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Swine Flu Outbreak Not a Pandemic, Yet

SUNDAY May 3, 2009 -- Although the number of swine flu cases continued to climb Sunday, the World Health Organization said there is no clear sign yet that the scope of the outbreak has reached pandemic proportions.

That doesn't mean it won't, however.

"At the present time, I would still propose that a pandemic is imminent because we are seeing transmission to other countries," Dr. Michael J. Ryan, director of the World Health Organization (WHO) global alert and response team, said in a teleconference from Geneva on Sunday. "We have to expect that Phase 6 will be reached. We have to hope that it is not."

As of Sunday morning, the WHO Web site was reporting 787 confirmed cases of swine flu in 17 countries. Mexico has reported 506 cases, with 19 deaths, while the United States has confirmed 160 cases in 21 states.

Currently, the outbreak is gauged a Level 5, meaning the disease is spreading throughout communities in at least two countries in one of WHO's six regions, in this case the United States and Mexico. To reach Phase 6, the geographic spread of the disease would have to occur in at least one other country in another region.

In a strange twist on Saturday, swine flu was discovered for the first time in pigs. WHO officials reported on the organization's Web site that the virus had been detected in sick pigs on a farm in Alberta, Canada. Until now, it was not known whether the virus could infect pigs, even though its genetic makeup clearly points to its having originated in that animal. However, in this case a human appears to have infected the livestock, not the other way around, the WHO reported. A worker on the farm had traveled to Mexico, come back to Canada and fallen ill. The swine are now under quarantine. WHO officials stressed that the swine flu cannot be transmitted through the consumption of pork products.

And the swine flu continued to spread across the United States on Saturday, as federal health officials reported there are now 160 confirmed cases in 21 states, with 13 hospitalizations and one death.

"We have information that this novel virus continues to spread with increasing cases and increased states affected, and we are acting actively and aggressively. Our highest priority is the health and safety of the American public," Dr. Anne Schuchat, interim deputy director for the science and public health program at the U.S. Centers for Disease Control and Prevention, said during a teleconference Saturday. "We have seen times when things appear to be getting better and then get worse again. With a new virus like this, we don't know how it's going to behave or change over time."

Since schools are the focus of many of the outbreaks, the CDC has issued new recommendations for school closings.

Because children may shed the virus longer than adults, the agency is now recommending that affected schools remain closed for two weeks instead of one, Schuchat noted. However, what individual communities decide to do is up to them and their own analysis of the situation, she added.

The U.S. Education Department said Friday that more than 430 schools had closed, affecting about 245,000 children, the Wall Street Journal reported.

Nancy Cox, chief of the influenza division of the National Center for Immunization and Respiratory Diseases at the CDC, did deliver some welcome news on the nature of the virus itself on Friday. She said during a teleconference that a preliminary analysis of the H1N1 strain finds it lacks certain "virulent characteristics" that made the 1918 flu pandemic strain so deadly.

And the new Secretary of Health and Human Services, Kathleen Sebelius, has made the decision to buy 13 million more courses of antivirals to replenish the antiviral stockpile, Schuchat said. "We don't know if we are going to need them, we just wanted to be ready," she said.

In addition, the United States has shipped 400,000 regimens of antivirals to Mexico, believed to be the source of the global outbreak, at the request of the Mexican government, Schuchat added.

Meanwhile, President Barack Obama has urged Americans to stay calm, noting that it was not clear whether the global outbreak of the never-before-seen flu strain was any worse than "ordinary flus." But, he added, agencies across the U.S. government are preparing for the worst, according to the AP.

Asia also announced its first case, in Hong Kong. Officials there quarantined an entire tourist hotel where the victim, a traveler from Mexico who entered via Shanghai, had stayed Thursday night before getting sick, according to the New York Times. On Saturday, South Korea reported its first case of swine flu.

Meanwhile, scientists were racing to produce a vaccine against the new flu strain, but the shots -- if needed at all -- wouldn't be available until fall at the earliest, U.S. health officials have said.

"We think 600 million doses is achievable in a six-month timeframe" from that fall start, U.S. Health and Human Services Assistant Secretary Craig Vanderwagen told lawmakers last week.

On Friday, U.S. health officials told reporters that six countries -- the United States, Canada, the Netherlands, Mexico, Germany and New Zealand -- have all shared samples of the virus for testing to further the vaccine effort.

"The good news is that the genes of all of the viruses we have examined to date are 99 to 100 percent identical," Cox said. "This means that it will be somewhat easier for us to produce an influenza vaccine."

"We are aggressively taking the very early steps that are necessary for vaccine manufacture should a decision be made go ahead and ramp up to full-scale production," Cox added.

The current plan is to have vaccine manufacturers complete production of next year's seasonal flu vaccine, then, if necessary, switch to the production of the H1N1 vaccine, Schuchat said.

The flu strain is a combination of pig, bird and human viruses, prompting worries from health officials that humans may have no natural immunity to the pathogen.

Meanwhile, the U. S. Food and Drug Administration and the Federal Trade Commission warned consumers Friday to avoid Internet sites and other promotions that offer products claiming to diagnose, prevent, treat or cure the swine flu virus.

"Consumers who purchase products to treat the novel 2009 H1N1 virus that are not approved, cleared or authorized by the FDA for the treatment or prevention of influenza risk their health and the health of their families," Michael Chappell, acting FDA Associate Commissioner for Regulatory Affairs, said in a news release. "In conjunction with the Federal Trade Commission, the FDA has developed an aggressive strategy to identify, investigate and take regulatory or criminal action against individuals or businesses that wrongfully promote purported 2009 H1N1 influenza products in an attempt to take advantage of the current flu public health emergency."

As with the previously tested strains of the swine flu virus, new testing has found that the pathogen remains susceptible to the two common antiviral drugs Tamiflu and Relenza, according to the CDC.

U.S. Human Cases of H1N1 Flu Infection
(As of May 2, 2009, 11:00 AM ET)
States # of
laboratory
confirmed
cases
Deaths
Arizona 4  
California 24  
Colorado 2  
Connecticut 1  
Delaware 4  
Florida 2  
Illinois 3  
Indiana 3  
Kansas 2  
Kentucky* 1  
Massachusetts 8  
Michigan 2  
Minnesota 1  
Missouri 1  
Nevada 1  
New Jersey 7  
New York 50  
Ohio 1  
South Carolina
13
 
Texas
28
1
Virginia
2
 
TOTAL (21) 160 cases 1 death
*Case is resident of Ky. but currently hospitalized in Ga.
Source: U.S. Centers for Disease Control and Prevention

More information

For more on swine flu, visit the U.S. Centers for Disease Control and Prevention.

Posted: May 2009


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