There is growing panic in Mexico tonight after it was confirmed this afternoon that the suspected Swine flu death toll is 149. Cases have been reported in the United States, Canada, and Europe, New Zealand and Israel. Today, the World Health Organization raised its pandemic alert to level four meaning that the virus is capable of significant human-to-human transmission. With 47 confirmed cases in the U.S and 26 in Mexico, what is Belize's position? At this time there are no reported cases of swine flu in Belize but the Ministry of Health is on high alert and is taking measures to minimize the risk. Jacqueline Godwin found out more at a press conference today.

Jacqueline Godwin Reporting,
Health officials are on high alert, but not panicking.

Dr. Michael Pitts, Director of Health Services
"In terms of Belize we have a robust response plan and this plan is part of what has been going on in terms of our preparedness for Avian Influenza and even though we don't have Avian Influenza, because of the planning for that, we are better poised in terms of what we can do in Belize."

Dr. Paul Edwards, Epidemiologist
"This new virus, which is thought to be a combination of Swine Virus, that normally occurs in pigs, combined with Avian Virus and now with human virus have produced a new virus and that is a type A virus and it is called H1N1. So what happened in the swine. Those who worked along and close with those animals that were sick became sick and what has happened now that is of great concern is the fact that there is transmission of human to human."

Dr. Michael Pitts,
"We are meeting with other stakeholders. Certainly we have a significant partner with us, PAHO, and by extension WHO, and certainly we have been interacting with CAREC to get specific advice on how to proceed and to see what type of equipment and supplies we can marshal together in preparedness if this disease reaches Belize. The first major thing that we need to do is to make sure that the population gets the right information about this disease and to know certainly that there are simple things that people can do at home to help safeguard themselves against the disease."

In Mexico City swine flu is suspected to have killed one hundred and forty nine people although only twenty six of those cases have been confirmed. Those persons who died were between the ages of twenty and forty years old. And there are close to two thousand possible cases of swine flu being treated in Mexico. While it is hoped that there will be no cases detected in Belize the reality is that our borders are porous. Health officials say the primary focus now in Belize is to educate the public about swine flu and what we can all do to prevent it from affecting the country.

Dr. Michael Pitts,
"The simple business of hand sanitation, washing hands, and so on will help."

Dr. Paul Edwards,
"What happens as well is when you cough and you sneeze, you want to cough and sneeze in here. We have changed the paradigm from whereby before you talked about coughing and sneezing in your hands. If you cough and you sneeze and you have that virus, you go and touch objects, for example a door. Somebody comes behind and they take their hands and put it to their mouth or their nose and that is one of the most common ways of transmission of this virus.

So we're pushing the agenda and we're working very close with our partners in education, we spoke about it this morning. We have materials to launch a clean hands and a respiratory etiquette campaign and we have those posters specifically geared for school, for the working place, and for health care professionals."

Ethan Gough, Epidemiologist
"Really the only way to confirm infection with swine flu is the laboratory and we're trying to make arrangements through the Caribbean Epidemiologist Center for us to ship specimens directly to the Center for Disease and Control in Atlanta for them to do the lab testing for us. But we still need to work out the details. Also there is an opportunity through the United States Southern Command Humanitarian Office for us to get a shipment of what we call personal protective equipment or PPE for short which are basically basic protective gears that can be used by healthcare workers to prevent transmission."

Dr. Paul Edwards,
"And it is our intent from the Epidemiology Unit to have a daily update that we will provide to the media in relation to what is happening internationally, what is happening in Belize, and what we are doing. We recognize that it is of paramount for the Belizean populace to be educated, to be informed, so we can all make educated decisions and not have fear looming above our heads."

Dr. Michael Pitts,
"The clinical response, it runs over a spectrum. You have mild disease over to severe disease. So mild disease would be those with the sniffles and the fever and the lethargy and so on that we could use some basic things. Where you have problems would be in severe diseases where you may have say severe pneumonia with respiratory stresses and so on. But at that level we have support. You know that for the country, the Minister of Health, we have four regional health facilities, we certainly have Karl Heusner with support. So at all of those facilities we have teams who are trained to treat people with severe pneumonias."

There are also plans to procure a supply of medication like this box of Tamiflu.

Dr. Michael Pitts,
"As a country in the region of the Americas, we are part of a process to bring in, where this drug was being stockpiled. It was being stockpiled in say Panama for the region of the Americas and even today we confirmed that we are able to get, access doses to treat 3,000 persons in the country through that facility. And when we look at that, we think that might be a reasonable amount to have for the country."

Dr. Paul Edwards,
"It is unfortunate that Tamiflu is not available over the counter for everybody in mass quantities. So the World Health Organization has stockpiled and as the need arises, they will provide for containment of the disease."

Dr. Beverly Barnett, PAHO Country Rep.
"And we will continue to do so, whether it is procurement, whether it is training, whether it is surveillance, evaluation, and I just wanted to assure everyone that PAHO/WHO and the rest of the UN family in Belize will continue to support the national response."

Dr. Michael Pitts,
"If we have issues for ventilators, we may be challenged there so our approach is to say to people listen: let's understand the symptoms, identify them, and come early so we could begin to treat early and limit the need for severe or major intervention like ventilators. The story out of Mexico so far is that they have deaths but most of those people who have died, were people who showed up to the healthcare facility late."

Dr. Paul Edwards,
"And how we can contain and prevent as best as possible, that responsibility lies with each one of us; not the healthcare system, not NEMO, not the Ministry of Agriculture. So we have a role to play. We might not be able to stop it from coming here but we can as best as possible contain and be available and ready to address those needs."

Dr. Michael Pitts,
"So that we are interacting with the Customs and Immigration officers to indicate to them for what to look for in terms of signs and symptoms of this disease. In addition, it is our plan over the next couple of days to place public health inspectors and nurses at the border to assist."

Ethan Gough,
"It is actually not recommended to close your border. For example, past influenza pandemics have shown that closing border points are not very effective in preventing something like swine flu from entering the country and there are economic implications in closing a border. So you will have a situation where you close your border, it doesn't prevent introduction into Belize, and you have still suffered some economic losses from having the border closed. So we are using the border points as an opportunity to screen people coming into the country."

Dr. Paul Edwards,
"Belizeans going to Mexico? What we are highly recommending is that you do not go unless it is a case of emergency."

Belizeans are being advised to wash hands often, cover your nose, and mouth when you cough and sneeze, avoid close contact with sick people and if you are getting medical attention stay home and limit your contact with others.