has cut its estimate of maximum annual production capacity of 4.9 billion vaccines, currently focusing on about half or even one quarter of that amount. It is still unclear whether one or two doses will be necessary.

In the meantime, plans to mobilise stockpiles of antiviral drugs such as Tamiflu, reinforce health care capacity and close down schools temporarily to limit the spread of infection have already been tested in the first wave.

Hartl said it was impossible to rule out the resurgence of A (H1N1) before October to November, the more usual period for the growth in seasonal influenza.

"Everyone must be ready," said the WHO spokesman.

"It is already amongst us, as we saw this summer."

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Swine flu looms over global economic recovery
Washington (AFP) Aug 23, 2009
The markets have begun to pop champagne over global economic recovery, but the elephant lurking in the room -- swine flu -- could trample those green shoots. Spotted just four months ago, the new A(H1N1) influenza virus spread by June into a global pandemic and experts warn it could take a toll on productivity and financial systems, depending on the severity of outbreaks. About 1,800 ... read more







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