July 11 (Bloomberg) -- Extremely fat swine flu sufferers may have a tendency to become severely ill, health officials in the U.S. and Europe said, after a report showed a “striking” prevalence of obesity among patients hospitalized in Michigan.
Nine of 10 patients with the pandemic flu strain admitted to an intensive care unit at Ann Arbor from late May to early June, were obese and seven were “extremely obese,” with a body mass index of at least 40, doctors said. Three of the 10 died and seven had no other known health problems.
The study, in the Morbidity and Mortality Weekly Report yesterday, supports a pattern seen by doctors tracking the pandemic in hospital reports from Glasgow to Melbourne and from Santiago to New York. Researchers say the trend is surprising because obesity hasn’t been identified previously as a risk factor for severe complications of seasonal flu.
“Clinicians should be aware that severe illness and fatal outcomes also can occur in patients without known risk factors for complications of seasonal influenza, including persons with extreme obesity,” the Centers for Disease Control and Prevention in Atlanta said in an editorial note accompanying its report.
With the new virus on a collision course with the obesity epidemic, the World Health Organization says it’s gathering statistics to confirm and understand this development.
“Morbid obesity is one of the most common findings turning up in severely ill patients,” said Nikki Shindo, who is leading the investigation of swine flu patients at the WHO in Geneva. “It’s a huge problem.”
Seeking More Answers
So far, the evidence is anecdotal. No global or national data have been reported and the CDC said it’s unknown whether obesity is an independent risk factor. Yesterday, the European Centre for Disease Control and Prevention in Stockholm began including obesity on a list of factors that put patients at risk of dying from the pandemic bug.
Drugmaker Roche Holding AG is combing through studies to determine whether heavier people should get bigger doses of its Tamiflu antiviral. The CDC said yesterday that, until more data are available, a double dose of the Roche pill or a longer course of treatment can be considered for severely ill hospitalized swine flu patients.
The pandemic strain is reported to have killed 429 people worldwide since its discovery in the U.S. and Mexico in April, according to the WHO’s most recent report. The infection, which has spread as far as New Zealand and Norway, causes little more than a fever and cough in most cases. The majority of those who died were pregnant, had asthma, diabetes or other chronic diseases, according to the WHO.
Obesity ‘Stands Out’
“About 75 percent of patients have underlying conditions, and clearly obesity stands out as a statistically significant factor involved in the seriousness of the disease,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland. “It was a bit of a surprise to us.”
It’s the first time the prominence of obesity has been widely recognized among severely ill flu sufferers, Fauci said in a July 9 interview. “It’s very likely that if we went back retrospectively and looked at people who did poorly during seasonal flu, what would shake out is that obesity would be one of the risks,” he said.
CDC researchers noted the association among California H1N1 patients in a May 22 report. The agency is investigating whether overweight people need different flu vaccinations. Last year, 26.1 percent of adults in the U.S. were obese, up from 25.6 percent in 2007, the CDC said in a July 8 statement.
Severe Pneumonia
Some patients are showing up at hospitals with viral pneumonia so severe they are suffocating. All 10 of the Michigan patients, ages 21 to 53, suffered acute respiratory distress and weren’t getting enough oxygen even when put on a conventional mechanical ventilator.
The patients, who represent “the most severely ill subset” of H1N1 sufferers, were notable for several reasons, the CDC said. Nine were male, five developed dangerous clots in the lung and major organs became dysfunctional in nine of the patients. The body mass index of nine patients ranged from 34.2 to 58.9, according to the report. People with a BMI of 25 to 29.9 are considered “overweight” and those higher than 30 are “obese.”
“The high prevalence of obesity in this case series is striking,” CDC said.
A 5-foot, 5-inch (1.65 meters) woman is considered overweight at 150 pounds (68 kilograms) and obese at 180 pounds. A 6-foot man is considered overweight at 184 pounds and obese at 221 pounds.
Cause or Complication
Scientists don’t yet know whether extremely overweight people get sicker because of associated conditions like heart disease and asthma, or whether the excess fat itself makes them more vulnerable. Both may be to blame.
Fat cells secrete chemicals that cause chronic, low-level inflammation that can hamper the body’s immune response and narrow the airways, says Tim Armstrong, a doctor working in the WHO’s chronic diseases department in Geneva.
What’s more, excess fatty tissue compresses the chest, and the fatty infiltration of the chest wall causes a decrease in lung function and an increase in the pulmonary blood volume, Armstrong said. “If you are obese, you tend to be less physically active and have an associated shallower breathing pattern. All these compound, leading to breathing difficulties.”
Insulin Resistance
The morbidly obese also are more likely to experience insulin resistance, a condition that makes it harder for doctors to lower the level of sugar in the blood of critically ill patients, said Greet Van den Berghe, head of acute medical sciences at Belgium’s Catholic University of Leuven.
“The question has always been, is it the obesity or the other problems?” said Melinda Beck, professor of nutrition at the University of North Carolina, Chapel Hill. “There haven’t been studies that looked just at weight. In my research, it appears to be the obesity itself.”
In mouse studies, flu killed about half of the rodents made obese by a high-fat diet, compared with a mortality rate of about 4 percent in lean animals, according to Beck’s research. She is studying whether obese humans might need stronger doses of vaccine or a different method of delivery.
People may reduce their risk of developing complications from swine flu -- as well as many other diseases -- by maintaining a healthy weight, quitting smoking, exercising regularly and moderating alcohol intake, said Frederick Hayden, a clinical virologist at the University of Virginia.
Rates Jump
Obesity rates have tripled in the U.S., U.K. and Australia during the past three decades, according to the Organization for Economic Cooperation and Development. The ranks of the overweight are also swelling in the developing world. In China, obesity doubled among women and tripled in men between 1989 and 2000 and it may double again in 20 years, according to research released last year in the journal Health Affairs.
Studies are needed to better understand the immune response of obese people and determine whether excess body weight impairs their ability to fight the infection, said Pamela Fraker, a professor of biochemistry at Michigan State University.
“It’s sort of strange that it’s been neglected with this major population,” Fraker said. “We need to know about this for the further care and protection of the growing number of obese we have and for society in general.”
To contact the reporter on this story: Jason Gale in Singapore at
Showing posts with label swine flu. Show all posts
Showing posts with label swine flu. Show all posts
Sunday, July 12, 2009
Tuesday, May 5, 2009
Swine flu broke out in California: CDC
The US disease prevention center claims the newly-spread potentially-fatal strain of swine flu virus may have originated from California.
The Centers for Disease Control and Protection (CDC) said on Saturday that the state preceded Mexico, the alleged source of the virus, in reporting cases of the affliction.
"As we do our investigations here in the US, we may find that there were cases earlier," CDC spokesman, Scott Bryan was quoted by AFP as saying.
As early as March, patients were diagnosed in California with a new type of viral infection resulting from the A(H1N1) -- the new strain of the swine flu virus, H1N1 which is apt to affect humans and pigs and resist antiviral treatment.
The patients had neither been to Mexico nor had they come into contact with pigs.
San Diego County and California County were the first to report sufferers in late March, The Wall Street Journal reported.
12 suspects had also tested positive for a strange strain from December 2005 to January 2009, Bryan added.
About 160 lab-confirmed cases have been reported in 21 US states with one leading to death. Two-thirds of the patients had not had any contact with Mexico.
As the disease crawls along in Europe and Asia after the Americas, Mexican health authorities claim they have been partially successful in stemming the contagion.
Ireland is the latest to report a case of swine flu. Infection with the virus has also been confirmed in Canada (51), Spain (15), Britain (13), Germany (6), New Zealand (4), Israel (3), Costa Rica (2), France (2), Austria (1), Benin (1), Denmark (1), Hong Kong (1), Netherlands (1), South Korea (1) and Switzerland (1).
The World Heath Organization (WHO) is considering raising the pandemic alert level to phase 6 -- the highest level and an indication of a global outbreak of the swine flu.
The Centers for Disease Control and Protection (CDC) said on Saturday that the state preceded Mexico, the alleged source of the virus, in reporting cases of the affliction.
"As we do our investigations here in the US, we may find that there were cases earlier," CDC spokesman, Scott Bryan was quoted by AFP as saying.
As early as March, patients were diagnosed in California with a new type of viral infection resulting from the A(H1N1) -- the new strain of the swine flu virus, H1N1 which is apt to affect humans and pigs and resist antiviral treatment.
The patients had neither been to Mexico nor had they come into contact with pigs.
San Diego County and California County were the first to report sufferers in late March, The Wall Street Journal reported.
12 suspects had also tested positive for a strange strain from December 2005 to January 2009, Bryan added.
About 160 lab-confirmed cases have been reported in 21 US states with one leading to death. Two-thirds of the patients had not had any contact with Mexico.
As the disease crawls along in Europe and Asia after the Americas, Mexican health authorities claim they have been partially successful in stemming the contagion.
Ireland is the latest to report a case of swine flu. Infection with the virus has also been confirmed in Canada (51), Spain (15), Britain (13), Germany (6), New Zealand (4), Israel (3), Costa Rica (2), France (2), Austria (1), Benin (1), Denmark (1), Hong Kong (1), Netherlands (1), South Korea (1) and Switzerland (1).
The World Heath Organization (WHO) is considering raising the pandemic alert level to phase 6 -- the highest level and an indication of a global outbreak of the swine flu.
Thursday, April 30, 2009
The horror that is Smithfield ~ Rolling stone
Smithfield Foods actually faces a more difficult task than transmogrifying the populations of America's thirty-two largest cities into edible packages of meat. Hogs produce three times more excrement than human beings do. The 500,000 pigs at a single Smithfield subsidiary in Utah generate more fecal matter each year than the 1.5 million inhabitants of Manhattan. The best estimates put Smithfield's total waste discharge at 26 million tons a year. That would fill four Yankee Stadiums. Even when divided among the many small pig production units that surround the company's slaughterhouses, that is not a containable amount.
Smithfield estimates that its total sales will reach $11.4 billion this year. So prodigious is its fecal waste, however, that if the company treated its effluvia as big-city governments do -- even if it came marginally close to that standard -- it would lose money. So many of its contractors allow great volumes of waste to run out of their slope-floored barns and sit blithely in the open, untreated, where the elements break it down and gravity pulls it into groundwater and river systems. Although the company proclaims a culture of environmental responsibility, ostentatious pollution is a linchpin of Smithfield's business model.
A lot of pig shit is one thing; a lot of highly toxic pig shit is another. The excrement of Smithfield hogs is hardly even pig shit: On a continuum of pollutants, it is probably closer to radioactive waste than to organic manure. The reason it is so toxic is Smithfield's efficiency. The company produces 6 billion pounds of packaged pork each year. That's a remarkable achievement, a prolificacy unimagined only two decades ago, and the only way to do it is to raise pigs in astonishing, unprecedented concentrations.
Smithfield's pigs live by the hundreds or thousands in warehouse-like barns, in rows of wall-to-wall pens. Sows are artificially inseminated and fed and delivered of their piglets in cages so small they cannot turn around. Forty fully grown 250-pound male hogs often occupy a pen the size of a tiny apartment. They trample each other to death. There is no sunlight, straw, fresh air or earth. The floors are slatted to allow excrement to fall into a catchment pit under the pens, but many things besides excrement can wind up in the pits: afterbirths, piglets accidentally crushed by their mothers, old batteries, broken bottles of insecticide, antibiotic syringes, stillborn pigs -- anything small enough to fit through the foot-wide pipes that drain the pits. The pipes remain closed until enough sewage accumulates in the pits to create good expulsion pressure; then the pipes are opened and everything bursts out into a large holding pond.
The temperature inside hog houses is often hotter than ninety degrees. The air, saturated almost to the point of precipitation with gases from shit and chemicals, can be lethal to the pigs. Enormous exhaust fans run twenty-four hours a day. The ventilation systems function like the ventilators of terminal patients: If they break down for any length of time, pigs start dying.
From Smithfield's point of view, the problem with this lifestyle is immunological. Taken together, the immobility, poisonous air and terror of confinement badly damage the pigs' immune systems. They become susceptible to infection, and in such dense quarters microbes or parasites or fungi, once established in one pig, will rush spritelike through the whole population. Accordingly, factory pigs are infused with a huge range of antibiotics and vaccines, and are doused with insecticides. Without these compounds -- oxytetracycline, draxxin, ceftiofur, tiamulin -- diseases would likely kill them. Thus factory-farm pigs remain in a state of dying until they're slaughtered. When a pig nearly ready to be slaughtered grows ill, workers sometimes shoot it up with as many drugs as necessary to get it to the slaughterhouse under its own power. As long as the pig remains ambulatory, it can be legally killed and sold as meat.
The drugs Smithfield administers to its pigs, of course, exit its hog houses in pig shit. Industrial pig waste also contains a host of other toxic substances: ammonia, methane, hydrogen sulfide, carbon monoxide, cyanide, phosphorous, nitrates and heavy metals. In addition, the waste nurses more than 100 microbial pathogens that can cause illness in humans, including salmonella, cryptosporidium, streptocolli and girardia. Each gram of hog shit can contain as much as 100 million fecal coliform bacteria.
Smithfield's holding ponds -- the company calls them lagoons -- cover as much as 120,000 square feet. The area around a single slaughterhouse can contain hundreds of lagoons, some of which run thirty feet deep. The liquid in them is not brown. The interactions between the bacteria and blood and afterbirths and stillborn piglets and urine and excrement and chemicals and drugs turn the lagoons pink.
More at rolling stone
Smithfield estimates that its total sales will reach $11.4 billion this year. So prodigious is its fecal waste, however, that if the company treated its effluvia as big-city governments do -- even if it came marginally close to that standard -- it would lose money. So many of its contractors allow great volumes of waste to run out of their slope-floored barns and sit blithely in the open, untreated, where the elements break it down and gravity pulls it into groundwater and river systems. Although the company proclaims a culture of environmental responsibility, ostentatious pollution is a linchpin of Smithfield's business model.
A lot of pig shit is one thing; a lot of highly toxic pig shit is another. The excrement of Smithfield hogs is hardly even pig shit: On a continuum of pollutants, it is probably closer to radioactive waste than to organic manure. The reason it is so toxic is Smithfield's efficiency. The company produces 6 billion pounds of packaged pork each year. That's a remarkable achievement, a prolificacy unimagined only two decades ago, and the only way to do it is to raise pigs in astonishing, unprecedented concentrations.
Smithfield's pigs live by the hundreds or thousands in warehouse-like barns, in rows of wall-to-wall pens. Sows are artificially inseminated and fed and delivered of their piglets in cages so small they cannot turn around. Forty fully grown 250-pound male hogs often occupy a pen the size of a tiny apartment. They trample each other to death. There is no sunlight, straw, fresh air or earth. The floors are slatted to allow excrement to fall into a catchment pit under the pens, but many things besides excrement can wind up in the pits: afterbirths, piglets accidentally crushed by their mothers, old batteries, broken bottles of insecticide, antibiotic syringes, stillborn pigs -- anything small enough to fit through the foot-wide pipes that drain the pits. The pipes remain closed until enough sewage accumulates in the pits to create good expulsion pressure; then the pipes are opened and everything bursts out into a large holding pond.
The temperature inside hog houses is often hotter than ninety degrees. The air, saturated almost to the point of precipitation with gases from shit and chemicals, can be lethal to the pigs. Enormous exhaust fans run twenty-four hours a day. The ventilation systems function like the ventilators of terminal patients: If they break down for any length of time, pigs start dying.
From Smithfield's point of view, the problem with this lifestyle is immunological. Taken together, the immobility, poisonous air and terror of confinement badly damage the pigs' immune systems. They become susceptible to infection, and in such dense quarters microbes or parasites or fungi, once established in one pig, will rush spritelike through the whole population. Accordingly, factory pigs are infused with a huge range of antibiotics and vaccines, and are doused with insecticides. Without these compounds -- oxytetracycline, draxxin, ceftiofur, tiamulin -- diseases would likely kill them. Thus factory-farm pigs remain in a state of dying until they're slaughtered. When a pig nearly ready to be slaughtered grows ill, workers sometimes shoot it up with as many drugs as necessary to get it to the slaughterhouse under its own power. As long as the pig remains ambulatory, it can be legally killed and sold as meat.
The drugs Smithfield administers to its pigs, of course, exit its hog houses in pig shit. Industrial pig waste also contains a host of other toxic substances: ammonia, methane, hydrogen sulfide, carbon monoxide, cyanide, phosphorous, nitrates and heavy metals. In addition, the waste nurses more than 100 microbial pathogens that can cause illness in humans, including salmonella, cryptosporidium, streptocolli and girardia. Each gram of hog shit can contain as much as 100 million fecal coliform bacteria.
Smithfield's holding ponds -- the company calls them lagoons -- cover as much as 120,000 square feet. The area around a single slaughterhouse can contain hundreds of lagoons, some of which run thirty feet deep. The liquid in them is not brown. The interactions between the bacteria and blood and afterbirths and stillborn piglets and urine and excrement and chemicals and drugs turn the lagoons pink.
More at rolling stone
Wednesday, April 29, 2009
Economic Stress and swine flu..
Some researchers speculate that in 1918 immune systems were weakened by malnourishment and the stresses of life. The lower socioeconomic groups of Mexico had been very stressed by a collapse in the oil price and hence economic activity generally, the US recession in contruction, which has lead to vastly decreased remittances from family members working in the US.
CDC officials expect to see more severe cases in the U.S. as well - and as better epidemiological work is done in Mexico, we'll probably hear about more mild cases there too.
The true severity of the H1N1 swine flu virus is an open question. The 1918 Spanish flu pandemic began with a fairly mild wave of infections in the spring, but the virus returned a few months later in a far more virulent form. That could happen with the current swine flu as well. "It's quite possible for this virus to evolve," said Fukuda. "When viruses evolve, clearly they can become more dangerous to people."
CDC officials expect to see more severe cases in the U.S. as well - and as better epidemiological work is done in Mexico, we'll probably hear about more mild cases there too.
The true severity of the H1N1 swine flu virus is an open question. The 1918 Spanish flu pandemic began with a fairly mild wave of infections in the spring, but the virus returned a few months later in a far more virulent form. That could happen with the current swine flu as well. "It's quite possible for this virus to evolve," said Fukuda. "When viruses evolve, clearly they can become more dangerous to people."
Advice ignored: 65m hogs are concentrated in 65,000 facilities.
Six years ago, Science dedicated a major story to evidence that "after years of stability, the North American swine flu virus has jumped onto an evolutionary fasttrack".
Since its identification during the Great Depression, H1N1 swine flu had only drifted slightly from its original genome. Then in 1998 a highly pathogenic strain began to decimate sows on a farm in North Carolina and new, more virulent versions began to appear almost yearly, including a variant of H1N1 that contained the internal genes of H3N2 (the other type-A flu circulating among humans).
Researchers interviewed by Science worried that one of these hybrids might become a human flu (both the 1957 and 1968 pandemics are believed to have originated from the mixing of bird and human viruses inside pigs), and urged the creation of an official surveillance system for swine flu: an admonition, of course, that went unheeded in a Washington prepared to throw away billions on bioterrorism fantasies.
But what caused this acceleration of swine flu evolution? Virologists have long believed that the intensive agricultural system of southern China is the principal engine of influenza mutation: both seasonal "drift" and episodic genomic "shift". But the corporate industrialisation of livestock production has broken China's natural monopoly on influenza evolution. Animal husbandry in recent decades has been transformed into something that more closely resembles the petrochemical industry than the happy family farm depicted in school readers.
In 1965, for instance, there were 53m US hogs on more than 1m farms; today, 65m hogs are concentrated in 65,000 facilities. This has been a transition from old-fashioned pig pens to vast excremental hells, containing tens of thousands of animals with weakened immune systems suffocating in heat and manure while exchanging pathogens at blinding velocity with their fellow inmates.
Last year a commission convened by the Pew Research Center issued a report on "industrial farm animal production" that underscored the acute danger that "the continual cycling of viruses … in large herds or flocks [will] increase opportunities for the generation of novel virus through mutation or recombinant events that could result in more efficient human to human transmission." The commission also warned that promiscuous antibiotic use in hog factories (cheaper than humane environments) was sponsoring the rise of resistant staph infections, while sewage spills were producing outbreaks of E coli and pfiesteria (the protozoan that has killed 1bn fish in Carolina estuaries and made ill dozens of fishermen).
Any amelioration of this new pathogen ecology would have to confront the monstrous power of livestock conglomerates such as Smithfield Farms (pork and beef) and Tyson (chickens). The commission reported systemic obstruction of their investigation by corporations, including blatant threats to withhold funding from cooperative researchers .
This is a highly globalised industry with global political clout. Just as Bangkok-based chicken giant Charoen Pokphand was able to suppress enquiries into its role in the spread of bird flu in southeast Asia, so it is likely that the forensic epidemiology of the swine flu outbreak will pound its head against the corporate stonewall of the pork industry.
This is not to say that a smoking gun will never be found: there is already gossip in the Mexican press about an influenza epicentre around a huge Smithfield subsidiary in Veracruz state. But what matters more (especially given the continued threat of H5N1) is the larger configuration: the WHO's failed pandemic strategy, the further decline of world public health, the stranglehold of big pharma over lifeline medicines, and the planetary catastrophe of industrialised and ecologically unhinged livestock production.
http://www.guardian.co.uk/commentisfree/2009/apr/27/swine-flu-mexico-health
Since its identification during the Great Depression, H1N1 swine flu had only drifted slightly from its original genome. Then in 1998 a highly pathogenic strain began to decimate sows on a farm in North Carolina and new, more virulent versions began to appear almost yearly, including a variant of H1N1 that contained the internal genes of H3N2 (the other type-A flu circulating among humans).
Researchers interviewed by Science worried that one of these hybrids might become a human flu (both the 1957 and 1968 pandemics are believed to have originated from the mixing of bird and human viruses inside pigs), and urged the creation of an official surveillance system for swine flu: an admonition, of course, that went unheeded in a Washington prepared to throw away billions on bioterrorism fantasies.
But what caused this acceleration of swine flu evolution? Virologists have long believed that the intensive agricultural system of southern China is the principal engine of influenza mutation: both seasonal "drift" and episodic genomic "shift". But the corporate industrialisation of livestock production has broken China's natural monopoly on influenza evolution. Animal husbandry in recent decades has been transformed into something that more closely resembles the petrochemical industry than the happy family farm depicted in school readers.
In 1965, for instance, there were 53m US hogs on more than 1m farms; today, 65m hogs are concentrated in 65,000 facilities. This has been a transition from old-fashioned pig pens to vast excremental hells, containing tens of thousands of animals with weakened immune systems suffocating in heat and manure while exchanging pathogens at blinding velocity with their fellow inmates.
Last year a commission convened by the Pew Research Center issued a report on "industrial farm animal production" that underscored the acute danger that "the continual cycling of viruses … in large herds or flocks [will] increase opportunities for the generation of novel virus through mutation or recombinant events that could result in more efficient human to human transmission." The commission also warned that promiscuous antibiotic use in hog factories (cheaper than humane environments) was sponsoring the rise of resistant staph infections, while sewage spills were producing outbreaks of E coli and pfiesteria (the protozoan that has killed 1bn fish in Carolina estuaries and made ill dozens of fishermen).
Any amelioration of this new pathogen ecology would have to confront the monstrous power of livestock conglomerates such as Smithfield Farms (pork and beef) and Tyson (chickens). The commission reported systemic obstruction of their investigation by corporations, including blatant threats to withhold funding from cooperative researchers .
This is a highly globalised industry with global political clout. Just as Bangkok-based chicken giant Charoen Pokphand was able to suppress enquiries into its role in the spread of bird flu in southeast Asia, so it is likely that the forensic epidemiology of the swine flu outbreak will pound its head against the corporate stonewall of the pork industry.
This is not to say that a smoking gun will never be found: there is already gossip in the Mexican press about an influenza epicentre around a huge Smithfield subsidiary in Veracruz state. But what matters more (especially given the continued threat of H5N1) is the larger configuration: the WHO's failed pandemic strategy, the further decline of world public health, the stranglehold of big pharma over lifeline medicines, and the planetary catastrophe of industrialised and ecologically unhinged livestock production.
http://www.guardian.co.uk/commentisfree/2009/apr/27/swine-flu-mexico-health
Tuesday, April 28, 2009
Two little pigs cooked up disaster ~ Swine Flu
according to wired...
The deadly H1N1 influenza virus that’s fueling fears of a global pandemic appears to be a hybrid of two common pig flu strains, scientists who have studied the disease told Wired.com Tuesday. Earlier reports called it a combination of pig, human and avian influenza strains.
The findings may resolve some uncertainty about the nature of the virus, but much is still unknown about its origins and effects.
“This is what we call a reassortment between two currently circulating pig flu viruses,” said Andrew Rambaut, a University of Edinborough viral geneticist. “Why it’s emerged in humans is anyone’s guess. It hasn’t been seen before in pigs as far as I know.”
Rambaut analyzed the gene sequences of viral samples taken from two infected California children. The samples were collected by the Centers for Disease Control and Prevention, and made available to researchers through an international database of flu genomes.
His conclusions were echoed by Eddie Holmes, a virus evolution specialist at the University of Pennsylvania, and Steven Salzberg, a University of Maryland bioinformaticist. Both have looked at the CDC-provided sequences. The CDC could not be reached for comment, but a document released to scientists and obtained by Wired.com affirms their analysis.
Researchers believe the samples from California represent the same viral strain as one that is believed to have killed as many as 150 of an estimated 1,600 hospitalized Mexicans, and caused hundreds more infections worldwide, including at least 64 in the United States. However, as samples from Mexico have not yet been sequenced, the similarity is not conclusive.
The two strains whose genes are found in the California samples belong to influenza families known generally as North American and Eurasian pig flu. The former was first described in the 1930s, and the latter in 1979. The Eurasian strain is generally found in Europe and Asia, rather than North America.
Neither of the strains have ever proven contagious in humans. One of the genes inherited from the Eurasian strain has reportedly never been seen in humans. It codes for the neuraminidase enzyme — the N1 in H1N1 — which controls the expansion of the virus from infected cells.
“The new neuraminidase gene that came in from Eurasian swine is one we’ve never before seen circulating in humans,” said Rambaut. “That’s one of the reasons it’s spreading rapidly. Very few people will have any immunity to this particular combination, which is what gives the concern that this will be a pandemic rather than just a normal seasonal flu outbreak. It remains to be seen how much and to what extent there is existing immunity.”
In medical terms, the genetic origins of the virus may not matter. Whether it come solely from pigs rather than a mix of pigs, birds and humans doesn’t change its immunological novelty.
However, understanding the origins could eventually help scientists determine how the virus evolved and where it originally emerged.
The earliest cases occurred in the town of La Gloria in the Mexican state of Veracruz, not far from a large and notoriously unsanitary hog farm operated by Granjas Carroll, a subsidiary of giant American food company Smithfield Foods.
Vercruz residents and some journalists have alleged that the virus could have evolved in the farm’s pigs, then passed into humans through water or insects tainted by infected waste. Many researchers, including the authors of a report issued last year by the Pew Commission on Industrial Farm Animal Production, have warned that unsanitary conditions at industrial hog farms could prove a breeding ground for new forms of influenza.
The World Health Organization has sent inspectors to the Granjas Carroll farm. The results of the investigation have not been announced. Smithfield issued a press release on Saturday stating that “it has found no clinical signs or symptoms of the presence of swine influenza in the company’s swine herd or its employees at its joint ventures in Mexico.” The company declined further comment, though CEO Larry Pope told USA Today that “(The term) swine flu is a misnomer.”
Rambaut, Holmes and Salzberg declined to speculate on whether the new H1N1 virus evolved on a hog farm or specifically in the Granjas Carroll facility.
However, it seems likely that pigs were the original host.
“That’s a logical conclusion,” said Salzberger. “It was probably two different pigs, or one who got co-infected from others. The two strains mixed, and now you have a brand-new strain.”
“Presumably somewhere there was a pig infected with both forms. We don’t know where or when. It could have been circulating in this form for a while,” said Rambaut.
What comes next is anyone’s guess.
“Influenza virus mutates remarkably rapidly so there is no doubt that the virus will mutate and evolve in humans,” said Holmes. “Quite what this evolution will result in is difficult to tell.”
http://tinyurl.com/d8jf4w
The deadly H1N1 influenza virus that’s fueling fears of a global pandemic appears to be a hybrid of two common pig flu strains, scientists who have studied the disease told Wired.com Tuesday. Earlier reports called it a combination of pig, human and avian influenza strains.
The findings may resolve some uncertainty about the nature of the virus, but much is still unknown about its origins and effects.
“This is what we call a reassortment between two currently circulating pig flu viruses,” said Andrew Rambaut, a University of Edinborough viral geneticist. “Why it’s emerged in humans is anyone’s guess. It hasn’t been seen before in pigs as far as I know.”
Rambaut analyzed the gene sequences of viral samples taken from two infected California children. The samples were collected by the Centers for Disease Control and Prevention, and made available to researchers through an international database of flu genomes.
His conclusions were echoed by Eddie Holmes, a virus evolution specialist at the University of Pennsylvania, and Steven Salzberg, a University of Maryland bioinformaticist. Both have looked at the CDC-provided sequences. The CDC could not be reached for comment, but a document released to scientists and obtained by Wired.com affirms their analysis.
Researchers believe the samples from California represent the same viral strain as one that is believed to have killed as many as 150 of an estimated 1,600 hospitalized Mexicans, and caused hundreds more infections worldwide, including at least 64 in the United States. However, as samples from Mexico have not yet been sequenced, the similarity is not conclusive.
The two strains whose genes are found in the California samples belong to influenza families known generally as North American and Eurasian pig flu. The former was first described in the 1930s, and the latter in 1979. The Eurasian strain is generally found in Europe and Asia, rather than North America.
Neither of the strains have ever proven contagious in humans. One of the genes inherited from the Eurasian strain has reportedly never been seen in humans. It codes for the neuraminidase enzyme — the N1 in H1N1 — which controls the expansion of the virus from infected cells.
“The new neuraminidase gene that came in from Eurasian swine is one we’ve never before seen circulating in humans,” said Rambaut. “That’s one of the reasons it’s spreading rapidly. Very few people will have any immunity to this particular combination, which is what gives the concern that this will be a pandemic rather than just a normal seasonal flu outbreak. It remains to be seen how much and to what extent there is existing immunity.”
In medical terms, the genetic origins of the virus may not matter. Whether it come solely from pigs rather than a mix of pigs, birds and humans doesn’t change its immunological novelty.
However, understanding the origins could eventually help scientists determine how the virus evolved and where it originally emerged.
The earliest cases occurred in the town of La Gloria in the Mexican state of Veracruz, not far from a large and notoriously unsanitary hog farm operated by Granjas Carroll, a subsidiary of giant American food company Smithfield Foods.
Vercruz residents and some journalists have alleged that the virus could have evolved in the farm’s pigs, then passed into humans through water or insects tainted by infected waste. Many researchers, including the authors of a report issued last year by the Pew Commission on Industrial Farm Animal Production, have warned that unsanitary conditions at industrial hog farms could prove a breeding ground for new forms of influenza.
The World Health Organization has sent inspectors to the Granjas Carroll farm. The results of the investigation have not been announced. Smithfield issued a press release on Saturday stating that “it has found no clinical signs or symptoms of the presence of swine influenza in the company’s swine herd or its employees at its joint ventures in Mexico.” The company declined further comment, though CEO Larry Pope told USA Today that “(The term) swine flu is a misnomer.”
Rambaut, Holmes and Salzberg declined to speculate on whether the new H1N1 virus evolved on a hog farm or specifically in the Granjas Carroll facility.
However, it seems likely that pigs were the original host.
“That’s a logical conclusion,” said Salzberger. “It was probably two different pigs, or one who got co-infected from others. The two strains mixed, and now you have a brand-new strain.”
“Presumably somewhere there was a pig infected with both forms. We don’t know where or when. It could have been circulating in this form for a while,” said Rambaut.
What comes next is anyone’s guess.
“Influenza virus mutates remarkably rapidly so there is no doubt that the virus will mutate and evolve in humans,” said Holmes. “Quite what this evolution will result in is difficult to tell.”
http://tinyurl.com/d8jf4w
Swine Infuenza Q and A from TED ~ Nathan Wolfe, Q&A, TED2009
.
SARS, avian flu, swine flu ... what's going on here? Why are we suddenly seeing so many more outbreaks of viruses from animals?
Viruses have always passed from humans to animals. In fact, the vast majority of human diseases have animal origins. But the human population is different from what it once was. For most of our history, we lived in geographically disparate populations. So viruses could enter from animals into humans, spread locally and go extinct. But the human population has gone through a connectivity explosion. All humans on the planet are now connected to each other spatially and temporally in a way that's unprecedented in the history of vertebrate biology. Humans -- as well as our domestic animals and wild animals we trade -- move around the planet at biological warp speed. This provides new opportunities for viruses that would have gone extinct locally to have the population density fuel they need to establish themselves and spread globally.
We've created a "perfect storm" for viruses. And we'll continue to see -- as we have in the past few years -- a whole range of new animal diseases as outbreaks in human populations. But we have to stop being surprised by them. Right now, global public health is like cardiology in the '50s -- just waiting for the heart attack, without understanding why they occur or the many ways to monitor for them, detect them early and ultimately prevent them. Swine flu is not an anomaly. We know that swine flu -- like the vast majority of new outbreaks -- comes from animals. We should be monitoring those animals and the humans that come into contact with them, so we can catch these viruses early, before they infect major cities and spread throughout the world.
Can we stop swine flu? Or is it too late?
If you catch one of these outbreaks early on, there may be the potential to do what we call containment, where you limit the outbreak to a particular site. But the reality is: By the time swine flu got on the radar screen of global public health, it had already spread. It was already in the States, it was in Mexico, it was in New Zealand. By the time it reaches that point, you've lost the ability to contain it. There are ways to decrease the spread of the pandemic, but by that point, it can't be contained. (Editor's note: See Larry Brilliant's 2006 TEDTalk for more on the importance of early containment.)
The more fundamental question is: How do we prevent these pandemics from occurring? There are commonalities among all the pandemics that occur, and we can learn from them. One commonality is that they all come from animals. And the other commonality is that we wait too long.
At the Global Viral Forecasting Initiative, our approach is to take it a step back. If we can contain and monitor animal viruses at an earlier stage -- when they're first entering human populations, preferably before they've had a chance to become human-adapted, certainly before they've had a chance to spread -- we can head off pandemics altogether.
Swine flu may or may not end up being an important human pandemic. But it's a perfect illustration of the need for a paradigm shift in the way we approach global disease control.
In your TEDTalk, you lay out plans for monitoring humans who have close contact with animals in African jungles and Asian "wet markets." Should you be monitoring pig farms as well?
Absolutely. What we do is all of the above. We monitor people with contact with wild animals as well as domestic animals. Chickens, ducks, pigs, monkeys ... wherever people have contact with animals, that's where we want to be, so we can catch potential pandemics at the moment that they're born.
The good news is: For a variety of reasons, the percentage of the human population that's in direct contact with animals is decreasing. So that gives us the potential to put a substantive percentage of that population into regular monitoring. Maybe we won't catch everything, but we can create a much more substantive safety net for capturing these things before they go international or global.
READ MORE: Nathan Wolfe talks about why swine flu victims are dying in Mexico but not yet in the US; how swine flu is a "cosmopolitan virus"; and more ...
Your Global Viral Forecasting Initiative is expanding worldwide, but mainly in Asia and Africa. If you were in Mexico, how might things have gone differently?
In this case, we would have hoped to catch and contain swine flu when there were just dozens -- instead of hundreds or thousands -- of cases in Mexico, and before it spread globally.
GVFI's objective is to monitor the portal of entry for new diseases into human populations -- that means looking at the point at which humans and animals interface. We work with people who have high exposure to animals throughout the world, whether that means exposure to domestic animals -- as with farm workers -- or wild animals, as with people who hunt bushmeat in Africa or people who work in live animal markets in Asia. The minute we see new viruses that are entering into humans, we make this information available for the public health community, so we can develop drugs and diagnostics and potentially vaccines based on them.
When we see new diseases spreading in local communities, we monitor them very closely. If we were working in Mexico -- and we were doing our jobs correctly -- we would have caught this thing, perhaps in rural villages, before it made it to a site like Mexico City, and before it went international.
How do we understand the difference between the cases reported in Mexico, where many have died, and those in the US, which seem very mild?
There is a striking anomoly between what appears to be a very low rate of mortality and illness among the American cases and what appears, on the surface, to be a higher rate of illness among the Mexican cases. It could, of course, be the result of a difference in the viruses, although that doesn't necessarily appear to be the case. It could be a difference in host populations, although again, that's difficult to explain.
One possibility is that because we've looked more carefully for cases in the States, we're more likely to see individuals who are mildly ill. We might find that if we looked more comprehensively in Mexico, we'd see the same number of people who were very ill -- because they're easy to find -- and a much larger number of people who were mildly ill. That would reduce the actual rate of mortality to a much lower number, and that may be more compatible with what we would see if the number increased in the American epidemic.
As the number of cases climb worldwide, many people are comparing this swine flu outbreak to the 1918 flu pandemic. Is that an apt comparison?
Well, they both represent novel introductions of influenza into human populations that were capable of spreading substantively. The 1918 flu was notable in the sense that it spread comprehensively, globally, and it had a very high rate of mortality -- affecting not only the very old or very young (who have weak immune systems) but also people in the prime of their lives, who are overcome by their body's own immune response.
Whether or not this happens with swine flu remains to be seen. Initially, it does not appear to have the level of deadliness that the 1918 flu had.
I love bacon. Am I at risk?
Go ahead and have that BLT. It's not a problem. You can't get swine flu from eating pork. You'd have to have close contact with a living, breathing, infected pig to get this virus -- or rather, in order to have contracted the original pig virus. The interesting and important thing about this "pig flu" is that it's now spreading from human to human. It's become a human virus.
So people should take the usual precautions: Stay away from individuals who are sick. Wash your hands frequently. And the less you touch your face, nose and eyes, the better.
Take us back a step or two: How did swine flu enter into the human population?
Swine flu has been known since at least the early part of the 20th century, since the 1930s. It was originally a virus of bird origin -- all influenza viruses were originally bird viruses -- and it probably spread to humans before it was in pigs.
Now, we still haven't received definitive information on the underlying genetics of this particular virus. But initial reports suggest that it may be what's known as a "mosaic virus," which includes components of swine influenzas, bird influenzas and human influenzas. A cosmopolitan virus like that wouldn't be unprecedented. (Editor's Note: see Joe DeRisi's 2006 TEDTalk for more on state-of-the-art virus detection.)
But in any case, this is a virus that appears to come from pigs, and pigs in close proximity spread the flu in much the same way that humans do -- coughing, sneezing, and so on. The virus probably initially entered into human populations through people who work with livestock.
Is swine flu here to stay?
Whether this particular virus will sustain itself and become a permanent part of the human landscape is unclear, but that's certainly what we're watching for. As it is, the virus may just disappear because of the weather; summers aren't good for flu viruses.
So this heat wave is working in our favor?
It might be. The virus has had a good start, from the flu perspective, considering that this is really the end of the season. But the unseasonably hot weather may bode poorly for this virus' potential to establish itself definitively and cause a pandemic. Had this happened in September or October, it would be much more concerning.
Having said that, it's not impossible that a virus like this might "go into hiding" -- in the southern hemisphere or the tropics -- and might come to light again next year. So there will be a lot of discussion about expanding the fall flu vaccine to try to control it next cycle.
Is it really possible for us to prevent future outbreaks like this?
Yes, I believe it is. We spend tons of money trying to predict complex phenomena like tsunamis, hurricanes, earthquakes. There's no reason to believe that a pandemic is harder to predict than a tsunami. And we'd be foolish not to include forecasting and prevention as part of our overall portfolio to fight these pandemics.
SARS, avian flu, swine flu ... what's going on here? Why are we suddenly seeing so many more outbreaks of viruses from animals?
Viruses have always passed from humans to animals. In fact, the vast majority of human diseases have animal origins. But the human population is different from what it once was. For most of our history, we lived in geographically disparate populations. So viruses could enter from animals into humans, spread locally and go extinct. But the human population has gone through a connectivity explosion. All humans on the planet are now connected to each other spatially and temporally in a way that's unprecedented in the history of vertebrate biology. Humans -- as well as our domestic animals and wild animals we trade -- move around the planet at biological warp speed. This provides new opportunities for viruses that would have gone extinct locally to have the population density fuel they need to establish themselves and spread globally.
We've created a "perfect storm" for viruses. And we'll continue to see -- as we have in the past few years -- a whole range of new animal diseases as outbreaks in human populations. But we have to stop being surprised by them. Right now, global public health is like cardiology in the '50s -- just waiting for the heart attack, without understanding why they occur or the many ways to monitor for them, detect them early and ultimately prevent them. Swine flu is not an anomaly. We know that swine flu -- like the vast majority of new outbreaks -- comes from animals. We should be monitoring those animals and the humans that come into contact with them, so we can catch these viruses early, before they infect major cities and spread throughout the world.
Can we stop swine flu? Or is it too late?
If you catch one of these outbreaks early on, there may be the potential to do what we call containment, where you limit the outbreak to a particular site. But the reality is: By the time swine flu got on the radar screen of global public health, it had already spread. It was already in the States, it was in Mexico, it was in New Zealand. By the time it reaches that point, you've lost the ability to contain it. There are ways to decrease the spread of the pandemic, but by that point, it can't be contained. (Editor's note: See Larry Brilliant's 2006 TEDTalk for more on the importance of early containment.)
The more fundamental question is: How do we prevent these pandemics from occurring? There are commonalities among all the pandemics that occur, and we can learn from them. One commonality is that they all come from animals. And the other commonality is that we wait too long.
At the Global Viral Forecasting Initiative, our approach is to take it a step back. If we can contain and monitor animal viruses at an earlier stage -- when they're first entering human populations, preferably before they've had a chance to become human-adapted, certainly before they've had a chance to spread -- we can head off pandemics altogether.
Swine flu may or may not end up being an important human pandemic. But it's a perfect illustration of the need for a paradigm shift in the way we approach global disease control.
In your TEDTalk, you lay out plans for monitoring humans who have close contact with animals in African jungles and Asian "wet markets." Should you be monitoring pig farms as well?
Absolutely. What we do is all of the above. We monitor people with contact with wild animals as well as domestic animals. Chickens, ducks, pigs, monkeys ... wherever people have contact with animals, that's where we want to be, so we can catch potential pandemics at the moment that they're born.
The good news is: For a variety of reasons, the percentage of the human population that's in direct contact with animals is decreasing. So that gives us the potential to put a substantive percentage of that population into regular monitoring. Maybe we won't catch everything, but we can create a much more substantive safety net for capturing these things before they go international or global.
READ MORE: Nathan Wolfe talks about why swine flu victims are dying in Mexico but not yet in the US; how swine flu is a "cosmopolitan virus"; and more ...
Your Global Viral Forecasting Initiative is expanding worldwide, but mainly in Asia and Africa. If you were in Mexico, how might things have gone differently?
In this case, we would have hoped to catch and contain swine flu when there were just dozens -- instead of hundreds or thousands -- of cases in Mexico, and before it spread globally.
GVFI's objective is to monitor the portal of entry for new diseases into human populations -- that means looking at the point at which humans and animals interface. We work with people who have high exposure to animals throughout the world, whether that means exposure to domestic animals -- as with farm workers -- or wild animals, as with people who hunt bushmeat in Africa or people who work in live animal markets in Asia. The minute we see new viruses that are entering into humans, we make this information available for the public health community, so we can develop drugs and diagnostics and potentially vaccines based on them.
When we see new diseases spreading in local communities, we monitor them very closely. If we were working in Mexico -- and we were doing our jobs correctly -- we would have caught this thing, perhaps in rural villages, before it made it to a site like Mexico City, and before it went international.
How do we understand the difference between the cases reported in Mexico, where many have died, and those in the US, which seem very mild?
There is a striking anomoly between what appears to be a very low rate of mortality and illness among the American cases and what appears, on the surface, to be a higher rate of illness among the Mexican cases. It could, of course, be the result of a difference in the viruses, although that doesn't necessarily appear to be the case. It could be a difference in host populations, although again, that's difficult to explain.
One possibility is that because we've looked more carefully for cases in the States, we're more likely to see individuals who are mildly ill. We might find that if we looked more comprehensively in Mexico, we'd see the same number of people who were very ill -- because they're easy to find -- and a much larger number of people who were mildly ill. That would reduce the actual rate of mortality to a much lower number, and that may be more compatible with what we would see if the number increased in the American epidemic.
As the number of cases climb worldwide, many people are comparing this swine flu outbreak to the 1918 flu pandemic. Is that an apt comparison?
Well, they both represent novel introductions of influenza into human populations that were capable of spreading substantively. The 1918 flu was notable in the sense that it spread comprehensively, globally, and it had a very high rate of mortality -- affecting not only the very old or very young (who have weak immune systems) but also people in the prime of their lives, who are overcome by their body's own immune response.
Whether or not this happens with swine flu remains to be seen. Initially, it does not appear to have the level of deadliness that the 1918 flu had.
I love bacon. Am I at risk?
Go ahead and have that BLT. It's not a problem. You can't get swine flu from eating pork. You'd have to have close contact with a living, breathing, infected pig to get this virus -- or rather, in order to have contracted the original pig virus. The interesting and important thing about this "pig flu" is that it's now spreading from human to human. It's become a human virus.
So people should take the usual precautions: Stay away from individuals who are sick. Wash your hands frequently. And the less you touch your face, nose and eyes, the better.
Take us back a step or two: How did swine flu enter into the human population?
Swine flu has been known since at least the early part of the 20th century, since the 1930s. It was originally a virus of bird origin -- all influenza viruses were originally bird viruses -- and it probably spread to humans before it was in pigs.
Now, we still haven't received definitive information on the underlying genetics of this particular virus. But initial reports suggest that it may be what's known as a "mosaic virus," which includes components of swine influenzas, bird influenzas and human influenzas. A cosmopolitan virus like that wouldn't be unprecedented. (Editor's Note: see Joe DeRisi's 2006 TEDTalk for more on state-of-the-art virus detection.)
But in any case, this is a virus that appears to come from pigs, and pigs in close proximity spread the flu in much the same way that humans do -- coughing, sneezing, and so on. The virus probably initially entered into human populations through people who work with livestock.
Is swine flu here to stay?
Whether this particular virus will sustain itself and become a permanent part of the human landscape is unclear, but that's certainly what we're watching for. As it is, the virus may just disappear because of the weather; summers aren't good for flu viruses.
So this heat wave is working in our favor?
It might be. The virus has had a good start, from the flu perspective, considering that this is really the end of the season. But the unseasonably hot weather may bode poorly for this virus' potential to establish itself definitively and cause a pandemic. Had this happened in September or October, it would be much more concerning.
Having said that, it's not impossible that a virus like this might "go into hiding" -- in the southern hemisphere or the tropics -- and might come to light again next year. So there will be a lot of discussion about expanding the fall flu vaccine to try to control it next cycle.
Is it really possible for us to prevent future outbreaks like this?
Yes, I believe it is. We spend tons of money trying to predict complex phenomena like tsunamis, hurricanes, earthquakes. There's no reason to believe that a pandemic is harder to predict than a tsunami. And we'd be foolish not to include forecasting and prevention as part of our overall portfolio to fight these pandemics.
Swine flu and Industrial scale pig farms ~ western owned
The boy’s hometown, La Gloria, is also close to a pig farm that raises almost 1 million animals a year. The facility, Granjas Carroll de Mexico, is partly owned by Smithfield Foods, a Virginia-based US company and the world’s largest producer and processor of pork products. Residents of La Gloria have long complained about the clouds of flies that are drawn the so-called “manure lagoons” created by such mega-farms, known in the agriculture business as Confined Animal Feeding Operations (CAFOs).
Related Links
LIVE: latest news on swine flu
UK tourists head home from Mexico after swine flu alert
Influence and influenza
Multimedia
LIVE: Map of the virus
It is now known that there was a widespread outbreak of a powerful respiratory disease in the La Gloria area earlier this month, with some of the town’s residents falling ill in February. Health workers soon intervened, sealing off the town and spraying chemicals to kill the flies that were reportedly swarming through people’s homes.
A spokeswoman for Smithfield, Keira Ullrich, said that the company had found no clinical signs or symptoms of the presence of swine influenza in its swine herd or its employees working at its joint ventures anywhere in Mexico. Meanwhile, Mexico’s National Organisation of Pig Production and Producers released its own statement, saying: “We deny completely that the influenza virus affecting Mexico originated in pigs because it has been scientifically demonstrated that this is not possible.”
According reports gathered on the website of James Wilson, a founding member of the Biosurveillance Indication and Warning Analysis Community (BIWAC), about 60 per cent of La Gloria’s 3,000-strong population have sought medical assistance since February.
“Residents claimed that three pediatric cases, all under two years of age, died from the outbreak,” wrote Mr Wilson. “However, officials stated that there was no direct link between the pediatric deaths and the outbreak; they said the three fatal cases were isolated and not related to each other.”
The case of the four-year-old boy was announced yesterday by Mexico’s Health Minister, Jose Angel Cordova, at a press conference that was briefly interrupted by an earthquake. “We are at the most critical moment of the epidemic. The number of cases will keep rising so we have to reinforce preventive measures,” he said, adding that in addition to the 149 deaths another 2,000 had been hospitalised with “grave pneumonia”, although at least half of that number had since made a full recovery.
Related Links
LIVE: latest news on swine flu
UK tourists head home from Mexico after swine flu alert
Influence and influenza
Multimedia
LIVE: Map of the virus
It is now known that there was a widespread outbreak of a powerful respiratory disease in the La Gloria area earlier this month, with some of the town’s residents falling ill in February. Health workers soon intervened, sealing off the town and spraying chemicals to kill the flies that were reportedly swarming through people’s homes.
A spokeswoman for Smithfield, Keira Ullrich, said that the company had found no clinical signs or symptoms of the presence of swine influenza in its swine herd or its employees working at its joint ventures anywhere in Mexico. Meanwhile, Mexico’s National Organisation of Pig Production and Producers released its own statement, saying: “We deny completely that the influenza virus affecting Mexico originated in pigs because it has been scientifically demonstrated that this is not possible.”
According reports gathered on the website of James Wilson, a founding member of the Biosurveillance Indication and Warning Analysis Community (BIWAC), about 60 per cent of La Gloria’s 3,000-strong population have sought medical assistance since February.
“Residents claimed that three pediatric cases, all under two years of age, died from the outbreak,” wrote Mr Wilson. “However, officials stated that there was no direct link between the pediatric deaths and the outbreak; they said the three fatal cases were isolated and not related to each other.”
The case of the four-year-old boy was announced yesterday by Mexico’s Health Minister, Jose Angel Cordova, at a press conference that was briefly interrupted by an earthquake. “We are at the most critical moment of the epidemic. The number of cases will keep rising so we have to reinforce preventive measures,” he said, adding that in addition to the 149 deaths another 2,000 had been hospitalised with “grave pneumonia”, although at least half of that number had since made a full recovery.
Sunday, April 26, 2009
Swine flu in Canada is mild
Swine flu confirmed in Canada
Unlike deadly outbreak in Mexico, the cases in Nova Scotia and B.C. were mild and didn't require hospitalization
April 26, 2009
Comments on this story (36)
STAR STAFF AND WIRE SERVICES
OTTAWA—Canadian health officials are rushing to contain the spread of swine flu through human contact after at least a half-dozen cases were confirmed in Nova Scotia and British Columbia.
Cases in both provinces were linked to Mexican travel — but unlike the deadly outbreak in that country, the illnesses in Nova Scotia and B.C. patients were so mild that none required hospitalization.
“This indicates that — yes — swine influenza is present in Canada,” said Danuta Skowronski, of B.C.’s Centre for Disease Control.
“What we can say so far is that, in the United States and Canada, we’re not picking up those signals of severe respiratory illness that Mexico has been grappling with. . .
“This swine influenza virus does not automatically mean hospitalization and death. It may have just the typical influenza-type presentation and symptoms . . . This is not necessarily scary monsters.”
But she warned that Canadian experts expect more cases in this country and that the public-health system remains on high alert.
Skowronski said the two people on the B.C. Lower Mainland who have contracted the flu have been asked to “self-isolate” but have not been quarantined.
She advised anyone developing flu-like symptoms to stay home and not go to work. If their symptoms are serious enough to see a doctor, she said, they should advise their physician in advance that they intend to pay a visit.
Four students from King’s-Edgehill School, a private high school in Windsor, N.S., have been placed in isolation. Two of them recently travelled to Mexico. Health authorities in Nova Scotia say their symptoms are mild.
The illness has proven itself to be potentially deadly. Mexico’s health minister says the disease has killed up to 86 people and likely sickened up to 1,400 since April 13.
Health authorities in Nova Scotia said Sunday the students reported fatigue, muscle aches and coughing, but nothing out of the ordinary for people who suffer from the flu.
Nova Scotia’s chief public health officer, Dr. Robert Strang, said the four “very mild” cases of swine flu were detected in students ranging in age from 12 to 17 or 18. All are recovering, he said.
“It was acquired in Mexico, brought home and spread,” Strang said.
Health officials urged anyone who thinks they might be ill with flu-like symptoms to stay away from work or school, wash their hands and avoid coughing into their hands.
Although four students at the school have reported getting sick, only two of them went on a school trip to Mexico between April 1 and 8.
Health officials say between 20 and 23 students were on the trip.
“We have to keep things in perspective — it is a mild illness,” Strang said.
Although health officials say four students have tested positive for swine flu, 11 of 17 students they have contacted so far who were on the trip to Mexico did get ill.
Because swine flu is so new, most laboratories don’t have tests to identify them, and they show up as untypeable influenza A when tests are run.
Foreign Minister Lawrence Cannon told CTV the federal cabinet has set up an operations committee and has been monitoring the swine flu situation closely.
Foreign Affairs has posted information on its website on the health situation in Mexico but is not telling Canadians to stay away from the country.
Although no cases of the flu strain have been confirmed in Ontario, 11 cases are being "looked at," said Steve Erwin, spokesperson for Ontario Minister of Health and Long-term Care David Caplan.
But that does not mean all those cases will be investigated or tested, he said.
The number of cases being looked at can change hourly, depending on when people seek medical advice.
He said the ministry would be issuing an update at about 5 p.m. today.
Although the situation is changing hour by hour, a Toronto expert cautioned against panic, noting that the latest confirmed cases in Nova Scotia were mild with none of the infected individuals requiring hospital care.
Around the world, countries from New Zealand to Spain reported suspected cases of swine flu and some warned citizens against travel to North America while others planned quarantines, tightened rules on pork imports and tested airline passengers for fevers.
Mexico, the United Satates and Canada were the only countries with confirmed human cases of swine flu Sunday as global health officials considered whether to raise the global pandemic alert level.
The news follows the World Health Organization’s decision Saturday to declare the outbreak first detected in Mexico and the United States a “public health emergency of international concern.”
U.S. officials say the virus has been found in New York, California, Texas, Kansas and Ohio, but so far no fatalities have been reported.
Governments including China, Russia and Taiwan began planning to put anyone with symptoms of the deadly virus under quarantine
Others were increasing their screening of pigs and pork imports from the Americas or banning them outright despite health officials’ reassurances that it was safe to eat thoroughly cooked pork.
Some nations issued travel warnings for Mexico and the United States.
WHO’s emergency committee is still trying to determine exactly how the virus has spread.
New Zealand said that 10 students who took a school trip to Mexico “likely” had swine flu. Israel said a man who had recently visited Mexico had been hospitalized while authorities try to determine whether he had the disease. French Health Ministry officials investigated four possible cases of swine flu, but three were later found to be negative.
Spanish authorities said a total of seven suspected cases were under observation.
Hong Kong and Taiwan said visitors who came back from flu-affected areas with fevers would be quarantined. China said anyone experiencing flu-like symptoms within two weeks of arrival from an affected area had to report to authorities. A Russian health agency said any passenger from North America running a fever would be quarantined until the cause of the fever is determined.
Tokyo’s Narita airport installed a device to test the temperatures of passengers arriving from Mexico.
Indonesia increased surveillance at all entry points for travellers with flu-like symptoms — using devices at airports that were put in place years ago to monitor for severe acute respiratory syndrome, or SARS, and bird flu. It said it was ready to quarantine suspected victims if necessary.
Hong Kong and South Korea warned against travel to the Mexican capital and three affected provinces. Italy, Poland and Venezuela also advised their citizens to postpone travel to affected areas of Mexico and the United States.
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.
thestar.com
Unlike deadly outbreak in Mexico, the cases in Nova Scotia and B.C. were mild and didn't require hospitalization
April 26, 2009
Comments on this story (36)
STAR STAFF AND WIRE SERVICES
OTTAWA—Canadian health officials are rushing to contain the spread of swine flu through human contact after at least a half-dozen cases were confirmed in Nova Scotia and British Columbia.
Cases in both provinces were linked to Mexican travel — but unlike the deadly outbreak in that country, the illnesses in Nova Scotia and B.C. patients were so mild that none required hospitalization.
“This indicates that — yes — swine influenza is present in Canada,” said Danuta Skowronski, of B.C.’s Centre for Disease Control.
“What we can say so far is that, in the United States and Canada, we’re not picking up those signals of severe respiratory illness that Mexico has been grappling with. . .
“This swine influenza virus does not automatically mean hospitalization and death. It may have just the typical influenza-type presentation and symptoms . . . This is not necessarily scary monsters.”
But she warned that Canadian experts expect more cases in this country and that the public-health system remains on high alert.
Skowronski said the two people on the B.C. Lower Mainland who have contracted the flu have been asked to “self-isolate” but have not been quarantined.
She advised anyone developing flu-like symptoms to stay home and not go to work. If their symptoms are serious enough to see a doctor, she said, they should advise their physician in advance that they intend to pay a visit.
Four students from King’s-Edgehill School, a private high school in Windsor, N.S., have been placed in isolation. Two of them recently travelled to Mexico. Health authorities in Nova Scotia say their symptoms are mild.
The illness has proven itself to be potentially deadly. Mexico’s health minister says the disease has killed up to 86 people and likely sickened up to 1,400 since April 13.
Health authorities in Nova Scotia said Sunday the students reported fatigue, muscle aches and coughing, but nothing out of the ordinary for people who suffer from the flu.
Nova Scotia’s chief public health officer, Dr. Robert Strang, said the four “very mild” cases of swine flu were detected in students ranging in age from 12 to 17 or 18. All are recovering, he said.
“It was acquired in Mexico, brought home and spread,” Strang said.
Health officials urged anyone who thinks they might be ill with flu-like symptoms to stay away from work or school, wash their hands and avoid coughing into their hands.
Although four students at the school have reported getting sick, only two of them went on a school trip to Mexico between April 1 and 8.
Health officials say between 20 and 23 students were on the trip.
“We have to keep things in perspective — it is a mild illness,” Strang said.
Although health officials say four students have tested positive for swine flu, 11 of 17 students they have contacted so far who were on the trip to Mexico did get ill.
Because swine flu is so new, most laboratories don’t have tests to identify them, and they show up as untypeable influenza A when tests are run.
Foreign Minister Lawrence Cannon told CTV the federal cabinet has set up an operations committee and has been monitoring the swine flu situation closely.
Foreign Affairs has posted information on its website on the health situation in Mexico but is not telling Canadians to stay away from the country.
Although no cases of the flu strain have been confirmed in Ontario, 11 cases are being "looked at," said Steve Erwin, spokesperson for Ontario Minister of Health and Long-term Care David Caplan.
But that does not mean all those cases will be investigated or tested, he said.
The number of cases being looked at can change hourly, depending on when people seek medical advice.
He said the ministry would be issuing an update at about 5 p.m. today.
Although the situation is changing hour by hour, a Toronto expert cautioned against panic, noting that the latest confirmed cases in Nova Scotia were mild with none of the infected individuals requiring hospital care.
Around the world, countries from New Zealand to Spain reported suspected cases of swine flu and some warned citizens against travel to North America while others planned quarantines, tightened rules on pork imports and tested airline passengers for fevers.
Mexico, the United Satates and Canada were the only countries with confirmed human cases of swine flu Sunday as global health officials considered whether to raise the global pandemic alert level.
The news follows the World Health Organization’s decision Saturday to declare the outbreak first detected in Mexico and the United States a “public health emergency of international concern.”
U.S. officials say the virus has been found in New York, California, Texas, Kansas and Ohio, but so far no fatalities have been reported.
Governments including China, Russia and Taiwan began planning to put anyone with symptoms of the deadly virus under quarantine
Others were increasing their screening of pigs and pork imports from the Americas or banning them outright despite health officials’ reassurances that it was safe to eat thoroughly cooked pork.
Some nations issued travel warnings for Mexico and the United States.
WHO’s emergency committee is still trying to determine exactly how the virus has spread.
New Zealand said that 10 students who took a school trip to Mexico “likely” had swine flu. Israel said a man who had recently visited Mexico had been hospitalized while authorities try to determine whether he had the disease. French Health Ministry officials investigated four possible cases of swine flu, but three were later found to be negative.
Spanish authorities said a total of seven suspected cases were under observation.
Hong Kong and Taiwan said visitors who came back from flu-affected areas with fevers would be quarantined. China said anyone experiencing flu-like symptoms within two weeks of arrival from an affected area had to report to authorities. A Russian health agency said any passenger from North America running a fever would be quarantined until the cause of the fever is determined.
Tokyo’s Narita airport installed a device to test the temperatures of passengers arriving from Mexico.
Indonesia increased surveillance at all entry points for travellers with flu-like symptoms — using devices at airports that were put in place years ago to monitor for severe acute respiratory syndrome, or SARS, and bird flu. It said it was ready to quarantine suspected victims if necessary.
Hong Kong and South Korea warned against travel to the Mexican capital and three affected provinces. Italy, Poland and Venezuela also advised their citizens to postpone travel to affected areas of Mexico and the United States.
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.
thestar.com
Saturday, April 25, 2009
Swine Flu may have reached New Zealand
LATEST An Auckland school group is being tested for swine flu after returning from Mexico with flu-like symptoms.
More than 80 people in Mexico are believed to have died and over 1300 are sick as a result of catching swine flu. Cases have also been reported in New York, California and Kansas and a British Airways pilot has been hospitalised in London with flu symptoms after returning from Mexico.
Three teachers and 22 senior students at Rangitoto College, New Zealand's largest secondary school, on Auckland's North Shore, yesterday returned to Auckland on a flight from Los Angeles, after a three week trip to Mexico.
Auckland Regional Public Health Service (ARPHS) said today some had symptoms of an influenza-like illness and were remaining in home isolation as a precaution while tests to exclude or confirm swine influenza were carried out.
One student was believed to be in hospital.
Ministry of Health spokesman Michael Flyger said the results of tests were expected this evening.
He said at this stage other passengers on the flight were not being sought and the next step would depend on what the tests showed.
"We don't believe at this point that there is a need for that.
"We might get no positives, we might get one, we might get all of them. It's a pretty big step to be taking (and) it's something that would be considered."
In the meantime the students and teachers had been told to stay at home in isolation and ARPHS was briefing their families and the school on infection control precautions.
While the virus' spread was considered serious enough for WHO declare a health emergency, Mr Flyger said it had proven responsive to drugs.
"It is concerning for sure. You've just got to look at the WHO's advice on this, but it has shown it reacts to treatment so it's not as bad as it could be.
"We're not looking at (the horror film) 28 Days Later."
The ARPHS had advised their families about infection control precautions.
The service was advising the school's principal and the Ministry of Education.
"We are taking this very seriously and doing everything necessary to manage this situation in Auckland," ARPHS clinical director Dr Julia Peters said.
"The Ministry of Health is managing the response to this issue at a national level."
The World Health Organisation (WHO) has warned the current situation with swine flu could start a global epidemic.
The flu has led to the closure of schools in Mexico City.
Dr Peters said anyone returning from Mexico or other places affected with the flu who had symptoms should visit a doctor before returning to work or school.
If symptoms were severe seek urgent medical attention.
The Ministry of Foreign Affairs and Trade has also issued a travel notice for people returning from Mexico, California and Texas. Anyone developing flu-like symptoms was advised to seek medical attention immediately.
The best things people could do to stop the spread of influenza were:
- stay at home and away from others if you are sick
- cover your coughs and sneezes with a tissue
- put used tissues into a rubbish bin
- avoid spreading germs by touching your eyes, nose or mouth to spread
- wash and dry hands frequently, even when you start feeling better.
More than 80 people in Mexico are believed to have died and over 1300 are sick as a result of catching swine flu. Cases have also been reported in New York, California and Kansas and a British Airways pilot has been hospitalised in London with flu symptoms after returning from Mexico.
Three teachers and 22 senior students at Rangitoto College, New Zealand's largest secondary school, on Auckland's North Shore, yesterday returned to Auckland on a flight from Los Angeles, after a three week trip to Mexico.
Auckland Regional Public Health Service (ARPHS) said today some had symptoms of an influenza-like illness and were remaining in home isolation as a precaution while tests to exclude or confirm swine influenza were carried out.
One student was believed to be in hospital.
Ministry of Health spokesman Michael Flyger said the results of tests were expected this evening.
He said at this stage other passengers on the flight were not being sought and the next step would depend on what the tests showed.
"We don't believe at this point that there is a need for that.
"We might get no positives, we might get one, we might get all of them. It's a pretty big step to be taking (and) it's something that would be considered."
In the meantime the students and teachers had been told to stay at home in isolation and ARPHS was briefing their families and the school on infection control precautions.
While the virus' spread was considered serious enough for WHO declare a health emergency, Mr Flyger said it had proven responsive to drugs.
"It is concerning for sure. You've just got to look at the WHO's advice on this, but it has shown it reacts to treatment so it's not as bad as it could be.
"We're not looking at (the horror film) 28 Days Later."
The ARPHS had advised their families about infection control precautions.
The service was advising the school's principal and the Ministry of Education.
"We are taking this very seriously and doing everything necessary to manage this situation in Auckland," ARPHS clinical director Dr Julia Peters said.
"The Ministry of Health is managing the response to this issue at a national level."
The World Health Organisation (WHO) has warned the current situation with swine flu could start a global epidemic.
The flu has led to the closure of schools in Mexico City.
Dr Peters said anyone returning from Mexico or other places affected with the flu who had symptoms should visit a doctor before returning to work or school.
If symptoms were severe seek urgent medical attention.
The Ministry of Foreign Affairs and Trade has also issued a travel notice for people returning from Mexico, California and Texas. Anyone developing flu-like symptoms was advised to seek medical attention immediately.
The best things people could do to stop the spread of influenza were:
- stay at home and away from others if you are sick
- cover your coughs and sneezes with a tissue
- put used tissues into a rubbish bin
- avoid spreading germs by touching your eyes, nose or mouth to spread
- wash and dry hands frequently, even when you start feeling better.
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
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
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