H1N1 Flu Poses Major Surveillance Challenge

Fragile health systems will make it difficult to spot cases and contain outbreaks
By Jane Parry
HealthDay Reporter

FRIDAY, May 1 (HealthDay News) -- Containment of the influenza A strain H1N1, or swine flu, outbreak is probably impossible because cases are already geographically widespread and countries with fragile health systems lack the ability to properly conduct surveillance and containment activities, according to an editorial published online April 30 in BMJ.

Richard Coker, M.D., of the University of Mahidol in Bangkok, Thailand, describes how the outbreak in Mexico in March and its subsequent spread to the United States in mid-April became a public health emergency of international concern under the World Health Organization's International Health Regulations, and notes that new and probable cases continue to emerge on a daily basis in countries all over the world.

Developed countries with robust surveillance systems have reported most of the cases so far, Coker notes, and he questions whether the entire global picture is really emerging, or whether cases are going undetected in countries with suboptimal surveillance systems in place.

"Although most countries now have plans, many countries, especially developing countries, will struggle to put them into operation," the author writes. "This is because they have limited health system resources to call on in the event of a pandemic; they have not stockpiled antiviral drugs in anything like the numbers needed for mitigation purposes; and they are unlikely to receive an effective vaccine early (if at all), once it is produced in large amounts."


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