Media Briefing: Influenza A (H1N1)
(Conducted by Dr. Jon K. Andrus, Pan American Health Organization, May 11,  2009)

Good afternoon. Welcome again to members of the press corps on the line, and thank you for taking the time to listen to today's briefing by the Pan American Health Organization on the Influenza A (H1N1) epidemic.

  • Today, I will focus on two issues: firstly, an update on the Influenza A (H1N1) candidate vaccines, and then secondly, implications of public health disease surveillance.

  • As expected, the H1N1 virus is spreading south to more countries of Central and South America. We estimate that in the Americas >4700 cases have been reported. A total of 54 deaths have been reported: Mexico 48, USA 4, Canada 1, and Costa Rica 1.

  • We are dealing with a new disease caused by a new virus that no one has ever seen before. Therefore, humans have no prior protective immunity and we just don't know what is going to happen.

  • One very positive development is the number of institutions advancing rapidly on the vaccine front. WHO Collaborating Centers at the CDC in Atlanta, and the National Institute for Biological Standards and Control in the UK are among a half-dozen laboratories that are developing candidate vaccine viruses using reverse genetics technology, and two of these expect to have their candidate viruses ready by the end of the month.

  • At least 3 other laboratories are working on vaccine virus candidates using the classical reassortant technology, and four others are developing vaccine potency reagents.

  • In addition, wild virus samples have been sent directly to at least 10 vaccine manufacturers for use in developing the necessary vaccines.

  • As I have said before, this rapid progress means that we may have H1N1 vaccines available within the next 6 months. Meanwhile, we need to remain focused on what we can do as individuals, and what our society as a whole can do to support our individual actions.

  • From an individual standpoint, I need to ask myself: What can I do to protect myself and my family from catching influenza A(H1N1)?

  • The main route of transmission of the new influenza A(H1N1) virus seems to be similar to seasonal influenza, via droplets that can be expelled by speaking, sneezing or coughing.

  • You can prevent getting infected: by avoiding close contact with people who show influenza-like symptoms by trying to maintain a distance of about 1 metre if possible, and by taking the following measures:
    • Avoid touching your mouth and nose; 
    • Clean hands thoroughly and frequently with soap and water; you can also use an alcohol-based hand rub on a regular basis; 
    • Reduce the time spent in crowded settings if possible; 
    • Improve airflow in your living space by opening windows; 
    • Practice good health habits including adequate sleep, eating nutritious food, and keeping physically active.

  • So what can society and the public health infra-structure do to control this outbreak? With a new disease, we need the best information to be able to understand it and therefore take the measures that will ensure the most effective outbreak response.

  • In the early phase of the epidemic, when countries try to combat the first cases, they try containment strategies, such as school closure and restricting attendance to public events. These strategies may help slow down the outbreak, which is good. We want to avoid overwhelming the health system.

  • We are learning that these measures may be helpful during the initial phases, particularly if the first cases in a country are from a smaller village or school.

  • Eventually, though, transmission spreads, and such measures are much less effective, if at all, during the later phases of the outbreak.

  • By far, one of the most important things we can do is implement effective surveillance so we can monitor trends and better understand risk factors.

  • Effective disease surveillance will help us identify people who have a more severe form of the disease so they can receive life-saving attention and treatments in a more timely fashion.

  • We have learned that the deaths in Mexico have occurred generally in two groups: one group includes people with chronic disease and the other includes young, healthy adults aged 20-40 years. The first group makes sense: they have chronic diseases which pose well-known risk factors for complications when stressed with acute infection. What we have learned about the second group is that these folks tended to reach the health facilities late, and therefore received the necessary medical attention and treatments late.

  • So, enhanced, more effective surveillance should help us prevent unnecessary deaths in countries newly reporting cases, particularly in the Southern Hemisphere.

  • PAHO and CDC are working to ensure as many of the accurate test kits as possible are getting to the countries. We are also discussing plans to ensure sustainable supplies of these kits over the long haul.

  • What is going to happen? We just don't know, so that is why it is vitally important that all measures address the long-term, as well as the short-term implications of understanding and controlling this outbreak.

  • Please refer to the PAHO and WHO websites for materials on pandemic preparedness.

Let me stop there to address any questions that you may have. Thank you.

(You can watch this media briefing on PAHO's Webcasts Page)