WHO predicts swine flu case 'explosion'

BEIJING (AP) - The global spread of swine flu will endanger more lives as it speeds up in coming months and governments must boost preparations for a swift response, the World Health Organization said Friday.

There will soon be a period of further global spread of the virus, and most countries may see swine flu cases double every three to four days for several months until peak transmission is reached, said WHO's Western Pacific director, Shin Young-soo.

"At a certain point, there will seem to be an explosion in case numbers," Shin told a symposium of health officials and experts in Beijing. "It is certain there will be more cases and more deaths."

WHO has declared the swine flu strain a pandemic, and it has killed almost 1,800 people worldwide through last week. International attention has focused on how the pandemic is progressing in southern hemisphere countries such as Australia, which are experiencing winter and their flu season.

But it is in developing countries where the accelerated spread of swine flu poses the greatest threat as it places underequipped and underfunded health systems under severe strain, Shin said.

WHO earlier estimated that as many as 2 billion people could become infected over the next two years — nearly one-third of the world's population.

Health officials and drug makers are looking into ways to speed up production of a vaccine before the northern hemisphere enters its flu season in coming months. Estimates for when a vaccine will be available range from September to December.

Delegates from Bangladesh and Myanmar appealed for help in procuring vaccines or making them more affordable for poorer countries, saying they were left vulnerable while rich nations pre-ordered most of the available stock.

"Developing countries like us, we have to fight this war without vaccines," said Mya Oo, deputy health minister of Myanmar. He urged pharmaceutical companies to consider selling the vaccines to developing countries at just above cost.

WHO's flu chief, Keiji Fukuda, said the agency was working hard on the issue, and noted that two drug makers had pledged to donate 150 million doses of vaccine to poorer countries by the end of October. He said more research was needed to determine how vaccines will be priced.

"Among the many pandemic response issues, this is probably the most critical issue: how we mobilize the vaccines, how we get them to developing countries," Fukuda said.

WHO has stressed that most cases of swine flu are mild and require no treatment, but the fear is that a rash of new infections could overwhelm hospitals and health authorities, especially in poorer countries.

Shin said governments must act quickly to educate the public, prepare their health systems to care for severe cases and protect those deemed more vulnerable to prevent unnecessary deaths.

"We only have a short time period to reach the state of preparedness deemed necessary," Shin said. "Communities must be aware before a pandemic strikes as to what they can do to reduce the spread of the virus, and how to obtain early treatment of severe cases."

Pregnant women face a higher risk of complications, and the virus also has more severe effects on people with underlying medical conditions such as asthma, cardiovascular disease, diabetes, autoimmune disorders and diabetes, WHO chief Margaret Chan said in a video address.

The last pandemic — the Hong Kong flu of 1968 — killed about 1 million people. Ordinary flu kills about 250,000 to 500,000 people each year.

Swine flu is also continuing to spread during summer in the northern hemisphere. Normally, flu viruses disappear with warm weather, but swine flu is proving to be resilient.

WHO: No Tamiflu for healthy people with swine flu

Healthy people who catch swine flu do not need antivirals like Tamiflu, but the young, the old and the pregnant surely do, the World Health Organization declared Friday in new advice to doctors.

The U.N. health agency said people who are otherwise healthy with mild to moderate cases of swine flu or regular flu don't need the popular drug, calling the medical evidence for giving it to those people "low quality."

But people thought to be at risk for complications from swine flu — children less than five years old, pregnant women, people over age 65 and those with other health problems like heart disease, HIV or diabetes — should definitely get the drug, WHO said.

WHO also recommended that all patients, including children, who have severe or worsening cases of swine flu, with breathing difficulties, chest pain or severe weakness, should get Tamiflu immediately, perhaps in higher doses than now used.

The advice contradicts some current government policies, such as those in England, whose health agency liberally hands out Tamiflu to healthy people with swine flu. Since the British set up a national flu service in July to deal with the surge of swine flu cases, Tamiflu has been available to anyone suspected of having the disease, including healthy people.

At its summer peak, British authorities guessed there were about 110,000 new cases of swine flu, also known as H1N1, every week. The number of new cases dropped last week to about 11,000, but the fall/winter flu season has not yet begun.

Boasting that Britain had the world's largest supply of Tamiflu, enough to cover 80 percent of its nearly 61 million people, Health Minister Andy Burnham promised the drug would be available to anyone who needed it.

Britons who call the national flu line can get Tamiflu without ever seeing a doctor — it is given out by call center operators who have no medical training. Scotland, Northern Ireland and Wales decided not to participate in the swine flu phone line.

On its swine flu Web site , the Department of Health says "the government has decided to offer the antiviral Tamiflu or Relenza to everyone confirmed with swine flu."

To stop people fraudulently getting Tamiflu, the web site says "the government is relying on the public to use the system responsibly."

Some experts have criticized that approach, warning that blanketing the population with Tamiflu increases the chances of resistant strains emerging.

Flu expert Hugh Pennington of the University of Aberdeen called the strategy "a very big experiment" and said England's approach was out of step with the rest of the world. The U.S. Centers for Disease Control and Prevention, for instance, says antivirals must be prescribed by a health care professional.

Pennington called for the national flu line to be dismantled because Tamiflu should be used more sparingly.

"This approach increases the likelihood of a resistant strain and that is not a risk worth running," Pennington said.

Officials have already found widespread drug resistance in seasonal strains of H1N1 flu and worry that might also crop up with swine flu. So far, only a handful of Tamiflu-resistant swine flu strains have been found.

WHO said most patients infected with swine flu worldwide recover within a week without any medical treatment. Still, about 40 percent of the severe swine flu cases are occurring in previously healthy children and adults, usually under 50 years of age.

WHO has estimated that as many as 2 billion people could become infected over the next two years with swine flu — nearly one-third of the world's population.