WHO eyes swine flu transmission rates, vaccine

Shoppers wear masks as precaution against swine flu at a shopping street in Kobe, western Japan, Sunday, May 17, 2009. The news of the rapid spread of the virus at schools came a day after Japan confirmed its first domestic case of swine flu in another student in the western port city of Kobe, about 270 miles (430 kilometers) west of Tokyo. Japan's first cases were believed to have contracted outside the country. (AP Photo/Kyodo News) ** JAPAN OUT MANDATORY CREDIT FOR COMMERCIAL USE ONLY IN NORTH AMERICA **

GENEVA -- Health experts are looking at the spread of swine flu among people in Spain, Britain and Japan, a WHO official said Sunday as Japan reported a one-day total of more than 70 new cases, mostly among teenagers.

The swine flu epidemic is already expected to dominate the World Health Organization's annual meeting, a five-day event that begins today in Geneva and involves health officials from the agency's 193 member states.

WHO director-general Dr. Margaret Chan will reveal experts' recommendations on the production of a swine flu vaccine sometime at the meeting. Pharmaceutical companies are ready to begin production, but many decisions have to be made first -- such as how much vaccine to make, how it should be distributed and who should get it.

Some experts say there's no question that a swine flu vaccine must be produced but WHO needs to discuss the issue with its members.

As of Sunday, the swine flu virus -- which WHO calls the A (H1N1) virus -- has sickened at least 8,480 people in 40 countries, killing 75 of them, mostly in Mexico.

Japan's health ministry confirmed dozens of new cases of swine flu in waves of announcements Sunday, prompting the government to shut down schools and cancel public events like Kobe's annual festival. By late Sunday, Japan's tally rose from five confirmed cases to 78 -- many of them high school students who had not traveled overseas.

Most new cases involved students in the western prefectures of Hyogo and Osaka, and health officials said they were recovering in local hospitals or at home.

"We have not determined how the virus spread in the region, and we are doing our best to track down the route of the infections and contain them," Chief Cabinet Secretary Takeo Kawamura said.

Japan had established strict quarantines at airports, but decided Saturday to focus on containing the domestic outbreak.

WHO spokesman Gregory Hartl said in-country transmission rates were a key factor in whether the global body decides to increase its pandemic alert level. Right now, the world is at phase 5 -- out of a possible 6 -- meaning that a global outbreak is "imminent."

"We already know about the UK and Spain, that they have a relatively high number of cases compared to other European countries, so by simple virtue of the fact that they have more cases they need to be kept an eye on," Hartl said in an interview with AP Television News.

"There seems to have been activity in the last few days in Japan so we need to watch that too," he said.

Spain and Britain have had the highest numbers of cases in Europe, reporting 103 and 101 cases respectively. Britain announced 14 new cases on Sunday -- with 11 of those being transmitted in-country -- people who had not traveled to Mexico or the United States but became infected from others who had the virus.

A pandemic could be triggered if the virus starts to be transmitted from person to person on a large scale outside the Americas, WHO experts have said. But it would have to jump among people outside schools, hospitals and other institutions that typically pass on such viruses quickly.

"We don't want to prejudge anything, but certainly this is something we are watching with interest," Hartl said of the weekend developments in Japan.

Chile, meanwhile, reported its first case of swine flu, a 32-year-old woman who had just arrived from the Dominican Republic. All passengers on the same Copa Airlines flight with her were being told to voluntarily stay at home for a few days.

WHO estimates up to 2 billion doses of swine flu vaccine could be produced yearly, although the first batches wouldn't be available for four to six months.

U.N. Secretary-General Ban Ki-moon will visit WHO on Tuesday to meet with senior representatives from the vaccine industry, but the U.N. declined to name the companies.

Most flu vaccine companies can only make one vaccine at a time: seasonal flu vaccine or pandemic vaccine. Production takes months and it is impossible to switch halfway through if health officials make a mistake.

The U.S. Centers for Disease Control and Prevention is working on a "seed stock" to make the vaccine, which should be ready in a few weeks. Until vaccine manufacturers get the seed stock, they won't know how many doses of vaccine they can make or how long that would take.

WHO is also negotiating with vaccine producers like GlaxoSmithKline PLC and Sanofi Pasteur to save some of their swine flu vaccine for poorer nations. Many rich nations -- such as Britain, Canada, Denmark, France, Switzerland and the United States -- have already signed deals with vaccine makers to guarantee them pandemic vaccines.

A sense of urgency about preventing a swine flu pandemic helped Taiwan get an observer seat on the World Health Assembly, taking part in the meeting for the first time in 38 years.

"Taiwan and China are both part of the world community. We should fight this disease together," Taiwanese Health Minister Dr. Yeh Ching-chuan told reporters in Geneva.

China and Taiwan split amid civil war in 1949. Beijing normally objects to Taiwan's participation in international organizations but relations have improved substantially over the past year.

WHO's health assembly will run through May 22, five days shorter than initially planned because health ministries are busy fighting the swine flu outbreak.


Eliane Engeler reported from Geneva and Mari Yamaguchi from Tokyo. AP Television News reporter Martin Benedyk in Geneva, AP Medical writer Maria Cheng in London and reporter Jennifer Quinn in London also contributed to this report.