Swine flu

doi:10.1136/bmj.b1791

Published 30 April 2009, doi:10.1136/bmj.b1791
Cite this as: BMJ 2009;338:b1791

Editorials

Swine flu

Fragile health systems will make surveillance and mitigationa challenge

The first 150 words of the full text of this article appear below.

During March, Mexico saw unusual patterns of acute cases ofrespiratory infection. On 18 April, a laboratory in the UnitedStates reported two human cases of swine flu—the resultof a novel reassortment of influenza A strain H1N1 from avian,swine, and human strains—in two children from California.A week later, on 25 April, the World Health Organization declaredthe swine flu outbreak in North America a "public health emergencyof international concern." This decision, in accordance withthe International Health Regulations, means that countries havebeen asked to step up reporting and surveillance of the deathsand illnesses associated with the disease. On 29 April, theInternational Health Regulations emergency committee recommendeda change from WHO pandemic influenza phase 4 to phase 5. Thismeans that WHO views a pandemic as imminent.

From 17 April to 26 April, 1840 suspected cases of flu withsevere pneumonia were reported in . . . [Full text of this article]

Richard Coker, professor of public health

¹ Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Faculty of Tropical Medicine, University of Mahidol, Bankgok 10400, Thailand

richard.coker@lshtm.ac.uk

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