11 June, the World Health Organization raised the pandemic alert level of Influenza H1N1 2009 to Phase 6 and confirmed the illness as a global pandemic.

The WHO update of 24 June confirms the disease in 108 countries. In Africa, Algeria, Cape Verde, Cote D’Ivoire, Egypt, Ethiopia, Morocco, South Africa and Tunisia have confirmed cases and there is possibility that it will spread to other countries.

The phase has been raised because of the rapid spread of the disease and not the severity of the disease. There is no vaccine against the disease, but prevention is reasonably easy through hygiene practices. Some people who are infected have recovered without requiring medical attention.

The concern in our region, is that we have people who are malnourished, have weak immune systems due to other diseases and in a setting of weak health systems. This makes our populations more vulnerable to the disease. It is therefore, important that everyone knows the symptoms, how the disease is spread, avoid infection and enable early management of suspected cases.

Since the announcement of the pandemic alert, the UN has been monitoring the situation very closely under the global leadership of WHO.

In Malawi, we are working with the Government through the Ministry of Health to strengthen the country’s surveillance so that any suspected cases are detected early and handled accordingly. The UN is assisting the Government with Tamiflu® (the drug for treatment), protective gear, assessing and training of staff at airports, border entry points and medical personnel in central hospitals, laboratory equipment for confirming cases and public awareness.

• Pandemic Influenza H1N1 2009 is a disease that is caused by a virus that affects the respiratory system.
• The symptoms of Pandemic Influenza H1N1 2009 are:
  • Fever
  • Cough or sore throat
  • Body aches
  • Headache, chills and fatigue
  • In some cases, vomiting and diarrhoea
• Complications of the disease include pneumonia and difficulty in breathing.
• Death may occur in persons who have other medical

• Influenza viruses are mainly spread from one person to another through droplets released during coughing or sneezing;
• Sometimes people may become infected by touching surfaces or holding objects contaminated with influenza viruses (e.g., hands, door handles, handkerchiefs, tissue paper) and then touching their own mouth, nose or eyes.

• There is no vaccine available at the moment; however, studies are being conducted to produce a vaccine;
• Antivirals (medicines used for managing infection with a virus), can be used to treat the disease. Oseltamivir (Tamiflu) is one of the effective medicines currently being used;
• Antiviral medicines work better if started soon after getting sick (within two days of appearance of symptoms);
• Those treated with antivirals usually recover fully; so far, no resistance to the recommended medicines for Pandemic Influenza H1N1 2009 virus has been documented;
• Health workers should make treatment decisions based on clinical and epidemiological assessment. Particular attention should be paid to patients with complications.
• WHO does not recommend the use of antivirals for mass prophylaxis.

• Regular washing of hands with soap and water is strongly recommended;
• Hand rubbing with alcohol is also advised where available
• Keep a distance of at least one step (one meter) from the infected person to avoid coming into contact with the influenza droplets;
• If contact with a sick person or with potentially infected surfaces or objects occurs, those involved must not touch their eyes, nose or mouth with unwashed hands;
• Close contact with a sick person should be avoided; people are advised to refrain from handshaking, kissing or hugging during an outbreak;
• Those taking care of a sick person should use a face mask in accordance with guidelines provided by national health

• They should cover their mouth with a piece of cloth or tissue paper when sneezing or coughing; the used tissue should be properly disposed of while the cloth should be washed with soap, dried and replaced as often as required;
• The infected person should wear a mask when in contact with others;
• Tissue paper, handkerchief or other material used by the sick person for wiping his nose or mouth, must not be used by others;
• If there is no tissue paper or cloth, the sick person should cover his face with his arm before sneezing or coughing, and not use his hands to contaminate surfaces or things that may be touched or held by others;
• Hands should be washed with soap and water especially after sneezing, or coughing, and before touching door handles and other objects or surfaces so as to prevent contamination with droplets;
• Sick persons should stay at home and limit contact with others as much as possible.
• People should seek treatment immediately if infection is suspected, if symptoms occur or when advised by a health worker.

• Ensure community members know how to limit the spread of influenza, the symptoms of the disease and what to do if infection occurs;
• Ensure provision of care for those infected;
• Support social distancing, isolation or quarantine when requested by a health worker (or as determined by health authorities);
• Establish contact with the nearest health facility that will provide support in managing the disease;
• Report suspected cases and deaths to a health worker or other relevant authority.

The World Health Organization issues regular updates on the spread and management of the disease. WHO http://www.who.int/csr/disease/swineflu/en/index.html UN Staff Pandemic page http://www.un.org/staff/pandemic Or consult WHO Malawi on 01 772 755 or the UN Doctor on 0999 960188. Please note that the name of the disease has changed: from Swine Flu to Influenza A (H1N1) and now to Pandemic H1N1 2009.