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Hybrid flu outbreak causes deaths in Mexico and U.S. – and triggers worldwide action

As of 6:00 GMT, May 2, 2009, The World Health Organization (WHO) website states that 15 countries have now officially reported 615 cases of the A(H1N1) virus infections. Mexico continues to be the "epicenter" reporting 397 confirmed cases and 16 deaths. Yet, according to a USA Today article, the Mexican Government believes the virus us not as severe or prevalent as they originally estimated. "The attack rate is not as broad as was thought," Mexico's Health Secretary Josu00e9 Cu00f3rdova told reporters. Mexico City Mayor Marcelo Ebrard's statement struck a hopeful tone: "The measures we have been taking are beginning to stabilize the situation," said Ebrard. But Secretary Cu00f3rdova could not confirm whether the government believed they had the virus under control. The U.S.Government reports 141 laboratory-confirmed cases. The death tole in the U.S. remains at one. An updated tally of the reported infection cases by country is also posted on the WHO site: Austria (1)Canada (34)China, Hong Kong Special Administrative Region (1)Denmark (1)France (1), Germany (4)Israel (2)Netherlands (1)New Zealand (4)Republic of Korea (1)Spain (13)Switzerland (1)United Kingdom (13). Reported May 1, 2009: The World Health Organization (WHO) and the Center for Disease Control in the US have both officially stopped referring to the flu as u201cswine fluu201d, instead adopting itu2019s virus classification u201cH1N1u201d as the name. As of May 1, the WHO confirms 331 human cases of virus and at least 10 deaths, nine in Mexico and one in the United States. The WHO list of reports cases in 11 countries : u2022 109 in the United States in 17 states (one death). u2022 156 in Mexico (nine deaths). u2022 34 confirmed cases in Canada. u2022 13 in Spain. u2022 Eight in the United Kingdom. u2022 Three in Germany. u2022 Three in New Zealand. u2022 Two in Israel. u2022 One in Austria. u2022 One in the Netherlands. u2022 One in Switzerland. WHO advises no travel restrictions or closure of borders, but does recommend that people who are ill delay international travel. It also requests people developing symptoms following international travel seek medical attention, in line with guidance from national authorities. The U.S. Centers for Disease Control and Prevention advises U.S. travelers returning from Mexico with at least two of the 2009 N1H1 flu symptoms to stay at home and avoid public places. Symptoms of the flu can include a fever, sore throat, cough, chills, headaches and runny nose. The CDC advices that people with no symptoms can continue their normal activities, using healthy precautions like hand washing and upon return, should monitor their health for seven days. In Mexico, the suspected origin of the virus, Health Secretary Jose Angel Cordova reports new cases and suspected deaths appear to be leveling off. At this point, scientists say they believe the H1N1 Virus would need to mutate further before it would cause the mass deaths estimated by some. Further analysis at the National Institute for Medical Research in the UK to determine the virusu2019s structure, its origin, and how quickly it could spread is underway. Professor Jonathan Ball, an expert in molecular virology at the University of Nottingham said, "Many people suspected that H5N1 was the most likely candidate for the next pandemic strain, but now it appears that this was a mistake - but that's not to say H5N1 or another reassortment containing parts of H5N1 may not happen in the future. "That's the trouble - you can't predict." Yet, the general public concern about the disease remains high. In San Diego County, for instance, The Public Health Lab is inundated with a backlog of about 400 untested possible H1N1 flu. The facility can processing capacity is roughly 20 tests per day. Those interested in more scientific information about the H1N1 virus, should visit the BBCu2019s website at the following link: http://news.bbc.co.uk/2/hi/health/8028371.stm To read earlier reports, follow the link below.

Reported April 30, 2009:

Governments and health organizations around the world are ramping up efforts to prevent a “hybrid” swine flu pandemic. As of 8:45 PM, Eastern Time (USA), April 29th, the World Health Organization (WHO) was reporting on their website 148 officially reported cases of swine influenza worldwide. The H1N1 virus, is a “hybrid” flu that comprises a previously unknown combination of genetic material from swine (pig), bird and human viruses.

In the United States, the CDC reported 91 laboratory confirmed cases in 11 states, including one death, a 23-month old boy. Many people who have confirmed cases – or are under suspicion – reported recently having traveled to Mexico. Subsequently, an additional 30 cases were reported on a US Marine base in California, and additional confirmed cases in Maine and Nevada and suspected cases in Louisiana and Delaware.

Health officials have confirmed that a toddler visiting from Mexico died in a Houston, Texas hospital this past Monday. According to the Texas Department of State Health Services, the young boy had traveled with his family from Mexico City in early April to Matamoros, Mexico, then crossed the border to Brownsville in south Texas. He developed a fever on April 8, and five days later, he was admitted to a hospital in Brownville, then transferred to Texas Children’s Hospital in Houston, where he died on April 27. Dr. David E. Persse, director of emergency medical services in Houston, and other city health officials tried to calm fears of an outbreak, reporting that no other members of the boy’s family had shown symptoms of the virus.

Mexico has reported 26 confirmed human cases of infection including seven deaths, a far lower number that the 159 deaths unofficially attributed to the A/H1N1 virus and 2,498 believed to be infected there.

The A/H1N1 infection has been reported in seven other countries worldwide: – Austria (1), Canada (13), Germany (3), Israel (2), New Zealand (3), Spain (4) and the United Kingdom (5), none of which report any deaths.

Dr. Margaret Chan, of WHO elevated the Influenza Pandemic Alert from phase 4 to 5. Phase 6 indicates a pandemic is underway. In her April 29th statement, Dr. Chan said, ” All countries should immediately activate their pandemic preparedness plans. Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.

At this stage, effective and essential measures include heightened surveillance, early detection and treatment of cases, and infection control in all health facilities.

This change to a higher phase of alert is a signal to governments, to ministries of health and other ministries, to the pharmaceutical industry and the business community that certain actions should now be undertaken with increased urgency, and at an accelerated pace.”

Reported Earlier:

According to Homeland Security Secretary Janet Napolitano, the U.S. government has declared a “public health emergency” and decided to release approximately 12.5 million units – one quarter of its 50-million-unit strategic reserve – of antiviral medications to states where the outbreak has occurred. She says that U.S. public health officials have emphasized that a “nationwide public health emergency” is no reason to panic, even though it may sound serious. “That sounds more severe than it really is,” Napolitano says. “This is standard operating procedure and allows us to free up federal, state and local agencies and their resources.” And she adds that it is “a routine move to ensure that the government was prepared in an environment where we really don’t know, ultimately, what the size or seriousness of this outbreak is going to be.”

White House Press Secretary Robert Gibbs told Meet the Press on Sunday that the “swine flu was serious enough to be a great concern to this White House and to this government. President Obama is receiving frequent updates on the situation and we are taking the proper precautions to address anything that happens.” He echoed Napolitano’s words, however, saying that “it is not time to panic.”

In addition to stockpiles of antiviral drugs being prepared for rapid distribution should the transmission of the virus accelerate, the Centers for Disease Control and Prevention is preparing yellow cards to give information to travelers about swine flu, which is not easy to distinguish from seasonal flu. Many countries are calling for greater vigilance at border crossings, as well as in airports. Should the World Health Organization (WHO) decide that the outbreak warrants being elevated to the pandemic threat level, other restrictions could be involved, including travel restrictions, more active screening of travelers and quarantining those with the illness, plus closings of schools and prohibiting public gatherings. In fact, this weekend, Mexico City resembled a “ghost town,” reports the Wall Street Journal, with high-profile soccer games played before empty stadiums, religious services cancelled, and many restaurants and movie theaters closed. Officials in Poland and Venezuela have warned against traveling to the U.S. and Mexico. Other countries, including Russia and Brazil, have already started screening some incoming international air passengers for signs of high fever – and Russia, along with China, have made plans to quarantine anyone with symptoms of the virus.

Baxter International announced this weekend that it is working with the World Health Organization on a potential vaccine to stop the deadly virus. Baxter’s cell-based technology allows the company to produce vaccines more rapidly should there be a pandemic than a decades-old method using eggs – in fact, production time can be cut in half. “Upon learning about the swine flu outbreak in Mexico, Baxter requested a virus sample from WHO to do laboratory testing for potentially developing an experimental vaccine,” says company spokesman Christopher Bona.

This hybrid flu is an influenza virus that comprises a previously unknown combination of genetic material from swine (pig), bird and human viruses. Health officials do not yet know how the disease is spread, although they do know it is able to move from one human being to another through coughing, sneezing or touching infected people or surfaces, then touching one’s mouth or nose. Since symptoms appear just like the regular flu, health experts recommend that people only seek medical attention if they’re suffering from such extreme symptoms such as having trouble breathing.

According to the Washington Post, it is clear that younger adults may be the most susceptible to the disease, writing that “the question of who contracts and ultimately dies from this virus has become a matter of central concern in Mexico. And the answers that are beginning to emerge as the death toll rises have been ominous. Relatively young adults, presumably among the population’s most healthy, have been the first to succumb.”

The hybrid flu outbreak raises a host of other critical healthcare issues. According to the New York Times, the Obama Administration is alarmed at doctor shortages and is looking for ways to increase the supply of physicians. In addition, in a speech to the National Academy of Sciences, President Obama emphasized that “science is more essential than ever before” for the nation’s security, health and economy,” and pointed out that the swine flu outbreak is clear proof. In his speech, he also “announced a pledge to increase research and scientific funding to a level equal to that during the space race to the moon, amounting to three percent of the gross domestic product.”

The book Infection Protection: Pandemic — Your Personal Survival Handbook for Today’s New Infectious Disease Threats, is an excellent source of information on pandemics. For more information, click here.

 

Sources:

News Release: Mexican Toddler in U.S. Dies From Swine Flu www.nytimes.com April 29, 2009

News Release: WHO moves closer to raising flu pandemic alert www.reuters.com April 29, 2009

News Release: U.S. confirmed swine flu total rises to 91: CDC www.reuters.com April 29, 2009

News Release: Attack of the swine flu www.slate.com April 27, 2009

News Release: Swine flu prompts U.S. emergency www.latimes.com April 27, 2009

News Release: U.S. steps up alerts as more swine flu is found www.washingtonpost.com April 27, 2009

News Release: Shortage of doctors prove obstacle to Obama goals www.nytimes.com April 27, 2009

News release: Flu fears spur global triage www.online.wsj.com April 27, 2009

News Release: Swine flu shows need for science, Obama says www.boston.com April 27, 2009

News release: Questions and answers about swine flu www.washingtonpost.com April 27, 2009

News release: In Mexico, Young Adults Appear Most at Risk www.washingtonpost.com April 27, 2009

News release: Swine flu: Baxter seeks swine flu sample to begin work on vaccine www.chicagotribune.com April 27, 2009

News release: Mexican officials say swine flu virus not as lethal as once thought www.usatoday.com May 2, 2009

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