Public Health Emergency of International Concern

Latin America and Caribbean on Alert for "Influenza A(H1N1)"

Washington, D.C., April 29, 2009 (PAHO/WHO) – Health authorities throughout Latin America and the Caribbean are activating national pandemic preparedness plans,  stepping up disease surveillance and preparing for possible outbreaks of swine influenza within their territories. Several countries in the region are investigating small numbers of cases of respiratory illness as suspected Influenza A(H1N1) cases. p>On Tuesday, the Pan American Health Organization (PAHO) convened ministers of health from throughout the region via teleconference to exchange information, address questions, and brief participants on actions taken by PAHO and the World Health Organization (WHO). Ministers and high-level officials from at least 26 countries participated in the conference.

Dr. Jarbas Barbosa, PAHO area manager for Health Surveillance, Disease Prevention and Control, said PAHO has mobilized experts in epidemiology, laboratory analysis, infection control and communication to assist Mexican health authorities in investigations of confirmed and suspected cases and other aspects of the outbreaks. Additional experts have been sent by WHO’s central office in st1:> Geneva, by the U.S. Centers for Disease Control (CDC) and by the Public Health Agency of Canada.

Because of previous concerns about the pandemic potential of H5N1 avian influenza, countries in Latin America and the Caribbean are better prepared for a possible pandemic than they were five years ago, Barbosa said.

“We have all been working on pandemic preparedness for several years, and all this work and experience will pay off in helping us to respond to and mitigate limited outbreaks or even a possible pandemic.”

Mexico first notified PAHO/WHO on April 16 of an unusual increase in cases of acute respiratory infections in two states, Oaxaca and Veracruz. On April 18, the first cases of Influenza A(H1N1) were confirmed in the United States, in California. On April 21, Mexico notified PAHO/WHO of outbreaks of severe respiratory illness in additional states. On April 23, Mexico reported its first laboratory-confirmed cases of Influenza A(H1N1) . Also on April 23, cases were confirmed in Texas, USA. On April 25, WHO’s director-general declared a Public Health Emergency of International Concern and convened a meeting of the Emergency Committee of the International Health Regulations. The same day, a PAHO expert team arrived in Mexico to assist health authorities with the outbreaks. On April 26, cases were confirmed in New York and Ohio, USA. On April 27, WHO raised the pandemic alert level from phase 3 to phase 4. On the same day, Canada notified its first confirmed cases. Today from Geneva, the director-general of WHO announced that the level of pandemic alert was being raised from phase 4 to phase 5.

In the teleconference with hemispheric health authorities on Tuesday, Barbosa said that, in addition to experts on the ground, PAHO/WHO is providing guidelines for its member countries on case definition, the use and procurement of antiviral drugs, infection control, and the shipment of specimens for laboratory testing. PAHO/WHO and other international experts are working to develop specific guidelines for clinical management of influenza A(H1N1) cases, and preliminary guidelines for management of influenza cases are available on the PAHO website ( www.paho.org ).

With PAHO technical cooperation, countries throughout the region have developed pandemic preparedness plans over the past three years and have worked to improve their ability to comply with the International Health Regulations, which establish specific outbreak reporting and investigation requirements for PAHO/WHO member countries. As part of this process, PAHO has helped countries strengthen their laboratory capacity and early warning systems for disease outbreaks. Over 750 health professionals from Latin America and the Caribbean have been trained by PAHO in enhanced nationwide surveillance, and some 120 professionals have received PAHO training as members of national or international rapid response teams.

Barbosa noted that each country’s national pandemic preparedness plan identifies the nearest laboratory available to analyze specimens or virus isolates to confirm possible cases of Influenza A(H1N1) . Guidelines for the preparation and shipment of laboratory samples are available on the PAHO website, in English and Spanish. PAHO is also currently sending reagents to enable member countries to do preliminary testing of suspected cases. As part of its work on the International Health Regulations, PAHO has helped several countries acquire immunofluorescence microscopes, diagnostic kits, and reagents and has provided training on the use of polymerase chain reaction to identify different types of influenza.

In Tuesday’s teleconference, Barbosa urged the region’s health authorities to enhance surveillance, keep informed, and follow PAHO/WHO guidelines for reporting and responding to outbreaks.

PAHO, founded in 1902, works with all the countries of the Americas to improve the health and quality of life of their peoples. It also serves as the Regional Office for the Americas of the World Health Organization (WHO).

For more information, please contact Donna Eberwine-Villagran,  This e-mail address is being protected from spam bots, you need JavaScript enabled to view it , Tel +1 202 974 3122, cel (202)320-0410, fax +1 202 974 3143 or Daniel Epstein, email:  This e-mail address is being protected from spam bots, you need JavaScript enabled to view it , Tel +1 202 974 3459 – mobile +1 202 316 5679, fax +1 202 974 3143 – www.paho.org