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H A I T I

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Haiti Earthquake: Health Q&As

 

What has been the health impact of the earthquake?

The earthquake has inflicted massive loss of life. The total number of people who have died in the disaster is not yet known but is believed to be in the tens of thousands, with hundreds of thousands injured or homeless.

What health care is available?

The earthquake damaged or destroyed at least eight hospitals and healthcare facilities in and around the capital, Port-au-Prince, and the remaining health facilities have been quickly overwhelmed by large numbers of survivors requiring a wide range of care, particularly for trauma injuries.

Before the earthquake, there were 371 health posts, 217 health centers and 49 hospitals nationwide in Haiti. In Port-au-Prince there are 11 hospitals. The total extent of the damage to Haiti's health sector is still unknown. Many hospitals have sustained damage but can continue to function, often with the help of NGOs.

Health services are also being provided at various health centers along Haiti’s border with the Dominican Republic. Some injured are being evacuated to Santo Domingo or to other countries.

Local organizations, including the Haitian Red Cross, are supporting government efforts to treat the injured and ill. Additionally, at least 13 countries from the Americas and a number of countries from other regions are providing health relief, along with United Nations agencies and NGOs.

Why is the coordination of healthcare so crucial?

Coordination between healthcare providers and first responders is crucial to enable effective and fast life-saving aid. If UN agencies, NGOs and other agencies work together and share expertise, medicines, staff and other capacities, while at the same targeting them to identified and commonly understood health needs, then there is a greater chance of reducing avoidable suffering and death in Haiti.

Following previous disasters, including the Asian tsunami of December 2004, intensive efforts to deliver relief aid in some cases were not properly coordinated, resulting in wasted materials and/or materials not well matched to specific needs. Subsequent humanitarian reform efforts produced a new "Cluster” approach," in which agencies performing humanitarian work are grouped together as clusters in their various areas of humanitarian response. The World Health Organization heads the Global Health Cluster and as such is the international lead for the health response to the Haiti crisis.

Is more healthcare relief needed?

Yes, but it needs to be introduced in a coordinated fashion so as not to overwhelm an already precarious situation characterized by damaged roads and infrastructure.

Due to the large number of people needing medical care, more doctors, surgeons, nurses, midwives, and other health workers are needed to help provide medical care.

What are the needs in relation to field hospitals?

Multiple field hospitals are operating and others are being sent to Haiti. The medical needs are great, but it is also important to properly coordinate the delivery of additional facilities so as not to overburden an already over-stretched situation.

How has the earthquake affected WHO activities?

The earthquake severely damaged the PAHO/WHO premises in Port-au-Prince and forced all staff to temporarily relocate their operational HQ to Haiti’s central medicine and vaccine storage warehouse near the airport, while the original HQ building is assessed for structural safety and telecommunications can be restored. PAHO/WHO also is establishing a field office in Jimani, Dominican Republic, located 1 ½ hours from Port-au-Prince, to serve as a bridge for the management of supplies and medical relief teams.

Do dead bodies pose a public health threat?

No. There is no risk of a communicable disease outbreak or any other public health threat associated with the presence of dead bodies.

However, there is a clear mental and psychosocial imperative that we have to take into consideration when supporting the fast and proper management of dead bodies.

Dead bodies in the streets are being taken to a central location for eventual identification and burial. It is important to avoid mass burials and to respect the rights of families to know the fates of their lost loved ones. For more information, go to www.paho.org/disasters.

What is WHO doing?

Around 20 WHO international staff from the Americas region and elsewhere in the organization's global network have been deployed to Haiti to assist in public health actions, mass casualty management, dead body handling, coordination, logistics and communications. These staff are supporting the approximately 52 staff working for the WHO Haiti country office.
The World Health Organization has dozens of staff in its Geneva headquarters and at the Pan American Health Organization headquarters in Washington, DC, working around the clock in support of the Haiti operations.
WHO is supporting Haiti’s Ministry of Public Health and coordinating the Health Cluster response. The Global Health Cluster has developed rapid health assessment tools that can be quickly adapted and used.
WHO will engage with the military to best utilize their logistics capacities, heavy equipment, expertise and experience to swiftly respond to the disaster. There are 9,000 UN troops in the country. 10,000 US soldiers are expected to be deployed.
WHO will work with the Haitian government and partners to embark on recovery and reconstruction efforts, assessing, rebuilding and helping the people of Haiti on the road to recovery.
What are others doing?

Countries in the Americas and around the world are offering to send and are already sending a great deal of assistance. The international mobilization and response is really extraordinary.
Examples include: Brazil sending plane-loads of equipment, medical supplies and staff; Chile sending a medical team to support an Argentine military hospital already operating on the ground; Ecuador, Peru, and several others sending medical supplies; Cuba sending medical teams; Jamaica is now receiving the overflow of patients into its nation’s hospitals and also sending several medical staff by its Coast Guard directly to Haiti; (as noted above) the Dominican Republic is receiving and caring for patients who have evacuated; Venezuela has sent plane loads of staff and fuel; and the response from the US and Canada has been extraordinary. Also countries from Europe (UK, France, Italy, Belgium and Spain in particular) and as far away as Israel and China are sending support.
Many representatives of smaller aid missions, and even individuals, want to join these efforts, many of them offering valuable skills. However, at this stage the situation is so difficult on the ground in Haiti that all outside aid teams must be completely self-sufficient.
Many WHO partners are already operating in the affected areas and are sending additional support. These include MSF, IFRC,
What is the situation regarding funding?

WHO has released almost US$­300,000 (Pan American Health Organization US$­220,000 and WHO Health Action in Crises US$­75,000) to provide for urgent response needs.
WHO and Health Cluster partners (UNICEF, UNFPA, UNAIDS, IOM, Save the Children, World Vision, International Medical Corps, International Rescue Committee, Merlin, Médecins du Monde, and Handicap International) have appealed for US$­ 34.3 million in the Flash Appeal launched 15 January.
Funding is being sought to support efforts to coordinate the health sector response, for disease outbreak control, to reactivate basic health care services, and for medicines and essential health supplies.
What can be done to reduce the impact of such disasters? What are the lessons learned?

In the health sector, one of the most important lessons we have learned—over and over again—is the importance of hospitals in the aftermath of a disaster.
All too often hospitals become victims of disasters themselves and are unable to provide their services precisely when they are most needed. This is exactly what has happened in Haiti.
But it is not inevitable. We know hospitals can be built to withstand the impact of disasters and can be planned and equipped to remain functional after disasters.
The additional cost of building hospitals to be disaster-safe is marginal, particularly in comparison to the cost of a failed hospital. Moreover, it is much less expensive to include earthquake safety measures at the design and construction stage than to retrofit a facility that has been damaged and is unable to function.
What was the humanitarian situation in Haiti like prior to the earthquake?
Haiti has already suffered from previous humanitarian crises and natural disasters, including a series of hurricanes that battered the country in 2008.
This has been the strongest earthquake ever recorded in Haiti along this fault line. Haiti is the poorest country in the Western Hemisphere and ranks 154th on the United Nations Human Development Index.
In 2008, Haiti was devastated by four major hurricanes/tropical storms: Faye, Gustav, Hanna and Ike, which wreaked havoc on physical and agricultural infrastructure. The storms killed almost 450 people, affected a million residents and left more than 150,000 living in shelters.
Haiti is in the group of 10 countries with lowest diphtheria toxoid, tetanus toxoid and pertussis vaccine (DTP3) coverage: 53% (2008) according to WHO/UNICEF estimates.
What can individuals do to support the international response?
Financial contributions to the health response are the most effective support that people around the world can provide. Information on donating to the Pan American Health and Education Foundation's Haiti appeal



*

Haiti Earthquake: Health Q&As

 

What was the impact of the earthquake?

As of 15 February, the national Civil Protection Agency estimates that 217,366 people died from the 12 January earthquake. More than 500,000 people have left Port-au-Prince for outlying departments, including nearly 100,000 who have gone to Grand Anse and more than 160,000 to Artibonite. The Government estimates that 97,294 houses were destroyed and 188,383 were damaged.

What are the most pressing health challenges?

Immediately following the quake, trauma injuries were the most urgent medical concern, but the focus now is on follow-up of patients who have had surgery as well as basic primary healthcare services, including services for maternal-child health and chronic diseases including diabetes, heart disease, HIV, and tuberculosis, among others. TB is a particular concern, as care has been interrupted for many of the 3,000 patients who were on treatment before the quake.

Cases of acute respiratory infections, acute diarrheal disease and tetanus have been reported without any epidemic characteristics up to now. The rainy season will increase the risk for childhood diseases such as acute respiratory infections and diarrhea as well as the risk for vector-borne diseases including malaria. There have been reported suspected cases of measles, but laboratory tests so far have been negative for measles.

Rehabilitation, including physical therapy, for amputees and other injured survivors will be critical to prevent or limit future disabilities. The Ministry of Health’s National Plan for Disability will deal with areas such as rehabilitation centers, prosthetics, orthotics, and accessible structures.

While there are no reliable statistics on mental health problems in Haiti prior to the earthquake, it is evident that demand for mental health care has increased dramatically, and resources are scare, thus creating a large need for clinicians in this area. Special efforts will be required to address the mental health needs of people who have had amputations, who have been victims of rape and/or violence, or who were unable to identify and properly bury family members who died in the quake. PAHO/WHO has been working with national authorities to improve mental health services, in particular through the completion of a mental health assessment that will support the development of a preliminary plan of action for the short, medium and long term.

What health facilities are in place to respond to health needs?

According to hospital assessments, there are 91 identified functioning hospitals, of which 59 are in the Port-au-Prince metropolitan area (4 public hospitals, 21 field hospitals, and 34 NGO- or private-run hospitals providing free health care since the earthquake). Fifty-six of these 59 have surgical capacity.

Mobile clinics are being deployed in 250 spontaneous settlements identified by the government. Also, 87 community outpatient care centers/mobile units for treatment of severe malnutrition are open throughout Haiti.

The Ministry of Health, PAHO/WHO and other partners have worked to establish an emergency surveillance system for disease control. A situation room was created for national and international partners to monitor and investigate cases and provide information to decision makers. Of particular concern are water-borne diseases and respiratory illness.

There are 52 government-defined sentinel sites to monitor diseases, 12 of which are located in Port-au-Prince and the surrounding area. Six of the 12 have begun reporting daily. Three mobile teams organized by the Ministry of Health, the US Centers for Disease Control and Prevention, and PAHO/WHO are conducting investigations. The Health Cluster subgroup on mobile health facilities has highlighted the need to include epidemiological surveillance in the activities of mobile clinics.

Is more healthcare relief needed?

Yes. Due to the large number of people needing medical care, more doctors, surgeons, nurses, midwives, and other health workers are needed to help provide medical care. PAHO/WHO is maintaining a web-based database of volunteers, shared with other agencies, to help match skills to needs on the ground. Potential volunteers may register at www.paho.org/haitivolunteers.

To ensure continuity of care and better meet existing needs, Haiti’s Ministry of Health has requested that all health partners currently working in Haiti provide information on where they are active and when they are leaving, and that organizations just arriving plan to stay between six months and one year.

What are future health challenges and what is being done to respond to these?

The impact of purely humanitarian relief interventions will soon reach its limit, and the focus is now shifting to ensuring that health services can be delivered while reconstruction and recovery efforts proceed. The international humanitarian community launched a revised Flash Appeal for Haiti on 18 February to respond to longer-term needs of Haitians, over a 12 month period, as they recover from the earthquake. PAHO/WHO and health sector partners are seeking US$­134 million to fund a wide range of projects in various fields that will, in turn, strengthen the Ministry of Health’s authority over the health sector and to re-establish the functionality of its health system.

Through the Flash Appeal, PAHO/WHO aims to do this through various projects, including:

Making essential medicines and supplies available
Ensuring surveillance and response to communicable diseases outbreaks
Reactivating basic health services
Coordination, assessment, disaster risk reduction
Environmental health
Supporting the Dominican Republic’s health response to Haitians
Post-earthquake rehabilitation
Control of vaccine-preventable diseases
Reactivating specialized health care in the Port-au-Prince metropolitan area
In the short term, the objectives are to make Haiti’s health districts operational and to ensure essential health services are available in affected areas. But over the longer term, Haiti will need help to rebuild its damaged health infrastructure, build institutional capacity to improve the health system in affected districts, and create the foundations for a sustainable, permanent health system.

Haiti also needs continuing support to maintain critical lifesaving interventions and to accelerate the pace for attaining health and nutrition-related Millennium Development Goals.

For more information regarding health sector funding needs, see:
http://ochaonline.un.org/tabid/6412/language/en-US/Default.aspx
Donor update: http://www.who.int/hac/donorinfo/haiti_alert_17february2010.pdf

What is happening regarding vaccination?

On 2 February, 2010, the Ministry of Health, with support from PAHO/WHO, UNICEF and nongovernmental partners, began a targeted immunization campaign focused on populations in temporary settlements. The campaign includes measles-rubella and diphtheria-tetanus-pertussis (whooping cough) vaccines for children under 7 and diphtheria and tetanus for older children and adults.

The first phase of the campaign is ongoing in temporary settlements and targets approximately 1.5 million people.

This number includes 250,000 children aged 6 weeks to 7 years, of which 175,000 are located in the Port-au-Prince metropolitan area and the remainder in affected towns in the west of the country, namely Petit Goave, Grand Goave, Léogane, and Gressier, plus Jacmel in the south.

The remaining 1.2 million people, including children over 8, adolescents and adults of all ages (men and women), will be vaccinated against tetanus and diphtheria.

The second phase of the vaccination aims to vaccinate the entire population once the situation has stabilized.

All aid workers going to Haiti should be vaccinated against both measles and rubella to prevent any volunteer who is not immunized from bringing measles or rubella into the country.

What will be the impact of the upcoming rainy and hurricane seasons on Haitians affected by the earthquake?

Heavy rain on 11 February already affected earthquake survivors in the tent camps of the Haitian capital. The tropical rainy season could start within weeks, and the Caribbean hurricane season begins on June 1, with the drainage canals of the capital choked with trash and earthquake rubble. Haiti has been virtually stripped of trees and is prone to deadly flash floods and mudslides.

What is the situation regarding drug supplies to health facilities?

To meet the enormous health challenges posed by the earthquake, Haitian authorities, United Nations agencies and donor countries have provided tons of medicines to scores of health partners on a daily basis through a large-scale coordinated effort run out of Haiti’s pharmaceuticals hub in Port-au-Prince, PROMESS (Program on Essential Medicine and Supplies), which is managed by PAHO/WHO. Established in 1992, PROMESS provided vital support for Haiti’s health system even before the quake. Following the disaster, it became a critical first line of response.

The Ministry of Health has guaranteed that medical products will be free to all public health facilities throughout Haiti until 12 April 2010. Specifically:

Public health institutions and Departmental Supply Centers (CDAI) will continue to have access to medicines and medical equipment at no cost through PROMESS.
Health services, including mobile clinics in camps for displaced persons and spontaneous settlements that are not dependent on any international NGO and that are accredited by the Ministry of Health will also benefit from free medicines and medical supplies.
International organizations, international NGOs, national NGOs, and charitable and religious organizations authorized to operate by the Ministry of Health will be able to obtain supplies from PROMESS and should defray the costs of under the payment modalities in effect prior to the disaster of 12 January.
Medicines and medical supplies received by PAHO as donations will be distributed at no cost to public health facilities through PROMESS. (These donations must conform to the quality standards established by PAHO/WHO.)
With help from the U.S. Government, a team of pharmacists and medical logisticians is sorting, classifying and checking expiration dates of donated drugs and getting them onto the shelves in PROMESS. The United States, Italy, Austria, Switzerland, Spain, Pakistan, Egypt, the Queen Sofia Foundation (via the Spanish Agency for International Cooperation), Chile, Taiwan and the Clinton Foundation, among many others, have provided medicines and supplies.

PAHO and WHO have clear guidelines on how to be a ‘good donor.’ These guidelines are available on the PAHO website www.paho.org/disasters (click on How to Donate).

What is the situation regarding amputees?

Among the many people injured in the earthquake, hundreds—if not thousands—suffered serious injuries that required amputations of limbs, hands and fingers. PAHO/WHO experts in disabilities are helping plan for the short- and longer-term needs of people who have undergone amputations and who require intensive wound care and rehabilitative services.

The Ministry of Health will complete a National Plan for Disability by 1 March that will encompass rehabilitation centers, prosthetics, orthotics, and accessible structures. Handicap International, Miami University, Healing Hands, and soon, CBM, are currently providing physical therapy in half or more existing hospital facilities.

Handicap International, CBM and the le Secretariat d’Etat a l’Integration des Personnes Handicapees (SEIPH) are currently working on funding to establish a common database and a hotline on disabilities. SEIPH has working with its counterpart in the Dominican Republic to help meet needs in Haiti.

What is the situation regarding malaria?

Malaria and dengue are widespread in Haiti during the rainy season (which begins in April), and the current conditions in which displaced Haitians are living will increase the risk of outbreaks. Thousands of anti-malarial bed nets have been provided to affected people. The Global Fund to Fight AIDS, Tuberculosis and Malaria is financing malaria programs in Haiti and has arranged to have an emergency supply of anti-malaria drugs sent to help Haiti maintain supplies in case of an increase in infections.

What is the role of the Health Cluster in Haiti?

The Health Cluster has helped coordinate the activities of, and the sharing of information among, more than 390 registered partners from the health field, including United Nations agencies, international organizations and NGOs.

PAHO/WHO is acting as the Health Cluster lead and coordinates the multiple partners and health actions in Haiti. Within the Health Cluster, several subgroups have been created to better meet the needs of the population, including: Primary Health Care/Mobile Clinics, Reproductive Health, Hospitals, Information Management, Mental Health, Epidemiology, Vector control, and Disability (led by Handicap International and CBM).

The Health Cluster also coordinates with other clusters, including those dedicated to logistics, water and sanitation, and nutrition. If UN agencies, NGOs and other agencies work together and share expertise, medicines, staff and logistics capacity, while at the same targeting identified and commonly understood health needs, there is a greater chance of reducing avoidable suffering and death in Haiti.

Why is sanitation a concern, and what is being done to address it?

Achieving “shelter before the rains” —that is, making sure everyone has some form of shelter— and improving sanitation and hygiene are top priorities for the humanitarian response.

Sanitation is a massive challenge that must be urgently resolved; an increasing number of diarrhea cases are being reported. If shelter and sanitation are not adequately addressed before the rainy season arrives, the risk of epidemic outbreaks of water-borne and other diseases will increase.

Sanitation in the temporary settlement sites remains a concern. The WASH Cluster estimates that a total of 1.1 million displaced people in Port-au-Prince, Leogane, Petit Goave, Gressier and Jacmel require emergency latrines. The interim plan is to provide 12,950 latrines by April (for approximately 650,000 people) and 21,000 more within six months (moving toward the goal of 1 latrine for every 20 people).

PAHO/WHO is helping to coordinate the delivery of water to affected communities and health facilities and is monitoring water quality in collaboration with the Direction Nationale pour l’Eau Potable et l’Assainissement (DINEPA). About 50 water tankers are providing water to healthcare settings and to the affected population.

Is there a concern regarding tuberculosis?

More than one year’s supply of anti-TB medicines are available in Haiti. The Ministry of Health is implementing a TB control post-disaster intervention plan (January 25 through April 30) in coordination with key partners in Haiti to ensure that all TB patients have access to proper health care and treatment. A key goal is to reactivate and operationalize the National Program of Fight Against Tuberculosis.



PANDEMIC H1N1

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What are antiviral drugs?

 

22 December 2009
Antiviral drugs are medicines that act directly on viruses to stop them from multiplying.

Are antiviral drugs used for treatment of pandemic (H1N1) 2009 infection?

Yes, two antiviral drugs are being used to treat pandemic influenza infections. These are oseltamivir and zanamivir, which both block the action of an influenza virus protein called neuraminidase. In clinical trials with seasonal influenza, these antiviral drugs have been shown to reduce the symptoms and duration of illness. Direct reports and observations from clinicians around the world also suggest that these treatments contribute to preventing severe disease and death related to pandemic influenza (H1N1) 2009 infections.

For the treatment of pandemic (H1N1) 2009, how many antiviral drugs are there?

There are two approved antiviral drugs for influenza that are available for treatment of pandemic influenza. These are the neuraminidase inhibitors oseltamivir and zanamivir, more commonly known by their trade names Tamiflu and Relenza.

Another class of approved antiviral drugs known as M2 inhibitors (amantadine and rimantadine) can be effective for treating seasonal influenza. However, the pandemic (H1N1) 2009 virus has been shown to be resistant to these particular antiviral drugs.

What is WHO’s guidance on the use of antiviral drugs?

For patients with symptoms of severe illness that are probably due to pandemic influenza, WHO recommends that treatment with oseltamivir should start immediately, no matter when the illness started and without waiting for laboratory results to confirm infection.

For patients at higher risk for serious disease from pandemic influenza, including pregnant women, children under age 5 and those with certain underlying medical conditions, WHO recommends treatment with either oseltamivir or zanamivir as soon as possible after the onset of symptoms, and without waiting for the results of laboratory tests.

People who are not from a higher risk group but who have persistent or rapidly worsening symptoms should be treated with antivirals. These symptoms include difficulty breathing or a high fever that lasts beyond three days.

In all cases, where oseltamivir is unavailable or cannot be used for any reason, zanamivir may be given.

What is meant by a higher risk group?

Individuals who have been identified as higher risk of more complicated or severe illness associated with infection by the pandemic influenza virus include:

What is meant by at-risk groups?

Individuals that have been identified as “at-risk” of more complicated or severe illness associated with infection by influenza virus include:

pregnant women (particularly in the later stages of pregnancy);
infants and children (
patients with chronic health conditions such as cardiovascular, respiratory or liver disease, or diabetes;
patients with immunosuppression related to treatment for transplant surgery, cancer or due to other diseases.
The elderly (>65) appear less susceptible to infection by pandemic H1N1 influenza virus, but are assumed to be at higher risk of more severe or complicated illness if infected.

ARE ANTIVIRAL DRUGS SUITABLE FOR EVERYONE?

Antivirals should only be used when prescribed by a qualified health care provider, as they will be able to assess each situation and make the appropriate decisions on care.

People who are not from a higher risk group and experience mild symptoms need not take antivirals. Most people recover from the pandemic influenza without the need for medical care.

Is it necessary to wait for a laboratory result before starting antiviral drug treatment?

No, if antiviral drug treatment is indicated by the clinical presentation, then treatment should start as soon as possible. If there is a delay, treatment may be less effective.

What is the standard treatment regimen for antiviral drugs?

For oseltamivir, the standard adult treatment course is one 75 mg capsule twice a day for five days. For severe or prolonged illness, physicians may decide to use a higher dose or continue the treatment for longer.

Zanamivir is taken as a powder by inhalation. The recommended dose for treatment of adults and children from the age of 5 years is two inhalations (2 x 5mg) twice daily for five days.



*

What is Phase 6 ?

 

What about severity?

At this time, WHO considers the overall severity of the influenza pandemic to be moderate. This assessment is based on scientific evidence available to WHO, as well as input from its Member States on the pandemic's impact on their health systems, and their social and economic functioning.

The moderate assessment reflects that:

Most people recover from infection without the need for hospitalization or medical care.
Overall, national levels of severe illness from influenza A(H1N1) appear similar to levels seen during local seasonal influenza periods, although high levels of disease have occurred in some local areas and institutions.
Overall, hospitals and health care systems in most countries have been able to cope with the numbers of people seeking care, although some facilities and systems have been stressed in some localities.
WHO is concerned about current patterns of serious cases and deaths that are occurring primarily among young persons, including the previously healthy and those with pre-existing medical conditions or pregnancy.

Large outbreaks of disease have not yet been reported in many countries, and the full clinical spectrum of disease is not yet known.

Assessing the severity of an influenza pandemic

Considerations for assessing the severity [pdf 318kb]
Does WHO expect the severity of the pandemic to change over time?

The severity of pandemics can change over time and differ by location or population.

Close monitoring of the disease and timely and regular sharing of information between WHO and its Member States during the pandemic period is essential to determine future severity assessments, if needed.

Future severity assessments would reflect one or a combination of the following factors:

changes in the virus,
underlying vulnerabilities, or
limitations in health system capacities.
The pandemic is early in its evolution and many countries have not yet been substantially affected.

More about the new influenza A(H1N1)
What is WHO doing to respond?

WHO continues to help all countries respond to the situation. The world cannot let down its guard and WHO must help the world remain and become better prepared.

WHO's support to countries takes three main forms: technical guidance, materials support, and training of health care system personnel.

WHO's primary concern is to strengthen and support health systems in countries with less resources. Health systems need to be able to prevent, detect, treat and mitigate cases of illness associated with this virus.

WHO is also working to make stocks of medicines (such as antivirals and antibiotics) and an eventual pandemic vaccine more accessible and affordable to developing countries.

Both antivirals and vaccines have important roles in treatment and prevention respectively. However, existing stocks of antivirals are unlikely to meet the demand. WHO is working closely with manufacturers to expedite the development of a safe and effective vaccine but it will be some months before it is available.

Therefore, rational use of the limited resources will be essential. And medicines are only part of the response. WHO is also deploying diagnostic kits, medicines and masks and gloves for health care settings, teams of scientific experts, and medical technicians so countries in need can respond to local epidemics.

A pandemic sets national authorities in motion to implement preparedness plans, identify cases as efficiently as possible, and minimize serious illness and deaths with proper treatment.

The goal is to reduce the impact of the pandemic on society.

Guidance for national authorities
What do I do now? What actions should I look for in my community?

Stay informed. Go to reliable sources of information, including your Ministry of Health, to learn what you can do to protect yourself and stay updated as the pandemic evolves. Community-specific information is available from local or national health authorities.

You can also continue to visit the WHO web site for simple prevention practices and general advice.

WHO is not recommending travel restrictions nor does WHO have evidence of risk from eating cooked pork.



*

What is the new influenza A(H1N1)?

 

Updated 11 June 2009
This is a new influenza A(H1N1) virus that has never before circulated among humans. This virus is not related to previous or current human seasonal influenza viruses.

How do people become infected with the virus?

The virus is spread from person-to-person. It is transmitted as easily as the normal seasonal flu and can be passed to other people by exposure to infected droplets expelled by coughing or sneezing that can be inhaled, or that can contaminate hands or surfaces.

To prevent spread, people who are ill should cover their mouth and nose when coughing or sneezing, stay home when they are unwell, clean their hands regularly, and keep some distance from healthy people, as much as possible.

There are no known instances of people getting infected by exposure to pigs or other animals.

The place of origin of the virus is unknown.

What are the signs and symptoms of infection?

Signs of influenza A(H1N1) are flu-like, including fever, cough, headache, muscle and joint pain, sore throat and runny nose, and sometimes vomiting and diarrhoea.

Why are we so worried about this flu when hundreds of thousands die every year from seasonal epidemics?

Seasonal influenza occurs every year and the viruses change each year - but many people have some immunity to the circulating virus which helps limit infections. Some countries also use seasonal influenza vaccines to reduce illness and deaths.

But influenza A(H1N1) is a new virus and one to which most people have no or little immunity and, therefore, this virus could cause more infections than are seen with seasonal flu. WHO is working closely with manufacturers to expedite the development of a safe and effective vaccine but it will be some months before it is available.

The new influenza A(H1N1) appears to be as contagious as seasonal influenza, and is spreading fast particularly among young people (from ages 10 to 45). The severity of the disease ranges from very mild symptoms to severe illnesses that can result in death. The majority of people who contract the virus experience the milder disease and recover without antiviral treatment or medical care. Of the more serious cases, more than half of hospitalized people had underlying health conditions or weak immune systems.

Most people experience mild illness and recover at home. When should someone seek medical care?

A person should seek medical care if they experience shortness of breath or difficulty breathing, or if a fever continues more than three days. For parents with a young child who is ill, seek medical care if a child has fast or labored breathing, continuing fever or convulsions (seizures).

Supportive care at home - resting, drinking plenty of fluids and using a pain reliever for aches - is adequate for recovery in most cases. (A non-aspirin pain reliever should be used by children and young adults because of the risk of Reye's syndrome.



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