- Mexico's chief epidemiologist accused the WHO of being too slow to respond to Mexico's early warnings about an unusual flu outbreak in mid-April. He said the WHO took at least 48 hours to notify its headquarters, when it should have been more immediate. The WHO disputes this and says it responded quickly once the virus was identified. - Swine flu cases have been confirmed in several countries including the US, Canada, parts of Europe, Hong Kong, Israel and New Zealand. The outbreak appears to be leveling off in Mexico. - Countries are taking measures to contain the outbreak like stockpiling antiviral drugs, deploying volunteers, and in Mexico's case, shutting down for 5 days over a holiday weekend to

1. Mexico's epidemiology boss faults WHO
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By ANDREW O. SELSKY, Associated Press Writer Andrew O. Selsky, Associated Press Writer – 29 mins ago
MEXICO CITY – A top Mexican medical officer accused the World Health Organization of being
slow to respond to the country's warning about a health crisis that turned into a global swine flu
scare. The WHO disputed the claim.
In the U.S., President Barack Obama said Friday the swine flu might end up running its course quot;like
ordinary flusquot; but said the government is preparing in case swine flu comes back in a more virulent
form.
quot;I'm optimistic that we're going to be able to manage this effectively,quot; Obama said.
Hong Kong confirmed a case of swine flu, Asia's first, and authorities there ordered a weeklong
quarantine of the hotel where the man, a 25-year-old Mexican tourist, stayed. Besides Mexico and
the U.S., cases have also been confirmed in six European nations, Canada, New Zealand and
Israel.
Mexico's chief epidemiologist, Dr. Miguel Angel Lezana, told The Associated Press late Thursday
his center alerted the Pan American Health Organization, a regional arm of WHO, on April 16 about
an unusually late rash of flu and pneumonia cases in Mexico.

2. But he said PAHO took at least 48 hours to notify WHO headquarters when normally that
notification occurs immediately. Eight days after Mexico's initial notification, WHO announced it was
worried the outbreak could become a pandemic.
quot;It seems it should have been more immediate,quot; Lezana, director of the National Epidemiology
Center, told AP in a telephone interview. He called for an investigation into WHO's handling of the
crisis.
WHO officials said Friday the agency learned April 9 of cases of quot;suspicious influenzaquot; from Mexico
and responded quickly on April 24 when U.S. and Canadian laboratories identified the virus as a
new strain of flu.
quot;We moved into operation within a matter of hours,quot; WHO spokesman Thomas Abraham told
reporters.
Mexican health authorities came under criticism, particularly from frustrated citizens, for a slow and
bumbling early response to the outbreak.
In the United States, the confirmed case count stood at 132. State lab operators say there are more
cases than the confirmed number because they are not testing all suspected cases, focusing on
finding new outbreak hot spots and limiting the flu's spread.
In Mexico, the outbreak's epicenter, new cases and the death rate were leveling off, the country's
top medical officer said. Health authorities there have confirmed 343 swine flu cases and 15 deaths
from the virus.
No new deaths from swine flu were reported overnight in the Mexican capital for the first time since
the emergency was declared a week ago, said Mexico City Mayor Marcelo Ebrard.
quot;This isn't to say we are lowering our guard or we think we no longer have problems,quot; Ebrard said.
quot;But we're moving in the right direction.quot;
As recently as Wednesday, Mexico's health secretary said there 168 suspected swine flu deaths in
the country and almost 2,500 suspected cases. Mexican officials have stopped updating that
number and say those totals may have been inflated.
quot;The fact that we have a stabilization in the daily numbers, even a drop, makes us optimistic,quot;
Mexican Health Secretary Jose Angel Cordova said. quot;Because what we'd expect is geometric or
exponential growth. And that hasn't been the situation.quot;

3. The only confirmed swine flu death outside Mexico was a Mexican toddler who died in a Texas
hospital Monday.
The United States is buying 13 million courses of anti-flu drugs to replenish its stockpile and
sending 400,000 courses to Mexico. U.S. health officials say a swine flu vaccine could not be ready
until fall at the earliest.
The Red Cross says it is readying an army of 60 million volunteers who could be deployed around
the world to help slow the virus' spread.
Cordova said Mexicans with flu symptoms are now seeking medical attention quickly, and
suspected swine flu cases are getting treatment even before the virus is confirmed, preventing
deaths and limiting the virus' spread.
quot;If the treatment is given the first day, the patient is practically not contagious,quot; Cordova said.
Cordova said outreach efforts to families of confirmed cases are turning up relatively few other
cases.
Mexico shut down all but essential government services and private businesses Friday, the start of
a five-day shutdown that includes a holiday weekend. Schools are also closed through Tuesday.
Mexico City's notoriously clogged avenues were clear, crime was down and the smog dropped to
levels normally seen only on holidays. Mexico is using the shutdown to determine whether to
extend or ease emergency measures.
Lezana, the chief epidemiologist, said his department was alarmed by flu and pneumonia cases in
Mexico earlier in April and notified the local office of PAHO by e-mail, following international
protocol.
He said the illnesses raised a red flag because the flu was occurring at least a month after flu
season normally ends in Mexico.
Four days later, PAHO still had not responded, so the National Epidemiology Center asked PAHO
whether it needed more, Lezana said. He said PAHO responded the alert was being handled.
Lezana said that as far as he knew, the PAHO regional office in Washington and WHO took no
action until April 24, when WHO announced an epidemic was under way.

4. Lezana had learned just the day before, from a testing of a sample that Mexico sent to a lab in
Canada, that people were coming down with a new, mutated and lethal swine flu virus. By then,
more than 1,000 people had been sickened in Mexico.
Daniel Epstein, a PAHO spokesman in Washington, told The Washington Post the agency received
a message from Mexican authorities April 16 about an unusual outbreak. He described a system
that sends messages to WHO headquarters in Geneva automatically.
WHO officials in Geneva confirmed Friday that the organization had received reports from Mexico
of cases of suspicious influenza and that the organization reacted quickly when the new flu virus
was identified on April 24.
WHO chief Dr. Margaret Chan was aboard a flight to the United States at the time but was briefed
immediately when she landed, Abraham said. She canceled her appointments, met with U.S. and
Mexican authorities and flew back to Geneva on April 25. That evening, WHO told the world it faced
a possible flu pandemic.
quot;I think that is a pretty rapid response,quot; Abraham said.
WHO flu chief Dr. Keiji Fukuda, speaking before the Mexican epidemiologist issued his criticism,
told reporters late Thursday there is always some delay when unusual illnesses are detected,
particularly during flu season.
quot;Most diseases do not come out with people walking around with 'new disease' written on their
forehead and 'we need to call an international response,'quot; he said. quot;And in this case the countries
which were affected earlier, they really were communicating in a very appropriate way.quot;
While Mexico waited for WHO to help, Lezana said, Mexican authorities tried to identify the
outbreak and stop it. Mexican medical teams interviewed 472 people who may have come into
contact with the first known swine flu fatality, a 39-year-old woman.
But only 18 of the 472, all hospital workers, were tested for swine flu. And in other parts of Mexico,
health workers only this week started visiting the families of victims to find out whether they
contracted it as well.