WHO raises global alert level on swine flu

This is one of the latest update from the World Health Organisation (WHO) about the swine flu. The pandemic phase has been raised from a level 3 to a level 4

"MEXICO CITY (AP) -- The swine flu epidemic entered a dangerous new phase Monday as the death toll climbed in Mexico and the number of suspected cases there and in the United States nearly doubled. The World Health Organization raised its alert level but stopped short of declaring a global emergency.

The United States advised Americans against most travel to Mexico and ordered stepped up border checks in neighboring states. The European Union health commissioner advised Europeans to avoid nonessential travel both to Mexico and parts of the United States.

The virus poses a potentially grave new threat to the U.S. economy, which was showing tentative early signs of a recovery. A widespread outbreak could batter tourism, food and transportation industries, deepening the recession in the U.S. and possibly worldwide.

The suspected number of deaths rose to 152 in Mexico, the epicenter of the outbreak with nearly 2,000 people believed to be infected.

The number of U.S. cases rose to 50, the result of further testing at a New York City school, although none was fatal. Other U.S. cases have been reported in Ohio, Kansas, Texas and California. Worldwide there were 79 confirmed cases, including six in Canada, one in Spain and two in Scotland.

The World Health Organization reported a slightly lower figure, 73. The WHO said it was still awaiting official reports from the U.K. about the Scottish cases, and it was reporting different numbers in the U.S. (40) and Mexico (26) from what those governments confirmed.

While the total cases were still measured in hundreds, not thousands, Mexican Health Secretary Jose Angel Cordova said the epidemic was entering an extremely dangerous phase, with the number of people infected mushrooming even as authorities desperately ramped up defenses.

"We are in the most critical moment of the epidemic. The number of cases will keep rising, so we have to reinforce preventative measures," Cordova said at a news conference.

The WHO raised the alert level to Phase 4, meaning there is sustained human-to-human transmission of the virus causing outbreaks in at least one country.

Its alert system was revised after bird flu in Asia began to spread in 2004, and Monday was the first time it was raised above Phase 3.

"At this time, containment is not a feasible option," as the virus has already spread to several other countries, said WHO Assistant Director-General Keiji Fukuda.

Putting an alert at Phases 4 or 5 signals that the virus is becoming increasingly adept at spreading among humans. That move could lead governments to set trade, travel and other restrictions aimed at limiting its spread.

Phase 6 is for a full-blown pandemic, characterized by outbreaks in at least two regions of the world.

It could take 4-6 months before the first batch of vaccines are available to fight the virus, WHO officials said.

Russia, Hong Kong and Taiwan said they would quarantine visitors showing symptoms of the virus amid global fears of a pandemic, an epidemic spread over a large area, either a region or worldwide.

President Barack Obama said the outbreak was reason for concern, but not yet "a cause for alarm."

Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention, said that so far the virus in the United States seems less severe than in Mexico. Only one person has been hospitalized in the U.S.

"I wouldn't be overly reassured by that," Besser told reporters at CDC headquarters in Atlanta, raising the possibility of more severe cases in the United States.

"We are taking it seriously and acting aggressively," Besser said. "Until the outbreak has progressed, you really don't know what it's going to do."

U.S. customs officials began checking people entering U.S. territory. Millions of doses of flu-fighting medications from a federal stockpile were on their way to states, with priority given to the five already affected and to border states. Federal agencies were conferring with state and international governments.

"We want to make sure that we have equipment where it needs to be, people where they need to be and, most important, information shared at all levels," said Janet Napolitano, head of the Homeland Security Department.

"We are proceeding as if we are preparatory to a full pandemic," Napolitano said.
She said travel warnings for trips to Mexico would remain in place as long as swine flu is detected.

Mexico canceled school at all levels nationwide until May 6, and the Mexico City government said it was considering a complete shutdown, including all public transportation, if the death toll keeps rising. Labor Secretary Javier Lozano Alarcon said employers should isolate anyone showing up for work with fever, cough, sore throat or other signs of the flu.

Even some of Mexico's most treasured national holidays were affected by the swine flu alert.
Authorities announced Monday the cancellation of the annual Cinco de Mayo parade, in which people in period costumes celebrate Mexican troops' defeat of a French army on May 5, 1862. The national labor umbrella group announced the cancellation of Mexico City's traditional May 1 parade and the National Institute of Anthropology and History said all of its 116 museums nationwide would be closed until further notice.

Amid the warnings, the Mexican government grappled with increasing criticism of its response. At least two weeks after the first swine flu case, the government has yet to say where and how the outbreak began or give details on the victims.

The health department lacked the staff to visit the homes of all those suspected to have died from the disease, Cordova said.

Cordova said 1,995 people have been hospitalized with serious cases of pneumonia since the first case of swine flu was reported April 13. The government does not yet know how many were swine flu.

He said tests show a 4-year-old boy contracted the virus before April 2 in Veracruz state, where a community has been protesting pollution from a large pig farm.

The farm is run by Granjas Carroll de Mexico, a joint venture half owned by Virginia-based Smithfield Foods, Inc. Spokeswoman Keira Ullrich said the company has found no clinical signs or symptoms of the presence of swine flu in its herd or its employees working anywhere in Mexico.

Mexico's Agriculture Department said Monday that its inspectors found no sign of swine flu among pigs around the farm in Veracruz, and that no infected pigs have been found yet anywhere in Mexico.

As if the country did not have enough to deal with, Cordova's comments were briefly interrupted by a 5.6-magnitude earthquake in southern Mexico that rattled already jittery nerves and sent mask-wearing office workers into the streets of the capital.

Aside from the confirmed cases, 13 are suspected in New Zealand, and one is suspected in both France and Israel.

European Union Health Commissioner Androulla Vassiliou advised Europeans to avoid nonessential travel to Mexico and parts of the United States, although Besser said that including the U.S. in the advisory seemed unwarranted at this time.

State Department spokesman Robert A. Wood said Vassiliou's remarks were his "personal opinion," not an official EU position, and therefore the department had no comment.

"We don't want people to panic at this point," Wood said.

The U.S. stepped up checks of people entering the country by air, land and sea, and the State Department warned U.S. citizens to avoid nonessential travel to Mexico. It said those who live in Mexico should avoid hospitals or clinics there unless they have a medical emergency.

The best way to keep the disease from spreading, Besser said, is by taking everyday precautions such as frequent handwashing, covering up coughs and sneezes, and staying away from work or school if not feeling well. He said authorities are not recommending that people wear masks at work because evidence that it is effective "is not that strong."

Besser said about 11 million doses of flu-fighting drugs from a federal stockpile have been sent to states in case they are needed. That's roughly one quarter of the doses in the stockpile, he said.

There is no vaccine available to prevent the specific strain now being seen, he said, but some antiflu drugs do work once someone is sick.

If a new vaccine eventually is ordered, the CDC already has taken a key preliminary step - creating what's called seed stock of the virus that manufacturers would use.

Many of the cases outside Mexico have been relatively mild. Symptoms include a fever of more than 100, coughing, joint aches, severe headache and, in some cases, vomiting and diarrhea.

European and U.S. markets bounced back from early losses as pharmaceutical stocks were lifted by expectations that health authorities will increase stockpiles of anti-viral drugs. Stocks of airlines, hotels and other travel-related companies posted sharper losses.

WHO spokesman Peter Cordingley singled out air travel as an easy way the virus could spread, noting that the WHO estimates that up to 500,000 people are on planes at any time.

Governments in Asia - with potent memories of previous flu outbreaks - were especially cautious. Singapore, Thailand, Japan, Indonesia and the Philippines dusted off thermal scanners used in the 2003 SARS crisis and were checking for signs of fever among passengers from North America. South Korea, India and Indonesia also announced screening.

In Malaysia, health workers in face masks took the temperatures of passengers as they arrived on a flight from Los Angeles.

China said anyone experiencing flu-like symptoms within two weeks of arrival had to report to authorities.

China, Russia and Ukraine were among countries banning imports of pork and pork products from Mexico and three U.S. states that have reported swine flu cases, while other countries, such as Indonesia, banned all pork imports.

The CDC says people cannot get the flu by eating pork or pork products.

Germany's leading vacation tour operators were skipping stops in Mexico City as a precaution. The Hannover-based TUI said trips through May 4 to Mexico City were being suspended, including those operated by TUI itself and through companies 1-2 Fly, Airtours, Berge & Meer, Grebeco and L'tur.

Japan's largest tour agency, JTB Corp., suspended tours to Mexico through June 30. Russian travel agencies said about a third of those planning to travel to Mexico in early May had already canceled.

By E. EDUARDO CASTILLO and PAUL HAVEN Associated Press Writers"

I guess what everyone can do now is to protect yourselves by improving and maintaining a good personal hygiene and to take care of your own health and the health of your loved ones around you. If you are sick, seek medical attention immediately and always always cover your mouth when you cough or sneeze.

The virus spreads easily via respiratory droplets from a cough/sneeze, and once another person breathes them in, he/she may catch this virus. Not only that, this new virus is contagious a day before clinical symptoms appear and 7 days after the first onset of symptoms, this is different from SARS of which a person becomes contagious a few days after the onset of symptoms. So for this new virus, the person could already be infectious before symptoms appear, and it makes the virus even more dangerous to detect.

Please protect yourselves and everyone around you, and help to prevent a possible pandemic.

The best way to keep the disease from spreading, Besser said, is by taking everyday precautions such as frequent handwashing, covering up coughs and sneezes, and staying away from work or school if not feeling well. He said authorities are not recommending that people wear masks at work because evidence that it is effective "is not that strong."

Mexico swine flu deaths spur global epidemic fears

I'm sure many of you are now aware of the swine flu outbreak that started in mexico:

"MEXICO CITY – A unique strain of swine flu is the suspected killer of dozens of people in Mexico, where authorities closed schools, museums, libraries and theaters in the capital on Friday to try to contain an outbreak that has spurred concerns of a global flu epidemic.

The worrisome new virus — which combines genetic material from pigs, birds and humans in a way researchers have not seen before — also sickened at least eight people in Texas and California, though there have been no deaths in the U.S.

"We are very, very concerned," World Health Organization spokesman Thomas Abraham said. "We have what appears to be a novel virus and it has spread from human to human ... It's all hands on deck at the moment."

The outbreak caused alarm in Mexico, where more than 1,000 people have been sickened. Residents of the capital donned surgical masks and authorities ordered the most sweeping shutdown of public gathering places in a quarter century. President Felipe Calderon met with his Cabinet Friday to coordinate Mexico's response.

The WHO was convening an expert panel to consider whether to raise the pandemic alert level or issue travel advisories.

It might already be too late to contain the outbreak, a prominent U.S. pandemic flu expert said late Friday.

Given how quickly flu can spread around the globe, if these are the first signs of a pandemic, then there are probably cases incubating around the world already, said Dr. Michael Osterholm at the University of Minnesota.

In Mexico City, "literally hundreds and thousands of travelers come in and out every day," Osterholm said. "You'd have to believe there's been more unrecognized transmission that's occurred."

There is no vaccine that specifically protects against swine flu, and it was unclear how much protection current human flu vaccines might offer. A "seed stock" genetically matched to the new swine flu virus has been created by the U.S. Centers for Disease Control, said Dr. Richard Besser, the agency's acting director. If the government decides vaccine production is necessary, manufacturers would need that stock to get started.

Authorities in Mexico urged people to avoid hospitals unless they had a medical emergency, since hospitals are centers of infection. They also said Mexicans should refrain from customary greetings such as shaking hands or kissing cheeks. At Mexico City's international airport, passengers were questioned to try to prevent anyone with flu symptoms from boarding airplanes and spreading the disease.

Epidemiologists are particularly concerned because the only fatalities so far were in young people and adults.

The eight U.S. victims recovered from symptoms that were like those of the regular flu, mostly fever, cough and sore throat, though some also experienced vomiting and diarrhea.
U.S. health officials announced an outbreak notice to travelers, urging caution and frequent handwashing, but stopping short of telling Americans to avoid Mexico.

Mexico's Health Secretary Jose Angel Cordoba said 68 people have died of flu and the new swine flu strain had been confirmed in 20 of those deaths. At least 1,004 people nationwide were sick from the suspected flu, he said.

The geographical spread of the outbreaks also concerned the WHO — while 13 of the 20 deaths were in Mexico City, the rest were spread across Mexico — four in central San Luis Potosi, two up near the U.S. border in Baja California, and one in southern Oaxaca state.

Scientists have long been concerned that a new flu virus could launch a worldwide pandemic of a killer disease. A new virus could evolve when different flu viruses infect a pig, a person or a bird, mingling their genetic material. The resulting hybrid could spread quickly because people would have no natural defenses against it.

Still, flu experts were concerned but not alarmed about the latest outbreak.

"We've seen swine influenza in humans over the past several years, and in most cases, it's come from direct pig contact. This seems to be different," said Dr. Arnold Monto, a flu expert with the University of Michigan.

"I think we need to be careful and not apprehensive, but certainly paying attention to new developments as they proceed."

The CDC says two flu drugs, Tamiflu and Relenza, seem effective against the new strain. Roche, the maker of Tamiflu, said the company is prepared to immediately deploy a stockpile of the drug if requested.

Both drugs must be taken early, within a few days of the onset of symptoms, to be most effective.

Cordoba said Mexico has enough Tamiflu to treat 1 million people, but the medicine will be strictly controlled and handed out only by doctors.

Mexico's government had maintained until late Thursday that there was nothing unusual about the flu cases, although this year's flu season had been worse and longer than past years.
The sudden turnaround by public health officials angered many Mexicans.

"They could have stopped it in time," said Araceli Cruz, 24, a university student who emerged from the subway wearing a surgical mask. "Now they've let it spread to other people."

The city was handing out free surgical masks to passengers on buses and the subway system, which carries 5 million people each day. Government workers were ordered to wear the masks, and authorities urged residents to stay home from work if they felt ill.

Closing schools across Mexico's capital of 20 million kept 6.1 million students home, as well as thousands of university students. All state and city-run cultural activities were suspended, including libraries, state-run theaters, and at least 14 museums. Private athletic clubs closed down and soccer leagues were considering canceling weekend games.

The closures were the first citywide shutdown of public gathering places since millions died in the devastating 1985 earthquake.

Mexico's response brought to mind other major outbreaks, such as when SARS hit Asia. At its peak in 2003, Beijing shuttered schools, cinemas and restaurants, and thousands of people were quarantined at home.

In March 2008, Hong Kong ordered more than a half-million students to stay home for two weeks because of a flu outbreak. It was the first such closure in Hong Kong since the outbreak of SARS, or severe acute respiratory syndrome.

"It's great they are taking precautions," said Lillian Molina, a teacher at the Montessori's World preschool in Mexico City, who scrubbed down empty classrooms with Clorox, soap and Lysol between fielding calls from worried parents.

U.S. health officials said the outbreak is not yet a reason for alarm in the United States. The five people sickened in California and three in Texas have all recovered.

It's unclear how the eight, who became ill between late March and mid-April, contracted the virus because none were in contact with pigs, which is how people usually catch swine flu. And only a few were in contact with each other.

CDC officials described the virus as having a unique combination of gene segments not seen before in people or pigs. The bug contains human virus, avian virus from North America and pig viruses from North America, Europe and Asia. It may be completely new, or it may have been around for a while and was only detected now through improved testing and surveillance, CDC officials said.

The most notorious flu pandemic is thought to have killed at least 40 million people worldwide in 1918-19. Two other, less deadly flu pandemics struck in 1957 and 1968.
____
Associated Press Writers Maria Cheng in London; Traci Carl in Mexico City; Mike Stobbe in Atlanta, Georgia; and Malcolm Ritter in New York contributed to this report. "

I started worrying when I first heard of this news on the bus on my way home, when it just started. Today, the news reported that in a high school in New York City more than 100 students began suffering a fever, sore throat and aches and pains and some of their relatives have also fallen ill. Some of the students had recently traveled to Mexico but they are still awaiting test results to confirm if the strain matches the same strain that killed people in Mexico. However, preliminary tests of samples taken from sick students' noses and throats confirmed that at least eight had a non-human strain of influenza type A, indicating probable cases of swine flu, city health officials reported.

As mentioned in the report above, a prominent U.S. pandemic flu expert said that it might already be too late to contain the outbreak. I agree with this since the virus may have an incubating period or may be found in asymptomatic people who carry the virus but do not display symptoms and are already spreading it around unknowingly. As of now, the virus is a new combination strain and researchers are still figuring out its mechanism. It has, however, already been confirmed that it is spread via the same way as SARS do, by respiratory droplets through coughing or sneezing.

Anyway I'll be watching news of this new virus as closely as I can. I really hope it won't spark a new global pandemic.

Just when all of us thought the avian flu might be a cause of a global pandemic, now a combination of swine, avian and human strains may cause us to relive the 1918 global nightmare.
At least with our experience with SARS, we should be better prepared to handle another pandemic if it comes as long as we do not get too complacent with ourselves at the same time.

Given how quickly flu can spread around the globe, if these are the first signs of a pandemic, then there are probably cases incubating around the world already, said Dr. Michael Osterholm at the University of Minnesota.