It is no longer possible to contain the deadly swine flu virus first found in Mexico, the World Health Organization (WHO) says. As a potential pandemic edges closer, governments around the world have been stepping up precautions against its spread.
AFRICA
Nigeria
In Africa’s most populous state, health minister Babatunde Osotimehin told the BBC his government was increasing surveillance, providing information about the disease to the public and medical centres, and making sure there were sufficient supplies of antiviral drugs. Nigeria was badly hit by bird flu three years ago.
Zambia
The authorities have formed an emergency task force to deal with a possible outbreak of swine flu.
AMERICAS
Argentina
The health authorities have been ordered to watch for an increase in respiratory illnesses and to promote vaccinations and preventative hygiene habits among health workers and the public. Flight crews have been urged to tell the authorities immediately if they or passengers experience any flu-like symptoms on flights from Mexico. The immigration authorities have been asked to provide information about passengers who arrived from Mexico in the last 15 days. The health ministry has said the stocks of Tamiflu are enough to provide 500,000 treatments, the Argentine press reported.
Bolivia
The government has declared a “state of health alert”. National director of epidemiology Eddy Martinez has said the control mechanisms for swine flu are based on what was done to prevent bird flu. If a case of swine flu were found in Bolivia, health-service workers would be transferred to all airports and border areas, he said.
Brazil
Plans are in place to monitor passengers arriving from Mexico and the US. Flight crews have been asked to discuss flu-like symptoms with passengers during flights. Travellers who arrive in the country from Mexico are having their luggage sterilised. People coming from those countries are being advised to avoid close contact with other people for the first 48 hours after their arrival. The company that manages Brazil’s international airports has said it can create special parking hubs for aircrafts coming from countries where the disease has been confirmed.
Canada
After six cases were confirmed in Canada, all involving only mild illness, the government said it was stepping up surveillance for possible new cases and urged people to take precautions like frequent hand-washing.
Travel to Mexico
Australia, Chile, India, Japan, New Zealand, Taiwan, South Korea, Singapore have issued advisories against travel to Mexico.
Japan advised its nationals in Mexico to consider returning home soon and has suspended visa waivers for Mexicans.
The European Union’s health commissioner, Androulla Vassiliou, said her personal advice to travellers would be to avoid areas of Mexico and the US where cases of swine flu have been reported.
Chile
All passengers arriving by plane from Mexico and the United States are being scanned for signs of infection. The authorities have also warned against travel to Mexico and the US, and border officials are on alert to monitor passengers arriving by land who have flu-like symptoms.
Colombia
Increased monitoring and preventative controls are in place at hospitals, ports and Bogota’s main airport, especially for people arriving from Mexico City, Texas and California.
Cuba
State-owned Cubana Airlines cancelled its Havana to Mexico City flight for Tuesday, but it did not explicitly say the cancellation was for flu protection reasons. Flights to and from Mexico will remain limited and officials are monitoring passengers arriving from Mexico. The island is updating its capabilities for epidemiological clinical surveillance and for providing treatment for the population through the public health system.
Ecuador
Health officials are to carry out medical checks on people with flu symptoms arriving via air and sea from affected countries.
El Salvador
Health officials in El Salvador are to watch for flu cases at the borders with Guatemala and Honduras.
The only deaths so far from the swine flu virus have occurred in Mexico
Guatemala
The country is able to provide 3,000 treatments with Oseltamivir to 1,500 adults and the same number of children. Health ministers from Guatemala, Nicaragua, Panama and Dominican Republic will seek to create a “sanitary cordon” in the region. Mexico’s southern neighbour has prohibited imports of Mexican animals and agricultural goods.
Mexico
The only deaths so far from swine flu have been in Mexico, where the outbreak originated. All schools, gyms and courts have been closed until 6 May to prevent contagion. The Mexican government has faced criticism for what some see as its slow response to this outbreak. In Mexico City, surgical masks have been given to the public. President Felipe Calderon has assumed new powers to isolate infected people.
Nicaragua
The health ministry has declared a health alert.
Panama
Airport officials are screening 40 flights a day from Mexico.
Peru
Airport controls have been reinforced in order to detect anyone with flu symptoms entering the country.
Trinidad and Tobago
The twin-island Caribbean state is increasing health checks on air travellers arriving from affected countries. The regional political grouping Caricom told the BBC its member countries have different levels of stockpiles and programmes of vaccinations against flu.
United States
The US was the second country to confirm flu cases; health officials have declared a public health emergency. President Barack Obama has said the outbreak is “cause for concern but not cause for alarm”. The state department says it is not yet prepared to restrict travel to Mexico but advises nationals against non-essential travel to Mexico. Inspections have been boosted at US borders and airports. Some schools have been closed in New York City, Texas, California, South Carolina and Ohio.
Venezuela
Health controls at airports have been stepped up to prevent the contagion from spreading. Venezuelans have been recommended to avoid travel to the US and Mexico. Any potentially ill travellers – particularly from the US and Mexico – are being isolated until the cause of their disease is determined.
Stocks of the relevant medicines are also being built up. The ministry of agriculture says they are “closely inspecting” pig farms in the country and have suspended imports of pork and live pigs.
ASIA-PACIFIC
Australia
With 8.7 million doses of Tamiflu and Relenza drugs stockpiled, Australia has enough antiviral drugs to cover about 41% of its 21m population. It also has large stores of surgical masks.
China
The authorities appear to have learned the lessons of previous deadly virus outbreaks such as the H5N1 avian flu and Sars (Severe Acute Respiratory Syndrome), and this time around have been quick to share information with the WHO. The central government has put in place a joint prevention and control system and hospitals have been told to report any suspected cases of swine flu swiftly. The official press is primed to report swiftly on cases of infection.
Citizens have been advised not to make tourist trips to Mexico and body temperature checks on passengers and crew at ports of entry have been re-introduced. Stockpiles of disease control equipment, antiviral drugs and clinical equipment have been increased. China has also banned imports of pork and pork products from Mexico and the US states of Texas, Kansas and California.
Hong Kong
Hong Kong authorities have 20m doses of Tamiflu and other anti-flu medication, media reports say. Port health protection measures have been increased, including body temperature screening machines at all checkpoints.
Asia has recent experience of crises involving respiratory illnesses
Indonesia
Temperature scanners have been installed at 10 airports and ports with immediate effect. At least 3m Tamiflu capsules are in stock.
Japan
The central government has Tamiflu and Relenza combined stockpiles which would cover nearly 20% of the population. Local governments have their own stockpiles but figures are not available. Passengers from Mexico, Canada and the US are being checked at international airports.
Kyrgyzstan
The import of meat products from the US and Mexico has been temporarily banned.
Malaysia
Tamiflu stockpile covering more than 2m people out of a population of 27m. It does not have a stockpile of personal protection equipment such as face masks for the general population yet, but has a supply for health staff who will be dealing with any outbreak.
New Zealand
With a number of confirmed cases already, public health officials say they have “ample stocks” of anti-flu drugs. The country built up a stockpile after the bird flu scare sufficient to cover between 25 and 30% of the 4.3m population.
Singapore
Thermal scanners are set up at airports and isolation units at hospitals, where staff at some emergency departments are wearing full protective clothing. Asean has 500,000 courses of antivirals stockpiled in Singapore (and a similar amount distributed among member states).
South Korea
Health authorities have a Tamiflu stockpile for 2.5m people and are working to increase that to 10% of the population of about 49m.
Taiwan
Taiwan currently has supplies of swine flu treatment to cover 10% of its 23m population. More than 1m facemasks for emergency use are available.
Thailand
The government has 320,000 courses of Tamiflu stockpiled. GPO, a state-owned drug-maker, can produce 1m capsules of generic Tamiflu if needed. Temperature screening checkpoints are in place at international airports in Bangkok, Chiang Mai and Phuket. The main targets for the thermal scanners were passengers on eight routes – from France, Tokyo, Dubai, Frankfurt, London, Chicago, Los Angeles and Texas – which had connecting flights from Mexico. Suspected cases of new arrivals will be put under close surveillance for three to five days during their stay in Thailand.
Philippines
Government says there are sufficient face masks and Tamiflu in stock. Surveillance and other measures have been stepped up at entry points. Thermal scanning of all arriving passengers from countries with reported swine flu cases is in place.
Vietnam
Ho Chi Minh City, Vietnam’s largest city of more than 8m people, has stocks of Tamiflu sufficient for a million people.
EUROPE
Austria
The authorities have stocks of antiviral drugs sufficient to treat 4m people (half the population), and have secured production capacity for prophylactic vaccines for the entire population. They have also stockpiled 8m protective masks.
Belgium
The country has 500,000 anti-viral treatments and the capacity to make 2m more. In addition, it has 32m face masks for patients and 6m for healthcare professionals.
Bulgaria
The government plans to post information on its website about swine flu and advice for passengers travelling to and from affected countries. Two thermal scanners have been installed at Sofia airport.
Czech Republic
The country has stocks of 2m doses of Tamiflu, enough to treat 20% of the population. General information on the viral strain has been circulated to hospitals, doctors and GPs. At Prague Airport, information boards on swine flu have been put up and medical examinations are available.
Denmark
A general pandemic plan has been in place since the bird flu scare. Denmark has stockpiled Tamiflu.
France
French nationals have been advised not to travel to Mexico. Checks at airports have been reinforced, especially for people returning from Mexico. France has a stock of more than 30m antiviral treatments, composed of 24m doses of Tamiflu and 9m doses of Relenza.
Germany
Nationals have been advised against non-vital travel to Mexico.
Greece
Has “strategic stocks” of Tamiflu and other antiviral medication.
Italy
Pamphlets are being handed out to passengers at Rome’s international airport, although there are no restrictions on travel. Italy has 10m doses of Zanamivir (Relenza) and 60,000 doses of Tamiflu, as well as enough Tamiflu powder to make 30m doses.
Norway
A “pandemic committee” will be assembled this week. Authorities have stored flu medicine covering one-third of the 4.7m population.
Russia
The health ministry recommends Russian citizens avoid trips to Mexico. Aircraft personnel arriving from the Americas have been instructed to look out for passengers with flu-like symptoms. Planes on which cases are suspected should be taxied to special zones, and passengers and crews examined by medics. Curbs have been imposed on meat imports from Mexico, a number of US states and the Caribbean.
Spain
The first European country to confirm a case of the virus, in a man who had recently returned from Mexico, Spain is distributing leaflets to other passengers arriving from there, advising them to report to a health centre if they suffer symptoms. Spain has a stockpile of 10m doses of Tamiflu. Flights to Mexico are being supplied with face masks and gloves.
UK
An outbreak in Scotland, in a couple returning from Mexico, was the UK’s first confirmed case of swine flu. The British government stresses it has enough antiviral drugs to treat more than half the population if necessary. Nationals have been advised against non-vital travel to Mexico.
Ukraine
Imports of live pigs and pork meat from countries where cases of swine flu have been recorded, including Mexico, the US, Canada and New Zealand, have been banned. All shipments received after 21 April will be subject to the ban.
MIDDLE EAST
Egypt
The authorities have increased numbers of medical staff at Cairo airport to check passengers arriving from Mexico and will monitor them during their stay.
Israel
The country has one confirmed case of infection. Health officials are meeting to decide on “specific policies and measures to counteract the new epidemic”.
SOUTH ASIA
Bangladesh
Travellers, particularly those coming from countries already hit by swine flu, are to be screened by teams comprising medical officers, epidemiologists and representatives from the WHO and the International Centre for Diarrhoeal Diseases Research in Bangladesh.
India
Preventative measures such as surveillance at ports and international airports have been taken, and people have been advised to defer non-essential travel to the affected areas.
The states within India have been advised to review their preparedness to investigate and contain any suspected cluster of swine flu cases, with central government providing expert, logistics and laboratory support. A toll-free call centre number has been set up for the public to report incidents of illness.
An Indian newspaper reports that the drug company Cipla has received orders from Latin America, Mexico and Israel for the antiviral Tamiflu. India has stockpiles of 1m Tamiflu doses and has requested another million doses which it expects to receive within about a week.
Nepal
Visitors from the US and Mexico will be screened, local media report. A team of health professionals will be stationed at Tribhuvan International Airport with a health-related questionnaire and take immediate action if anyone is suspected to have contracted the flu.
Sources: Reuters and other news agencies, BBC World Service
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