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Page last updated at 18:14 GMT, Monday, 27 April 2009 19:14 UK

Lessons from recent epidemics

A passenger, arriving from Mexico carries a mask at Frankfurt airport 27 April
Experts suspect swine flu has killed more than 100 people in Mexico

As international concern about swine flu grows, the BBC's Jill McGivering asks what relevant lessons have been learned in the past 12 years, since the emergence of the new strain of bird flu and the Sars epidemic.

It is new, but it is also familiar - 12 years ago, a new strain of bird flu emerged in Hong Kong that was seen as the possible start of a deadly flu pandemic.

Six years ago came the Severe Acute Respiratory Syndrome (Sars) epidemic. That too was centred on Asia but caused more than 800 deaths worldwide.

Since then, there has been massive investment in dealing with a flu-like pandemic.

Many individual countries learnt painful lessons.

Spirit of openness

Some, like China, found they needed to be much more transparent and to improve their basic surveillance and reporting systems.

South Korean quarantine researchers check samples of Mexican pork in Anyang on April 27
Scientists are now in a better position to make a vaccine quickly

To stop spread, cases need to be identified quickly and effectively.

Governments needed to accept that information must be shared globally, even if the political instinct was to avoid admitting the scale of the problem.

The continuing anxiety about a bird flu pandemic has forced bodies like the World Health Organization (WHO) to invest in prevention strategies.

There have been years of developing strategy and training on how to handle a flu pandemic - and multiple workshops and mock exercises.

Scientific advances

Experts have been sent around the world to assess procedures on the ground and give advice.

Although the threat in mind was from an H5 or H9 type flu, much of the training has been generic, so it is just as relevant now.

Scientists say the investment in global research may pay off too.

More people now recognise that it is better for everyone if they pool information, rather than sit on it

They are now in a much better position than they were 10 years ago to make a vaccine quickly, one which is perfectly matched against a particular viral strain.

Some experts in the field say that with the heightened level of co-operation that now exists, it may be possible to have a vaccine for this form of H1N1 ready to distribute in a matter of months.

Scientists, as well as politicians, have learned to share information more openly.

The culture of secrecy and competition that persisted 10 years ago was addressed during the Sars crisis - and largely resolved.

More people now recognise that it is better for everyone if they pool information, rather than sit on it, and understand that the WHO will keep a stock of any resulting vaccine so they can help poorer countries have access to it.

Public awareness

Governments who found themselves on the front line of previous crises have become some of the best prepared.

An Indonesian health official monitors thermal scanners at Ngurah Rai International Airport in Bali April 27
Indonesia has brought back thermal scanners used for Sars and bird flu

And where people have previously experienced a threat, there seems to be more readiness for the public to accept rules and procedures which might limit individual freedoms, but could help to protect them.

Hong Kong, for example, has kept up the practice of facial thermal imaging, introduced during Sars.

It automatically screens every new arrival to identify those with high temperatures - a possible flu symptom.

Governments, especially those in the developing world, have to make tough decisions about how to use their limited resources.

Is it better to invest in protection against a possible future crisis, like a flu pandemic, which may never happen? Or to focus on meeting more immediate daily health problems?

Fundamental questions about this new strain still need to be answered and its progress is very unpredictable.

But whatever course it takes, most countries which have already experienced bird flu and Sars have emerged from those crises far better equipped to deal with the next one.



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