Friday, May 1, 2009

Swine Flu Widens; Symptoms No Worse Than Seasonal Bug

Swine flu reached 14 countries and there’s evidence the new virus is spreading in five nations among people unconnected to Mexico. The symptoms may be no more severe than seasonal flu, health officials said.

In little more than a week, world health authorities have tracked the emergence of swine flu, formally known as H1N1, from a few cases in Texas and California to the brink of the first influenza pandemic since 1968. Thousands of cases were suspected. At least 433 U.S. schools closed yesterday, a hotel was quarantined in Hong Kong and Continental Airlines Inc. cut seating capacity on flights to Mexico in half.

The U.K., U.S., Germany, Canada and Spain each confirmed cases in people who didn’t travel to Mexico, where the virus has struck hardest. The expanding wave of sickness has been similar to seasonal flu, though health authorities are taking no chances with a virus that may flash across the globe, infecting a population with no natural immunity, said the U.S. Centers for Disease Control and Prevention.

“Even though we might be seeing only mild cases now, we cannot say what will happen in the future,” Gregory Hartl, a spokesman for the World Health Organization, told reporters yesterday. “If at the end of the day it remains a mild pandemic or if we can somehow avert the worst of the disease or stop the worst of the disease, then that’s fantastic. We will have done our job well.”

Ten Deaths

Hong Kong, France and Denmark confirmed their first cases yesterday. Hong Kong, part of China, declared a public-health emergency. Geneva-based WHO raised its six-tier pandemic alert to 5 on April 29 and may move soon to the highest level. Stage 6 would signal a pandemic and alert governments to enact plans against the disease.

The virus is already at pandemic level, according to Ira Longini, a researcher at the University of Washington in Seattle who advises the U.S. government on flu.

“The definition of a pandemic is that the new virus has spread to several countries and is transmissible,” Longini said in an interview yesterday. “It’s hard to imagine it’s not going to continue to spread in some form.”

Laboratory tests verified that at least 365 people in North America, Europe, Asia and New Zealand had the illness, with 10 deaths, according to WHO’s Web site. New York officials said they suspect more than 1,000 cases, so many that the government has stopped testing all but the sickest there.

Guests Confined

In Hong Kong, a 25-year-old Mexican man flew into the city yesterday from Shanghai after originally departing from Mexico. The man was prescribed Tamiflu and quarantined. The hotel where he was staying was cordoned off by police, confining guests and staff. Hong Kong was the center of an outbreak of severe acute respiratory syndrome, or SARS, in 2003 that killed 299 there and 774 worldwide.

“We need to prepare for the long-term,” President Barack Obama said yesterday in Washington. “Even if it turns out that the H1N1 is relatively mild on the front end, it could come back in a more virulent form during the actual flu season.”

Evidence suggests “transmission is widespread, and that less severe illness is common,” the Atlanta-based CDC said in a report yesterday. In Mexico, where WHO said nine of the world’s 10 confirmed deaths from the virus occurred, “a large number of undetected cases of illness might exist in persons seeking care in primary-care settings or not seeking care at all,” the CDC report said.

New York Tests

New York health officials will test for swine flu only in patients with a severe illness or if there’s a cluster of cases, Health Commissioner Thomas Frieden said at a news conference yesterday. All of New York’s 49 confirmed cases and the more than 1,000 suspected have had symptoms similar to those of seasonal flu, he said.

In the U.S., at least 433 schools closed yesterday in 17 states, leaving parents to find other arrangements for 245,449 students, according to the Education Department. Five colleges closed, the department said in an e-mail.

The CDC raised its flu count to 141 cases in 19 states, including the only U.S. fatality, a 22-month-old child who died April 27 at a Houston hospital.

Pigs, People, Birds

The new influenza strain, a conglomeration of genes from swine, bird and human viruses, poses the biggest threat of a flu pandemic since 2003, when the H5N1 strain killed millions of birds and hundreds of people, William Schaffner, an influenza expert at Vanderbilt University School of Medicine in Nashville, Tennessee, said in an interview yesterday.

“In Nashville, we are getting the sense that out in our community there is a lot of relatively mild influenza illness among children and increasing among their parents -- much of this is suspected to be H1N1,” Schaffner said. “By now our usual influenza season is over by weeks, but that’s clearly not the case.”

The 2003 avian flu killed more than half of the people who got it. It didn’t spread from person to person and only infected 421 people. The Spanish flu of 1918, another version of bird flu, killed as many as 50 million people in one of history’s deadliest outbreaks.

Evolving Viruses

“There are some genetic tests that have shown the virus we’re dealing with right now does not have the factors that we think made the 1918 virus so bad,” said Julie Gerberding, former head of the CDC, in an interview yesterday on ABC News. “But we have to be careful not to over-rely on that information, because these flu viruses always evolve.”

Batches of seed virus are being developed for potential vaccine production, according to WHO. Paris-based Sanofi-Aventis SA, Baxter International Inc. of Deerfield, Illinois, and GlaxoSmithKline Plc of London are talking with world health authorities about producing shots, the agency said.

“It seems most likely that the manufacturers will proceed and we will certainly support them,” Marie-Paule Kieny, WHO’s vaccine director, told reporters in Geneva.

Production of vaccines against the new H1N1 influenza will be completed “in parallel with or after the seasonal vaccine is produced,” Nancy Cox, chief of the flu division at the CDC’s Center for Immunization and Respiratory Disease, at a news conference today in Atlanta.

Jose Cordova, the health minister in Mexico, said yesterday number of H1N1 flu cases confirmed by laboratory tests climbed to 381 and the death toll rose to 16. Deaths will probably continue, he said.

Seating Cuts

Continental Airlines Inc. cut seating to Mexico in half, AirTran Holdings Inc. trimmed two weekly flights and Delta Air Lines Inc. began using smaller planes as swine flu concerns reduced travel.

WHO’s statistics, which lag behind those reported by national and local agencies, confirmed cases in the U.S., Mexico, Canada, the U.K., Austria, Germany, the Netherlands, Denmark, Switzerland, Spain, Israel, Hong Kong and New Zealand. France also confirmed two cases.

The three main seasonal flu strains -- H3N2, H1N1 and type- B -- cause 250,000 to 500,000 deaths a year globally, according to WHO. The new flu’s symptoms are similar, including fever and coughing, nausea and vomiting, according to the CDC.

Authorities advised hand-washing, hygiene and staying home if sick as the most effective ways to control the outbreak.