Containing illness

Ukraine's European neighbors took action to prevent the fast-moving flu from spreading outside the country, where the Ukrainian Health Ministry reported at least 174 deaths and more than 1 million infections due to acute respiratory illness as of Tuesday.

The World Health Organization (WHO) assumes the majority are swine flu cases, according to a statement.

Slovakia, which reported its first swine flu death on Friday, announced it would close most road crossings in the east along its shared border with Ukraine, while Russia plans to examine people entering the country from Ukraine at checkpoints along its western border.

The decision to shut down border crossings in Slovakia goes beyond WHO guidelines for combating swine flu, which do not advocate travel restrictions and border closures.

"This is the flu," Dr. David Mercer, head of WHO Europe's communicable diseases unit, told Deutsche Welle. "Efforts at containing it are not going to succeed."

The WHO urged caution before another potential surge in infections in Ukraine, though new reports cite a drop in new cases. Dr. Mercer called such predictions "premature."

"We are expecting, in fact, that there will be an increase in cases and a fairly high disease burden for weeks," he added.

Ukraine's call for help

Polish Prime Minister Donald Tusk appealed to the European Union to provide aid for Ukraine in a bid to contain the outbreak. Poland borders western Ukraine, a region that has seen the biggest spike in "influenza-like illness."

"A team of EU experts are in Ukraine to oversee the delivery of the EU assistance," European Commission health spokesperson Nina Papadoulaki told Deutsche Welle.

The Commission is in regular contact with the EC delegation in Kyiv and WHO Europe, and Papadoulaki said member states have set up several meetings to address the situation.

Both Slovakia and Poland have responded to Ukrainian President Victor Yushchenko's request for medical supplies.

Ukraine's government has already taken steps to curb the spread of swine flu, including school closures, travel restrictions and cancellations of public gatherings. Officials are also contemplating full or partial quarantines across the country.

At the request of the Ukrainian Health Ministry, the WHO dispatched a nine-person team to areas hardest hit by what the agency suspects is the H1N1 swine flu virus. Experts were sent to Lviv and Zhytomyr, a city west of the Ukrainian capital of Kyiv where almost 20,000 cases of acute respiratory illness were reported during the first week of November.

On Tuesday, Ukraine's deputy health minister confirmed 67 cases of swine flu and 14 deaths due to the virus.

Eastern Europe by the numbers

The move coincides with WHO reports of "increasing and active transmission" of swine flu across Northern and Eastern Europe. Belarus and Bulgaria were among 10 European countries reporting high H1N1 pandemic activity in an update released Monday by WHO Europe.

In Moldova, 615 suspected H1N1 infections were reported as of Monday, as well as three deaths, according to statistics collected by the European Centre for Disease Control and Prevention (ECDC)

The WHO expects at least 80 percent of viral influenza to be caused by H1N1 this winter, according to Dr. Mercer, who said the virus is replacing seasonal flu strains. "We don't expect that to change during this season at all," he told Deutsche Welle.

Dr. Mercer characterized the swine flu virus as "mild" but said serious cases would affect more people under 50 than normal flu.

A region at risk

Harsh winter conditions and less-developed health care systems could heighten the risk of pandemic influenza in Eastern Europe. "Health systems there might not have as many resources as in Western Europe," the WHO's H1N1 spokesperson Gregory Hartl told Deutsche Welle.

Plans to dispatch WHO teams to other Eastern European countries would happen on a "one-to-one basis," Hartl said, depending on requests by individual governments.

A WHO statement praised Ukraine's openness in reporting the recent outbreak, which is seen as a potential "early warning signal" and model for how the virus might behave in countries throughout Eastern Europe during an early start to the flu season.

Author: Amanda Price/Reuters/AP/AFP

Editor: Matt Zuvela