Associated Press and McClatchy-Tribune
April 26, 2009, 7:09PM
Houston Chronicle
WASHINGTON — The federal government declared a public health emergency Sunday to deal with the emerging new swine flu, much like the government does to prepare for approaching hurricanes.
Officials reported 20 U.S. cases of swine flu in five states so far, with the latest in Ohio and New York. Unlike in Mexico where the same strain appears to be killing dozens of people, cases in the United State have been mild — and U.S. health authorities can’t yet explain why.
“As we continue to look for cases, we are going to see a broader spectrum of disease,” predicted Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention. “We’re going to see more severe disease in this country.”
Eight Queens, N.Y., high school students have contracted confirmed cases of swine flu, New York City Mayor Michael Bloomberg said on Sunday, while Nassau, N.Y., officials said they have one suspected case and test results for eight Suffolk, N.Y., residents were negative.
At a White House news conference, Besser and Homeland Security Secretary Janet Napolitano sought to assure Americans that health officials are taking all appropriate steps to minimize the impact of the outbreak.
Top among those is declaring the public health emergency. As part of that, Napolitano said roughly 12 million doses of the drug Tamiflu will be moved from a federal stockpile to places where states can quickly get their share if they decide they need it. Priority will be given to the five states with known cases so far: California, Texas, New York, Ohio and Kansas.
Napolitano called the emergency declaration standard operating procedure — one was declared recently for the inauguration and for flooding. She urged people to think of it as a “declaration of emergency preparedness.”
“Really that’s what we’re doing right now. We’re preparing in an environment where we really don’t know ultimately what the size of seriousness of this outbreak is going to be.”
U.S. officials will begin asking travelers about illness if they’re entering the country from areas with confirmed swine flu.
Passengers won’t be barred from getting into the United States. But they could be referred for further testing.
Quarantines, tighter pork rules
Canada became the third country to confirm human cases of swine flu Sunday as global health officials considered whether to raise the global pandemic alert level.
Nations from New Zealand to Spain also reported suspected cases, and some warned citizens against travel to North America while others planned quarantines, tightened rules on pork imports and tested airline passengers for fevers.
The six Canadian cases in Nova Scotia and British Columbia all had links to people who had traveled to Mexico, and all are the same swine flu strain. The six people have recovered, said Dr. David Butler-Jones, Canada’s chief public health officer.
But “these are probably not the last cases we’ll see in Canada,” he said.
The news follows the World Health Organization’s decision on Saturday to declare the outbreak first detected in Mexico and the United States a “public health emergency of international concern.”
A senior World Health Organization official said the agency’s emergency committee will meet for a second time on Tuesday to examine the spread of the virus before deciding whether to increase the alert for a possible pandemic, or global epidemic.
Governments including China, Russia and Taiwan began planning to put anyone with symptoms of the deadly virus under quarantine.
Russia banned the import of meat products from Mexico, California, Texas and Kansas. South Korea said it would increase the number of its influenza virus checks on pork products from Mexico and the U.S.
2 more deaths in Mexico
Mexico City Mayor Marcelo Ebrardo said two more people died of swine flu overnight in the overcrowded capital, and three other deaths are suspected to have been caused by the strain. An additional 73 more people were hospitalized with influenza, possible swine flu.
City Health Secretary Armando Ahued said most of the fatalities involve victims who only sought medical help after the disease was well advanced and urged people to seek urgent care
President Felipe Calderon has assumed new powers to isolate people infected with the deadly swine flu strain that health officials say has killed up to 86 people and likely sickened about 1,400 in the country since April 13.
The flu has spread beyond Mexico’s borders with 20 confirmed cases in five U.S. states: New York, California, Texas, Kansas and Ohio.
In Mexico, soldiers and health workers patrolled the capital’s subway system on Sunday handing out surgical masks and looking for possible flu cases. People were advised to seek medical attention if they suffered from symptoms including a fever of more than 100 degrees, body aches, coughing, a sore throat, respiratory congestion and, in some cases, vomiting and diarrhea.
Hundreds of public events from concerts to sports matches to were called off to keep people from congregating and spreading the virus in crowds. Zoos were closed and visits to juvenile correction centers were suspended.
About a dozen federal police in blue surgical masks stood in front of Mexico City’s Metropolitan Cathedral, which was nearly empty after a measure canceling services to avoid large concentrations of people.
Johana Chavez, 22, said she showed up for her confirmation only to find a sign advising that all Masses, baptisms and confirmations were canceled until further notice.
“We are all Catholic so this is a big step, closing the cathedral,” she said, cradling a squirming infant in her arms. “The flu must be bad. I guess I’ll have to come back later.”
Markets and restaurants were nearly empty. And throngs of Mexicans — some with just a fever — rushed to hospitals.
Mexico appears to have lost valuable days or weeks in detecting the new flu strain, a combination of pig, bird and human viruses that humans may have no natural immunity to. Health officials have found cases in 16 Mexican states. Two dozen new suspected cases were reported in the capital on Saturday alone.
The first death was in southern Oaxaca state on April 13, but Mexico didn’t send the first of 14 mucus samples to the Centers for Disease Control and Prevention until April 18, around the same time it dispatched health teams to hospitals looking for patients with severe flu or pnuemonia-like symptoms.
Those teams noticed something strange: The flu was killing people aged 20 to 40. Flu victims are usually either infants or the elderly. The Spanish flu pandemic, which killed at least 40 million people worldwide in 1918-19, also first struck otherwise healthy young adults.
The World Health Organization on Saturday asked all countries to step up reporting and surveillance of the disease, as airports around the world were screening travelers from Mexico for flu symptoms.
On Sunday, New Zealand reported that 10 students “likely” have swine flu after a school trip to Mexico, though Health Minister Tony Ryall said none of the students was seriously ill and there was no guarantee they had swine flu. Israel’s Health Ministry said there is one suspected case in that country and France is investigating four possible cases.
WHO Director-General Margaret Chan said the outbreak of the never-before-seen virus has “pandemic potential.” But she said it is still too early to tell if it would become a pandemic — an epidemic that spreads in humans around the world.
Mexican authorities ordered schools closed in the capital and the states of Mexico and San Luis Potosi until May 6.
A team from the CDC was in Mexico to help set up detection testing for the swine flu strain, something Mexico previously lacked.
Health authorities noticed a threefold spike in flu cases in late March and early April, but thought it was a late rebound in the December-February flu season.
Testing at domestic labs did not alert doctors to the new strain. Health Secretary Jose Cordova acknowledged Mexican labs lacked the profiling data needed to detect the previously unknown strain.
Even though U.S. labs detected the swine flu in California and Texas before last weekend, Mexican authorities as recently as Wednesday were referring to it as a late-season flu.
But mid-afternoon Thursday, Mexico City Health Secretary Dr. Armando Ahued said, officials got a call “from the United States and Canada, the most important laboratories in the field, telling us this was a new virus.”
Asked why there were so many deaths in Mexico, and none so far among the U.S. cases, Cordova noted that the U.S. cases involved children — who haven’t been among the fatal cases in Mexico, either.
“There are immune factors that are giving children some sort of defense, that is the only explanation we have,” he said.
Another factor may be that some Mexican patients may have delayed seeking medical help too long, Cordova said.
Others are forced to work and leave their homes despite health concerns.
Wearing two dirty, blue surgical masks she says she found and a heavy coat, Daniela Briseno swept garbage early Sunday morning from the streets in Mexico City.
“This chill air must be doing me harm. I should be at home but I have a family to support,” the 31-year-old said.
Scientists have warned for years about the potential for a pandemic from viruses that mix genetic material from humans and animals.
