UPDATED:
A new swine flu strain that has killed as many as 81 people and sickened more than 1,000 across Mexico has “pandemic potential,” the World Health Organization chief said Saturday, and it may be too late to contain the sudden outbreak.
Mexico’s president assumed new powers Saturday to isolate people infected with a deadly swine flu strain as authorities struggled to contain the outbreak.
The disease has already reached Texas and California, and with 24 new suspected cases reported Saturday in Mexico City alone, schools were closed and all public events suspended in the capital until further notice - including more than 500 concerts and other gatherings in the metropolis of 20 million.
A hotline fielded 2,366 calls in its first hours from frightened city residents who suspected they might have the disease. Soldiers and health workers handed out surgical masks at subway stops, and hospitals dealt with crowds of people seeking help.
Mexican authorities ordered schools closed in the capital and the states of Mexico and San Luis Potosi until May 6.
Mexican soldiers and health workers patrolled airports and bus stations as they tried to corral people who may be infected with the swine flu, as it became clearer that the government may have been slow to respond to the outbreak in March and early April.
Now, even detaining the ill may not keep the strain — a combination of swine, bird and human influenza that people may have no natural immunity to — from spreading, epidemiologists say.
The World Health Organization on Saturday asked countries around the world to step up reporting and surveillance of the disease and implement a coordinated response to contain it.
The Mexican government issued a decree authorizing President Felipe Calderon to invoke special powers letting the Health Department isolate patients and inspect homes, incoming travelers and baggage.
Officials said the decree gives clear legal authority to Health Department workers who might otherwise face reprisals.
The World Health Organization’s director-general, Margaret Chan, said the outbreak of the never-before-seen virus is a very serious situation and has “pandemic potential.” But she said it is still too early to tell whether it would become a worldwide outbreak.
“The situation is evolving quickly,” Dr. Chan said in a telephone news conference in Geneva. “A new disease is by definition poorly understood.”
This virus is a mix of human, pig and bird strains that prompted the WHO to meet Saturday to consider declaring an international public health emergency - a step that could lead to travel advisories, trade restrictions and border closures. Spokesman Gregory Hartl said a decision would not be made Saturday.
Two cases of the human swine influenza have been confirmed in Kansas and one more in California, bringing the U.S. total to 11. At least eight students at a New York City high school probably have swine flu also, but health officials said Saturday they don’t know whether they have the same strain of the virus that has killed people in Mexico.
New York Gov. David Paterson on Saturday directed the state Department of Health to mobilize its infectious-diseases, epidemiology and disaster preparedness workers to monitor and respond to possible cases of the flu. He said 1,500 treatment courses of the antiviral Tamiflu had been sent to New York City.
Kansas health officials said Saturday they had confirmed swine flu in a married couple living in the central part of the state after the husband visited Mexico. The couple, who live in Dickinson County, were not hospitalized, and the state described their illnesses as mild.
Dr. Jason Eberhart-Phillips, the state health officer, said, “Fortunately, the man and woman understand the gravity of the situation and are very willing to isolate themselves.”
The man traveled to Mexico last week for a professional conference and became ill after returning home. His wife became ill later. Their doctor suspected swine flu, but it wasn’t confirmed until flu specimens were flown to the federal Centers for Disease Control and Prevention in Atlanta.
Swine flu is a respiratory disease of pigs caused by type A flu viruses, the CDC’s Web site says. Human cases of swine flu are uncommon but can happen in people who are around pigs and can be spread from person to person. Symptoms of the flu include a fever of more than 100 degrees, body aches, coughing, a sore throat, respiratory congestion and, in some cases, vomiting and diarrhea.
At least nine swine flu cases have been reported in California and Texas. The new California case, the seventh there, was a 35-year-old Imperial County woman who was hospitalized but recovered. The woman, whose illness began in early April, had no known contact with the other cases.
The 11 U.S. swine flu victims range in age from 9 to over 50. All recovered or are recovering; at least two were hospitalized.
Health officials are worried because people appear to have no immunity to the virus, a combination of bird, swine and human influenzas. Also, the virus presents itself like other swine flus, but none of the U.S. cases appears to involve direct contact with pigs, said Eberhart-Phillips, who called the strain “a completely novel virus.”
“It appears to be able to transmit easily between humans,” Eberhart-Phillips said. “It’s something that could potentially become very big, and we’re only seeing, potentially, the very beginning of a widespread outbreak.”
New York health officials said more than 100 students at the private St. Francis Preparatory School, in Queens, had come down with a fever, sore throat and other aches and pains in the past few days. Some of their relatives also have been ill.
New York City Health Commissioner Thomas Frieden said nose and throat swabs had confirmed that eight students had a non-human strain of influenza type A, indicating probable cases of swine flu, but the exact subtypes were still unknown.
Samples had been sent to the CDC for more testing. Results were expected Sunday.
Parent Elaine Caporaso’s 18-year-old son Eddie, a senior at the school, had a fever and cough and went to a hospital where a screening center had been set up.
“I don’t know if there is an incubation period, if I am contaminated,” Caporaso told the Daily News. “I don’t want my family to get sick, and I don’t want to get anybody else sick.”
The symptoms in the New York cases have been mild, Frieden said, but the illnesses have caused concern because of the deadly outbreak in Mexico, where classes in Mexico City, neighboring Mexico state and the northern state of San Luis Potosi have been canceled until May 6 and where up to 81 deaths are suspected and 20 have been confirmed.
Frieden said that if the CDC confirms that the New York students have swine flu, he will likely recommend that the school remain closed Monday “out of an abundance of caution.”
One factor, he said, is that the illness appears to be moving efficiently from person to person, affecting as many as 100 to 200 people in a student body of 2,700.
“We’re very concerned about what may happen,” he said, although he noted that the pattern of illness appeared different from in Mexico, where much larger groups of people have become much sicker. Overall, he said, flu cases have been declining in the city in recent weeks.
The school was being sanitized over the weekend but still was holding a reunion featuring cocktails, dinner and dancing for hundreds of alumni from as far back as 1939. A health department spokeswoman said the sanitization was just a precaution because it’s not really the environment that passes the flu.
Alumna Joyce Kal, of the Class of 1979, said she wasn’t worried about getting sick.
“I did think about it, but I didn’t, you know, worry, because if it’s the kids, I don’t think it’s going to linger,” said Kal, a physical therapist from the Bayside neighborhood.
The city health department has asked doctors to be extra vigilant in the coming days and test any patients who have flu-like symptoms and have traveled recently to California, Texas or Mexico.
Investigators also were testing children who fell ill at a day care center in the Bronx, Frieden said. And two families in Manhattan had contacted the city, saying they had recently returned ill from Mexico with flu-like symptoms.
Frieden said New Yorkers having trouble breathing due to an undiagnosed respiratory illness should seek treatment but shouldn’t become overly alarmed. Medical facilities in the part of Queens near St. Francis Prep, he said, had already been flooded with people overreacting to the outbreak.
This swine flu and regular flu can have similar symptoms - mostly fever, cough and sore throat, though some of the American victims who recovered also experienced vomiting and diarrhea. But unlike with regular flu, humans don’t have natural immunity to a virus that includes animal genes - and new vaccines can take months to be brought into use.
But experts at the WHO and the U.S. Centers for Disease Control and Prevention say the nature of this outbreak may make containment impossible. Already, more than 1,000 people have been infected in as many as 14 of Mexico’s 32 states, according to daily newspaper El Universal. Tests show 20 people have died of the swine flu, and 48 other deaths are likely due to the same strain.
The CDC and Canadian health officials were studying samples sent from Mexico, and airports around the world were screening passengers from Mexico for symptoms of the new flu strain, saying they may quarantine passengers.
Mexico’s president said his government only discovered the nature of the virus late Thursday, with the help of international laboratories. “We are doing everything necessary,” he said in a brief statement.
Across Mexico’s capital, residents reacted with fatalism and confusion, anger and mounting fear at the idea that their city may be ground zero for a global epidemic.
Authorities are urging people to stay home if they feel sick and to avoid shaking hands or kissing people on the cheeks.
The local Roman Catholic Church recommended that priests shorten Mass; place communion wafers in worshippers’ hands, instead of their mouths; and ask parishioners to avoid kissing or shaking hands during the Rite of Peace. The Archdiocese also said Catholics could fulfill their Mass obligation by radio.
The CDC says two flu drugs, Tamiflu and Relenza, seem effective against the new strain.
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