Swine influenza in the US and Mexico a public health event of international concern

In a communication following the meeting of the Emergency Committee under the International Health Regulations (IHR) yesterday, Margret Chan, Director-General of the World Health Organization (WHO) announced that the swine flu outbreaks in Mexico and the United States are a public health event of international concern (PHEIC). However, the Committee decided not to raise the pandemic alert level (from the current level 3) considering the fact that there are still gaps in knowledge about the clinical features, epidemiology and virology of reported cases and the appropriate responses taken. Based on information from the US Centers for Disease Control and Prevention, WHO and the Mexican Ministry of Health the situation in the two countries is as follows:

United States
As of 25 April 2009 (19:30 Atlanta time), the US CDC is confirming 11 cases of swine influenza A(H1N1) in the US, seven from California, two from Texas and two from Kansas. Three clusters of two cases each, have been identified: one in Texas (two 16 year-old boys from the same school), a father-daughter pair in California, and a married couple in Kansas. None of the confirmed cases has had any exposure to pigs. Laboratory investigations showed that all eight viruses have same genetic pattern. Only one of the cases required brief hospitalisation because of an underlying disease, all others reported mild clinical symptoms. Further cases with symptoms of influenza-like illness (ILI) are being investigated for a possible connection to the current cases.

According to information on its website, the New York City Health Department is investigating a cluster of respiratory illness in a non-public school in New York City and least eight students are considered as probable cases of human swine influenza.

The Mexican Minister of Health announced in a press release on 24 April 2009 that 68 persons had died following severe pneumonia, and of these, 20 had been laboratory-confirmed to be of the novel viral strain. There were three separate clusters identified: in the Federal District of Mexico since 18 March 2009, 854 cases of pneumonia have been recorded in the capital city; in San Luis Potosi in central Mexico, 24 cases of ILI with three deaths have been reported; and in Mexicali (which is close to the US border) four cases of ILI with no deaths have been reported. No further updates on the epidemiological situation are available to date and epidemiological and virological investigations are ongoing.

The multidisciplinary team at European Centre for Disease Prevention and Control (ECDC) published a document with Questions and Answers concerning the current situation and is providing a map based on the official information from the WHO and the US CDC that indicates where cases have occurred so far.

Media in New Zealand are reporting that in this country cases are currently under investigation.

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