Argentina on Verge of Declaring Swine Flu "Emergency"
Argentina on Verge of Declaring Swine Flu "Emergency"
Argentine health authorities said Saturday that a "health emergency" could be declared nationwide after elections on Sunday because of the exponential spread of the AH1N1 flu virus, which up till now has taken 26 lives and has infected 1,587 people. Meanwhile, health organizations said that the number of people infected in the country "is substantially greater" than the official toll and that hospitals are "verging on collapse"
Medical Emergency in Buenos Aires Raises Pandemic Concerns
June 27, 2009 23:43 | By Dr Henry Niman | Recombinomics
Some hospitals began to strengthen measures, including the case of Posadas Hospital, one of the largest hospitals in the province of Buenos Aires that concentrates a large number of internees from the flu. Through a press release, the hospital reported that it declared a state of emergency by the Institution that "all staff will be available to the agency needs to be ad
dressed" after the epidemic of influenza A.
In addition, the Posadas created through Resolution No. 640/09 an Internal Crisis Committee itself, with the aim of ensuring compliance and monitoring of the actions that the hospital must develop to deal with the situation posed by an outbreak of Influenza A .
Meanwhile, health authorities in Buenos Aires and Buenos Aires have some alternatives to strengthen the system, including the use of military hospital in Campo de Mayo, the release of bed in the hospital's intensive care Malvinas Argentinas, the installation of sanitary units in campaign Buenos Aires and mobile primary care close to railway stations and Eleven Constitution.
The above translation describes the declaration of a medical emergency in Buenos Aires. The Buenos Aires Ministry of Health website lists 15 confirmed fatalities, 180 confirmed cases, and 559 suspect cases as of Friday (see Buenos Aires map), but media reports suggest the actual number of cases is higher. Recent reports out of Argentina also described the rapid decline of relative young patients (15-50), with descriptions similar to those used to describe dying patients in 1918. In addition, there has been an outbreak of H1N1 at a pig farm northwest of Buenos Aires (see map).
The sudden jump in cases and fatalities are cause for concern. In the country the number of confirmed fatal cases rose to 27, but there are reports of 15 more fatalities that are suspect. There have also been reports of travelers from Argentina testing positive at airport checks in multiple countries. These travelers should provide multiple samples for sequencing studies to determine if there have been changes in the virus.
Recently PB2 E627K was reported in a traveler from the United States. However, the sequence suggested the change was acquired in China. Although the E627K was present in the original samples and confirmed in the initial clone, and subsequent sub-clone had reverted back to the wild type sequence, raising concerns that some key changes may not be stable under certain culture conditions, and important changes could be lost especially if the virus is cultured in chicken eggs, which could select against important changes associated with adaptation to human hosts.
Therefore, analysis by multiple labs of these sequences would be useful. The flu season is just beginning in the southern hemisphere, providing a favorable environment for rapid adaptive changes. The movement of a swine H1N1 into a human host parallels the 1918 pandemic, which also was associated with mild infections in the later spring, followed by a much more virulent and lethal H1N1 in the fall.
The rapid developments in Buenos Aires bear close scrutiny and active sequence analysis as H1N1 increases its gene pool transmitting through human hosts. Many countries worldwide, including those in the southern hemisphere are experiencing explosive growth, and the developments in Buenos Aires may signal a new wave of Pandemic H1N1.
June 27, 2009 23:43 | By Dr Henry Niman | Recombinomics
Some hospitals began to strengthen measures, including the case of Posadas Hospital, one of the largest hospitals in the province of Buenos Aires that concentrates a large number of internees from the flu. Through a press release, the hospital reported that it declared a state of emergency by the Institution that "all staff will be available to the agency needs to be ad
dressed" after the epidemic of influenza A.In addition, the Posadas created through Resolution No. 640/09 an Internal Crisis Committee itself, with the aim of ensuring compliance and monitoring of the actions that the hospital must develop to deal with the situation posed by an outbreak of Influenza A .
Meanwhile, health authorities in Buenos Aires and Buenos Aires have some alternatives to strengthen the system, including the use of military hospital in Campo de Mayo, the release of bed in the hospital's intensive care Malvinas Argentinas, the installation of sanitary units in campaign Buenos Aires and mobile primary care close to railway stations and Eleven Constitution.
The above translation describes the declaration of a medical emergency in Buenos Aires. The Buenos Aires Ministry of Health website lists 15 confirmed fatalities, 180 confirmed cases, and 559 suspect cases as of Friday (see Buenos Aires map), but media reports suggest the actual number of cases is higher. Recent reports out of Argentina also described the rapid decline of relative young patients (15-50), with descriptions similar to those used to describe dying patients in 1918. In addition, there has been an outbreak of H1N1 at a pig farm northwest of Buenos Aires (see map).
The sudden jump in cases and fatalities are cause for concern. In the country the number of confirmed fatal cases rose to 27, but there are reports of 15 more fatalities that are suspect. There have also been reports of travelers from Argentina testing positive at airport checks in multiple countries. These travelers should provide multiple samples for sequencing studies to determine if there have been changes in the virus.
Recently PB2 E627K was reported in a traveler from the United States. However, the sequence suggested the change was acquired in China. Although the E627K was present in the original samples and confirmed in the initial clone, and subsequent sub-clone had reverted back to the wild type sequence, raising concerns that some key changes may not be stable under certain culture conditions, and important changes could be lost especially if the virus is cultured in chicken eggs, which could select against important changes associated with adaptation to human hosts.
Therefore, analysis by multiple labs of these sequences would be useful. The flu season is just beginning in the southern hemisphere, providing a favorable environment for rapid adaptive changes. The movement of a swine H1N1 into a human host parallels the 1918 pandemic, which also was associated with mild infections in the later spring, followed by a much more virulent and lethal H1N1 in the fall.
The rapid developments in Buenos Aires bear close scrutiny and active sequence analysis as H1N1 increases its gene pool transmitting through human hosts. Many countries worldwide, including those in the southern hemisphere are experiencing explosive growth, and the developments in Buenos Aires may signal a new wave of Pandemic H1N1.
Last week the World Health Organization announced a declaration that Swine flu has reached the level of a pandemic. According to the WHO, excluding the deaths in Argentina there have been 163 deaths globally attributed to the virus as of Monday. There are approximately 36,000 cases of the virus in 76 countries.
"The emergency does not mean we're closing everything down, the emergency is a frame of reference for having medicines ready for direct purchase and mobilizing health personnel," said Claudio Zin, health minister in Buenos Aires province where the greatest number of deaths and infections have been recorded.
Zin said that this alert, which doctors' organizations have requested for days, "is a frame of reference for taking quick decisions" to combat the illness.
"It doesn't mean we're going to close schools and shopping malls and suspend transport on the metro," because "that's not the point," he said.
A different approach from that taken in Mexico City where, at the height of the epidemic, leisure and entertainment locations were shuttered along with part of the capital's 35,000 restaurants.
Schools were closed nationwide for 10 days and normally bustling Mexico City became a ghost town as people were urged to stay home to halt the spread of the illness.
The Buenos Aires health minister has, however, confirmed comments by members of the "crisis committee" created by the Argentine government to deal with the new flu virus, who say that the possibility of declaring a national emergency next week after this Sunday's legislative elections is being considered.
In "areas at risk" of contagion, "alcohol in gel and pads" are being distributed for wetting the finger used for sticking shut vote envelopes without using saliva, election official Alejandro Tullio said Friday.
To the prevention measures that authorities are recommending to the public, Tullio added that voters ought to "keep their distance one from the other in case people line up to vote and they should go to the polls early to avoid the crowds."
Health organizations said that the number of people infected in the country "is substantially greater" that the official toll and that hospitals are "verging on collapse."
The total number of deaths in Argentina from the swine-flu virus reached 26 on Friday, when three new fatalities were confirmed along with 99 new cases of the illness, raising the total to 1,587.
The Health Ministry said in a communique that under study are specimens from 967 people suspected of having caught the AH1N1 flu virus.
Argentina Swine-Flu Deaths Rise to 23
Swine Flu Death Toll Rises to 21 in Argentina
Swine Flu Deaths Cause Alarm in Argentina
Swine Flu Death Toll in Argentina Rises to Six
Argentina Confirms 2nd Death from Swine Flu
Argentina Reports First Death from Swine Flu
OMS: 35,928 casos de influenza A(H1N1) in the world
Influenza A(H1N1) – update 49
The breakdown of the number of laboratory-confirmed cases by country is given in the following table and map.
| Country | Cumulative total | Newly confirmed since the last reporting period | ||
| | Cases | Deaths | Cases | Deaths |
| Argentina | 343 | 0 | 0 | 0 |
| Australia | 1823 | 0 | 221 | 0 |
| Austria | 7 | 0 | 0 | 0 |
| Bahamas | 1 | 0 | 0 | 0 |
| Bahrain | 1 | 0 | 0 | 0 |
| Barbados | 3 | 0 | 0 | 0 |
| Belgium | 17 | 0 | 3 | 0 |
| Bolivia | 7 | 0 | 2 | 0 |
| Brazil | 54 | 0 | 2 | 0 |
| Bulgaria | 2 | 0 | 0 | 0 |
| Canada | 2978 | 4 | 0 | 0 |
| Cayman Islands, UKOT | 2 | 0 | 0 | 0 |
| Chile | 1694 | 2 | 0 | 0 |
| China | 318 | 0 | 100 | 0 |
| Colombia | 42 | 1 | 7 | 0 |
| Costa Rica | 104 | 1 | 0 | 0 |
| Cuba | 6 | 0 | 0 | 0 |
| Cyprus | 1 | 0 | 0 | 0 |
| Czech Republic | 4 | 0 | 0 | 0 |
| Denmark | 12 | 0 | 1 | 0 |
| Dominica | 1 | 0 | 0 | 0 |
| Dominican Republic | 93 | 1 | 2 | 0 |
| Ecuador | 80 | 0 | 13 | 0 |
| Egypt | 18 | 0 | 8 | 0 |
| El Salvador | 95 | 0 | 26 | 0 |
| Estonia | 4 | 0 | 0 | 0 |
| Finland | 4 | 0 | 0 | 0 |
| France | 80 | 0 | 7 | 0 |
| Germany | 170 | 0 | 75 | 0 |
| Greece | 19 | 0 | 12 | 0 |
| Guatemala | 119 | 1 | 45 | 0 |
| Honduras | 89 | 0 | 0 | 0 |
| Hungary | 4 | 0 | 0 | 0 |
| Iceland | 4 | 0 | 0 | 0 |
| India | 16 | 0 | 7 | 0 |
| Ireland | 12 | 0 | 0 | 0 |
| Israel | 117 | 0 | 49 | 0 |
| Italy | 67 | 0 | 11 | 0 |
| Jamaica | 11 | 0 | 0 | 0 |
| Japan | 605 | 0 | 56 | 0 |
| Korea, Republic of | 65 | 0 | 6 | 0 |
| Kuwait | 18 | 0 | 0 | 0 |
| Lebanon | 8 | 0 | 0 | 0 |
| Luxembourg | 1 | 0 | 0 | 0 |
| Malaysia | 5 | 0 | 0 | 0 |
| Mexico | 6241 | 108 | 0 | 0 |
| Morocco | 1 | 0 | 1 | 0 |
| Netherlands | 61 | 0 | 26 | 0 |
| New Zealand | 86 | 0 | 28 | 0 |
| Nicaragua | 56 | 0 | 0 | 0 |
| Norway | 13 | 0 | 0 | 0 |
| Panama | 272 | 0 | 0 | 0 |
| Paraguay | 25 | 0 | 0 | 0 |
| Peru | 91 | 0 | 12 | 0 |
| Philippines | 77 | 0 | 0 | 0 |
| Poland | 7 | 0 | 0 | 0 |
| Portugal | 3 | 0 | 1 | 0 |
| Romania | 13 | 0 | 2 | 0 |
| Russia | 3 | 0 | 0 | 0 |
| Saudi Arabia | 11 | 0 | 5 | 0 |
| Singapore | 47 | 0 | 22 | 0 |
| Slovakia | 3 | 0 | 0 | 0 |
| Spain | 488 | 0 | 0 | 0 |
| Sweden | 32 | 0 | 13 | 0 |
| Switzerland | 22 | 0 | 2 | 0 |
| Thailand | 29 | 0 | 21 | 0 |
| Trinidad and Tobago | 5 | 0 | 1 | 0 |
| Turkey | 10 | 0 | 0 | 0 |
| Ukraine | 1 | 0 | 0 | 0 |
| United Arab Emirates | 1 | 0 | 0 | 0 |
| United Kingdom | 1226 | 0 | 404 | 0 |
| United States of America | 17855 | 45 | 4638 | 18 |
| Uruguay | 36 | 0 | 0 | 0 |
| Venezuela | 25 | 0 | 0 | 0 |
| Viet Nam | 25 | 0 | 2 | 0 |
| West Bank and Gaza Strip | 2 | 0 | 2 | 0 |
| Grand Total | 35928 | 16 |
Source: www.recombinomics.com
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