Page last updated at 11:07 GMT, Tuesday, 5 May 2009 12:07 UK

The world response to flu crisis

It is no longer possible to contain the deadly swine flu virus first found in Mexico, the World Health Organization (WHO) says. Governments around the world have been stepping up precautions against its spread.



The government formed a national task force to co-ordinate the response to the disease and the Ethiopian Red Cross plans to train 800 volunteers in preventative strategies. African Union health ministers are discussing the continent-wide response at a conference in Ethiopia's capital Addis Ababa from 4 May. The conference was planned months ago to discuss Africa's response to pandemics.


The government has suspended all pork imports and increased health checks at border entry points. It is also encouraging citizens to wash their hands and avoid large groups.


The authorities have banned imports of pork and pork products. The country has drugs available and a quarantine system in place should any cases be identified.


Officials are monitoring visitors who have come from infected areas such as the US, Canada, Israel, Spain and the UK. Kenyan hospitals have been asked to monitor patients with flu-like symptoms. The government says it has enough medication to treat people and the facilities for quarantining.


In the African country closest to Spain, the worst-hit country in Europe, health and airport workers have been issued with equipment such as gloves and masks. Official stocks of Tamiflu are reportedly sufficient for one million of the 34 million people who live there.


In Africa's most populous state, Health Minister Babatunde Osotimehin told the BBC his government was increasing surveillance, providing information about the disease to the public and medical centres, and making sure there were sufficient supplies of anti-viral drugs. He said the government had alerted all borders to be on alert for potential carriers of the disease. Nigeria was badly hit by bird flu three years ago.

South Africa

South Africa has stockpiled about 100,000 doses of Tamiflu and has access to more if needed, said Barry Schoub, director of South Africa's National Institute for Communicable Diseases. Thermal scanners have been installed at major entry ports. All passengers on flights from affected countries must complete questionnaires about possible symptoms and their travel patterns.


The government has banned any person arriving directly from Mexico from entering the country. It has set up offices at the airport and at Port Sudan to examine people exhibiting flu-like symptoms. Transit passengers arriving from countries with problems relating to the disease were kept in a room at the airport for four to seven days. Sudan says it has the capability to treat 45,000 cases.


The government has installed thermal scanners at airports and stepped up medical surveillance at entry points. Tunisians are being advised not to visit Mexico.


The avian flu National Taskforce has been revived to deal with the new threat. Officials say they have 10,000 doses of Oseltamivir, a cheap generic version of Tamiflu, in stock. All arrivals into the country are being screened.


The authorities have formed an emergency task force to deal with a possible outbreak of swine flu.


Teams have been deployed at ports of entry to check for suspected flu cases. But Zimbabwe does not have enough drugs in stock to treat a swine flu outbreak. It is asking the regional WHO office for supplies.



The country has suspended flights to and from Mexico. Immigration authorities have been asked to provide information about passengers who arrived from Mexico in the last 15 days. The authorities have installed a field hospital at the main international airport - where heat sensors are already operating - to attend to passengers arriving with flu-like symptoms. Health authorities have been ordered to watch for an increase in respiratory illnesses and to promote vaccinations and preventative hygiene habits among health workers and the public. The health ministry has said the stocks of Tamiflu are enough to provide 500,000 treatments, the Argentine press has reported.


This country on Mexico's south-eastern border has ordered the cancellation of all major events which involve big public gatherings. These range from a reggae concert to the national agriculture and trade show, and performances by a visiting circus from neighbouring Guatemala.


The government has declared a "state of health alert". National director of epidemiology Eddy Martinez said the control mechanisms for swine flu are based on what was done to prevent bird flu. If a case of swine flu were found in Bolivia, health-service workers would be transferred to all airports and border areas, he said. Officials are checking for people with flu symptoms arriving from affected countries. Bolivia's health minister says it has only 100 doses of Tamiflu, but adds that the WHO has promised an emergency shipment of 12,000 more.


Brazil is authorising $67m (£45m) in emergency funding to combat swine flu. Most of the funds will be directed to public information campaigns.

Monitoring of passengers, initially restricted to those arriving from Mexico and US, has been extended to all international flights. It has started to distribute medication giving priority to Rio de Janeiro and Sao Paulo, states which receive the highest number of passengers from abroad.

Brazil says it is well-prepared but has Tamiflu for nine million out of a population of 190 million people. The authorities are also building stockpiles of medicines in other cities such as Recife, where international flights also arrive, and ordering face masks.

Travellers arriving from the US and Mexico are being advised to avoid close contact with other people for the first 48 hours after their arrival. Arrivals from Mexico are having their luggage sterilised. Passengers from these countries are being screened - as are ships docking in Brazil.


After cases were confirmed in Canada - all involving only mild illness - the government said it was stepping up surveillance for possible new cases and urged people to take precautions like frequent hand-washing.

Australia, Japan, New Zealand, Taiwan, South Korea, Singapore, Vietnam and Indonesia have issued advisories against travel to Mexico.
Japan advised its nationals in Mexico to consider returning home soon and has suspended visa waivers for Mexicans.
Health ministers from EU states have ruled out a co-ordinated suspension of flights to Mexico

A pig herd was quarantined after testing positive for swine flu, but the Canadian Food Inspection Agency said food safety had not been breached. The government has advised against non-essential travel to Mexico and two major airlines have said they will suspend flights to Mexican resorts.


All passengers arriving by plane from Mexico and the US are being scanned for signs of infection. The authorities have also warned against non-vital travel to Mexico and the US, and border officials are on alert to monitor passengers arriving by land who have flu-like symptoms.


Colombia has declared a disaster situation as a way of providing funds for increased monitoring of potential cases and to allow for the mass purchase of medicine and masks.

Increased monitoring and preventative controls are in place at hospitals, ports and Bogota's main airport, especially for people arriving from Mexico City, Texas and California. Colombians displaying flu symptoms are being urged to stay at home and children with similar symptoms should be kept away from class - although schools would remain open. Mexican football teams have been prevented from playing scheduled matches in the capital Bogota.

Costa Rica

The authorities have declared a national health state of emergency after confirmed cases of swine flu in the central American country.


The government has suspended flights to and from Mexico and officials are monitoring passengers who have arrived from Mexico, visiting them in their homes and hotels to conduct checks. The island is updating its capabilities for epidemiological clinical surveillance and for providing treatment for the population through the public health system.


Health officials are carrying out medical checks on people with flu symptoms arriving via air and sea from affected countries. The country has banned imports of pigs and pork products from the US and Mexico. Flights to Mexico have been cut.

El Salvador

The country's health minister has said that clinics and public hospitals are stepping up measures to combat the disease. Health officials are continuing watch for flu cases at the borders with Guatemala and Honduras.

A US transport security officer wearing a mask near the border with Mexico
Deaths from the swine flu virus have occurred in North America


A team of medical officials at the international airport are checking passengers arriving in the Caribbean state for flu symptoms. Locals studying in Mexico have been told they cannot return immediately. One student and her Surinamese boyfriend who had already returned have been ordered to remain at home for a week while officials monitor them.


The country is able to provide 3,000 treatments with Oseltamivir to 1,500 adults and the same number of children. Health ministers from Guatemala, Nicaragua, Panama and Dominican Republic will seek to create a "sanitary cordon" in the region. Mexico's southern neighbour has prohibited imports of Mexican animals and agricultural goods.


The swine flu outbreak originated in Mexico. But officials say that the most lethal outbreak may be levelling off.

Restaurants and cafes in Mexico City are scheduled to reopen imminently with other public institutions to follow suit. Government officials are still discussing when schools and businesses can resume work.

President Felipe Calderon assumed new powers to isolate infected people. He ordered government offices and private businesses not crucial to the economy to stop work to avoid further infections from the new virus.


The health ministry has declared a health alert. All public activities, including those scheduled to mark International Workers' Day, have been suspended.


Airport officials are screening 40 flights a day from Mexico.


The government has declared a health emergency that would release funds, which could be used to help deal with the situation. It would also give the government authority to cancel international events.


Airport controls have been reinforced in order to detect anyone with flu symptoms entering the country. Flights to and from Mexico have been cut.

St Lucia

The administration says they have health personnel at ports looking out for people who may have the disease. They have also increased surveillance at hospitals and private offices.

Trinidad and Tobago

The twin-island Caribbean state is increasing health checks on air travellers arriving from affected countries. The regional political grouping Caricom told the BBC its member countries have different levels of stockpiles and programmes of vaccinations against flu.

United States

The US was the second country to confirm flu cases - health officials have declared a public health emergency. President Barack Obama has said the outbreak is "cause for concern but not cause for alarm". The Centers for Disease Control and Prevention is sending out testing kits to US states so that individual state laboratories will be able to confirm their own cases of swine flu.

Inspections have been boosted at US borders and airports. Some schools have been closed in New York City, as well as Texas, California and other states where there have been confirmed flu cases. The government recommends that schools with confirmed cases of the disease close for at least a fortnight.

The US has a stockpile of 50 million courses of anti-viral drugs and has begun distributing the medication. It will spend $251m to buy 13 million more courses of flu medicine.

The administration has ruled out closing the frontier with Mexico but the state department advises nationals against non-essential travel to the country.


Health controls at airports have been stepped up to try to prevent the contagion from spreading. Venezuelans have been recommended to avoid travel to the US and Mexico. Any potentially ill travellers - particularly from the US and Mexico - are being isolated until the cause of their disease is determined.

Stocks of the relevant medicines are also being built up. The ministry of agriculture says they are "closely inspecting" pig farms in the country and have suspended imports of pork and live pigs.



Ministers have approved new powers to detain and disinfect people suspected of carrying swine flu. All incoming flights have to declare any suspected flu cases on arrival. Thermal scanners and extra medical staff are also being sent to airports for screening of incoming passengers. With 8.7 million doses of Tamiflu and Relenza drugs stockpiled, Australia has enough anti-viral drugs to cover about 41% of its 21-million population. It also has large stores of surgical masks. The government plans to maintain the swine flu threat level.


Checkpoints screening temperature have been installed at the country's main airports. But the WHO's country director has said that "if and when it does come to Cambodia it will challenge the authorities there". Prime Minster Hun Sen has made a personal plea for Cambodians to continue to eat pork as usual. "The infection does not come by eating pork," he said.


The authorities appear to have learned the lessons of previous deadly virus outbreaks such as the H5N1 avian flu and Sars (Severe Acute Respiratory Syndrome), and this time around have been quick to share information with the WHO. The central government has put in place a joint prevention and control system and hospitals have been told to report any suspected cases of swine flu swiftly. The official press is primed to report swiftly on cases of infection. The ministry of health has asked for daily flu status updates from local government.

Citizens have been advised not to make tourist trips to Mexico and body temperature checks on passengers and crew at ports of entry have been re-introduced. Stockpiles of disease control equipment, anti-viral drugs and clinical equipment have been increased and China says it has the capacity to make anti-viral medicines. China has also banned imports of pork and pork products from Mexico and the US states of Texas, Kansas and California.

A charter plane collected Mexican nationals who were quarantined in China because of fears they may be infected with swine flu. Mexico has issued strongly-worded statements over the past few days condemning Beijing's actions.

China has also placed some Canadian and US citizens under quarantine.

Hong Kong

Hong Kong authorities have 20 million doses of Tamiflu and other anti-flu medication, media reports say. Port health protection measures have been increased, including body temperature screening machines at all checkpoints. About 400 guests and staff at a hotel remain under quarantine following the diagnosis of a guest with swine flu.

An elderly man wears a surgical mask in Hong Kong
Asia has recent experience of crises involving respiratory illnesses


Temperature scanners have been installed at 10 airports and ports with immediate effect. At least three million Tamiflu capsules are in stock. Imports of pigs and pork products have been completely banned.


Passengers from Mexico, Canada and the US are being checked at international airports. Officials are inspecting all imported pigs across the country (about 420 pigs were imported in 2008). The central government has Tamiflu and Relenza combined stockpiles which would cover nearly 20% of the population. New supplies of anti-viral drugs to treat 8.3 million people have been ordered. Local governments have their own stockpiles but figures are not available.


The import of meat products from the US and Mexico has been temporarily banned.


Tamiflu stockpile covering more than two million people out of a population of 27 million. It does not have a stockpile of personal protection equipment such as masks for the general population yet, but has a supply for health staff who will be dealing with any outbreak. It is using thermal scanners at airports.

New Zealand

With the first confirmed cases in the region, public health officials say they have "ample stocks" of anti-flu drugs. The government has raised the level of the national pandemic plan and is screening all flights from the US. The country built up a stockpile after the bird flu scare sufficient to cover 25-30% of the 4.3 million population.


Airports are equipped with thermal scanners, and additional medical staff have been hired. The government says it has enough Tamiflu for 60,000 possible cases and is buying 10m pesos ($206,000) worth of additional Tamiflu. This covers a fraction of the Philippine population of 90 million. Government says there are sufficient masks in stock.


Anyone who has visited Mexico in the past seven days has been instructed to remain at home in self imposed quarantine for a week and to keep in contact by telephone with officials monitoring flu symptoms.

Thermal scanners are set up at airports and isolation units at hospitals, where staff at some emergency departments are wearing full protective clothing. Asean has 500,000 courses of anti-virals stockpiled in Singapore (and a similar amount distributed among member states).

South Korea

The government has set up a 24 hour emergency quarantine centre. The agriculture ministry has suspended imports of live pigs from North America and recommended its nationals leave Mexico unless on urgent business. Health authorities have a Tamiflu stockpile for 2.5 million people and are working to increase that to 10% of the population of about 49 million. It has called on nationals staying in Mexico to leave unless on urgent business.


Taiwan currently has supplies of swine flu treatment to cover 10% of its 23 million population. More than a million facemasks for emergency use are available.


The government has 320,000 courses of Tamiflu stockpiled. GPO, a state-owned drug-maker, can produce 1m capsules of generic Tamiflu if needed. Temperature screening checkpoints are in place at international airports in Bangkok, Chiang Mai and Phuket. The main targets for the thermal scanners were passengers on eight routes - from France, Tokyo, Dubai, Frankfurt, London, Chicago, Los Angeles and Texas - which had connecting flights from Mexico. Suspected cases of new arrivals will be put under close surveillance for three to five days during their stay in Thailand.


Visitors arriving from the flu-affected countries are to be isolated. Vietnamese nationals have been advised not to visit areas affected by the disease. Ho Chi Minh City, Vietnam's largest city of more than eight million people, has stocks of Tamiflu sufficient for a million people.



The authorities have stocks of anti-viral drugs sufficient to treat four million people (half the population), and have secured production capacity for prophylactic vaccines for the entire population. They have also stockpiled eight million protective masks.


The country has 500,000 anti-viral treatments and the capacity to make two million more. In addition, it has 32 million masks for patients and six million for healthcare professionals.


It has recommended people avoid travel to affected countries. Bosnia's Muslim-Croat federation has stocks of 12,000 boxes of Tamiflu. Bosnia's Serb Republic said it has 5,000 boxes of anti-virals and more boxes and protective masks are on order.


Customs officers are checking the luggage of passengers arriving from Mexico, the US, Canada and Japan to ensure they are not importing pork products. Two thermal scanners have been installed at Sofia airport.

Czech Republic

The country has stocks of two million doses of Tamiflu, enough to treat 20% of the population. General information on the viral strain has been circulated to hospitals, doctors and GPs. At Prague Airport, information boards on swine flu have been put up and medical examinations are available.


A general pandemic plan has been in place since the bird flu scare. Denmark has stockpiled Tamiflu.

A man just returned from Mexico wears a mask in Bilbao, Spain
People in Europe, unlike this man, are not wearing masks generally


More than 90,000 doses of anti-viral medication have already been stockpiled. An additional 880,000 doses of the Relenza are to be acquired.


French nationals have been advised not to travel to Mexico. A national information campaign will be launched next week. Passengers arriving from Mexico will be tracked and their health checked. France has a stock of more than 30 million anti-viral treatments, composed of 24 million doses of Tamiflu and nine million doses of Relenza.


Nationals have been advised against non-vital travel to Mexico.


Passengers coming from countries where swine flu has occurred are being tracked and doctors at the airport will carry out checks. The country has "strategic stocks" of Tamiflu and other anti-viral medication.


Medical imaging cameras have been installed in Budapest's main Ferihegy airport. The cameras are linked to computers which analyse the electromagnetic radiation of the human body to screen passengers for signs of the flu infection.


Pamphlets are being handed out to passengers at Rome's international airport, although there are no restrictions on travel. Italy has 10 million doses of Zanamivir (Relenza) and 60,000 doses of Tamiflu, as well as enough Tamiflu powder to make 30 million doses.

The Netherlands

The Dutch government is acquiring 19 million doses of anti-viral medication.


A "pandemic committee" will be assembled this week. Authorities have stored flu medicine covering one-third of the 4.7-million population.


Has stocks of 2.5 million doses of Tamiflu - enough for a quarter of the population.


Air crew arriving from the Americas have been told to look out for passengers with flu-like symptoms. Planes with suspected cases are sent to special airport zones, where passengers and crew can be examined by medics. Curbs have been imposed on meat imports from Mexico, a number of US states and the Caribbean. Russia will retain bans imposed on imports of raw pork from countries affected.


With population of 5.4 million, it has around 700,000 doses of Tamiflu in official reserves.


The authorities have 500,000 doses of Tamiflu, which is sufficient to treat a quarter of the population.


The first European country to confirm a case of the virus, in a man who had recently returned from Mexico, Spain is distributing leaflets to other passengers arriving from there, advising them to report to a health centre if they suffer symptoms. Spain has a stockpile of 10m doses of Tamiflu. Flights to Mexico are being supplied with masks and gloves.


Health ministry launches "Catch it, Bin it, Kill it!" campaign on tv, radio and internet to urge people to use tissues when they sneeze, dispose of them and then wash their hands. Leaflets giving advice about the new H1N1 swine flu virus are to be sent to every home in Britain. But health authorities are not advising the general public to wear masks. The British government stresses it has enough anti-viral drugs to treat more than half the population if necessary.


Imports of live pigs and pork meat from countries where cases of swine flu have been recorded, including Mexico, the US, Canada and New Zealand, have been banned. All shipments received after 21 April will be subject to the ban.



A cull has been ordered of all pigs in the country. The animals are mainly eaten by members of the Coptic Christian minority in the largely Muslim state.

Experts say the flu cannot be caught from eating pig meat, and there is no scientific rationale for slaughtering pigs or banning pork.

The authorities have increased numbers of medical staff at Cairo airport to check passengers arriving from Mexico and will monitor them during their stay.


The Israeli government has stepped up preventive measures ordering travellers returning from Mexico to undergo medical checks at airports or other points of entry. A "crisis cell" has been formed in the defence ministry to deal with the outbreak were the disease to spread inside the country. Israel, Jordan and the Palestinian Authority will hold a joint meeting "to discuss ways to prevent the spreading of the epidemic," Israel's foreign ministry announced.


The health ministry has set up a telephone advice line to answer question about the disease and its symptoms; a pamphlet on the disease will be distributed in hospitals and health centres. A medical team is screening air travellers arriving from flu-infected areas.


The government has 10 million capsules of Tamiflu, enough for a million flu patients, roughly the number of Kuwaitis. Of the 3.44 million people who live in the state 2.35 million are foreigners.


Among the reported measures to prevent contagion, Health Minister Mohammad Khalifeh has issued advice for schools and employers and suggested people should avoid "social kissing". Pigs and pork from the affected countries have been banned.



Travellers, particularly those coming from countries already hit by swine flu, are to be screened by teams comprising medical officers, epidemiologists and representatives from the WHO and the International Centre for Diarrhoeal Diseases Research in Bangladesh.


Preventative measures such as surveillance at ports and nine international airports have been taken, and people have been advised to defer non-essential travel to the affected areas. About 50,000 passengers who have come from countries affected by swine flu have been traced and checks would be carried out on them, a senior health official Vineet Chaudhary said.

The states within India have been advised to review their preparedness to investigate and contain any suspected cluster of swine flu cases, with central government providing expert, logistics and laboratory support. A toll-free call centre number has been set up for the public to report incidents of illness.

The authorities are opening quarantine facilities in all 17 international airports.

An Indian newspaper reports that the drug company Cipla has received orders from Latin America, Mexico and Israel for the anti-viral Tamiflu. India has stockpiles of a million Tamiflu doses and is taking steps to stockpile up to 10 million doses.


Visitors from the US and Mexico will be screened, local media report. A team of health professionals will be stationed at Tribhuvan International Airport with a health-related questionnaire and take immediate action if anyone is suspected to have contracted the flu.

Sources: Reuters and other news agencies, BBC World Service, BBC Monitoring

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