After bird flu in 2007 and 2008, swine flu affected people in several countries in 2009. World Health Organisation (WHO) confirmed 1000 cases of influenza and infections with 26 deaths from 20 countries, in May 2009.
India, on 27 April, issued a swine flu rechristened as A(H1N1) infection by the World Health Organisation advisory and asked travellers to India coming from the affected countries such as Mexico, US, Canada, New Zealand, Spain, France and UK to report symptoms of cough, cold and fever to airport health authorities. The Government, however placed no restrictions on eating pork or testing pigs for the virus.
Swine flu was confirmed in three more countries on 30 April, prompting the World Health Organisation to raise its flu alert level to five, a warning that the world is on the brink of an epidemic.
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WHO officials raised a global alert to an unprecedented level as swine flu was blamed for more deaths in Mexico and the epidemic spread to some other countries, with the first cases confirmed in West Asia and the Asia-Pacific regions.
Swine flu spread to several countries and appeared to be jumping borders via airplane flights. In New Zealand, a group of students and teachers were confirmed with the virus after a recent trip to Mexico, where the virus was suspected to have infected nearly 2,000 people and caused more than 150 deaths. Another case was confirmed in Israel.
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The pandemic alert raised to Phase 5 was a warning that the new swine flu virus was demonstrating a level of infectivity in humans that could take it rapidly to every country across the globe. WHO’S Phase 5 is just one step short of a full pandemic alert.
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The change to a higher alert is a signal to governments, ministries of health and other ministries, the pharmaceutical industry and the business community that certain actions should now be undertaken with increased urgency and at an accelerated pace.
Phases 5 and 6 “represent periods of time when the virus is beginning to spread from country to country” and becoming established. It can be interpreted to mean that we are already in that process. Phase 6 can be interpreted to mean that the virus is establishing itself in more regions and more countries.
Pigs have long been feared as a mixing pot for flu viruses. Apart from harbouring porcine flu viruses, pigs can also be infected by both human and bird flu strains. The genetic material of the flu virus is in eight segments. So if two or more strains of flu infect a cell, their progeny can receive a mix of those genetic segments.
The result, as in the case of the new H1N1 strain of swine flu, can be a potent virus that humans have not encountered before and against which their immune systems are almost defenceless. Analysing the genetic make-up of the new swine flu, scientists have found it to be a mix of genetic material from human and bird flu viruses.
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The WHO officials emphasised, however, that with the new swine flu showing robust human-to-human transmission, the risk of catching the disease did not come from pigs or pork consumption. Rather the virus was spreading through people who had become infected.
Health authorities across Asia are scrambling to limit the spread of swine flu as two confirmed cases were reported in one of the world’s most densely populated regions. South Korea reported that a 51-year old woman, who recently visited Mexico, tested positive for swine flu, while Hong Kong’s first confirmed case was a 25-year old Mexican who arrived in the city from Mexico via Shanghai.
Though Government said that no case of A(H1N1) flu had been reported in the country, a 25-year old man, who returned from Texas in the US, was admitted to the Ram Manohar Lohia Hospital, New Delhi on 2 May, 2009 with suspected symptoms.
The man reportedly turned up at the hospital due to media coverage. He was kept under observation in the isolation ward but did not show any symptoms of A(H1N1) flu.
The Health Ministry has decentralised its stockpile of Oseltamivir, the drug that is most effective against the virus.
Mock drills random sample collection at all international airports of the country to be sent to labs for testing were started to identify critical gaps in its existing sample collection and transportation mechanism.
In its preparation for a pandemic or an outbreak of a deadly influenza virus, possibly the H1N1 flu, State governments were asked to collect samples from passengers showing any sort of ill health, not necessarily influenza symptoms, and send them to the National Institute of Communicable Diseases (Delhi) and National Institute of Virology (Pune) for testing.
India has four bio-safety level III labs NICD, NIV, National Institute of Cholera and Enteric Diseases (Kolkata), and Regional Medical Research Centre (Dibrugarh) that have the capability of handling dangerous pathogens like the H1N1 virus. Samples were picked up from India’s 22 international airports irrespective of whether they get one international flight a day or one flight a week.
Mexico, which was said to be the starting point of swine flu, moved past the peak of an H1N1 flu epidemic in May 2009 and was in the “phase of descent”, the Government said, although world health officials still felt that the unpredictable virus could become a pandemic.
Mexico’s Health Minister Jose Angel Cordova said the outbreak appeared to have peaked in Mexico between 23 and 28 April and fewer people had admitted themselves to hospitals with serious flu symptoms after that.
However, new cases of the virus, which mixes swine, avian and human flu strains, were still being tracked across the world. Colombia became the latest country to report a confirmed case of the disease.
The other countries which have reported laboratory confirmed cases but with no deaths were : Austria, Canada, Denmark, France, Germany, Hong Kong, Israel, Netherlands, New Zealand, Republic of Korea, Spain, Switzerland and the United Kingdom.
In a latest research, a virus believed to have originated from pigs was found to be jumping from humans to swine’s. Canada reported the globe’s first reverse transmission of H1N1 from humans to pigs.
The country’s health officials believe the infection that was found in 220 hogs about 10 per cent of the farm’s pig population spread from a farm worker who became ill during a trip to Mexico. Another worker on the farm was being tested for symptoms.
Interestingly, the same H1N1 strain that was infecting humans was found to have caused the infection in pigs. The global health body, WHO, however, was quick to reiterate that at present there, was no recommendation to cull pigs.
Some countries, including Mexico, where the disease caused maximum damage, started to believe that the worst was over with the outbreak having peaked between 23 and 28 April, 2009. But what most nations and WHO were most worried about was what they called “the second wave of the H1N1 Pandemic”.
Behavioural studies conducted on earlier pandemics have shown that they came in two phases the first wave usually being mild followed by a more devastating wave, in autumn and winter months.
All four of the well-known pandemics have come in waves. It was what happened during the deadly 1918 Spanish flu outbreak that killed over 50 million people.
There was a concern about the infection travelling to the Southern Hemisphere, as that part of the world was heading into the winter months, when influenza viruses become active.
The only way to fight such pandemics is to strengthen the system of early detection of infection, isolating infected people from public at large in medical centres, giving them proper medical attention, and last but at least, making people aware how to save themselves from being infected.