WHO Cites Potential for Swine Flu Pandemic

WHO Cites Potential for Swine Flu Pandemic
Mexico's Leader Orders Sweeping Measures As Cases Exceed 1,000

By Joshua Partlow and Rob Stein
Washington Post Foreign Service
Sunday, April 26, 2009


MEXICO CITY, April 25 -- The World Health Organization rushed to convene an emergency meeting Saturday to develop a response to the "pandemic potential" of a new swine flu virus that has sparked a deadly outbreak in Mexico and spread to disparate parts of the United States.

Health officials reported that at least eight students at a private high school in New York City had "probable" swine flu. They also confirmed three new cases -- two in Kansas and one in California -- bringing the total number of confirmed U.S. cases to 11. The president of Mexico, where the outbreak has killed as many as 81 people, issued an order granting his government broad powers to isolate patients and question travelers.

"This is a serious moment for the nation," President Felipe Calderón said Saturday. "And we are confronting it with seriousness, with all the pertinent measures."

The director general of the World Health Organization, Margaret Chan, said the "situation is evolving quickly."

"We do not yet have a complete picture of the epidemiology or the risk, including possible spread beyond the currently affected areas," said Chan, who cut short a trip to the United States so she could rush back to the WHO's headquarters in Geneva to convene an emergency meeting of expert advisers to formulate a response to the virus. It is the first time the committee has been called upon since it was created two years ago to help handle disease outbreaks after the SARS, or severe acute respiratory syndrome, epidemic.

"In the assessment of the WHO, this is a serious situation that must be watched very carefully," she said. "It has pandemic potential."

The virus, for which there is no vaccine for humans, has nearly brought Mexico City to a halt. Normally congested downtown streets in this city of 20 million were almost empty Saturday, and of the few people who ventured outside, many said they did so only out of necessity. Soldiers posted at subway stations handed out face masks to passersby from the back of armored vehicles. Some pedestrians covered their mouths and noses with scarves and rags.

"We can't escape the air," said Antonio Gonzáles, 56, who wore a surgical mask outside a public hospital. "If it was something in the food, we'd have a chance."

The Mexican government reported more than 1,300 suspected cases of the virus, which mixes animal and human strains of flu. Bars and nightclubs, schools, gallery openings and sporting events were cancelled until further notice. Authorities advised people to wash their hands regularly and avoid the customary greeting of kissing on the cheek. The government issued a decree giving the Health Ministry power to enter people's homes, close public events, isolate patients, and inspect travelers and their baggage.

The Associated Press reported that 24 new cases of the flu emerged Saturday in Mexico.

Worry and uncertainty seemed contagious. Many people had heard inconsistent reports on how many people were sick or dead, how the flu would manifest itself and which areas, if any, were safe.

"The people are disoriented. I think the government doesn't know what they are confronting," said Gonzalo Sariñana, 40, a university official from the northern city of Monterrey who was in Mexico City. "We are just guarding ourselves, waiting to hear what the government tells us to do."

Outside the General Hospital of the 32nd Zone, dozens of people wearing medical masks waited for word about relatives, some of whom had symptoms they suspected could be swine flu.

On Friday around 6 p.m., after returning from her job at the airport with Mexicana Airlines, Monserrat Montoya, 22, developed a fever, headache, aching bones and a cough, said her mother, Lourdes Resendes.

Montoya was taken to the hospital early Saturday and was put in isolation. Waiting outside the emergency room, Resendes did not know whether her daughter had tested positive for swine flu.

"This is very serious, more than anything because this hospital is not prepared for something like this," Resendes said. "There were people here from 11 at night that weren't attended to until 9 in the morning."

In remarks at a hospital opening in the southern state of Oaxaca, Calderón stressed that the flu was curable and that Mexico had sufficient supplies of antiviral medicine to deal with the situation.

The Mexico deaths are of particular concern to authorities because the victims have tended to be young, healthy adults, whereas ordinary flu mostly kills infants and the elderly.

In New York City, about 200 of the 2,700 students attending St. Francis Preparatory School in Queens had missed school earlier in the week because of flulike symptoms, prompting school officials to notify the health department.

A preliminary analysis of viral samples obtained from nose and throat swabs from nine students found that eight tested positive for influenza A. Because none matched the known H1 and H3 subtypes of human flu, they were considered "probable" cases of swine flu, said Thomas R. Frieden, commissioner of the New York City Department of Health and Mental Hygiene.

"We're concerned," Frieden said. "When we see the serious cases in Mexico, and we see it spreading fairly rapidly in one school, it's a situation that has to be monitored very carefully."

The St. Francis students had just returned from spring break, during which some may have traveled to Mexico, he said.

The WHO, after the committee met for about two hours, described the outbreak as a "public health emergency of international concern" and recommended that countries intensify their efforts to identify "unusual outbreaks of influenza-like illness and severe pneumonia."

The committee concluded that it needed more information about the outbreak before any decision could be made about raising the pandemic alert status, which is currently Level 3, meaning very limited spread of virus from person to person.

Chan stressed that a pandemic was not yet underway or inevitable, and she noted that no outbreaks had been reported elsewhere.

All of the confirmed cases in the southwestern United States -- seven in California and two in Texas -- have been relatively mild. Only one patient has been hospitalized, and no one has died, giving officials hope that the situation may not be as dire as in Mexico.

Late Saturday, state health officials in Kansas said the Centers for Disease Control and Prevention had confirmed two cases of swine flu that involved two adults who lived in the same house. Neither was hospitalized, but one was still ill and undergoing treatment, officials said. One had recently traveled to Mexico, they said.

The CDC has dispatched teams to Southern California to help state and local officials and plans to send a team to Texas. The agency is also analyzing samples from other suspected cases and taking steps that would be needed to produce a vaccine if necessary.

"We're trying to take action early before things get worse," said Anne Schuchat, the CDC's interim deputy director for science and public health. "We are worried, and because we're worried, we're acting aggressively on a number of fronts."

Stein reported from Washington.

http://www.washingtonpost.com/wp-dyn/content/article/2009/04/25/AR2009042503128_pf.html