Snoopers Tip #8: Track Swine Flu Online With International Health Organizations

Since the World Health Organization (WHO) has declared the H1N1 influenza a pandemic, I am republishing my April 28th Snoopers Tip.

Below is the recent WHO update, and the original posting follows.

A Healthy “Epidemic” of Health Authorities. The growing swine influenza A (H1N1) outbreak that first attacked Mexico, and then appeared in the United States, Canada, the European Union, New Zealand, and Israel prompted a quick and furious response, certainly, as we know, by radio and television, some of it inaccurate or hysterical. One way to avoid the media “infotainment” treatment of an important public health challenge is to rely less on them. And that’s what Snoopers Tips (TM) help you do, by uncovering the authoritative primary players and guiding you to access their information. I think of these tips as “pathfinders” to authoritative information before it gets filtered and embellished, often badly, by reporters and talking heads.

Other than journalists, another group responded to the reports of swine flu: the world public health system. This Snoopers Tip, our eighth, leaves the domestic U.S. Congressional scene to introduce international governmental and nongovernmental public health organizations, and point to their swine influenza A (H1N1)-specific sites. Armed with this information, in many cases you can stay ahead of the reported news. Read and analyze for yourself, as narrowly or widely as you desire, about the science, the medicine, the prevention, the spread, and – hopefully soon – the neutralization or demise of the virus.

Importantly, while this Snoopers Tip has its context in the swine flu outbreak, the information discovery methods and the organizations cited form a group of “bookmarks” you will return to again whenever new public health concerns and policy issues arise.

Finally, note that detailed information regarding the United States public health system will be featured this weekend, but for today, here are the primary international players thus far. (Note that I have not included vast portions of the world public health system – India, China, Indonesia, etc. These areas have not yet reported H1N1 swine flu outbreaks. I’ve also confined this to cases confirmed by the World Health Organization. Should other countries be so unfortunate in the future, I’ll update this Snoopers Tip.)

Mexico. This version of the swine flu first struck in Mexico, so their public health service was the first group to respond. Mexico’s Secretario de Salud is the lead organization in that unfortunate country, where influenza is entrenched, and the country at a standstill (all links in this paragraph, except “actions taken,” are to Babelfish translations to English). Their swine flu site provides information such as an FAQ, links to press conferences, preventive measures, actions taken, and the Decreto Acciones en Materia De Salubridad (setting out emergency powers for the Secretary of Health), and even an online forum. I found no RSS Feed.

International Organizations. Of course, pandemics are by definition worldwide and require a coordinated effort. As the reported incidences of swine flu increased, two other organizations quickly became involved, the World Health Organization (WHO) and the Pan American Health Organization (PAHO).

Who’s WHO? The World Health Organization (WHO), among many roles, directs and coordinates public health surveillance and responses within the United Nations system. They coordinate the worldwide response to this new swine flu. Their swine flu world tracking information is accessed here, and will keep you authoritatively updated on the international response.

Importantly, WHO has developed six phases of pandemic alert as a way to inform the world of the seriousness of the pandemic threat. Here, the WHO chart of the pandemic can be accessed regularly. The most recent one is at the left, with this pandemic at phase 5 [REPUBLICATION NOTE: The pandemic in now at phase 6 (as of June 11, 2009)]:

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Here are some other excellent sources of information that you will find at WHO’s site:

1. Swine influenza frequently asked questions;

2. Swine influenza virtual press briefings – Audio files and transcripts from daily briefings;

3. Daily Update Links – Found on their swine flu homepage. Here’s their update for today (April 29):

29 April 2009 — The situation continues to evolve rapidly. As of 18:00 GMT, 29 April 2009, nine countries have officially reported 148 cases of swine influenza A/H1N1 infection. The United States Government has reported 91 laboratory confirmed human cases, with one death. Mexico has reported 26 confirmed human cases of infection including seven deaths. The following countries have reported laboratory confirmed cases with no deaths – Austria (1), Canada (13), Germany (3), Israel (2), New Zealand (3), Spain (4) and the United Kingdom (5)

4. Latest news on the swine influenza around the world via RSS feeds – receive WHO’s updates in your reader (like how I hope you get your subscription updates to this blog – pardon this little advert. . .);

5. Other – WHO’s swine flu homepage (link above) also carries links to many other areas: traveler’s alerts, scientific information, and press statements.

Pan Am Still Flies High. Unlike the long defunct airline of my youth, Pan Am, the Pan American Health Organization (PAHO) is alive and well. It describes its mission:

an international public health agency with more than 100 years of experience in working to improve health and living standards of the countries of the Americas. It serves as the specialized organization for health of the Inter-American System. It also serves as the Regional Office for the Americas of the World Health Organization and enjoys international recognition as part of the United Nations system.

Naturally, with the locus of the swine flu primarily, at present, in the Americas, PAHO is intimately involved. Note also that PAHO is WHO’s Regional Office for the Americas. Thus, they act in concert, although WHO appears to carry the primary responsibilities. PAHO’s primary net site opens to a listing of influenza-oriented hyperlinks , some of which link back to WHO sites listed above. (Their RSS feeds do not include a specific swine flu feed.) Here’s two items to check:

1. PAHO’s swine influenza homepage. There you’ll find a link to their influenza FAQ, and other information, again, some of it WHO information.

2. On the right hand side of their influenza homepage, you’ll find a topic “Epidemiological Alerts,” and a number of hyperlinks to daily updates. The present day’s update is, sensibly enough, at the top. Click it and you’ll arrive at a summary PAHO’s own daily report for the America’s (“Influenza cases by a new sub-type: Regional Update”). Today’s (April 29th) summary is here, and the full text here.

Canada. As of today, Canadian authorities have confirmed 19 case of H1N1 swine flu. The Public Health Agency of Canada is the lead public health agency, and their swine influenza site, among many other features, provides:

1. Daily Cases of Human Swine Influenza in Canada;

2. An FAQ;

3. Fact Sheet Human Swine Influenza.

4. RSS Feed: Human Swine Influenza Updates: English . . . . . . French

Provincial Health Ministries/Departments – Each link below (with the exception of Nunavut) takes you to the provincial health authorities’ specific swine influenza information. Useful province-specific information such as school closings; Help lines; provincial response plans and implementation; and links to national and international public health organizations.

Alberta . . . British Columbia . . . Manitoba . . . New Brunswick

Newfoundland and Labrador . . . Northwest Territories . . .

Nunavut (No specific swine influenza site found; link is to the Health & Social Services Dept.)

Ontario . . . Prince Edward Island . . . Quebec (En Francais) . . . . In English

Saskatchewan . . . Yukon

European Union. The European Union has begun to respond to the swine flu outbreak as cases arose in Spain, the United Kingdom, and yesterday, Germany and Austria. The Union, through its “driving force in the Union’s institutional system,” the European Commission, has delegated the coverage of the influenza crisis to its Directorate-General for Health and Consumer Protection (DG SANCO). Note that the EU refers to the H1N1 influenza virus as the novel virus, and DG SANCO’s novel virus site has a variety of links worth noting:

1. Press releases, publications, coordination meetings, and videos;

2. Cumulative number of EU Member States novel flu virus case reports, updated regularly;

3. A link to information sources directly from each Member State, Candidate, and European Economic Area (EEA) health department;

4. RSS Feed: None found.

In addition, the European Centre of Disease Prevention and Control (ECDC) functions, in effect, like our Centers for Disease Control and Prevention (CDCP): “ECDC’s mission is to identify, assess and communicate current and emerging threats to human health posed by infectious diseases. . . ECDC works in partnership with national health protection bodies across Europe to strengthen and develop continent-wide disease surveillance and early warning systems.” Note that their main page has much information regarding the outbreak.

Also, within the ECDC domain, their novel virus site is an important one and has vital information:

1. An FAQ;

2. A Daily Situation Report (this link is to today’s report (April 29); each day’s report is accessed from ECDC’s main novel virus page

3. An ECDC Risk Assessment, although, surprisingly, as of this writing, it has not been updated since April 24th;

4. RSS Feed: “Pandemic Influenza” (not specific to swine flu)

Israel. WHO reports two confirmed Israeli cases, although other reports seem to differ. However, I found no H1N1 influenza-specific information at their Ministry of Health or at The Israeli National Institute for Health Policy and Health Services Research sites. An April 30 news report in Haaretz.com indicates that “[t]he ministry will begin disseminating information about the disease today.” No RSS Feed.

New Zealand. New Zealand has one confirmed case of swine flu in today’s WHO survey, although New Zealand public health authorities report 13 confirmed and 96 suspected. The Ministry on Health maintains a Mexican Swine Flu Updates page with links to media releases, WHO, CDC, and other information. Each day’s New Zealand update appears on the page as well, and here is today’s. I found no RSS feed at the site.

There you have it, based upon today’s WHO reports. As I wrote at the outset, these links, although swine flu based, will introduce you to important international health organizations and give you a feel fo other countries’ health systems. Spend some time nosing around their sites for information not related to the pandemic, especially the international organizations and the EU sites. Bookmark the major ones of interest in an “International Organizations” sub-folder in your “Snoopers Tips” folder. We’ll be adding to it from time to time.

I hope this Snoopers Tip gave you a good and meaningful introduction to international resources. In a few days, I’ll introduce the United States public health system and its response to the swne flu outbreak, including the White House, the Department of Health and Human Services, the Centers for Disease Control and Prevention, the Surgeon General, and, although it may seem out of place in this list, the Department of Homeland Security. We’ll also have a look at what response Congress has made in the form of proposed legislation, hearings, or just plain griping . . .

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