The Global War On Swine Flu

As the UK prepares for a winter wave of the virus, Health Editor Madeleine Brindley examines how swine flu is affecting the rest of the world

IN FRANCE the practice of greeting someone with a kiss could be at risk, while the thousands of pilgrims who make the Hajj to Mecca this year are being told to take precautions against swine flu.

The French health ministry recommends avoiding direct contact with people, including not kissing, shaking hands or caressing the face of others especially sick people.

It also advises maintaining a one-metre buffer zone from other people and although it does not specifically mention la bise, some children are being told not to kiss their teachers or other students.

In one town in western Brittany so-called bise boxes have been set up to allow pupils to put heart-shaped greetings into before they are exchanged in class.

The Foreign and Commonwealth Office has advised the elderly, pregnant women, the chronically ill and children not to take part in the Hajj this year.

Pilgrims will also need to be able to prove that they have been vaccinated against seasonal flu before applying for a visa to travel to Mecca. All passengers arriving in Saudi Arabia will be screened.

Elsewhere in the world both Angola and Lesotho have recorded their first cases of swine flu, while in China more than 9,000 people have already been confirmed with swine flu, as rates begin to spike.

More than 200 people have died in India after contracting swine flu. Schools, colleges and even cinemas have been closed temporarily in a bid to control the virus.

Passenger screening has been introduced at Indias 22 international airports because it is thought that a large number of cases have been in people returning from overseas travel.

In the southern hemisphere there is evidence that the flu season is coming to an end.

At its peak in Australia, more than 90 people a day were being admitted to hospital with swine flu, that figure had fallen to about 70 at the end of last month.

In neighbouring New Zealand a country with many similarities to Wales restrictions put in place by the Catholic Church to prevent the spread of infection have been lifted as the spring starts. More than 3,000 cases of swine flu were confirmed by laboratory tests and 17 deaths have been linked to the virus.

Dr Roland Salmon, director of the communicable disease surveillance centre at the National Public Health Service for Wales, said: New Zealand has had an epidemic but it has been modest and that gives an indication of what we may expect.

In the four months since the World Health Organisation (WHO) declared a pandemic, swine flu cases have been reported on every populated continent. The latest figures reveal there have been more than 277,000 confirmed cases the actual total is considerably higher as most countries no longer test every person with symptoms and at least 3,205 deaths.As the southern hemisphere moves into spring, rates of swine flu are declining but WHO said there is still active transmission in the tropical regions of the Americas and Asia.

Swine flu activity in the northern hemisphere, however, is variable. In the United States, regional increases in influenza activity are being reported, most notably in the south eastern states. Most of Europe is reporting low or moderate respiratory diseases activity Wales continues to see low level activity but WHO said some parts of Eastern Europe are beginning to report increases in activity.

Experts are continuing to warn that although the majority of people infected with the H1N1 virus will experience a mild illness, there is a risk of severe respiratory illness in at-risk groups, including pregnant women and those with asthma, cardiovascular disease and diabetes and people who are immuno- suppressed.

The WHO added: Current evidence points to some important differences between patterns of illness reported during the pandemic and those seen during seasonal epidemics of influenza.

The age groups affected by the pandemic are generally younger. This is true for those most frequently infected, and especially so for those experiencing severe or fatal illness. To date, most severe cases and deaths have occurred in adults under the age of 50 years, with deaths in the elderly comparatively rare. This age distribution is in stark contrast with seasonal influenza, where around 90% of severe and fatal cases occur in people 65 years of age or older.