Thursday, May 7, 2009

Swine Flu Cases Widen Reach With ‘Epidemic Curve’

Swine flu may spread to at least one- third of the world’s population within the next year and a full- fledged pandemic remains possible, the World Health Organization said.

In two weeks, the flu jumped from isolated reports in the U.S. and Mexico to a widening circle of infections in Central America, South America, Europe, the Middle East, Asia and New Zealand. The disease has been confirmed in 2,371 people in 24 countries, with 44 deaths, the WHO reported today.

A panel of the Geneva-based agency will meet May 14 to decide whether drugmakers should begin producing hundreds of millions of doses of a vaccine against the new illness, a form of H1N1 influenza. Keiji Fukuda, the WHO’s assistant director- general of health, security and environment, said in a video broadcast from Geneva to Asian ministers in Bangkok today that more of the world’s 6 billion people will fall ill.

“Even if the illnesses appear relatively mild at the individual level, the global population level adds up to enormous numbers,” Fukuda said.

Fukuda declined to say how many deaths there might be in a full pandemic.

In the U.S., an outbreak in Illinois led to a jump in the number of confirmed cases to at least 896, the U.S. Centers for Disease Control and Prevention said today on its Web site. The cases include two U.S. deaths and may represent a fraction of those infected, officials said.

Not ‘Petering Out’

Illinois cases totaled 204, the agency said. Most of the surge is attributable to the state’s new testing capability, Illinois officials said. Before this week, only the CDC lab in Atlanta could definitively identify U.S. cases of swine flu. Test kits were delivered May 5 to laboratories in all 50 states.

“As we look at the data so far, we’re not seeing any sign that this is petering out,” Richard Besser, the acting director of the CDC, said today on a conference call. “We’re still in the upswing of what we call the epidemic curve. We see ongoing transmission and we expect that to continue.”

Hong Kong, which confirmed its first case of swine flu on May 1, and China are today releasing some people who were isolated after they were found to be on the same flight as an infected patient.

A 58-year-old Polish woman, that country’s first confirmed swine flu case, is recovering and the passengers on her May 2 flight from New York to Warsaw are being monitored for symptoms, Pawel Wierdak, a spokesman for the Polish mission to the United Nations in New York, said yesterday in an interview.

World Impact

Disease trackers are monitoring 88 cases in Spain and 34 in the U.K. to determine whether the virus has established itself outside North America. Such a finding would prompt the WHO to declare a pandemic, the first since 1968, the agency said.

The WHO panel next week will determine whether to go ahead with production of a swine flu shot and may later ask companies to stop making seasonal flu vaccines in order to free manufacturing capacity, said Marie-Paule Kieny, director of WHO’s initiative on vaccine research, at a news conference in Geneva yesterday.

“We are very early in the epidemic,” Kieny said. “We have recommended for all manufacturers to put everything into place to be able to start manufacturing the vaccines.”

Younger Patients

Data so far suggest that the virus affects youth more than seasonal influenza, and that younger patients are entering hospitals, Besser said yesterday. Few with swine flu are older than 60, and the median age is 16. It’s possible that older people have greater immunity or that younger people spread the disease on spring break vacation trips to Mexico, he said.

The CDC reversed U.S. school-closure recommendations that shut 468,000 students out of classes this week, saying schools should reopen and sick children should stay home. About 103,000 students returned to school yesterday, and it will take several days for most schools to reopen, the U.S. Education Department said.

The virus is milder than originally thought and has already rooted itself in communities across the country, making containment impossible, Besser said, explaining the school policy reversal. Even if symptoms remain mild, the ease with which the new virus spreads makes it a threat, he said.

The three main seasonal flu strains -- H3N2, another form of H1N1, and type B -- cause 250,000 to 500,000 deaths a year globally, according to the WHO. The new flu’s symptoms are similar: aches, coughing and fever.

Mexico City

Mexico City’s government planned to reduce its emergency alert level for swine flu today to “yellow,” or medium alert, from “orange,” or elevated warning, said Carolina Pavon, a spokeswoman for the city. The change could allow businesses such as bars, gymnasiums and theaters to reopen under the city’s sanitary guidelines.

Hong Kong has isolated 386 people under a seven-day quarantine imposed after they had contact with a 25-year-old man who flew in from Mexico by way of Shanghai and was tested positive for swine flu. The city released 28 people with no swine flu-like symptoms from the Lady MacLehose Holiday Village, Thomas Tsang, controller at Hong Kong’s Centre for Health Protection, said today.

China started allowing about 110 passengers on the same flight as the Mexican man to leave their hotels today after holding them under quarantine for seven days, the official Xinhua News Agency said, citing some of the people.

South Korea today confirmed its third case of swine flu.

Affected Countries

In addition to the U.S. and Mexico, swine flu has been confirmed in Austria, Canada, Colombia, Costa Rica, Denmark, El Salvador, France, Germany, Guatemala, Hong Kong, Ireland, Israel, Italy, the Netherlands, New Zealand, Poland, Portugal, South Korea, Spain, Sweden, Switzerland and the U.K.

The virulence of the swine flu may reveal itself when the Southern Hemisphere faces its influenza season beginning this month through September, Besser said. Scientists will watch the virus to see whether it becomes the dominant flu strain or mutates into a deadlier illness.

WHO determined that a swine flu shot would have to be made in separate plants from the seasonal flu version. The swine flu vaccine may also require a follow-up booster shot to be effective because it is an entirely new strain, Kieny said. The single-shot seasonal flu vaccine itself acts as a booster, reinforcing natural antibodies from previous flu exposures, health authorities said.

Vaccine Makers

Sanofi-Aventis SA of Paris, Baxter International Inc. of Deerfield, Illinois, and GlaxoSmithKline Plc of London are talking with world health authorities about producing shots, the agency said.

Baxter received a sample of the virus from the WHO and is taking steps to produce a vaccine, Chris Bona, a company spokesman, said today in an interview.

The U.S. Food and Drug Administration yesterday licensed Sanofi’s new vaccine plant in Swiftwater, Pennsylvania, the agency and the company said in separate statements. Sanofi said the new plant can produce 100 million doses of seasonal flu vaccine when it is operating at full capacity and the company’s Sanofi-Pasteur unit can produce another 50 million doses at its older Swiftwater facility.

Authorities advised hand washing, hygiene and staying home if sick as the most effective ways to control the outbreak. The WHO and CDC said closing borders or killing animals are costly steps that wouldn’t slow the spread of flu.