Swine-Flu Warning Raised as Virus Crosses Continents (UPDATE 1)
Tom Randall
April 28, 2009
Bloomberg
The World Health Organization, acknowledging the growing threat of swine flu, raised its global pandemic alert, saying the disease is no longer containable.
The alarm level, raised to 4 from 3, is at its highest since the warning system was adopted in 2005, and the virus has been confirmed in the U.K., Mexico, the U.S., Canada and Spain. The emphasis for health officials worldwide should be treating patients and strengthening preparations for outbreaks, said Keiji Fukuda, assistant director-general for health security and environment. The Geneva-based WHO isn’t recommending travel restrictions.
Swine flu cases in the U.S. doubled to 40, and Mexico’s toll of flu-related deaths reached 149. Fears among global health officials about other outbreaks spurred an emergency meeting of the WHO. U.S. officials yesterday recommended that nonessential travel to Mexico be avoided, the European Union has told travelers to avoid outbreak areas, and Australia, Japan, Singapore and South Korea are screening air passengers.
The increased threat level “signifies that we have taken a step closer” to pandemic, Fukuda said in a conference call with reporters yesterday. “It is also possible that as the situation evolves over the next few days we could move into Stage 5.”
A pandemic is an unexpected outbreak of disease that spreads from person to person across borders. Pandemics occur when a new influenza A-type virus, to which almost no one has natural immunity, emerges and spreads internationally. The U.S. Department of Health and Human Services estimates that a moderate pandemic would kill 209,000, and a flu as severe as the 1918 outbreak would kill 1.9 million.
Not Inevitable
The raised level indicates health officials need to prepare for a pandemic, though it’s not inevitable, Fukuda said. This is the first time risk has risen above level 3 on the WHO’s six- step alert system since the current scale was adopted.
“The situation is very fluid, very dynamic, and it is rapidly evolving,” said Tim Uyeki, an epidemiologist in the U.S. Centers For Disease Control and Prevention’s flu division. “The cases in the U.S. don’t have any links to contact with pigs. This appears to be ongoing human-to-human transmission.”
Production of influenza vaccine for seasonal outbreaks, which U.S. health officials have said is ineffective against the new flu, should continue, Fukuda said. WHO is working with companies to prepare for a swine-flu vaccine, and would help produce such a vaccine if the outbreak becomes a pandemic, he said.
“We don’t think that any of the existing vaccines are effective,” said Richard Besser, the acting head of the CDC.
No Vaccine
The U.S. Food and Drug Administration signed emergency authorizations yesterday that will permit the CDC to use an unapproved lab test for swine flu and more dosing options than currently recommended for influenza treatments Tamiflu and Relenza.
Homeland Security Secretary Janet Napolitano said 25 percent of “courses of treatments” of drugs, known as antivirals, were being released from U.S. stockpiles. In all, there are 50 million courses, she said. Among those are Tamiflu, sold by Swiss drugmaker Roche Holding AG, and Relenza, from London-based GlaxoSmithKline Plc.
There are enough stockpiles of Tamiflu to meet current demand, said Roche spokesman Terence Hurley. Roche has the capacity to manufacture, over one year, enough courses of treatment for 400 million people, Hurley said in a telephone interview. A fifth of those treatments would be made in the U.S.
Available Treatments
The WHO has told Roche that it appears Tamiflu would work against this strain of the virus, Hurley said yesterday.
Glaxo has increased production of its antiviral Relenza and is in contact with the WHO and CDC, spokeswoman Sarah Alspach said yesterday.
President Barack Obama said yesterday the emergence and spread of swine flu in the U.S. merits heightened concern “but it’s not a cause for alarm.” He declared a public emergency after 40 U.S. cases were confirmed in California, Kansas, New York, Ohio and Texas, according to the CDC. New Jersey has identified five probable cases, the state’s Department of Health and Senior Services said yesterday in a statement on its Web site. All five cases are awaiting confirmation by the CDC, the department said.
The U.S. Department of Health and Human Services issued an emergency declaration as a “precautionary tool” to free resources to monitor and respond to the spread of the virus, Obama said yesterday in a speech to the National Academy of Sciences in Washington.
New York Outbreak
New York City has 28 confirmed cases of swine flu, all from St. Francis Preparatory School in Queens, Mayor Michael Bloomberg said yesterday at a news conference. All the cases were mild and as many as 100 may ultimately be found at the school, the mayor said.
The number of confirmed cases in Mexico is 26, WHO spokesman Gregory Hartl said yesterday on a conference call. Testing has been limited, and U.S. and international experts are being sent to help track the disease, WHO and CDC said. Mexico’s Health Minister Jose Cordova said as many as 149 people may have died in Mexico from an outbreak of swine flu, though the cause of the deaths hasn’t been confirmed.
Eight people in Canada contracted swine flu, said Margaret Chan, World Health Organization chief. New Zealand officials are monitoring 56 people, South Korea has a suspected case and the U.K. confirmed two people contracted the disease.
Travel restrictions are unnecessary and based on political, not medical considerations, Chan said.
Economic Standstill ?
“By definition, pandemic influenza will move around the world,” Chan said on the call yesterday. “Does that mean we are going to close every country? Does that mean we are going to bring the world’s economy to a standstill?
“We know from past experience that transmission of influenza or the spread of new influenza disease would not be stopped by closing borders and would not be stopped by restricting movement of people or goods,” Chan said.
The Mexican government requested that bars, movie theaters and churches be closed in Mexico City. It also extended its school closure to May 6 and may shut down more activities, Mexico’s Cordova said.
Swine flu results in symptoms similar to regular human influenza such as fever, lethargy and cough, and may also cause nausea, vomiting and diarrhea, according to the CDC. Swine-flu viruses aren’t transmitted by food, and eating properly handled and cooked pork and pork products is safe, according to the CDC. There’s no evidence the disease is spread by exposure to “pork or pigs,” WHO’s Fukada said.
Scientists are trying to determine why the virus has been more severe in Mexico. In the U.S. only one person has required hospitalization, said Besser of the CDC.
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