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Swine flu

April 27, 2009

Now that its EU neighbors have reported cases of swine flu, Germany is taking measures at airports, but its stockpile of anti-virals is low. Baffling scientists, the new viral strain has only been deadly in Mexico.

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People wearing protective face masks stand outside a hospital in Toluca, Mexico
Mexico is experiencing more lethal symptoms of the virusImage: AP

There is nothing unusual about swine flu, which is as commonplace among livestock as seasonal flu is among humans. But the latest outbreak of swine flu that is believed to have claimed more than 100 lives in Mexico and infected 1,600 others - mainly healthy adults in their prime - has come as a complete surprise.

The new sub-variant of the H1N1 influenza virus, which infected an estimated 40 percent of the world's population in the pandemic of 1918, has been deadly in Mexico, where it wasn't recognized for quite some time.

What's puzzling is that the new viral strain is apparently milder in the US, Canada and Spain, where cases have also been confirmed, said Otto Haller, a virologist at the University Clinic in Freiburg in southwest Germany.

What is known is that the airborne virus has spread from recent travelers who had no contact with pigs in Mexico to faraway Europe and possibly New Zealand, meaning that the new strain is transmitted through human-to-human contact.

Those infected with swine flu outside Mexico, however, have generally experienced only mild symptoms, such as nausea, sore throats and fever, that are hardly distinguishable from the common flu.

Fatal only in Mexico

Haller suggested the pattern of transmission and the degree of exposure to the virus could have been factors in the Mexican fatalities.

"In Mexico, people in direct contact with pigs could have gotten heavy exposure to the virus, so much that it killed them," said Haller. "Or there could be some other infectious agent that exists in Mexico but not elsewhere."

Although the airborne virus is called swine flu, it is a recombinant mixture of DNA segments from pigs, birds and humans. The virus is a new genetic strain, which medical experts say could mutate into an even more dangerous variant of potentially pandemic proportions, since no one would have immunity to it.

For that reason the World Health Organization (WHO) was quick to call the current outbreak "a public health emergency of international concern."

First confirmed EU case

Tamiflu capsules
Tamiflu is a commonly used anti-viral drugImage: AP

In the European Union, Spanish authorities confirmed the first case of swine flu in the 27-nation bloc on Monday - a 23 year-old-man who had just returned from Mexico harbors the new viral strain, but otherwise appears healthy.

On Monday, the EU called for an emergency meeting of health ministers and issued a travel advisory against non-essential trips to areas where the deadly virus has surfaced.

In Spain, some 20 people are under observation, while dozens of suspected cases have cropped up in Britain, Sweden, Denmark, Switzerland, France and Italy. Later Monday, two cases in Britain were confirmed. The victims had recently returned from a holiday in Mexico.

"At the moment it's hard to say what the consequences for Germany are," according to a statement released by the press office of the Robert Koch Institute, a Berlin-based center for infectious disease control.

A spokeswoman told reporters that the institute is working with state ministries and major airports to deal with any suspected cases in Germany.

Airport checks

There were no visible signs of heightened health security at Frankfurt Airport on Monday, unlike the high alert status at airports in Asia.

In Hong Kong, which was the epicenter of the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003 that killed nearly 800 people, mostly in the Asia-Pacific region, all passengers arriving by air or ferry must now undergo an infrared temperature check to test for signs of fever.

The state ministry in Hesse, which is home to Frankfurt Airport, did however issue a press statement on health measures to be taken at one of the busiest hubs on the European continent where flights feed into other destinations from all over the world.

Travelers from Mexico exhibiting flu-like symptoms will be initially examined by health authorities at the airport clinic. If further evaluation is deemed necessary, they will be sent to the university clinic in Frankfurt's city center. Those testing positive for the new H1N1 strain will then be given anti-viral medication, such as Tamiflu, to slow the spread of the disease.

Low anti-viral stockpile in Germany

Immigration agents, wearing surgical masks and gloves as a precaution against infection in Mexico
Airport checks have been stepped up in Mexico and other airportsImage: AP

In the event of a pandemic, the stockpile of anti-virals in Germany is unusually low, compared with Britain and France, where more than half the population could be treated in an emergency.

But Thomas Scharberg, a specialist for respiratory infectious disease in the northern German town of Rotenburg, defended Germany's low stockpile, which would cover at most 20 percent of the population.

"There is absolutely no data showing that anti-viral drugs will save a patient's life," he said, citing clinical studies which show that anti-virals only reduce the duration of the disease's symptoms, but did not actually kill viruses, which keep mutating and become resistant to drug treatment over time.

"Anti-virals are not the same as antibiotics which kill bacteria and cure the patient," explained Scharberg. "The only way out is a new vaccine that could save lives."

US scientists are currently developing a promising new vaccine, but it will take at least three months time to fine tune and mass produce it, according to Haller. The good news, said Haller, is that outside of Mexico there have been no other reported deaths so far.

Author: Diana Fong

Editor: Darren Mara