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日本といっしょにWHO「フェイズ６」警戒度引き上げに反対していた英国でも、防疫戦術の破綻が露呈した（AP通信）
英国は、「豚インフルエンザ」感染容疑者にかたっぱしからタミフルを投与して
感染者を一網打尽にする戦術をとっていたようであるが、すでにこの作戦は
破綻をきたし、捕捉できた人数よりもはるかに多くの感染者が生じている
可能性が高いという。
下記の記事には、こんな記述もある。
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Similar strategies were initially tried in the U.S, Canada and Japan but authorities quickly dumped the tactic. Japanese officials had hoped to contain their outbreak, but now say they probably can't, as confirmed cases soared from four to more than 260 in just a week.
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上述のような、感染者の完全捕捉とタミフルによる治療での「しらみつぶし」作戦は
まず米国とカナダ、次いで日本でも採用されたけれども、これらの国の衛生当局は
すぐにこの戦術を放棄した。 「日本の厚生当局者は（この戦術で）国内の感染爆発
を押さえ込めると期待していたが、たった１週間で確認症例が４例から260例以上に
急増するにおよび、今や無理だろうと語る始末である。」
WHOの警戒度引き上げに「待った」をかけていた日本および英国は、それぞれの
戦術の失敗を露呈させるに及び、結果的に世界的な汎流行への扉をひらく
損な役割を引き受けてしまったのかも知れない。
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http://www.google.com/hostednews/ap/article/ALeqM5jFxC9J09NFVDTVGPoi06l0y2cpAQD98AP4F80
（09年5月21日、AP通信；日本時間22日午前3時50分に入手）
UK's attempts to stop swine flu called flawed
By MARIA CHENG – 1 hour ago
LONDON (AP) — Flu experts are looking very closely at Britain — and some have decided that the U.K.'s swine flu-fighting tactics are seriously off the mark and may be hiding a much larger outbreak.
Since Britain has the most confirmed swine flu cases in Europe, how the outbreak develops here will have a significant influence on whether the World Health Organization decides to raise its flu alert to the highest level — a pandemic, or global epidemic.
British authorities have relied on an aggressive strategy to try to snuff out the virus before it spreads, blanketing suspect cases and anyone connected to them with the antiviral medication Tamiflu.
But experts criticize the strategy for wasting valuable medicine and say there's little point trying to contain swine flu, which is more infectious than regular flu.
"Containment using Tamiflu is a flawed concept," said Michael Osterholm, a flu expert at the University of Minnesota. "It's like trying to maintain the integrity of your submarine with screen doors."
Osterholm, who has advised U.S. authorities on preparing for a pandemic, said the swine flu virus travels too fast to stop it with Tamiflu.
"You are never going to contain a flu virus with this strategy and at the end of it all, you will have wasted time and drugs," he said, because it takes much more Tamiflu to prevent a case than it does to treat one.
Similar strategies were initially tried in the U.S, Canada and Japan but authorities quickly dumped the tactic. Japanese officials had hoped to contain their outbreak, but now say they probably can't, as confirmed cases soared from four to more than 260 in just a week.
Authorities in Mexico never even tried to contain the virus, it was too widespread before they realized what it was.
Swine flu has sickened more than 11,000 people in 41 countries and killed 85, according to WHO, whose figures often trail those of individual countries. Mexico has reported 75 swine flu deaths, the United States 10, and there has been one death each in Canada and Costa Rica.
British health officials have confirmed 112 swine flu cases — the most in Europe, ahead of Spain, which raised its total to 111 on Thursday. Still, that number has raised eyebrows among experts for being suspiciously low, given swine flu's infectiousness and its rapid spread elsewhere.
Rumors have swirled among health officials for weeks that Britain's caseload is far higher than officials are admitting.
"It's odd that we haven't seen more cases in Britain after the initial burst of cases," said Andrew Pekosz, a flu expert at Johns Hopkins University in Baltimore.
Osterholm called Britain's official numbers "meaningless" and said while authorities were not hiding cases, they also weren't looking very hard for the virus.
"The numbers in Britain are really not telling the story," Osterholm said.
Swine flu was first detected in Britain last month. Experts say flu viruses only need a couple of weeks to become established in a new location.
Albert Osterhaus, a virologist at Erasmus MC University in the Netherlands, said once the virus has been circulating, it's time to abandon the containment strategy and save Tamiflu for patients.
Experts said Britain's attempt to squash swine flu might also be masking the true size of the outbreak. Antivirals like Tamiflu work by reducing the amount of virus in a person's body, so people who have swine flu and are taking Tamiflu might test negative for the virus.
"Using Tamiflu to contain a virus may nip (an outbreak) in the bud ... but you might also pick up fewer cases," said Osterhaus.
Still, Britain's Health Protection Agency defended its methods.
"We are still in the early phases of the swine flu outbreak," a spokesman said, speaking on condition of anonymity in line with official government policy. "We believe containment is still an effective strategy but we will certainly reconsider it if swine flu spreads."
Pekosz said the low numbers of confirmed cases in Britain could also be due to limited testing.
The U.S. Centers for Disease Control and Prevention is testing up to 400 specimens a day, but the British health agency has refused to say how many tests are being done daily. The U.K. is also only testing people with a history of visiting infected countries like Mexico or the United States, or people with links to already-established cases. That limited criteria means authorities could be missing lots of other cases if the virus has already spread into communities.
"There's no reason to think this virus would behave differently in Europe than in North America," Pekosz said. "The numbers in the U.S. and Mexico suggest that once you have a certain number of cases, you can seed a relatively wide outbreak."
For its part, Spain is taking much the same tactic as Britain. Health authorities have started announcing new swine flu cases only once a week and are handing out antiviral drugs to both confirmed and suspected cases.
Countries outside of North America may be reluctant to admit they have a bigger outbreak on their hands, since that could prompt WHO to declare a pandemic.
Many governments fear that announcing a pandemic would produce mass panic and confusion, with citizens clamoring for measures — including vaccines, antiviral medications, trade restrictions and travel bans — that could be costly or even ineffective.
On Monday, British Health Secretary Alan Johnson urged WHO to raise its standards for determining a pandemic.
For now, British authorities say they are still trying to contain swine flu with Tamiflu and have no plans to change who they test.
Experts remained skeptical.
"If there really are that few cases in Europe, we should all be sending teams there to find out what is going on," Osterholm said.
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Copyright © 2009 The Associated Press. All rights reserved.
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http://mainichi.jp/select/science/news/20090519ddm001040017000c.html
新型インフルエンザ：日本、警戒度上げ反対−−ＷＨＯ総会
（毎日新聞 2009年5月19日 東京朝刊）
【ジュネーブ澤田克己】世界保健機関（ＷＨＯ）の年次総会が１８日、ジュネーブの国連欧州本部で始まった。関連会合で、新型インフルエンザの世界的大流行（パンデミック）への警戒度を巡り各国が意見表明を行い、英国が警戒度引き上げに慎重な判断を求めた。日本や中国も同調し、渡辺孝男副厚生労働相は記者団に「柔軟な対応が必要だ。勇み足の決断は問題だ」と、現段階での警戒度引き上げには事実上反対する姿勢を示した。
総会には台湾がオブザーバー参加した。台湾が国連機関の会合に参加するのは７１年の国連脱退以降初めて。
チャンＷＨＯ事務局長が各国閣僚らと開いた会合で、ジョンソン英保健相は「（新型インフルエンザの地理的な感染拡大という）機械的な判断で（パンデミックを意味する）フェーズ６にすべきでない」と主張。ニュージーランドも賛成した。
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記者の目：新型インフルエンザ メキシコの教訓＝庭田学
余録：広がる感染の波紋
社説：新型インフル 蔓延期の現実的指針を
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毎日新聞 2009年5月19日 東京朝刊
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http://sankei.jp.msn.com/world/europe/090519/erp0905191758005-n1.htm
（産経新聞）
【新型インフル】「６」引き上げは当面見送り
2009.5.19 17:57
このニュースのトピックス：新型インフルエンザ
【ジュネーブ＝木村正人】世界保健機関（ＷＨＯ）緊急委員会委員の田代真人・国立感染症研究所インフルエンザウイルス研究センター長は１９日、ＷＨＯ本部で記者団に対し、「感染の地理的な広がりだけから機械的に警戒フェーズを最高度の６に引き上げることはない」と述べ、当面はパンデミック（世界的大流行）を意味する「６」への引き上げはないとの見通しを示した。
これはマーガレット・チャンＷＨＯ事務局長が１８日、英国や日本の要請を受けて判断したもので、田代氏は「政治的な決断だ」と指摘した。パンデミックを宣言した場合、各国政府は移動・集会規制の措置をとらなければならず、弱毒性の新型インフルエンザの健康被害に比べ影響が大きすぎるためだ。パンデミック宣言を行うか否かを最終的に決断するチャン事務局長に、今後は健康被害の状況も加味する裁量権が与えられたという。
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http://www.nikkei.co.jp/kaigai/eu/20090518D2M1802H18.html
更新： 2009/05/21 22:10
チャンWHO事務局長、警戒水準「５」を維持 変更、慎重に検討
（日経新聞：09年5月18日）
【ジュネーブ＝藤田剛】世界保健機関（ＷＨＯ）のチャン事務局長は18日に開幕した総会で演説し、新型インフルエンザの警戒水準（フェーズ）について「今日は５に据え置いた」と語った。さらに最高度の「６」（世界的大流行＝パンデミック）への引き上げは、慎重に検討を進める方針を示した。
ＷＨＯの定義上は、米州地域以外で地域レベルの持続的感染が確認されれば、フェーズを「６」に引き上げる条件が整う。日本での感染拡大などを受けて、現在「５」のフェーズを引き上げるとの観測が浮上。一方で英国や日本からは引き上げをけん制する意見が出ていた。
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