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Old 04-27-2009, 09:20 AM   #45 (permalink)
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My best friend and her hubby just got back from Mexico this past Saturday morning. She tells me that he has a ''cold'' but it's not that flu.

How does she know?! They got home at 1am, and she was emailing me around 10am that same day.She had no time to go to the dr yet!! I told her to get his butt to a dr and find out for sure!

Jeez...

(oh, btw, they live in Canada, not the US)
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Old 04-27-2009, 10:11 AM   #46 (permalink)
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there is also some video/picture coverage at this site

http://news.aol.com/article/school-f...-test%2F445903


Officials Race to Contain Swine Flu
Students in Private New York School Contracted Virus
By KAREN MATTHEWS

posted: 1 HOUR 10 MINUTES AGO

WASHINGTON (April 27) — Governments are racing to find and contain pockets of swine flu around the globe, seeking to stem both the threat of a pandemic and public panic.
"We're preparing in an environment where we really don't know ultimately what the size or seriousness of this outbreak is going to be," U.S. Homeland Security Secretary Janet Napolitano said Sunday.


In Mexico, the outbreak's epicenter, soldiers handed out 6 million face masks to help stop the spread of the novel virus that is suspected in up to 103 deaths. Most other countries are reporting only mild cases so far, with most of the sick already recovering. Cases have been confirmed in Canada — six — and the U.S. — 20.
Spain reported its first confirmed swine flu case on Monday and said another 17 people were suspected of having the disease. The European Union health commissioner advised Europeans to avoid nonessential travel to Mexico and the United States. Also, three New Zealanders recently returned from Mexico are suspected of having it.
World Health Organization spokesman Peter Cordingley said the new virus was spreading quickly in Mexico and the southern United States, raising fears of a global pandemic.
"These are early days. It's quite clear that there is a potential for this virus to become a pandemic and threaten globally," Cordingley, WHO's spokesman for the Western Pacific, told AP Television News.
"But we honestly don't know," he added. "We don't know enough yet about how this virus operates. More work needs to be done."
Skip over this content

The U.S. declared the health emergency amid confusion about whether new numbers really mean ongoing infections — or just that health officials had missed something simmering for weeks or months. But the move allows the government to ship roughly 12 million doses of flu-fighting medications from a federal stockpile to states in case they eventually need them.
President Barack Obama is set to address the health crisis Monday in remarks to a meeting of the nation's top scientists. His administration sought on Sunday to strike a balance, informing Americans without panicking them.
"We do think this will continue to spread but we are taking aggressive actions to minimize the impact on people's health," said Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention.
The World Bank said it would send Mexico $25 million in loans for immediate aid and $180 million in long-term assistance to address the outbreak, plus advice on how other nations have dealt with similar crises. Mexico officials say the flu strain may have sickened 1,614 people since April 13 but laboratory testing to confirm that and how many truly died from it — at least 22 so far out of the 103 suspected deaths — is taking time.
Worldwide, attention focused sharply on travelers.
"It was acquired in Mexico, brought home and spread," Nova Scotia's chief public health officer, Dr. Robert Strang, said of Canada's first confirmed cases.
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A New York City school where eight cases were confirmed will be closed Monday and Tuesday, and 14 schools in Texas, including a high school where two cases were confirmed, will be closed for at least the next week. Some schools in California and Ohio also were closing after students were found or suspected to have the flu.
China, Russia and Taiwan began planning to quarantine travelers arriving from flu-affected areas if they have symptoms. Italy, Poland and Venezuela advised citizens to postpone travel to affected parts of Mexico and the U.S.
Singapore, Thailand, Japan, Indonesia, South Korea and the Philippines were checking for signs of fever among passengers arriving at airports from North America. In Malaysia, health workers in face masks took the temperatures of passengers as they arrived from a flight from Los Angeles.
Travelers with flu-like symptoms would be given detailed health checks.
Multiple airlines, including American, United, Continental, US Airways, Mexicana and Air Canada, are waiving their usual penalties for changing reservations for anyone traveling to, from, or through Mexico, but have not canceled flights.
Officials along the U.S.-Mexico border were asking health care providers to take respiratory samples from patients who appear to have the flu. Travelers were being asked if they visited flu-stricken areas.
Skip over this content

The U.S. hasn't advised against travel to Mexico but does urge precautions such as frequent hand-washing while there, and began questioning arriving travelers about flu symptoms.
Associated Press writers Mark Stevenson and Olga R. Rodriguez in Mexico City; Frank Jordans in Geneva; Mike Stobbe in Atlanta; and Maria Cheng in London contributed to this report.
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Old 04-27-2009, 10:13 AM   #47 (permalink)
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Quote:
China, Russia and Taiwan began planning to quarantine travelers arriving from flu-affected areas if they have symptoms.
and THIS is what we should be doing!!!

but no...... not Napolitano!
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Old 04-27-2009, 10:47 AM   #48 (permalink)
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Originally Posted by SurferGirl View Post
I have a strong suspicion that anotherstar is right.
I think they aren't going to test people coming from Mexico because they want there government controlled health care.
"Never waste a good crisis"....sound familiar?
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Old 04-27-2009, 11:40 AM   #49 (permalink)
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Quote:
Originally Posted by atprm View Post
and THIS is what we should be doing!!!

but no...... not Napolitano!
Because this administration does not want to alienate a huge voter base that will come about when they legalize 12 million illegals.
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Old 04-27-2009, 12:05 PM   #50 (permalink)
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Swine flu: Every passenger arriving in Britain from Mexico screened

Every passenger arriving in Britain from Mexico is to be tested for signs of swine flu amid fears that the disease has spread across the world.


Two travellers were admitted to a hospital in Scotland when they complained of flu-like symptoms after returning from holiday in the country.

Alan Johnson, the Health Secretary, said Britain was on "constant alert" after the previously unknown influenza spread from Mexico to America and cases were reported as far afield as New Zealand, France, Spain, Israel and Canada.

He said he had no doubt that there would be more cases of travellers coming into Britain with flu-like symptoms and promised that they will be examined "very, very quickly" by the NHS.

The crisis was discussed at an emergency Cobra meeting of government officials from Whitehall and the devolved administrations.

More than 80 Mexicans are believed to have died from pneumonia and respiratory illness linked to the virus. At least 20 cases have been confirmed as swine flu, also known as H1N1.

As travellers arrive back at London's Heathrow airport, many have been seen wearing face masks.

President Felipe Calderón called for calm as he said the majority of the 1,300 people who had complained of flu symptoms over the weekend did not have the virus.

In Britain, Mr Johnson advised all returning Britons who felt feverish not to go to their GPs or hospitals, but to stay at home and contact NHS Direct instead.

Last night, the Foreign Office updated its travel advice, warning visitors to Mexico to avoid large crowds, kissing and to maintain a distance of at least 6ft from other people.

In America, The White House declared a state of public health emergency as they confirmed 20 cases of swine flu across five states.

In addition, six cases were confirmed in Canada, 10 reported in New Zealand, four reported in France, seven reported in Spain, one reported in Israel and two reported in Britain.

In Northamptonshire, a businessman and his family have been told to stay at home after returning from Mexico with flu-like symptoms.

Virologists in Britain agreed that in the worst case scenario, an outbreak of the virus could lead to as many as 120 million deaths worldwide.

But they were also quick to point out that it was far too early to predict the scale of the problem and that the country is well stocked with Tamiflu, the antiviral drug which has proved effective so far in Mexico.

Britain has stockpiled an estimated £500 million worth of anti-virals Tamiflu and Relenza, enough to treat half the population, according to John Oxford, professor of virology at Barts and The London School of Medicine and Dentistry.

Over the weekend, the World Health Organisation (WHO) warned of a "potential pandemic" as it launched a global emergency system to monitor the virus.

It is currently treating swine flu as a phase three virus, where there are sporadic outbreaks of the virus in humans, but there was growing pressure to raise the risk level to four, where there is evidence of community outbreaks.

Dr Keiji Fukuda, Assistant Director-General of the WHO's Interim for Health Security and Environment, said the threat level would not be increased until further tests were carried out.

"It is clear that we are in a period in which we have to be very careful to collect the best possible information.

"We really need to understand a little more about the epidemiology, we need to understand the behaviour of these viruses. I think it is fair to categorise the situation as serious."

The two tourists taken to hospital in Scotland suffered mild symptoms of flu but were admitted as a precaution and given antiviral drugs.

The pair had not travelled to any of the areas within Mexico affected by the outbreak but are understood to have undergone a number of tests at Monklands Hospital in Airdrie, Lanarkshire after arriving home on April 21.

Nicola Sturgeon, the Scottish health minister, hinted at three other cases in Britain over the weekend which had all proved negative.

One was that of a British Airways cabin crew member who fell ill on a flight back from Mexico but was found not to have the virus.

Miss Sturgeon insisted there was "no immediate threat to public health" as she sought to calm fears.

But Professor Nigel Dimmock, a virologist and Emeritus professor of Warwick University, said it was unclear how much drug resistance this new strain may have.

"There is reason to be worried," he said. "The virus will travel and if it is, as seems, a new virus and people have no resistance to it, then there's nothing to stop it spreading from person to person and by various means around the world.

"It's poised on a knife edge. It could either burn itself out or it could get very nasty indeed – only time will tell.

"So far it has killed 2 per cent of those infected. In the worst case scenario it could kill 2 per cent of the world's population. "There have been three big pandemics of flu, one in 1918, one in 1957 and one in 1968. Fifty million died in 1918 and from the other pandemics, maybe a million. This flu has the potential to be bigger than Spanish influenza.

"You don't want to panic too much – it may go away. We have to hope for the best and plan for the worst."

Dr John McCauley, virologist at the National Institute for Medical Research, said the figure of 120 million was "not unreasonable".

Mr Johnson said Britain had been planning for potential flu pandemics for several years because of the threat of bird flu. The WHO rated Britain as one of the two countries best prepared for an outbreak, alongside France.

"We've got a whole range of measures in place. If you have flu-like symptoms, don't go to your GP but stay at home and call NHS Direct.

"The whole point about these kinds of epidemics is you don't want to spread them and you spread them by going out and mixing with other people."

The H1N1 swine influenza has combined – or "re assorted" – features of the pig, avian and human viruses.

As a new strain of influenza, it will take several months to create a suitable vaccine, but anti-virals will help control the symptoms, scientists said.

Symptoms include feverish illness accompanied by one or more of a cough, sore throat, headache and muscle aches, according to the Health Protection Agency.

http://www.telegraph.co.uk/health/he...swine-flu.html
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Old 04-27-2009, 12:08 PM   #51 (permalink)
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U.S. set to issue travel warning to Mexico

WASHINGTON (Reuters) - The U.S. State Department plans to issue a travel warning later on Monday urging Americans to avoid all "nonessential" travel to Mexico because of an outbreak of swine flu, a U.S. official said.

Swine flu has killed 103 people in Mexico and has spread to the United States. Spain has reported one case of the virus, the first to be confirmed in Europe.

"There will be a travel warning urging Americans to avoid all nonessential travel to Mexico because of the swine flu," said a U.S. official, who spoke on condition he not be named as the warning has not yet been announced.

(Reporting by Sue Pleming; Editing by Will Dunham)
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Old 04-27-2009, 12:10 PM   #52 (permalink)
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Russia to check all planes from the Americas for swine flu

Russia will inspect all planes coming from north and south America for swine flu starting Monday, the country's chief medical official said, quoted by news agencies.

"From today all flights coming from the American continent will be inspected," said the official, Gennady Onishchenko, noting that suspected cases of the virus had been identified in Canada and Brazil.

The announcement came as health authorities worldwide attempted to limit the spread of the potential deadly virus after it killed over 100 people in Mexico.

"These conditions are being imposed to minimize the possibility of the virus' entry into our country," Onishchenko said.

He added that regional authorities in Russia had been ordered to monitor all suspected cases of swine flu and conduct tests for the virus.

On Sunday Russia banned meat imports from Mexico, several US states and nine Latin American nations in a bid to contain the virus, which has appeared in the United States and Canada and is feared to have spread as far as New Zealand.
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Old 04-27-2009, 12:41 PM   #53 (permalink)
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The Obama admnistration declares health emergency.Department of Homeland Security Head Janet Napolitanosaid to free up resources to deal with the Swine Flu.


Lead Swine Flu stories...

Swine Flue HITS North America ALERT NOW
Human Swine Influenza Investigation

April 25, 2009 19:30 EDT


Human cases of swine influenza A (H1N1) virus infection have been identified in the U.S. in San Diego County and Imperial County, California as well as in San Antonio, Texas. Internationally, human cases of swine influenza A (H1N1) virus infection have been identified in Mexico.

Investigations are ongoing to determine the source of the infection and whether additional people have been infected with similar swine influenza viruses.

CDC is working very closely with state and local officials in California, Texas, as well as with health officials in Mexico, Canada and the World Health Organization. On April 24th, CDC deployed 7 epidemiologists to San Diego County, California and Imperial County, California and 1 senior medical officer to Texas to provide guidance and technical support for the ongoing epidemiologic field investigations. CDC has also deployed to Mexico 1 medical officer and 1 senior expert who are part of a global team that is responding to the outbreak of respiratory illnesses in Mexico.

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. There are many things you can to do preventing getting and spreading influenza:
There are everyday actions people can take to stay healthy.

Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

Wash your hands often with soap and water, especially after you cough or sneeze.

Alcohol-based hands cleaners are also effective.

Avoid touching your eyes, nose or mouth. Germs spread that way.

Try to avoid close contact with sick people.

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

http://www.emergencyemail.org/newsem...asp?a=353&z=29


CDC says virus spread cannot be contained

The U.S. Centers for Disease Control, Interim Deputy Director Dr. Anne Schuchat, warned that officials "cannot contain the spread of this virus."

http://www.emergencyemail.org/newsem...asp?a=356&z=34


Mexican Swine Flu Death Toll Growing, 81 Died


Train riders in Mexico City wear masks after outbreak of swine flu, 24 Apr 2009
Mexico's health minister says the swine flu outbreak may now be responsible for 81 deaths.

Jose Angel Cordova issued the revised death toll late Saturday as the Mexican government announced it was shutting down schools in the capital and surrounding areas until May 6.

With reports of more confirmed and possible cases from Mexico and the United States, the World Health Organization declared the virus "a public health emergency of international concern" with "pandemic potential."

The U.S. Centers for Disease Control, Interim Deputy Director Dr. Anne Schuchat, warned that officials "cannot contain the spread of this virus."

New Zealand's health minister Tony Ryall said Sunday 10 students who recently visited Mexico are "likely" to have contracted swine flu.

Officials in Mexico suspect more than 1,300 Mexicans have been sickened by the virus. Sunday Mass has been suspended in many Roman Catholic churches throughout the country.

Mexico City's mayor has canceled all public events for 10 days, and the country's health department has been given the power to isolate patients and inspect travelers.

In the United States, health officials confirmed three new non-fatal cases of the virus, one in California and two in Kansas, bringing the total to 11.

Health officials in the southern U.S. state of Texas say they have temporarily closed a school outside the city of San Antonio after identifying possible cases of swine flu.

New York City's health commissioner said Saturday tests on eight of nine samples taken from sick students at one school came up "probable" for swine flu. But he said all of the possible cases were mild and that many of the children are feeling better.

The WHO is recommending that all countries intensify efforts to track its potential spread but there are growing concerns about the impact swine flu may have on air travel.

British Airways said Saturday a crew member was taken to a London hospital with flu-like symptoms after a flight from Mexico City. And Mexicana Airlines is giving international travelers the option of rescheduling flights to Mexico City at no extra cost.

Health officials say the unusual flu strain contains genetic material from pigs, birds and humans but authorities say none of the U.S. patients had any contact with pigs.

U.S. health officials say swine flu symptoms resemble the regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing.

http://www.emergencyemail.org/newsem...asp?a=355&z=29

Our Home Page has content updated constantly...http://www.EmergencyEmail.org
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Old 04-27-2009, 12:45 PM   #54 (permalink)
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Obama: Swine flu not reason for 'alarm'
By LAURAN NEERGAARD, AP Medical Writer
35 mins ago


WASHINGTON – President Barack Obama said Monday the threat of spreading swine flu infections is matter of concern but "not a cause for alarm." The United States and other countries across the globe increased their vigilance as the World Health Organization said there are now 40 confirmed cases in the U.S.

That's twice the number previously reported by the Centers for Disease Control and Prevention in Atlanta.

The WHO, a United Nations agency, said none of the cases in the U.S. has been fatal.

Amid increasing worries about a possible global pandemic, Obama told a gathering of scientists that his administration's Department of Health and Human Services "has declared a public health emergency as a precautionary tool to ensure that we have the resources we need at our disposal to respond quickly and effectively."

The acting head of the CDC said earlier Monday that people should be prepared for the problem to become more severe, and that it could involve "possibly deaths." Dr. Richard Besser said officials were questioning people coming into the U.S. about how their health.

THIS IS A BREAKING NEWS UPDATE. Check back soon for further information. AP's earlier story is below.

WASHINGTON (AP) — President Barack Obama said Monday the threat of spreading swine flu infections is cause for concern but "not a cause for alarm," as the United States stepped up border monitoring and countries across the globe increased their vigilance as well.

"The Department of Health and Human Services has declared a Public Health Emergency as a precautionary tool to ensure that we have the resources we need at our disposal to respond quickly and effectively," Obama told a gathering of scientists, amid increasing worries worldwide about a possible pandemic.

The acting head of the Centers for Disease Control and Prevention earlier Monday had said that people should be prepared for the problem to become more severe, and that it could involve "possibly deaths." Dr. Richard Besser said U.S. officials were questioning border visitors about how their health.

The quickening pace of developments in the United States in response to some 1,600 swine flu infections in neighboring Mexico was accompanied by a host of varying responses around the world. The European Union advised against nonessential travel to the United States and Mexico, China, Taiwan and Russia considered quarantines and several Asian countries scrutinized visitors arriving at their airports.

In the United States, a private school in South Carolina was closed Monday because of fears that young people returning from Mexico might have been infected.

"We are closely monitoring the emerging cases of swine flu in the United States," Obama said. "I'm getting regular updates on the situation from the responsible agencies, and the Department of Health and Human Services as well as the Centers for Disease Control will be offering regular updates to the American people so that they know what steps are being taken and what steps they may need to take."

"But one thing is clear: Our capacity to deal with a public health challenge of this sort rests heavily on the work of our scientific and medical community," the president said. "And this is one more example of why we cannot allow our nation to fall behind."

Besser described the new U.S. border initiative as "passive screening." He said authorities were "asking people about fever and illness, looking for people who are ill."

The U.S. declared a national health emergency in the midst of uncertainty about what the mounting sick count — 1,600 or more in Mexico alone — meant ongoing infections or merely resulted from health officials missing something that had been simmering for weeks or months. The declaration did, nevertheless, allow Washington to ship roughly 12 million doses of flu-fighting medications from a federal stockpile to states in case they eventually need them.

Besser traveled the morning news-show circuit Monday, telling interviewers the U.S. government was being "extremely aggressive" and saying he wouldn't personally recommend traveling to parts of Mexico where the new virus has taken hold. But he noted that the issue of a travel ban was under discussion and that nothing had been decided.

Besser said he was not reassured by the fact that so far in the U.S., no one has died from the disease.

"From what we understand in Mexico, I think people need to be ready for the idea that we could see more severe cases in this country and possibly deaths," he said. "That's something people have to be ready for and we're looking for that. So far, thankfully, we haven't seen that. But we're very concerned and that's why we're taking very aggressive measures."

Meanwhile, officials of Newberry Academy in South Carolina said Monday in a statement that seniors from the school were in Mexico earlier this month and some had flu like symptoms when they returned.

State Department of Health and Environmental Control spokesman Jim Beasley said test results on the students could come back as early as Monday afternoon. The agency has stepped up efforts to investigate all flu cases in South Carolina. There have been no confirmed swine flu cases in the state.

A New York City school where eight cases were confirmed will be closed Monday and Tuesday, and 14 schools in Texas, including a high school where two cases were confirmed, will be closed for at least the next week. Some schools in California and Ohio also were closing after students were found or suspected to have the flu.

In Mexico, the outbreak's epicenter, soldiers handed out 6 million face masks to help stop the spread of the novel virus that is suspected in up to 103 deaths. Most other countries are reporting only mild cases so far, with most of the sick already recovering. Cases have been confirmed in Canada — six — and the U.S. — 20.

Spain reported its first confirmed swine flu case on Monday and said another 17 people were suspected of having the disease. The European Union health commissioner advised Europeans to avoid nonessential travel to Mexico and the United States. Also, three New Zealanders recently returned from Mexico are suspected of having it.

Complicating response strategies was what World Health Organization spokesman Peter Cordingley described as major difficulty that experts were having in assessing precisely the nature of the threat.

"These are the early days. It's quite clear that there is a potential for this virus to become a pandemic and threaten globally," Cordingley said. He said it was spreading rapidly in Mexico and the southern United States.

Cordingley said "honestly don't know" the extent of the problem. He added: "We don't know enough yet about how this virus operates. More work needs to be done."

Multiple airlines, including American, United, Continental, US Airways, Mexicana and Air Canada, said they were waiving usual penalties for changing reservations for anyone traveling to, from, or through Mexico, but have not canceled flights.

The World Bank pledged to send Mexico $25 million in loans for immediate aid and $180 million in long-term assistance to address the outbreak, plus advice on how other nations have dealt with similar crises. Mexico officials say the flu strain may have sickened 1,614 people since April 13 but laboratory testing to confirm that and how many truly died from it — at least 22 so far out of the 103 suspected deaths — is taking time.

Worldwide, attention focused sharply on travelers.

"It was acquired in Mexico, brought home and spread," Nova Scotia's chief public health officer, Dr. Robert Strang, said of Canada's first confirmed cases.

Besser said that while the U.S. hasn't advised against travel to Mexico, it has urged people to take precautions, such as frequent hand-washing while there.

___

Associated Press writers Mark Stevenson and Olga R. Rodriguez in Mexico City; Frank Jordans in Geneva; Mike Stobbe in Atlanta; and Maria Cheng in London contributed to this report.

http://news.yahoo.com/s/ap/20090427/.../med_swine_flu
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Old 04-27-2009, 12:52 PM   #55 (permalink)
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Swine Flu: 5 Things You Need to Know About the Outbreak
By BRYAN WALSH Bryan Walsh
1 hr 48 mins ago


Concern that the world could be on the brink of the first influenza pandemic in more than 40 years escalated Sunday as France, Hong Kong, New Zealand and Spain reported potential new cases in which people had been infected with swine flu and Canada confirmed several new cases. In the U.S., where 20 such infections have been confirmed, federal health officials declared a public-health emergency and are preparing to distribute to state and local agenciesa quarter of the country's 50 million-dose stockpile of antiviral drugs. Meanwhile, in hard-hit Mexico, where more than 80 people have died from what is believed to be swine flu, the government closed all public schools and canceled hundreds of public events in Mexico City.

Though the World Health Organization (WHO) is referring to the situation as a "public-health emergency of international concern," the apparent emergence in several countries of an entirely new strain of H1N1 flu virus has led some scientists to believe that it is only a matter of time before the WHO declares pandemic status, a move that could prompt travel bans to infected countries. "We are clearly seeing wide spread," says Michael Osterholm, a pandemic risk expert who runs the University of Minnesota's Center for Infectious Disease Research and Policy. "There is no question." (Read about the vaccine being prepared in case of a pandemic.)

Health officials in Washington were quick to point out Sunday that none of the 20 cases identified in the U.S. so far has been fatal; all but one of the victims has recovered without needing to be hospitalized. Officials also noted that only one American has been infected so far who had not recently traveled to Mexico - a woman in Kansas got sick after her husband returned from a business trip in that country, where he became ill - but that could change as more intensive disease surveillance begins. "As we continue to look for more cases, I expect we're going to find them," said acting Centers for Disease Control (CDC) director Richard Besser.

In the U.S., where cases have also been found in California, Texas, and New York City, the declaration of a public-health emergency is part of what federal officials termed an "aggressive response" to the outbreaks. In addition to releasing from the national stockpile some 12.5 million doses of the antiviral drugs Tamiflu and Relenza - which scientists say has so far been effective against the H1N1 swine flu virus - the Department of Homeland Security will begin "passive surveillance" to screen people entering the U.S. Any traveler coming from a country with a confirmed human swine flu infection will be questioned, checked for symptoms and potentially isolated if they are found ill. Though the CDC has issued public warnings about the more serious outbreak in Mexico, there are no recommendations from Washington against traveling to the neighboring country.

That is in contrast to the more extreme actions of some other governments, including Hong Kong, where officials on Sunday urged residents to avoid going to Mexico. Hong Kong officials also ordered the immediate detention in a hospital of anyone who arrives with a fever above 100.4 F, respiratory symptoms and a history of traveling over the past seven days to a city with a confirmed case of swine flu infection.

But Washington officials Sunday did their best not to overstate the situation and emphasized that their response wasn't out of the ordinary. "I wish we could call it declaration of emergency preparedness, because that's really what it is in this context," said Secretary of Homeland Security Janet Napolitano. "We're preparing in an environment where we really don't know ultimately what the size or seriousness of this outbreak is going to be."

Right now health officials around the world are trying to take precautions without inciting panic. Here are just a few of the questions facing them - and ultimately, us as well:

1. Is this a flu pandemic?

The influenza virus is constantly mutating. That's why we can't get full immunity to the flu, the way we can to diseases like chicken pox, because there are multiple strains of the flu virus and they change from year to year. However, even though the virus makes us sick, our immune systems can usually muster enough of a response so that the flu is rarely fatal for healthy people.

But every once in awhile, the virus shifts its genetic structure so much that our immune systems offer no protection whatsoever. (This usually happens when a flu virus found in animals - like the avian flu still circulating in Asia - swaps genes with other viruses in a process called reassortment, and jumps to human beings.) A flu pandemic occurs when a new flu virus emerges for which humans have little or no immunity and then spreads easily from person to person around the world. In the 20th century we had two mild flu pandemics, in 1968 and 1957, and the severe "Spanish flu" pandemic of 1918, which killed an estimated 40 to 50 million people worldwide.

The WHO has the responsibility of declaring when a new flu pandemic is underway, and to simplify the process, the U.N. body has established six pandemic phases. Thanks to H5N1 avian flu, which has killed 257 people since 2003 but doesn't spread very well from one human to another, we're currently at phase 3. If the WHO upgraded that status to phase 4, which is marked by a new virus that begins to pass easily enough from person to person that we can detect community-sized outbreaks, such a move would effectively mean that we've got a pandemic on our hands.

The H1N1 swine flu virus has already been identified as a new virus, with genes from human and avian flus as well as the swine variety. And since it is apparently causing large-scale outbreaks in Mexico, along with separate confirmed cases in the U.S. and Canada and suspected cases in other countries, it would seem that we've already met the criteria for phase 4. But though an emergency committee met on April 25 to evaluate the situation, the WHO hasn't made the pandemic declaration yet. Keiji Fukuda, the WHO's interim assistant director-general for health, security and environment, said on Sunday that its experts "would like a little bit more information and a little bit more time to consider this." The committee is set to meet again by April 28 at the latest.

As health officials have repeatedly emphasized, with good reason, the swine flu situation is evolving rapidly, and more lab tests are needed to ascertain exactly what is going on in Mexico and elsewhere. "We want to make sure we're on solid ground," said Fukuda, a highly respected former CDC official and flu expert.

2. What will happen if this outbreak gets classified as a pandemic?

Moving the world to pandemic phase 4 would be the signal for serious containment actions to be taken on the national and international level. Given that these actions would have major implications for the global economy, not to mention the effects of the public fear that would ensue, there is concern that the WHO may be considering politics along with science. "What the WHO did makes no sense," says Osterholm. "In a potential pandemic, you need to have the WHO be beyond question, and (April 25) was not a good day for them."

Of course, declaring a pandemic isn't a decision that should be taken lightly. For the WHO, phase 4 might trigger an attempt to keep the virus from spreading by instituting strict quarantines and blanketing infected areas with antivirals. But we appear to have missed the opportunity to contain the disease at its source since the virus is already crossing borders with ease. "We cannot stop this at the border," said Anne Schuchat, the CDC's interim director for science and public health. "We don't think that we can quench this in Mexico if it's in many communities now."

That would leave the WHO and individual countries to fall back on damage control, using antivirals and old-fashioned infection control - like closing schools, limiting public gatherings and even restricting travel - to slow the spread of the virus. But such efforts would likely inflict serious damage on an already faltering global economy - and the truth is, we don't know how well those methods will work.



continues...
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