Times Topic
Swine Flu
April 27, 2009
The New York Times
OVERVIEW
An outbreak of swine flu in Mexico has raised concerns worldwide that the disease could be emerging as a global pandemic. On April 26, 2009, American officials declared a public health emergency after 20 cases of swine flu were confirmed in the United States; by the next day, the number had doubled.
The virus in the American cases looked identical to the A (H1N1) swine flu in Mexico that is believed to have killed 149 people and sickened about 1,600. Health officials in the United States and at the World Health Organization urged the public not to panic, noting that the cases confirmed outside of Mexico had been mild, and that the virulence of the virus remained unknown.
Still, they urged Americans to forego nonessential travel to Mexico, where many schools and public venues had been shut. On April 27, the European Union's health commissioner urged Europeans to avoid nonessential travel to the United States or Mexico. The acting director of the Centers for Disease Control and Prevention, Dr. Richard Besser, responded that the advisory was unwarranted.
Officials said that 28 of the 50 confirmed cases in the United States were diagnosed in New York City, all among students at St. Francis Preparatory School in Fresh Meadows, Queens. Officials said they had also confirmed cases in California, Kansas, Texas and Ohio. Diagnoses have also been made in Canada, Spain, Scotland and New Zealand.
Mexican officials said they had traced the origins of the outbreak to a rural area known as La Gloria in the southeastern state of Veracruz, the site of several major pig farms.
SWINE FLU QUESTIONS
The new swine flu cases are caused by an influenza strain called H1N1, which appears to be easily passed from person to person. Doctors have little information yet on the mortality rate, as there is no reliable data on the total number of people infected.
The central question every flu expert in the world would like answered, Dr. Martin Cetron, director of global migration and quarantine for the Centers for Disease Control, said in an interview, is how many mild cases Mexico has had.
The ages of the victims in Mexico concern health officials. Unlike typical flu seasons, when infants and the aged are usually the most vulnerable, none of the initial deaths in Mexico were in people older than 60 or younger than 3 years old, a spokeswoman with the World Health Organization said. Pandemic flus - like the 1918 flu and outbreaks in 1957 and 1968 - often strike young, healthy people the hardest.
Reports from the United States suggest that some cases may be mild and therefore may go undetected - allowing the disease to spread further. Flu experts are trying to determine if this year's flu shots, which contain H1N1 strain, offer any protection.
In contrast, the lethal avian flu that has kept world health authorities anxious for years is caused by H5N1 influenza virus. It has killed 257 of the 421 people who have contracted it, or 61 percent. But it has shown very little ability to pass from person to person, mainly infecting poultry, and some experts have suggested that there may be something about the H5N1 virus that makes it inherently less transmissible among people.
As a benchmark, the deadliest influenza pandemic in the past century, the Spanish influenza of 1918 to 1919, had an estimated mortality rate of around 2.5 percent but killed tens of millions of people because it spread so widely. Many of those lives would have been saved if anti-flu drugs, antibiotics and mechanical ventilators had existed.
The virus that caused widespread panic in Asia in 2003, SARS - severe acute respiratory syndrome - is both easily spread and virulent. In the 2003 outbreak in Hong Kong, it killed 299 of the 1,755 people it infected there, or 17 percent.
RESPONSE FROM PUBLIC HEALTH OFFICIALS
Homeland Security Secretary Janet Napolitano called the United States' emergency declaration "standard operating procedure," and said she would rather call it a "declaration of emergency preparedness."
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.
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.
There were no immediate signs of shortages of flu drugs. Roche, the Swiss maker of Tamiflu, said Monday that the World Health Organization has enough stockpiled to treat up to 5 million people, on top of millions more doses held by governments. Tamiflu has been stockpiled for years by governments, companies and health authorities.
Shares of GlaxoSmithKline and Roche, makers of prescription flu treatments, rose Monday amid expectations that the swine flu scare would lift demand for their products.
The lessons learned from SARS did not go to waste in Hong Kong. While Mexico struggles to confirm cases of swine flu and sends samples to the United States, Hong Kong is already performing swift genetic tests on patient samples and will have laboratories doing so at six local hospitals by Thursday. Tens of thousands of doctors and nurses, including retirees and those with medical training who have moved to other occupations, are tracked on databases and ready to be mobilized.
OVERVIEW
An outbreak of swine flu in Mexico has raised concerns worldwide that the disease could be emerging as a global pandemic. On April 26, 2009, American officials declared a public health emergency after 20 cases of swine flu were confirmed in the United States; by the next day, the number had doubled.
The virus in the American cases looked identical to the A (H1N1) swine flu in Mexico that is believed to have killed 149 people and sickened about 1,600. Health officials in the United States and at the World Health Organization urged the public not to panic, noting that the cases confirmed outside of Mexico had been mild, and that the virulence of the virus remained unknown.
Still, they urged Americans to forego nonessential travel to Mexico, where many schools and public venues had been shut. On April 27, the European Union's health commissioner urged Europeans to avoid nonessential travel to the United States or Mexico. The acting director of the Centers for Disease Control and Prevention, Dr. Richard Besser, responded that the advisory was unwarranted.
Officials said that 28 of the 50 confirmed cases in the United States were diagnosed in New York City, all among students at St. Francis Preparatory School in Fresh Meadows, Queens. Officials said they had also confirmed cases in California, Kansas, Texas and Ohio. Diagnoses have also been made in Canada, Spain, Scotland and New Zealand.
Mexican officials said they had traced the origins of the outbreak to a rural area known as La Gloria in the southeastern state of Veracruz, the site of several major pig farms.
SWINE FLU QUESTIONS
The new swine flu cases are caused by an influenza strain called H1N1, which appears to be easily passed from person to person. Doctors have little information yet on the mortality rate, as there is no reliable data on the total number of people infected.
The central question every flu expert in the world would like answered, Dr. Martin Cetron, director of global migration and quarantine for the Centers for Disease Control, said in an interview, is how many mild cases Mexico has had.
The ages of the victims in Mexico concern health officials. Unlike typical flu seasons, when infants and the aged are usually the most vulnerable, none of the initial deaths in Mexico were in people older than 60 or younger than 3 years old, a spokeswoman with the World Health Organization said. Pandemic flus - like the 1918 flu and outbreaks in 1957 and 1968 - often strike young, healthy people the hardest.
Reports from the United States suggest that some cases may be mild and therefore may go undetected - allowing the disease to spread further. Flu experts are trying to determine if this year's flu shots, which contain H1N1 strain, offer any protection.
In contrast, the lethal avian flu that has kept world health authorities anxious for years is caused by H5N1 influenza virus. It has killed 257 of the 421 people who have contracted it, or 61 percent. But it has shown very little ability to pass from person to person, mainly infecting poultry, and some experts have suggested that there may be something about the H5N1 virus that makes it inherently less transmissible among people.
As a benchmark, the deadliest influenza pandemic in the past century, the Spanish influenza of 1918 to 1919, had an estimated mortality rate of around 2.5 percent but killed tens of millions of people because it spread so widely. Many of those lives would have been saved if anti-flu drugs, antibiotics and mechanical ventilators had existed.
The virus that caused widespread panic in Asia in 2003, SARS - severe acute respiratory syndrome - is both easily spread and virulent. In the 2003 outbreak in Hong Kong, it killed 299 of the 1,755 people it infected there, or 17 percent.
RESPONSE FROM PUBLIC HEALTH OFFICIALS
Homeland Security Secretary Janet Napolitano called the United States' emergency declaration "standard operating procedure," and said she would rather call it a "declaration of emergency preparedness."
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.
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.
There were no immediate signs of shortages of flu drugs. Roche, the Swiss maker of Tamiflu, said Monday that the World Health Organization has enough stockpiled to treat up to 5 million people, on top of millions more doses held by governments. Tamiflu has been stockpiled for years by governments, companies and health authorities.
Shares of GlaxoSmithKline and Roche, makers of prescription flu treatments, rose Monday amid expectations that the swine flu scare would lift demand for their products.
The lessons learned from SARS did not go to waste in Hong Kong. While Mexico struggles to confirm cases of swine flu and sends samples to the United States, Hong Kong is already performing swift genetic tests on patient samples and will have laboratories doing so at six local hospitals by Thursday. Tens of thousands of doctors and nurses, including retirees and those with medical training who have moved to other occupations, are tracked on databases and ready to be mobilized.
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