The World Health Organization is convening a meeting of its emergency committee on pandemic influenza today to seek its advice on whether to move the current outbreak of swine influenza to Phase 6, which describes a full-scale pandemic.

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Phase 6 by definition implies that a new strain of influenza to which most or all people are susceptible is spreading freely in at least two regions of the world. If WHO moves to Phase 6, it will be acknowledging what has been clear for several weeks — that there is “community transmission” of the novel strain of influenza A (H1N1) in places other than Mexico, the United States and Canada.

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Clinical information on this SRI from Mexico remains the same:

  • Initial symptoms:  high fever, headache, eye pain, shortness of breath, extreme fatigue
  • Rapid progression to severe respiratory distress within about 5 days, many needing mechanical ventilation
  • Most cases are previously healthy young adults (age 25-44), including some health care workers
  • The outbreak virus is resistant to amantadine but sensitive to oseltamivir.  The current seasonal influenza
  • vaccine is not expected to provide much if any protection against this new swine flu virus.

Severe Respiratory Illness (SRI) in Mexico another example of need to take care with SRI
Recent media reports on serious respiratory illness (SRI) in Mexico are a good reminder that unusual SRI’s can occur anywhere in the world.  It is important to take care to protect yourself, your patients, and other health care workers against infectious SRI.
BCCDC has advised that two clusters of about 100+ patients with SRI have been identified in various parts of
south and central Mexico.  Nine of the patients died.  The situation is still under investigation and it has not yet been determined if these cases of SRI are unusual or not.  Here is what has been reported at this point:

  • The cases developed influenza-like illness (ILI) (ILI is typically defined as fever + cough + other symptoms.)
  • Rapid progression to severe respiratory distress within about 5 days
  • A high proportion of cases required mechanical ventilation
  • The case-fatality rate was relatively high among hospitalized patients (5% in one cluster and 20% in the other)
  • Most cases were among previously healthy young adults
  • Some health care workers were affected0aeee8fc-a67e-4b72-89ea-ad496b45b204.jpg