By LARA PICKFORD-GORDON Thursday, October 29 2009

The World Health Organisation/ Pan American Health Organisation is warning that while the current pattern of the pandemic H1N1 (swine flu) is mild the impact of the virus could worsen during the second and third waves as “larger numbers of people become infected.”

It has said large numbers of people in all countries remain susceptible to the pandemic H1N1.

An influenza pandemic may occur when a new influenza virus appears against which humans have no immunity to.

Persons who become severely ill will need intensive care and this “is likely to be the most urgent burden on health services, creating pressures that could overwhelm intensive care units and possibly disrupt the provision of care for other diseases.”

WHO/PAHO said it cannot predict how high the wave will go or how long it will last.

TT has 163 confirmed cases of pandemic H1N1 and four deaths. PAHO stated in its Regional Update issued on October 26 that Caribbean countries have reported variable signs of acute respiratory disease activity.

Some countries reported increased trends in respiratory disease while others have decreasing or unchanged trends.

An analysis of regional data (including member states, North America, Central and South America) indicated that approximately half of the confirmed cases were among women, while children accounted for the highest hospitalisation rates.

Fifty to sixty percent of persons hosptialised had underlying medical conditions, and 25 percent of confirmed cases were pregnant women. It was found that risk was highest in the third trimester.

Dr Yitades Gebre, Advisor Family Health and Disease Management, PAHO/WHO said the pandemic virus had similar features with seasonal influenza, but differed in several aspects.

“The primary difference is that the virus causes very severe progressive pneumonia that is very difficult to manage, especially in younger age groups.”

Seasonal influenza affects mainly the elderly.

Gebre said the “progression of the viral pneumonia is rapid and support with ventilators alone is not sufficient.”

He added that most patients infected with the pandemic virus experience typical influenza symptoms and fully recover without medical treatment. WHO/PAHO has recommended treatment with antivirals (most effective when prescribed within the first 48 hours of the onset of symptoms) for patients who initially present with severe illness or whose condition begins to deteriorate. Top three groups at increased risk of severe illness and deaths are pregnant women; children younger than two years of age; and people with chronic lung disease including asthma, disadvantaged populations and obesity have been reported with higher incidence of severe complications.

Gebre said effectively combatting the pandemic required the strengths of many different partners from many parts of civil society. Many organisations and countries have already shown their global solidarity by their actions (sharing of information, contribution of resources, donations, etc). “Everyone and every organisation has a role to play in making Trinidad and Tobago better prepared for this pandemic,” Gebra said. PAHO/WHO is partnering with other UN agencies and NGOs in applying low-cost, existing, simple public health measures to prepare communities for the pandemic.