Confirmed cases of swine influenza A (H1N1) virus in three countries in the WHO European Region

On 27 April 2009, National Focal Points (NFPs) for the International Health Regulations (IHR) informed WHO/Europe about the detection of four confirmed cases of swine influenza A (H1N1) virus infection: two cases...

each in Spain and the United Kingdom. On 28 April 2009, the NFP of Israel reported an additional confirmed case.

The five people with confirmed cases in the WHO European Region presented with mild illness and had recently returned from travel in Mexico. As of 27 April 2009, 43 additional people in 8 countries in the Region were under investigation for infection.

Situation in the European Region

The reports of confirmed cases from Israel, Spain and the United Kingdom reflect important steps taken by the national authorities to ensure early detection and response in association with the evolving situation in the Americas. National authorities are advised to intensify surveillance efforts for the early detection of people who may be infected with swine influenza A (H1N1) virus and may transmit the infection to others.

On 27 April 2009, the WHO Regional Director for Europe, Dr Marc Danzon, informed the health ministers, chief medical officers and NFPs in the Region of WHO/Europe’s response. He acknowledged that cooperation between WHO and national and international counterparts was crucial in preparing for and responding to the potential spread of swine influenza A (H1N1) virus in the European Region.

WHO/Europe is working closely with the Directorate-General for Health and Consumers of the European Commission and the European Centre for Disease Prevention and Control. Similarly, WHO is in close consultation with development partners, United Nations agencies and other international organizations (including those involved in trade and travel), and manufacturers of vaccines, drugs, diagnostic equipment and personal protection equipment.
Global situation

The five cases in the WHO European Region are the first confirmed cases identified outside the Americas. The WHO headquarters web pages on swine influenza offer additional information on the global situation, including Canada, Mexico and the United States of America.
Change in pandemic alert level

On 27 April 2009, the second meeting of the Emergency Committee was convened as stipulated under the IHR. Following the Committee’s advice, the WHO Director-General, Dr Margaret Chan, decided to change the current phase of pandemic alert from level 3 to level 4.

This decision was based primarily on epidemiological data demonstrating human-to-human transmission and the ability of the virus to cause community-level outbreaks. As further information becomes available, WHO may decide either to revert to phase 3 or to raise the level of alert further.

The outcome of the Emergency Committee’s meeting included recommendations to countries not to close borders or to restrict international travel. It is considered prudent for people who are ill to delay international travel and for those developing symptoms following international travel to seek medical attention. In addition, WHO will facilitate the process needed to develop a vaccine effective against the A (H1N1) virus.

WHO published interim guidance for the surveillance of human infection with swine influenza A (H1N1) virus, including case definition and requirements for reporting to WHO, on 27 April 2009.