The World
Health Organization declared a Level 6 alert on 11 June 2009
in response to a serious outbreak of H1N1 influenza that
began earlier this year in Mexico and now has spread to more
than 70 countries.
The Level 6 alert indicates that a pandemic is ongoing. WHO
said it was warranted because human-to-human transmission of
the disease, popularly known as swine flu, has shown up in
multiple countries. The health agency said further that,
although the number of cases remains relatively low, no one
knows exactly what this new form of the disease will do, and
thus the utmost precautions should be applied. Health
officials also worry about a resurgence of the illness,
possibly in a more virulent form, in autumn months when the
incidence of seasonal influenza generally increases.
The declaration has serious implications both for the health
of travelers and for their ability to travel conveniently.
WHO has declined to recommend travel restrictions, saying
they wouldn't be effective, but most countries are
scrutinizing travelers for signs of disease. Those found to
be suffering from influenza-like symptoms could be placed in
quarantine.
While everyone should take the situation seriously, it's
important to keep perspective: In the United States alone,
normal seasonal flu kills about 36,000 people a year,
compared to the fewer than 50 fatalities so far reported
worldwide from H1N1. And most patients who have contracted
H1N1 have recovered on their own, with no need for medical
intervention.
Background
Symptoms of the H1N1 virus are similar to those of seasonal
influenza: fever, body aches, coughing, sneezing, nausea and
diarrhea. One major difference from seasonal influenza is
that H1N1 appears to cause illness in young adults who
normally are less at risk.
Health agencies have said that the new virus contains
elements of swine, human and bird flu. There's no vaccine to
prevent infection, but there are some antiviral drugs that
have been shown effective in infected people, including
Tamiflu and Relenza, which many nations have stockpiled in
case of emergency.
The number of cases and locations where they have been
reported are changing daily. The exact source of the illness
is not yet known, but cases were first reported in Mexico.
The largest number of cases has been reported in the U.S.,
where many cases have involved students in schools where
some children made recent trips to Mexico. Officials in the
U.S. declined to close the border or significantly restrict
travel, because they simply didn't believe it would be
effective.
However, the U.S. has been questioning travelers coming
across the border about the state of their health, and many
countries are screening travelers. Among the precautions
that have been applied are thermal scanners to check for
fever, a requirement to complete a health declaration card,
and disinfectant foot mats on which travelers may be
required to wipe their shoes. Anyone who is believed to be
ill may be subject to quarantine, possibly for up to 14
days. These requirements, too, are changing daily.
Airline crews have been instructed to watch for passengers
who have a high fever; persistent coughing, nausea and/or
diarrhea; impaired breathing or a skin rash; or otherwise
appear obviously unwell. In some cases, pilots have opted to
make an emergency landing to offload an ill passenger.
Recommendations
Recommendations are offered as information only, and some
recommendations may not apply in all situations. Because the
situation is changing so rapidly, it's best to stay in close
contact with your airline and local authorities at your
destination to remain aware of the most current
developments.
- Don't travel if you're ill.
- Avoid people who are sick while you're on your trip.
In areas affected by the virus, close physical contact
is best avoided.
- If you become sick while on your trip, don't go to
business meetings or other places where you could spread
the illness to others. Your embassy can help you find
appropriate medical care (note that the embassy will not
provide the care itself or pay for it). Be sure you know
the phone number for your embassy before you leave.
- If you become ill after returning from a trip to one
of the affected areas, contact your physician. Health
authorities are asking that individuals who have
symptoms telephone their medical providers before coming
in or going to an emergency room.
- Practice good hygiene while on your trip. Wash your
hands frequently with soap and water and avoid touching
your mouth, nose or eyes. Alcohol-based hand cleaners
can be used when soap and water are not convenient to
use.
- If you cough or sneeze, cover your mouth and nose
with a tissue, then discard the tissue. If you don't
have a tissue, cough or sneeze into your sleeve, rather
than your hand. Wash your hands after you sneeze or
cough.
- If you have a pre-existing illness that puts you at
high risk from seasonal influenza and you're heading to
an area where cases of the virus have been reported, see
your health care provider about whether you should get
antiviral drugs in advance and take them during your
trip.
- Be sure you are up-to-date on all your vaccinations,
including a routine annual flu shot, before you leave.
- Stay in contact with your airline and local
authorities for the latest information on what
complications you may face at the airport.
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