Swine flu illness in the United States and Mexico

Swine flu illness in the United States and Mexico - update 2

26 April 2009 -- As of 26 April 2009, the United States Government has reported 20 laboratory confirmed human cases of swine influenza A/H1N1 (8 in New York, 7 in California, 2 in Texas, 2 in Kansas and 1 in Ohio). All 20 cases have had mild Influenza-Like Illness with only one requiring brief hospitalization. No deaths have been reported. All 20 viruses have the same genetic pattern based on preliminary testing. The virus is being described as a new subtype of A/H1N1 not previously detected in swine or humans.

Also as of 26 April, the Government of Mexico has reported 18 laboratory confirmed cases of swine influenza A/H1N1. Investigation is continuing to clarify the spread and severity of the disease in Mexico. Suspect clinical cases have been reported in 19 of the country's 32 states.

WHO and the Global Alert and Response Network (GOARN) are sending experts to Mexico to work with health authorities. WHO and its partners are actively investigating reports of suspect cases in other Member States as they occur, and are supporting field epidemiology activities, laboratory diagnosis and clinical management.

On Saturday, 25 April, upon the advice of the Emergency Committee called under the rules of the International Health Regulations, the Director-General declared this event a Public Health Emergency of International Concern.

WHO is not recommending any travel or trade restrictions.

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Statement by WHO Director-General, Dr Margaret Chan
25 April 2009
Swine influenza

Related link

Swine influenza

Current WHO phase of pandemic alert

International Health Regulations (IHR)



In response to cases of swine influenza A(H1N1), reported in Mexico and the United States of America, the Director-General convened a meeting of the Emergency Committee to assess the situation and advise her on appropriate responses.

The establishment of the Committee, which is composed of international experts in a variety of disciplines, is in compliance with the International Health Regulations (2005).

The first meeting of the Emergency Committee was held on Saturday 25 April 2009.

After reviewing available data on the current situation, Committee members identified a number of gaps in knowledge about the clinical features, epidemiology, and virology of reported cases and the appropriate responses.

The Committee advised that answers to several specific questions were needed to facilitate its work.

The Committee nevertheless agreed that the current situation constitutes a public health emergency of international concern.

Based on this advice, the Director-General has determined that the current events constitute a public health emergency of international concern, under the Regulations.

Concerning public health measures, in line with the Regulations the Director-General is recommending, on the advice of the Committee, that all countries intensify surveillance for unusual outbreaks of influenza-like illness and severe pneumonia.

The Committee further agreed that more information is needed before a decision could be made concerning the appropriateness of the current phase 3.

http://www.who.int/mediacentre/news/statements/2009/h1n1_20090425/en/index.html

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NPB Issues Warning against New Swine Flu Strain
US - The National Pork Board is urging pork producers to enhance the biosecurity plans on their farms as the result of a new strain of the swine influenza virus type H1N1 being reported by the US Centers for Disease Control and Prevention (CDC). The virus is unique and has not been seen in the US swine herd.



At this time, no pigs have been found to be infected or sick with the virus. It is unknown if this new strain causes any type of illness in swine. However, because it is novel, the National Pork Board is urging producers to take extra precaution to protect our industry's workers and our animals.

To prevent the introduction of the new strain of swine influenza virus type H1N1 into your operation, follow good biosecurity practices. Because people have been reported sick with this virus, make sure your biosecurity practices place special emphasis on protecting your animals and your operation's workers by monitoring all persons having access to your operation.

Consider the following practices:
Establish, implement and enforce strict sick leave policies for workers presenting influenza-like symptoms such as fever, cough, body aches, and sometimes vomiting and diarrhea.

Prevent worker exhibiting these symptoms from entering swine facilities for at least seven days after presenting symptoms of respiratory illness, even mild ones.

Recommend that workers with these symptoms be seen by a medical provider immediately and recommend that the person's contact with pigs is communicated to the care provider during the visit

Encourage workers to report if members of their household present influenza-like symptoms. Encourage them to receive medical attention and to share that a member of the household has contact with pigs. Encourage workers to report if a member of the household is diagnosed with influenza. Consider restricting the contact that this worker has with the animals.

Implement biosecurity for workers reporting international travel.

This recommendation is not limited to those people who had contact with animals in foreign countries.

Consider preventing the entry of worker who have travelled internationally, and particularly to Mexico, into your operation.

If entry is essential, consider requiring that these people use face masks, or preferably N95 respirators, and gloves, upon entering and during their permanence inside a swine housing facility.

If workers reporting international travel present influenza-like symptoms, restrict their access to the farm. Recommend that they seek immediate medical attention and that they report their travel to the medical professional.

Limit visitors to swine facilities

Limit the entry of people into your facility to workers and essential service personnel.

Prevent international visitors from entering your facilities.

Prevent the entry of people who report international travel (especially from Mexico) as recently as in the past two weeks.

Follow other generally accepted biosecurity practices, including:

Pay attention to ventilation - Ventilation systems in production facilities should be designed to minimize re-circulation of air inside animal housing facilities. This is important to reduce the exposure of pigs to viruses from other pigs, to reduce their exposure to human influenza viruses.

Enforce basic hygiene practices -
Workers should shower and change into farm-specific clothes and shoes before entering swine facilities. If this is not possible, enforce at least the use of farm shoes and hand and arm washing before contact with pigs.

Recommend frequent hand-washing of workers, in barns and in offices.


Implement and enforce the use of personal protective equipment - Provide basic personal protective equipment (PPE) to the people working in barns. This should include face masks, or preferably respirators; eye protection and gloves.

Vaccinate pigs against the influenza virus - Vaccination of pigs can reduce the levels of virus shed by infected animals

Recommend that all workers are vaccinated against the seasonal influenza virus - The vaccine is produced on a yearly basis and contains only human, not swine, strains of influenza viruses. Nonetheless, these vaccines are likely to provide some level of protection against infection with swine viruses of the same type. Vaccination of farm workers will reduce the amounts of viruses they shed if infected during human influenza outbreaks, and limit the potential for human influenza virus infection of pigs.

If you observe, or employees report, respiratory illness in pigs, contact a swine veterinarian immediately, especially if the onset or presentation of this illness is unusual. If deemed necessary, your veterinarian may require samples be taken from animals to send to veterinary diagnostic laboratories. If animals present fever or go off feed, the veterinarian may take lung tissues samples and nasal swabs to send to a veterinary diagnostic laboratory.

If you have workers collect the samples, require that they use personal protective equipment including an N95 respirator, gloves and safety goggles.

Talk to your veterinarian if influenza-like symptoms have been reported or observed in any of the people that have or have had contact with your animals and report that upon submission of the samples to a diagnostic laboratory.


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