More Cases of H1N1 Flu Confirmed Across World; Texas State Health Department Confirms First Death of U.S. Resident

State health officials announced that a Texas woman's death earlier this week marks the first U.S. resident to die from H1N1 (swine) influenza, Reuters reports (Baltimore, Reuters, 5/6). The AP/Google.com writes, "The Texas woman, the second to die of swine flu in the U.S., lived not far from the Mexico border and had chronic medical conditions, as did the Mexico City toddler who died of H1N1 flu last week during a visit to Houston, Texas, health officials said" (Stevenson/Anderson, AP/Google.com, 5/6). Texas Department of State Health Services (DSHS) confirmed the woman's death from swine flu on Tuesday (Texas DSHS, 5/5).

The WHO on Wednesday reports that 22 countries have officially reported 1,516 cases of H1N1 flu. Laboratory tests have confirmed 822 cases swine flu in Mexico, including 29 deaths, and the U.S. has reported 403 cases, including one death. Additionally, "The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (165), China, Hong Kong Special Administrative Region (1), Colombia (1), Costa Rica (1), Denmark (1), El Salvador (2), France (4), Germany (9), Guatemala (1), Ireland (1), Israel (4), Italy (5), Netherlands (1), New Zealand (6), Portugal (1), Republic of Korea (2), Spain (57), Switzerland (1) and the United Kingdom (27) (WHO Swine Influenza A(H1N1) - update 17, 5/6).

Even though the cases of H1N1 flu appear to be slowing in Mexico – the epicenter of the outbreak – health officials said that the global spread of the flu continued to pick up, Reuters reports. "For authorities worldwide, the question remained how far the virus would spread and how serious would it be," Reuters writes.

"If it spreads around the world you will see hundreds of millions of people get infected," said WHO assistant director-general Keiji Fukuda (Reuters, 5/6). Fukada said Tuesday that investigators from around the world continue to believe this flu strain predominately infects young people, although it is not yet clear why, VOA reports (Saine, VOA, 5/5).

The Seattle Post-Intelligencer writes, "The numbers public health authorities have reflect the situation days or even weeks ago. For each of the U.S. cases confirmed by the [CDC], there are several probable cases waiting for the lab work to be done -- and an unknown number of less-severe cases that go unreported" (Cohen, Seattle Post-Intelligencer, 5/5). "Those numbers will go up, we anticipate, and unfortunately there are likely to be more hospitalizations and more deaths," U.S. Health and Human Services Secretary Kathleen Sebelius said (Reuters, 5/6).

U.S. health officials announced Tuesday that they no longer recommend that schools close if students become infected with swine flu, after growing evidence that the swine flu is milder than originally feared, AP/Google.com reports. The CDC recommends that teachers and children with flu-like symptoms stay home for seven days (Stobbe, AP/Google.com, 5/5).

The Baltimore Sun examines the warnings by infectious disease experts and public health officials that though the threat of H1N1 flu seems to be lessening, the flu could resurface in the fall (Desmon, Baltimore Sun, 5/6).

WHO Sends Antivirals to Developing Countries

After promising to provide 2.4 million doses of antivirals to poor countries last week, the WHO on Tuesday said they had begun sending shipments of Tamiflu to developing countries from stockpiles located in the United Arab Emirates, the U.S. and Switzerland, Inter Press Service News Agency reports (Capdevila, IPS, 5/5).

WHO spokeswoman Fadela Chaib said, "WHO will also supplement regional stockpiles in our six regions as contingency plans for further supplies to countries," but did not indicate "how much more in anti-virals the agency planned to stock," AFP/Yahoo! News reports. Though there is no vaccine for H1N1, antivirals help to reduce the transmission of the virus and severity of the symptoms of the flu (AFP/Yahoo! News, 5/5).

The AP/Washington Post Examines How African Countries Are Dealing With H1N1 Threat

The AP/Washington Post examined how African countries are trying to keep the swine flu out of a continent already burdened by a host of diseases, including HIV/AIDS and malaria. Even though there have been no confirmed H1N1 cases in Africa, public health officials worry that it will reach the southern hemisphere, just as the region gears up for winter – "when even seasonal influenza causes sickness and death worsened by poverty, lack of decent shelter and food and overcrowding," the AP/Washington Post writes.

Health experts also worry that if H1N1 reaches Africa, health authorities might be unable to trace or treat the virus. The AP/Washington Post writes, "the chaotic health system in Nigeria has prompted concern about whether authorities in Africa's most populous nation would be able to trace or control swine flu cases. Zimbabwe struggled to cope with easily treatable cholera, resulting in an epidemic that killed more than 4,000 people and sickened 80,000 – in an ominous sign of what might happen in the event of the swine flu virus taking hold."

Even in South Africa, the richest country in Africa, HIV/AIDS claims the lives of an estimated 1,000 people each day, while in urban areas, "tuberculosis has reached four times the level classified as an emergency by the [WHO]," according to the AP/Washington Post. Eric Goemaere of Doctors Without Borders outside of Cape Town, said, "We are in a country that faces several health emergencies on a regular basis, and we have few resources to deal with them." He added, "We just don't have the luxury to build up stocks of Tamiflu where we have lots of other priorities."

While H1N1 "has infected some 1,600 people in more than 20 countries," around Africa thousands "die unseen and unnoticed every day of preventable and treatable diseases," the AP/Washington Post writes. "Why isn't there such an emergency mobilization against diarrheal diseases which kill 2.5 million children a year?" said David Sanders, professor of public health at the University of the Western Cape (Nullis, AP/Washington Post, 5/5).

Lancet Examines Global Response to H1N1 Outbreak

A Lancet editorial (pdf) examined the scientific basis for some of the international measures taken in response to the H1N1 flu outbreak. The authors write, "While it is reassuring that there is a global effort in the fight against influenza A (H1N1), more attention is needed at a national level to ensure that those on the front-line are kept abreast of accurate updates and practical advice," adding, "Some of these national responses have been found wanting" (Lancet, 5/5).

John McConnell, the editor of the journal Lancet Infectious Diseases, questions the sustainability of administering Tamiflu if the H1N1 flu is declared a pandemic in an accompanying Lancet comment (pdf). Previous studies suggest "that for a group of 1000 people 16 times as much antiviral was needed to prevent influenza infection as to treat it," McConnell writes, adding "By this measure, the UK has stockpiles of [Tamiflu] sufficient to treat 30 million people (about half the population) but to prevent infection in only 1.9 million" (McConnell, Lancet, 5/5).

In a separate report (pdf), the Lancet also examines whether or not the local and international response to the swine flu outbreak was fast enough (Moloney, Lancet, 5/5).