[blogforlovxr]

April 27, 2009



U.S. Declares Public Health Emergency Over Swine Flu

By DONALD G. McNEIL Jr.
Responding to what some health officials feared could be the leading edge of a global pandemic emerging from Mexico, American health officials declared a public health emergency on Sunday as 20 cases of swine flu were confirmed in this country, including eight in New York City.
Other nations imposed travel bans or made plans to quarantine air travelers as confirmed cases also appeared in Mexico and Canada and suspect cases emerged elsewhere.
Top global flu experts struggled to predict how dangerous the new A (H1N1) swine flu strain would be as it became clear that they had too little information about Mexico’s outbreak — in particular how many cases had occurred in what is thought to be a month before the outbreak was detected, and whether the virus was mutating to be more lethal, or less.
“We’re in a period in which the picture is evolving,” said Dr. Keiji Fukuda, deputy director general of the World Health Organization. “We need to know the extent to which it causes mild and serious infections.”
Without that knowledge — which is unlikely to emerge soon because only two laboratories, in Atlanta and Winnipeg, Canada, can confirm a case — his agency’s panel of experts was unwilling to raise the global pandemic alert level, even though it officially saw the outbreak as a public health emergency and opened its emergency response center.
As a news conference in Washington, Homeland Security Secretary Janet Napolitano called the emergency declaration “standard operating procedure,” and said she would rather call it a “declaration of emergency preparedness.”
“It’s like declaring one for a hurricane,” she said. “It means we can release funds and take other measures. The hurricane may not actually hit.”
American investigators said they expected more cases here, but noted that virtually all so far had been mild and urged Americans not to panic.
The speed and the scope of the world’s response showed the value of preparations made because of the avian flu and SARS scares, public health experts said.
The emergency declaration in the United States lets the government free more money for antiviral drugs and give some previously unapproved tests and drugs to children. One-quarter of the national stockpile of 50 million courses of antiflu drugs will be released.
Border patrols and airport security officers are to begin asking travelers if they have had the flu or a fever; those who appear ill will be stopped, taken aside and given masks while they arrange for medical care.
“This is moving fast and we expect to see more cases,” Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention, said at the news conference with Ms. Napolitano. “But we view this as a marathon.”
He advised Americans to wash their hands frequently, to cover coughs and sneezes and to stay home if they felt ill; but he stopped short of advice now given in Mexico to wear masks and not kiss or touch anyone. He praised decisions to close individual schools in New York and Texas but did not call for more widespread closings.
Besides the eight New York cases, officials said they had confirmed seven in California, two in Kansas, two in Texas and one in Ohio. The virus looked identical to the one in Mexico believed to have killed 103 people — including 22 people whose deaths were confirmed to be from swine flu — and sickened about 1,600. As of Sunday night, there were no swine flu deaths in the United States, and one hospitalization.
Other governments tried to contain the infection amid reports of potential new cases including in New Zealand, Hong Kong and Spain.
Dr. Fukuda of the W.H.O. said his agency would decide Tuesday whether to raise the pandemic alert level to 4. Such a move would prompt more travel bans, and the agency has been reluctant historically to take actions that hurt member nations.
Canada confirmed six cases, at opposite ends of the country: four in Nova Scotia and two in British Columbia. Canadian health officials said the victims had only mild symptoms and had either recently traveled to Mexico or been in contact with someone who had.
Other governments issued advisories urging citizens not to visit Mexico. China, Japan, Hong Kong and others set up quarantines for anyone possibly infected. Russia and other countries banned pork imports from Mexico, though people cannot get the flu from eating pork.
In the United States, the C.D.C. confirmed that eight students at St. Francis Preparatory School in Fresh Meadows, Queens, had been infected with the new swine flu. At a news conference on Sunday, Mayor Michael R. Bloomberg said that all those cases had been mild and that city hospitals had not seen a surge in severe lung infections.
On the streets of New York, people seemed relatively unconcerned, in sharp contrast to Mexico City, where soldiers handed out masks.
Hong Kong, shaped by lasting scars as an epicenter of the SARS outbreak, announced very tough measures. Officials there urged travelers to avoid Mexico and ordered the immediate detention of anyone arriving with a fever higher than 100.4 degrees Fahrenheit after traveling through any city with a confirmed case, which would include New York.
Everyone stopped will be sent to a hospital for a flu test and held until it is negative. Since Hong Kong has Asia’s busiest airport hub, the policy could severely disrupt international travel.
The central question is how many mild cases Mexico has had, Dr. Martin S. Cetron, director of global migration and quarantine for the Centers for Disease Control, said in an interview.
“We may just be looking at the tip of the iceberg, which would give you a skewed initial estimate of the case fatality rate,” he said, meaning that there might have been tens of thousands of mild infections around the 1,300 cases of serious disease and 80 or more deaths. If that is true, as the flu spreads, it would not be surprising if most cases were mild.
Even in 1918, according to the C.D.C., the virus infected at least 500 million of the world’s 1.5 billion people to kill 50 million. Many would have been saved if antiflu drugs, antibiotics and mechanical ventilators had existed.
Another hypothesis, Dr. Cetron said, is that some other factor in Mexico increased lethality, like co-infection with another microbe or an unwittingly dangerous treatment.
Flu experts would also like to know whether current flu shots give any protection because it will be months before a new vaccine can be made.
There is an H1N1 human strain in this year’s shot, and all H1N1 flus are descendants of the 1918 pandemic strain. But flus pick up many mutations, and there will be no proof of protection until the C.D.C. can test stored blood serum containing flu shot antibodies against the new virus. Those tests are under way, said an expert who sent the C.D.C. his blood samples.
Reporting was contributed by Sheryl Gay Stolberg from Washington, Jack Healy from New York, Keith Bradsher from Hong Kong and Ian Austen from Ottawa.


Copyright 2009 The New York Times Company

Understanding Swine Flu

United States officials declared a public health emergency on Sunday over increasing cases of swine flu, but urged Americans not to panic, as most of the cases have been mild. Related Article
@import url(http://graphics8.nytimes.com/package...-web/flu.css); Confirmed cases

As of Sunday, officials had confirmed 20 cases of a new A(H1N1) swine flu virus in the United States, including eight New York City high school students. Six cases were identified in Canada — all linked to travel in Mexico. While only a handful of swine flu cases in Mexico have been confirmed, officials say there are at least 1,400 suspected infections and at least 86 suspected deaths.

Swine flu and humans

Swine flu viruses can be passed between pigs and humans, but human infections are not common. Most infections occur among people with direct pig contact. Sometimes a flu virus can mutate to be more transmissible to humans. An outbreak occurred among soldiers in Fort Dix, N.J., in 1976, resulting in 200 infections, several serious illnesses and one death.
Human symptoms All flus are passed by coughs and sneezes. Symptoms can included fever, fatigue, coughing, vomiting and diarrhea. Seasonal flus typically kill the old and young. New flus like this one can kill healthy people whose own immune reactions overwhelm them.

Vaccine and treatments Officials do not know if the seasonal flu vaccine will protect against the A(H1N1) swine flu virus. In the laboratory, the antiviral drugs Tamiflu and Relenza are effective against this new flu; amantadine and rimantadine are not.

Swine flu versus avian flu The avian flu, A(H5N1), is found among birds and humans and is highly lethal but not very transmissible. Scientists believe this new flu is more transmissible but less lethal.


Precautions

The Centers for Disease Control and Prevention recommends washing hands frequently, avoiding touching the face, covering the nose and mouth when sneezing and staying home when sick. People cannot be infected by eating pork.


Copyright 2009 The New York Times Company

[BashBeissedat]

I wonder if Donald Rumsfeld has an investment in a Swine Flu vaccine (as he did with Tamiflu, the heavily promoted Bird Flu [hoax?] vaccine).

[TornadoPD]

Hoax?

[RuttyUttepe]

1400 in mexico? How did this jump from 100 or less in other news agencies?

[Thydaysuh]

It's a good way to deal with the Mexico Drug problem. Now there is a good excuse for an international initiative to stop every Mexican for questioning and grab them off the street under the guise of "quarantine"

Footnote: Texas, where 37% of the population support secession and it governor who called for secession have asked for Federal Aid to deal with this.

[crazuMovies]

Adios, Texas.

What do we really need it for anyway?

[prkddfokic]

Off topic for a moment: Texas governor is ignorant of the law. Texas has no different path to secession than any other state.

What is different is that the 1845 resolution to annex Texas stipulated that it could divide into 5 separate states, free or slave in accordance with the 1820 Missouri Compromise. It's all here.

[myspacepro]

Adios, Texas.

What do we really need it for anyway?

Cultural repository for big hair.

[Jesslovers]

One thing we have to keep in mind with all of this.

IT IS THE FLU!

This is not Malaria, or smallpox, or Polio.

It is a debilitating disease that makes you feel like hell for a week or two that could hurt small kids and elders, but aside from that, all the media panic being spread about this is quite irritating.

They name it "swine flu" because of its origins, but somehow calling it that makes it sound worse, more foreign. Hell, it even makes you think about AIDS (and the "rumor" that it was originally present in monkeys...).

The key here is to stay healthy, keep good care of yourself, and try not to lick toilet bowls.

Seriously though, this is an unnecessary national emergency, and Texas should be told to STFU.

[K0aM7urg]

Yeah it was 'just' the flu for at least 20, young healthy, people in Mexico.

[DaleJrGirl]

IT IS THE FLU!

This is not Malaria, or smallpox, or Polio.

That's the common [and dangerous] perception.

Read about the 1918 -1920 Spanish Flu pandemic. It killed so many people so quickly that no one knows even an approximate number. So the estimates are 50 to 100 million dead.

All of today's flu virus strains are descendant of the virulent 1918 virus. All it would take is a mutation for a similar pandemic.

[mralabama]

If memory serves me correctly, pneumonia is the #1 worldwide killer of humans.

[Ygd2qr8k]

That's the common [and dangerous] perception.

Read about the 1918 -1920 Spanish Flu pandemic. It killed so many people so quickly that no one knows even an approximate number. So the estimates are 50 to 100 million dead.

Apply that to who got it and the state of the medical system at the time.

Were these deaths the direct result of the flu, or from bacteriological infections of the lungs due to pneumonic reaction from the flu?

All of today's flu virus strains are descendant of the virulent 1918 virus. All it would take is a mutation for a similar pandemic. Again, you have to look and see where this is coming from. You want to Panic? Go on ahead. I hear they are selling Theraflu at the local market. Pick up as many packages as you can! You never know what may come next!!!!


The lesson is simple. Take care of yourself. Don't be afraid to go to the doctor. What I have been hearing from doctors and others in the profession is that this callout is just a warning, not an actual threat as of yet, and that the arial strain of this virus seems substantially less strong than the one aquired through direct contact. (That was just a line I heard on the news this morning while getting ready...).

Alonzo, do you have any more info on the 20 that died? What was the ratio? What socioeconomic group were they in? How old were they? It is always horrible when people die, but when an 80 year old dies from the flu, you do not set the entire population to panic.

[CymnMaync]

If memory serves me correctly, pneumonia is the #1 worldwide killer of humans.

Pneumonia is different than the flu.

I will have to check and see if it is a disease or rather a symptom OF a disease. I THINK it might be the bacteriological infection of the lungs due to abnormal levels of fluid in them.

Basically your lungs are drowning themselves.....but this is not directly related to the flu. It can happen in many different ways....

[Jffxljtw]

Apply that to who got it and the state of the medical system at the time.

Were these deaths the direct result of the flu, or from bacteriological infections of the lungs due to pneumonic reaction from the flu?

You obviously didn't take my suggestion to do any research on the subject.

The last pandemic in 1968-1970 killed one million worldwide, and 34,000 in the US.

Despite the state of the medical system, there is no cure for another viral strain that causes the common cold, despite decades of opportunity to study it and find one. That's it's not deadly is just a matter of luck.

The 1918 outbreak was the first significant worldwide occurrence because troop movement in WWII and the increased popularity of steamship travel provided an opportunity for transmission and mutation. Compare that to the state of worldwide travel today.

The lesson is simple. Take care of yourself. Cytokine storm. See "Role in Pandemic Death."

Again, you have to look and see where this is coming from. You want to Panic? Go on ahead. I hear they are selling Theraflu at the local market. Pick up as many packages as you can! You never know what may come next!!!! The only panic in this thread is your posting. Is this going to go the route of the Smoking thread?

Virologists have been stating for years that another major pandemic is just a matter of statistics. The only defense is to treat any early suspicious cases with extreme seriousness, because after a few weeks, it would be too late. For the two extremes, panic is more beneficial than burying your head in the sand.

[SeftyJokipl]

One thing we have to keep in mind with all of this.
IT IS THE FLU!

This is not Malaria, or smallpox, or Polio.

You're exactly right. This isn't some slowly spreading disease. This is much worse. This is a disease that spreads quickly, and every few generations mutates into a form that instead of killing infants and the elderly by overwhelming their immune system, instead kills HEALTHY adults by triggering an overreaction of the immune system.

Will it end civilization? No. Does it have a 99.9% mortality rate like (untreated) HIV? No. But I'm personally frightened by the idea of a disease that in 1918 infected 1/4 the US, and killed 2.5% of all adults. Lets see - 2.5% of NYC is ~250,000 people. See a lot of spare hospital beds? Ventilators? I'm not curious to see how our medical system, which has baked out all of its spare capacity in the name of "efficiency" will do in a crisis.

[Junrlaeh]

Alonzo, do you have any more info on the 20 that died? What was the ratio? What socioeconomic group were they in? How old were they? It is always horrible when people die, but when an 80 year old dies from the flu, you do not set the entire population to panic.

young healthy

As far as I know the majority were young and healthy. While I get your point that that alone isnt cause for global panic your indifference to the possible risks show you dont understand the potential of a pandemic.

[dr-eavealer]

The last pandemic in 1968-1970 killed one million worldwide, and 34,000 in the US Zip, that is bad, but questions on that:

1. How many did not die?
2. How many were under the age of 3 or over the age of 60?
3. How many were in rural, or medically unprepared/underserviced areas?

I guess I should look into it too, but the point I am making is simple, panic is an easy thing to foster over something that may not warrant it.

[IRYzouNv]

As far as I know the majority were young and healthy. While I get your point that that alone isnt cause for global panic your indifference to the possible risks show you dont understand the potential of a pandemic.

Please don't patronize me Alonzo.

Panic and misinformation can cause more problems than any particular disease. Crying "wolf" about something is going to do very little good. Are you staying home? Are you going out in a mask, goggles and rubber gloves for the next 3 months?

Because if this is truly as you are saying it, and how all of you seem to be saying it is, then that's what you all should be doing.

But whatever. I am sure Roche isn't worried.

[Clielldub]

Normally, I wouldnt think much of outbreaks but once they start putting up pictures of entire hemispheres and track # of incident the situation starts to become a little bit on the eerie side. With all the world-wide traveling within hours and cross-contamination of people from Ancorage to Patagonia, San Francisco to Saigon a potent/contageous enough bug can and will spread in a matter of weeks, if not days.

By the time we realize what is going on by finding enough infections that a disease trend is noticed; then afterwards performing characterization of a microbial culprit [which is not a little stupid 2 minute blue-red litmus tests like TV programs and movies like to project ;it could take weeks for this step to happen] things could get very serious

Being proactive is the only way to go IMO.