Global Health Officials Mull How to Slow Swine Flu

Some Muslim countries are advising pregnant women
not to attend the hajj pilgrimage. China is quarantining any
visitor suspected of having a fever, while priests in New Zealand
have been banned from placing Communion wafers on worshippers'
tongues.

It's all part of a global effort to slow the spread of swine flu
until a vaccine is ready, although experts are divided on whether
the measures will work.

Students across Europe may have their summer vacations extended
after the World Health Organization said Tuesday that closing
schools was one option countries could consider.

Deaths from the H1N1 virus have doubled in the past three weeks,
to over 700 from about 330 at the start of July, the agency said.

"We expect to see more cases and deaths in the future," WHO
spokeswoman Aphaluck Bhatiasevi told The Associated Press in
Geneva.

The agency gave no breakdown, but as of last week, the United
States had reported 263 deaths, Canada had 45 and Britain had 29.
According to WHO's last update on July 6, there were 119 deaths in
Mexico.

Yet even the latest figures may seriously underestimate the true toll because not all swine flu cases are being picked up due to
testing limitations.

The race is now on to develop a vaccine that is effective
against the pandemic strain before the flu season begins this fall
in the northern hemisphere. Estimates for when a vaccine will be
available range from September to December.

In the meantime, the U.N. health agency is working with its
national counterparts around the world to examine what countries
can do.

"School closures is one of the mitigation measures that could
be considered by countries," Bhatiasevi told reporters.

Experts have argued that school closures may be among the most
effective measures, but warn there may be a considerable economic
downside, too.

Religious leaders have been drawn into the debate after
authorities in Jordan and health officials at a conference in Saudi
Arabia recommended that people thought to be most at risk,
including pregnant women and those with chronic diseases, skip the
hajj pilgrimage this year.

Arab health ministers are holding an emergency meeting Wednesday
in Cairo to come up with a unified plan to confront the pandemic.

In New Zealand, the Roman Catholic Church imposed a ban on
priests placing Communion wafers on the tongues of worshippers and
on the sharing of Communion wine. It also asked parishioners to
avoid bodily contact at services, including shaking hands.

In Chile, where 40 people have died from swine flu, authorities
canceled a popular religious festival that normally draws tens of
thousands of worshippers to the northern town of La Tirana,
prompting protests from the faithful.

"The key question is whether citizens will accept the measures
governments impose," said Christian Drosten, head of the Institute
for Virology at the University of Bonn in Germany.

"You need to get the population on board, otherwise your
efforts won't work," he said. "Once people take the disease
seriously, you'll begin to see the kind of social distancing that
limits infection."

"But it's all a question of culture," Drosten added. "What
works in Europe may not work in other countries, and vice versa."

In Switzerland, supermarket chains are considering requiring
customers to disinfect their hands and put on a face mask as they
enter the store.

"We can put these measures in place as quickly we get food into
the stores," said Urs Peter Naef, a spokesman for the Migros
chain, Switzerland's biggest.

China's practice of forcibly quarantining visitors has caused
bewilderment elsewhere, particularly when hundreds of American,
British and other foreign students have been sealed off in hotels
for days on just the suspicion of infection.

Chinese officials in masks or hazmat suits board planes,
pointing temperature guns at passengers' foreheads. If a passenger
is diagnosed with swine flu, anyone seated within three rows is
often tracked down. Those quarantined get to leave if they are
healthy seven days from the date they landed.

In Britain, health officials' advice that women put off planning
to have children due to the global outbreak was met with ridicule
since the swine flu pandemic may last years.

One measure comes up again and again - school closures - but it
has its own risks.

A paper published Tuesday in the medical journal The Lancet
argues that closing schools can help break the chain of
transmission, slowing the pace of the disease and lessening the
burden on health care systems.

But the paper, written by researchers at London's Imperial
College, also noted the considerable economic costs as parents are
forced to stay home to look after their children.

France's Education Ministry has already prepared nearly 300
hours of educational programming for radio and television to allow
those affected by school closures to follow their lessons, the Le
Parisien daily reported.

The experience of school closures in the United States during
the early days of the epidemic may prove to be a guide for how best
to handle outbreaks in an educational setting.

Initially, authorities recommended schools close for two weeks
if there was a suspected case, but when the virus turned out to be
milder than feared they switched to advising parents to keep only
sick students home. Schools could still close if there were a large
number of student and staff out sick - the same guidance for
schools contending with an outbreak of seasonal flu.

"We have some general philosophies and principles that the best
place for healthy kids is in school, where they can learn ... and
where many of them get breakfast and lunch and can be nourished as
well," Dr. Anne Schuchat of the U.S. Centers for Disease Control
and Prevention said last week.

Apart from school closures, a team of WHO experts is also
examining other measures including postponing mass gatherings, such
as sports events and concerts, Bhatiasevi said. That could prove
very unpopular since football and Major League Baseball, as well as
world soccer teams all have heavy fall schedules.

Ultimately, the responsibility to decide what to do to keep the
pandemic under control rests with individual governments,
Bhatiasevi said.

"Different countries could be facing a pandemic at different
levels at different times. It is really up to countries to consider
what mitigation efforts suit them."


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