Swine flu could still mutate

The new H1N1 flu virus could still mutate into a more virulent form and spark an influenza pandemic that could be expected to circle the globe up to three times, the World Health Organization (WHO) has said.

The impact of any pandemic would vary, as a virus that causes only mild illness in countries with strong health systems can become “devastating” in those with weak health systems, shortages of drugs and poorly equipped hospitals, it said.

The new virus, commonly referred to as swine flu, “appears to be more contagious than seasonal influenza” and practically the whole world lacks immunity to it, the WHO said in a document entitled, Assessing the severity of an influenza pandemic.

Nikki Shindo of the WHO’s global influenza programme said that 10% of those infected with the strain in Mexico and the United States needed to be admitted to hospital, far more than the rate for seasonal flu, which kills up to 500,000 people a year.

Despite this, she said most patients could recover from H1N1 with simple steps like hydration and without any drug treatment, raising questions about the rush to stockpile and prescribe antivirals to treat the disease.

The WHO will soon issue new guidance, recommending that Tamiflu and other antiviral drugs be used only for vulnerable patients such as pregnant women and people with other health problems such as diabetes and cardiovascular disease, she said. Aspirin should not be used because of a risk of liver damage, she added.

Health experts worry about the chance that the virus might become more lethal in the coming months, saying it is important not to overuse antiviral drugs since supplies are limited.

The 1918 influenza pandemic, which killed tens of millions of people, began mild and returned within six months in a much more lethal form. The 1968 pandemic began relatively mild, with sporadic cases prior to the first wave, and remained mild in its second wave in most, but not all countries.

Latest WHO data showed 7,520 people in 34 countries were confirmed to have caught the influenza A(H1N1) virus. Some 65 people have died in the outbreak.

India and Turkey have confirmed their first cases of swine flu and Japan has recorded its first domestic case of the illness.

Meanwhile, the Turkish Health Ministry says an American flying from the United States via Amsterdam was found to be suffering from the virus after arriving at Istanbul Airport en route to Iraq.

Malaysia confirmed its second case of swine flu, a female student who was on the same flight as a 21-year-old man whom authorities a day earlier announced had tested positive.