PAHO Urges Southern Hemisphere to Remain Alert for Influenza A(H1N1)

Expert says stigmatization of affected people and countries is unwarranted

Washington, D.C., May 5, 2009 (PAHO/WHO) — While the vast majority of confirmed cases of influenza A(H1N1) have been in the Northern Hemisphere, a top Pan American Health Organization (PAHO) expert today cautioned that Southern Hemisphere countries should remain on high alert, as their winter season is just now beginning. 

"There is a strong likelihood that there will be an upsurge of cases in your countries," said Dr. Jon K. Andrus, PAHO's lead senior technical advisor in immunizations. "Implementing your pandemic plans is very important. Most countries are already protecting their populations with seasonal vaccination as we speak. In addition, most, if not all, of our Southern Hemisphere countries have already enhanced their surveillance and monitoring procedures. The challenge will be not to drop your guard."

North America (Mexico, the United States and Canada) currently accounts for all but 7 of the total 1,255 confirmed influenza A(H1N1) cases in the Americas. Three other countries in the PAHO region have reported the 7 additional cases: Colombia (1), Costa Rica (4), and El Salvador (2).

Andrus noted that the World Health Organization's pandemic alert level could be raised from 5 to 6 if sustained community transmission of influenza A(H1N1) were to be found in another WHO region.

"In our region, most countries are already implementing their emergency plans," said Andrus. "The term phase 6 is more relevant for the rest of the world than it is for us because we are already implementing our emergency plans."

Andrus emphasized that PAHO and WHO are recommending that countries not impose travel restrictions nor close borders.

"We would also like to emphasize that countries around the world should be fair with individuals. It is not helpful to blame or stigmatize people who happen to be citizens of affected countries or happen to become victims of the disease."

Andrus also described how Mexico is currently handling suspected cases of influenza A(H1N1).

First, providers decide whether a patient's symptoms warrant a test for influenza A. If appropriate, treatment is provided. Next, depending upon the facility's capabilities, the specimen is tested on site or sent to a reference laboratory for analysis. If the result is positive for influenza A, the patient is classified as a probable case, and the specimen is sent to a more specialized lab to determine if it is positive for influenza A(H1N1). If the result is positive, the case is considered confirmed.

Subsequent investigation focuses on when and where the patient may have been infected, and who else might have been exposed. Known contacts are notified and tested as well.

In addition, virologists study the virus's genetic makeup to better understand it and determine how it may be mutating.

"I hope you can begin to imagine the huge volume of effort that all this work entails," Andrus said. He added that PAHO, the Public Health Agency of Canada, and the U.S. Centers for Disease Control and Prevention (CDC) are assisting these efforts by mobilizing their own experts as well as others from countries throughout the hemisphere.

"We have never had such close surveillance of the emergence of a new virus such as for this new influenza A(H1N1) virus," said Andrus, "and so we are learning as we go."

PAHO, founded in 1902, works with all the countries of the Americas to improve the health and quality of life of their peoples. It also serves as the Regional Office for the Americas of the World Health Organization (WHO).

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