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To Travel or Not to Travel? A Swine Flu Dilemma

2009-05-07T10:56:00.000-07:00

By William Lee Adams / London Thursday, Apr. 30, 2009 http://www.time.com/time/health/article/0,8599,1894660,00.html

Fearing that their vacations could comprise of surf, sand and swine flu, potential travelers are turning to health organizations for guidance on whether to pack their bags or stay home. And while opinions from health officials have come thick and fast, their often contradictory advice doesn't make it any easier to decide whether to fly or not to fly.

On Monday, the European Union's health commissioner Androulla Vassiliou told reporters in Luxembourg that she was "not worried at this stage" about a pandemic sweeping across Europe, but she urged travelers to avoid Mexico and the United States anyway. That prompted a swift rebuke from Richard Besser, the acting director of the Centers for Disease Control and Prevention (CDC) in Atlanta, who rejected her advisory as "quite premature." Even so, the CDC website "recommends that U.S. travelers avoid all nonessential travel to Mexico." As for the World Health Organization, it's calling on nations to keep their borders open and to avoid restricting international travel, and emphasizes that a pandemic is not inevitable. Despite that plea, Argentina and Cuba have suspended all flights from Mexico, and tour operators and airlines across the globe — including some based in Canada, Germany and the U.K. — have canceled flights and holiday packages to sunshine destinations like Cancún and Cozumel. (See pictures of thermal scanners hunting for swine flu.)

So much for a relaxing summer break. Andrew Nolan, 30, a lawyer living in London, had planned to fly to Los Angeles on April 30. But the conflicting travel advisories left him so uneasy that he decided to stay put. "If these large international bodies are having difficulty deciding where it's safe to travel, I thought it was better to cancel," he says of the trip he started planning two months ago. "I'm in no way assured that they understand the full extent of the epidemic, or that they have it under control."

Those concerns will take center stage on Thursday when health ministers from the 27 E.U. states convene at an emergency conference in Luxembourg to define and coordinate a response — and a unified travel advisory. "During these meetings we will ask our European colleagues to consider the suspension of flights going to Mexico," France's Health Minister Roselyne Bachelot told reporters after meeting with French president Nicholas Sarkozy to discuss the flu scare. But France won't advocate suspending flights returning from Mexico, as that would strand thousands of passengers, leaving them in a scramble to find other ways out of the country and potentially increasing their risk of exposure to the virus. (Read a brief history of the flu vaccine.)

For those in the tourism industry, discussing restrictions simply doesn't fly. The world travel sector is already experiencing its first contraction since 2003, when the outbreak of SARS in Asia decimated tourism revenues. Michael O'Leary, chief executive of discount airline RyanAir, drew criticism on Tuesday for publicly suggesting that only the world's poorest people will succumb to swine flu, despite the fact that two middle-class Scottish newlyweds have been isolated in a hospital for several days after having tested positive for the H1N1 virus. "It is a tragedy only for people living in slums in Asia or Mexico. But will the honeymoon couple from Edinburgh die? No. A couple of Strepsils will do the job," he said, suggesting that all they have to do is suck on the popular candy-flavored, over-the-counter throat lozenges.

Geoffrey Lipman, assistant secretary-general of the United Nations World Tourism Organization, has a less inflammatory take. "We know from the past that restrictions don't actually serve to hold back the spread of this kind of virus," he says. "It's already out there around the world in different places."

That's not just hot air. According to Dr. Meirion Evans, an epidemiologist with the U.K.'s Faculty of Public Health, the government body that sets public health standards, "If we start seeing countries reporting contractions from person-to-person, then visiting anywhere in the world would be as risky as visiting Mexico." And despite the high number of swine flu cases reported in Mexico — over 2,000, with more than 150 deaths so far — that number may stabilize or fall, suggesting that Mexico "could be over the worst of its problems, whereas other countries have the worst to come."

Even so, countries continue to take precautions. Officials at Tokyo's Narita International Airport have installed a device at the arrival gate for flights from Mexico to measure the temperature of disembarking passengers, and passengers flying into the Philippines who report fevers have been quarantined in government hospitals. (Read "Battling Swine Flu: The Lessons from SARS.")

As the threat of travel restrictions spreads, it's those kinds of inconveniences — not health concerns — that put some people off their vacation plans. Yvonne Worth, 50, a freelance editor in London, says she's debating whether to travel to New York and Massachusetts to visit old friends because she worries the airline will cancel her flight. "If I book a ticket and end up losing it because of travel restrictions, I may not get my money back," she says. "Maybe I'll go see somebody in Amsterdam instead." Apparently not even a deadly virus can kill the travel bug in some folks.

:::My Reaction:::

1Of cause, the swine flu did effect to the tourism industry. We need to accept that. I disagree with the WHO calling for the avoidance of restricting international travel. As we know, from the SARs experience, that the flu can be spread out by inhale and international travel is one of the causes of making the flu epidemic. It is the airport and airline responsibility to restrict the unnecessary travel in order to limit the disease not to spread out rapidly. I know that restriction travel can not stop the flu. But it give us a bit more time to prepare ourselves to handle the flu.

2.It is not right to say that anywhere in the world would be as risky as visiting Mexico. The density of population is different so how the level or risky could be the same. If everyone is thinking like this, the spread of the flu would be growing up so fast such that it would be too late to control it

3.As we are in a globalization, the virus is also global. It could transfer from one continent to another within 3days, coming by the air passengers.

Canada: Farmer possibly gave swine flu to pigs

2009-05-05T21:03:00.000-07:00

http://edition.cnn.com/2009/HEALTH/05/03/swine.flu.canada/index.html

(CNN) -- More than a week after the swine flu outbreak rattled the world, with cases of infected people popping up from Mexico to South Korea, the new virus strain has shown up in a herd of swine

The catch, Canadian officials say, is that the animals may have caught the flu from a human.
Canadian officials are quarantining pigs that tested positive for the virus -- scientifically known as 2009 H1N1 -- at an Alberta farm in what could be the first identified case of pigs infected during the recent outbreak.

They said the pigs may have been infected by a Canadian farmer who recently returned from a trip to Mexico, the epicenter of the outbreak that has sickened more than 680 people.
The farmer "may have exposed swine on the farm to an influenza virus," said Dr. Brian Evans of the Canadian Food Inspection Agency.

"We have determined that the virus H1N1, found in these pigs, is the virus which is being tracked in the human population," he added.

Evans and other officials said it is not uncommon for flu viruses to jump from humans to animals and that it does not pose a risk for consuming pork. The number of pigs infected was not disclosed.

The infected farmer had flu-like symptoms and is recovering, Evans said.
Meanwhile, as the number of confirmed swine flu cases reached 787 worldwide, the World Health Organization said Sunday it had started distributing 2.4 million doses of a common anti-viral drug to 72 nations. So far, 17 countries have confirmed cases of swine flu, the WHO said.

Dr. Michael J. Ryan, the WHO director of its global alert and response team, said the doses of the drug Tamiflu came from a stockpile that was donated by Swiss health-care giant Roche in 2005 and 2006.

Roche said it was working with the WHO to prepare for the virus. The drug should be taken within 48 hours of experiencing symptoms, according to the drug's Web site.
Mexico has the most confirmed swine flu cases, with 506 infected people and 16 deaths, the WHO said. Mexican Health Minister Jose Angel Cordova Villalobos reported that the country has confirmed 421 cases and 19 deaths.

Several other countries, including Canada and Italy, had confirmed additional cases that had not yet been added to the WHO's total.

The United States has the second-highest number of confirmed cases, with 160 sickened and one death, according to the Centers for Disease Control and Prevention and the WHO.
President Barack Obama spoke with Mexican President Felipe Calderon on Saturday afternoon to discuss both countries' "efforts to limit the spread of the 2009 H1N1 flu strain and the importance of close U.S.-Mexican cooperation," the White House said in a statement.Other than Mexico and the United States, the WHO confirmed cases in 14 other countries: Canada, with 70; the United Kingdom with 15; Spain with 13; Germany with six; New Zealand with four; Israel with three; France, with two; and Austria, China, South Korea, Denmark, the Netherlands, Switzerland and Costa Rica, each have one

Ryan said the WHO was still preparing for a pandemic.
"At this point we have to expect that phase six will be reached," he said, referring to the organization's highest pandemic threat level. "We have to hope that it is not reached." And he noted that a pandemic describes "the geographic spread of the disease, not its severity."
The latest developments come as parts of Asia discovered they were not immune to the spread of the virus.

Hundreds of guests and staff were under quarantine in China after health officials determined that a hotel guest had contracted the H1N1 virus.
Nearly 200 hotel guests and 100 staff members were ordered to stay in Metro Park Hotel in Hong Kong for seven days to stop the spread of the H1N1 virus, a government spokesman said.

The quarantine was ordered after a 25-year-old Mexican man stayed in the hotel and became sick, according to the spokesman. It is the first confirmed case of the virus in Hong Kong, local medical officials said.

South Korean officials on Saturday confirmed their first case -- a 51-year-old nun who recently traveled to Mexico for volunteer work

:: Reaction ::

1. Having infected pigs doesn’t means the virus would come from the Mexico through the farmer only. From the article “Swine Flu Shows Need for Better Animal Testing” on http://www.time.com/time/health/article/0,8599,1895738,00.html, there is some part of the article saying that the H1N1 virus has Eurasian genes which mean it could come from Europe where had been exported live pigs through the U.S. and Mexico. Then, it could be that the virus are contained in a pig since the beginning of imported but was just show the symptom and was just diagnosed by the veterinarian

2.As the WHO announced the phase 6, the vaccine should be prepared in every hospital especially in a risk area like airport, hotel nearby, and pig farm. Also, because the drug would work the best within 48 hours of contagious symptoms, the hospital should be prepared to check whether the patient sick of a swine flu or just a normal flu

Influenza is a world problem

2009-05-04T20:43:00.000-07:00

Published: 28/04/2009 at 12:00 AM
Bangkokpost
Newspaper section: News
http://www.bangkokpost.com/opinion/opinion/15779/influenza-is-a-world-problem

The slow and uncoordinated response to the alarming outbreak of swine flu in North America has been an unpleasant surprise. Government authorities from the prime minister to senior civil servants issued conflicting statements on the influenza problem believed to have originated in Mexico. For several days, the public has been in an official information limbo.

Prime Minister Abhisit Vejjajiva now says that relevant agencies have completed the first of a three-day meeting to discuss the dangers and response. Let us hope this produces a more credible result than the obviously off-handed weekend statements that "there is no reason for alarm".
There is not just reason for alarm, but an actual alarm. The World Health Organisation last week elevated its International Pandemic Alert to Phase 3 of six. The WHO said their experts and colleagues believe the world is closer to a deadly worldwide killer flu than at any time since 1968, the latest of three such pandemics. These WHO alerts are meant to inform the world of the seriousness of a threat, in order to urge governments everywhere to step up their preparedness.
It is unclear how Thailand has responded to these alerts. Across Asia, many countries stepped up high-profile monitoring of arrivals at airports and land borders, but such measures were not obvious at Thai airports. There has been no mention of Mexico, a growing trade partner and source of tourists. In that country, dozens of flu victims have already died and hundreds are suspected of carrying the disease. Travellers from Mexico, and from North and Central America in general, should have been receiving careful vetting at border crossings for many days.

One should not think, as Disease Control Department director-general Somchai Jakkraphan said on Sunday, that a flu outbreak can be contained inside one country. The Mexican swine flu has already sickened people in the US. The bird flu and Sars outbreaks proved they have no borders.
[I totally agree with this]

The lack of information and spread of misinformation has been most troubling. Mr Abhisit spoke of deaths in Mexico, the US and China, although swine flu had not been detected in China or elsewhere in Asia. On Sunday, the premier advised against eating semi-cooked pork - perfectly good advice, but not relevant to the flu outbreak. As Permanent Secretary for Public Health, Prat Boonyawongvirot, contradicted the premier hours later on Sunday, eating pork can neither cause nor contribute to swine flu.

When both the WHO and the US Centers for Disease Control and Prevention raise the alarm about an outbreak, so should all the world. Medical workers nationwide must now be put on alert and provided with up-to-date information about the symptoms and treatment of swine flu. Fortunately, like bird flu, it responds to Tamiflu.
Entry points to the country must screen arrivals, and all hospitals should step up preparations to receive infected patients. There has been bad advice from the Public Health Ministry, calling on people with high fever, body aches, coughing, and runny nose to wear protective masks. They should seek medical attention, and on the double if they have been in North America.
Full and fast disclosure of information to the public is the best guard against a worldwide pandemic. Misinformation or, worse, withholding important news, is the enemy of public health. The government and medical authorities must bring themselves up to speed and act swiftly to protect the nation from swine flu.

:: My reaction ::

1. Yes, scanning people coming from Mexico at the airport might be the easiest way to minimize the spread of the flu. However, not only the Mexican people to be infected, there might be some case of taking over the plane and any people who having interact with the sickened might be also infected. Also some people might get the flu from a person sitting nearby on the plane. In this case, it is too hard to indicate the patients out of normal people.

2. I think an outbreak alarm of WHO are not much necessary for our country. We don’t have to shut the restaurant down as the Mexico did. What I suggest is that the WHO should indicate the area of high risk and low risk just like what we did on the bird flu period. Red zone, yellow zone and green zone would help the world to see the overall picture of wide spreading easily. Also, it would help the official to being able to control the virus to be within that area.