The World Health Organization has now raised the swine flu epidemic warning level to Phase 6 - the highest level. Media attention to this serious worldwide pandemic faded after the immediate fears of widespread infection and deaths subsided - unfortunately the swine flu has not subsided at all and is more dangerous and spreading more quickly than earlier anticipated. Widespread human infection is underway. The death toll is also increasing. Statistics as of July 2009 indicate, in the USA alone, there has been over 40,600 confirmed or probable cases of swine flu and at least 263 deaths. States leading the pack with infected populations are California, Connecticut, Florida, Illinois, Mass., New Jersey, New York, Penn., Texas and Wisconsin. Wisconsin and Texas lead with 6,031 and 4,975 cases respectively. The situation is becoming so serious and developing so rapidly that the Center for Disease Control (CDC) has already deployed over 25% of its stockpile of supplies of antiviral drugs, personal protection equipment and respiratory protection devices and is trying to quickly train personnel at newly designated dispensaries (PODs) throughout the U.S. The big question is will scientists be able to develop a vaccine that works and will it be available soon enough and in large enough supply to vaccinate everyone. Much of the World's supply of flu vaccine is produced outside of the U.S. and the demand will be very high globally. No one is sure at this point when a vaccine will be available and how much will be available on such short notice. A monumental effort is underway Worldwide to develop an effective vaccine in large enough quantities to vaccinate the World population. Will this effort be successful?

Who is most at risk? Any person who is high risk for the seasonal flu is also in the high-risk category for the swine flu (H1N1). This risk list may be revised as more epidemiologic data becomes available but for now the high risk group includes: pregnant women, young children (under 5, but higher risk if under 2 years old), people with chronic health problems, including pulmonary conditions (includes asthma), cardiovascular, renal, hepatic, neurologic, neuromuscular, hematological and metabolic disorders, anyone 19 or younger on aspirin therapy and nursing home and chronic care facility patients. People in the high risk categories plus anyone already diagnosed with H1N1 would be first in line for available therapies, including vaccines.

Guidance for Employers:

1) Require employees to immediately report to you any flu-like symptoms. Employees with flu symptoms should be required to stay away from work for 7 days after the flu symptoms appear or until they are symptom-free for 24 hours, whichever is longer.

2) Ask employees to cover their nose and mouth with a tissue when coughing or sneezing and dispose of that tissue.

3) Ask employees to wash their hands frequently with soap and water or use alcohol-based hand sanitizers.

4) Advise employees to avoid touching their eyes, nose or mouth with their hands.

5) Ask employees who have been exposed to a person with flu symptoms to monitor their health every day, to notify you if they develop flu symptoms and if they do have symptoms stay at home.

6) If an employee comes to work with flu-like symptoms, send the employee home as soon as possible (see # 1 above). Ask the employee's co-workers to closely monitor themselves for symptoms.

7) The swine flu virus can survive for up to 12 hours on paper - this makes it easily spreadable within an office environment. Go as paperless as possible!

What can I do to totally avoid exposure to this potentially deadly worldwide swine flu epidemic? Short of moving to the Moon- nothing for now but please stay informed of developments by Googling "swine flu" for the latest updates.