Israel, New Zealand Confirm Cases As U.N. Health Agency Says Travel Restrictions Not Worth Economic Cost
CBS/AP) Cases of swine flu were confirmed Tuesday in at least two more countries as global health officials warned that travel restrictions and warnings were doing nothing to stop its advance.
The World Health Organization said it could be days before scientists are even able to reliably determine how big a threat the new virus poses. Officials in New Zealand and Israel confirmed a handful of cases, and said other people were still suspected of infection with the H1N1 virus, which is suspected of killing 152 people in Mexico.
The number of confirmed infections in the United States almost doubled Monday to 42 as the Obama administration said it was responding aggressively, as if the outbreak would spread into a full pandemic. New Zealand's health minister says his country has 11 confirmed cases of swine flu - the first in the Asia-South Pacific region.
Tony Ryall told reporters in the capital of Wellington that "New Zealand's status is we have 11 confirmed cases'' of swine flu and 43 suspected cases. Those infected were members of a group of students and teachers from a single school that reported having fevers and other flu-like symptoms on their return from a recent visit to Mexico.
He said swine flu was confirmed by laboratory tests on samples from three of 11 students from the group and "on that basis we are assuming" the eight others are also infected. An Israeli hospital, meanwhile, confirmed the country's first case of swine flu and said the patient had fully recovered. Hospital officials said the 26-year-old patient recently returned from Mexico. Laniado Hospital's medical director said Israeli Health Ministry laboratory tests confirmed swine flu.
Dr. Avinoam Skolnik said he didn't know whether the strain was the same one that appeared in Mexico. Skolnik said Tuesday the patient was in "excellent condition." No other details were immediately available. No new cases of the disease were reported in Mexico or the United States overnight.
Thus far, the only deaths confirmed to have been caused by the virus (20 as of Tuesday morning) have been in Mexico, posing one of the most urgent questions for health officials. The World Health Organization (WHO) upgraded its global alert on Monday to an unprecedented level-4. The highest ranking is 6, which indicates a full-blown pandemic. WHO flu spokesman Gregory Hartl said Tuesday the alert was raised because evidence showed swine flu passing from human to human - without any contact with infected animals.
He also said scientists suspect U.S. swine flu patients may have transmitted the virus to others in the United States. Confirmation would indicate the new flu strain is spreading beyond those travelers returning from Mexico. The global health agency says so far, most people confirmed with swine flu were infected in Mexico.
But Hartl said the source of some infections in the United States, Canada and Britain was unclear. Hartl said two of the main challenges facing the world's health authorities are figuring out how efficiently the virus spreads within a population, and why it's only killing people in Mexico.
He said it was likely the virus would continue to spread around the world in the short term, as efforts to limit cross-border travel had failed to halt the disease. Hartl said the WHO was recommending that all countries drop their travel bans and warnings, saying, "it didn't work."
He said the economic cost of restricting peoples' movement around the world would be greater than the cost, in terms of public health, of trying to stop the spread of a virus which had already crossed so many borders and was spreading indigenously.
"Border controls don't work. Screening doesn't work," he said at a news conference at the Geneva headquarters of the United Nation's public health agency. No airport quarantine units have been activated in the U.S., reports CBS News correspondent Thalia Assuras. Customs officials are using only "passive surveillance," - simply watching for symptoms and questioning suspect passengers.
Other countries have taken more dramatic measures, reports Assuras. Russia, Hong Kong and Taiwan have sought to quarantine people showing symptoms, and Japan is using heat sensors to detect flu-like temperatures in airport arrival halls - though their reliability is questionable. European Union officials warned citizens Monday against traveling to the United States or Mexico.
Hartl also said the WHO had still not determined the source of the swine flu. Mexican and American health officials are urgently trying to zero in on the origins. One potential lead, reported CBS News correspondent Hari Sreenivasan, are the massive industrial hog farms that have sprung up in Mexico in recent years - some operated by U.S. companies such as Virginia-based Smithfield Foods.
They deny being the source and say they're cooperating with health officials. But Sreenivasan reported that just last year the nonprofit Pew Charitable Trusts warned that hog farms could become breeding grounds for new strains of the flu.
"The warm conditions and the close proximity of animals being able to pass viruses back and forth and to the human workers," said Bob Martin of the Pew Environmental Group.
"It's a situation ripe for the development of a novel virus." As for the disease's mysterious fatal exclusivity to Mexico, Hartl said it remained just that, a mystery. "We don't understand why the disease has been more severe in Mexico," Hartl said. He suggested it may be due to other flu-season illnesses already being carried by the hardest-hit populations, weaker immune systems in the area, or a failure by medical officials to identify and treat the illness quickly enough, as it was still unrecognizable at the time.
Hartl said it could still be days before WHO scientists were able to determine exactly how virulent this strain of H1N1 swine flu is - whether it passes easily between people of different age groups and fitness levels particularly. This assessment, he said, would help the world body decide whether to elevate the risk level beyond the current 4. Monday evening, New Jersey health officials said they had identified five probable cases of swine flu in people who recently traveled to Mexico and California.
The New Jersey Department of Health and Senior Services said Monday that all have mild forms of the flu and none has been hospitalized. The department is arranging for confirmatory testing at the CDC. Also, 14 schools in Texas, including a high school where two cases were confirmed, will be closed for at least the next week.
Some schools in California and Ohio also were closing after students were found or suspected to have the flu. The CDC is releasing 11 million doses of the stockpiled anti-viral drug Tamiflu to affected areas, reports CBS News correspondent Kelly Wallace. New York City pharmacists report a run on the drug, which requires a doctor's prescription.
But the CDC fears that doctors giving it to patients who don't really need it may cause shortages for those who are sick. Ariana Drauch, a swine flu victim from St. Francis Prep, told Wallace her family can't find it anywhere. "We called every drug store in Queens, New York, everywhere," Drauch said. "And there is no Tamiflu available."
Tuesday, April 28, 2009
My Friend Ivan Explains
Most deaths from illness occur during the night when the body's defenses are at its lowest to fight stress, ie; the fight and flight reflex. Corticosteroid levels are at their lowest. So the stress the flu does put on the body is very consequential.
In addition MOST people DO NOT die of the flu but rather from secondary causes. Most of the secondary causes are bacterial pneumonia, ARDS, asthma, COPD, spesis , DIC, and not to name a few. The available antivirals have SOFT evidence to say that they lessen the severity or the course. There really is no clear hard evidence. Most attention for taking care of those affected by the flu is to take care of the secondary effects and infections. People at risk, or those with compromised pulmonary function or immune systems should be monitored closely.
One reason why this flu will spread is because it is one of the types of influenza A for which we dont have a vaccine. The CDC would be able to develop one shortly if a pandemic occurs. Influenza A virus of all types are know for mutating which is why we have a flu season yearly and a different manufactured vaccine. If we predicted this flu typ and were vaccinated against it we would not have the pandemic occur.
BTW most people who died in 1918 in the pandemic died of secondary causes. We did not have the antibiotics available to treat the pneumonias. Using lymphatic pumping was the only thing we really had.
So in the end you are both partially right and I hope the above clears things up. DONT GO TO THE STATE FAIR JUST YET. (lol)
Ivan
In addition MOST people DO NOT die of the flu but rather from secondary causes. Most of the secondary causes are bacterial pneumonia, ARDS, asthma, COPD, spesis , DIC, and not to name a few. The available antivirals have SOFT evidence to say that they lessen the severity or the course. There really is no clear hard evidence. Most attention for taking care of those affected by the flu is to take care of the secondary effects and infections. People at risk, or those with compromised pulmonary function or immune systems should be monitored closely.
One reason why this flu will spread is because it is one of the types of influenza A for which we dont have a vaccine. The CDC would be able to develop one shortly if a pandemic occurs. Influenza A virus of all types are know for mutating which is why we have a flu season yearly and a different manufactured vaccine. If we predicted this flu typ and were vaccinated against it we would not have the pandemic occur.
BTW most people who died in 1918 in the pandemic died of secondary causes. We did not have the antibiotics available to treat the pneumonias. Using lymphatic pumping was the only thing we really had.
So in the end you are both partially right and I hope the above clears things up. DONT GO TO THE STATE FAIR JUST YET. (lol)
Ivan
Monday, April 27, 2009
Instructions from our Chief, Infectious Diseases
I work at a large city hospital. These are our latest instructions:
To all,
Most of you are aware that as of April 27, 2009, there have been 40 confirmed cases of swine influenza A (H1N1) reported in the US; 7 cases in California, 2 cases in Kansas, 1 case in Ohio, 2 cases in Texas, and 28 cases in New York City. Updates on swine flu are available at the CDC website:
http://www.cdc.gov/swineflu/
Although there have been no cases reported in Arizona, because we are a border state, we need to monitor, especially, our emergency, urgent care, and outpatient settings.
Please be advised that any patients with acute febrile respiratory illness, especially, those who recently visited Mexico, the states and the city listed above need to follow cough etiquette such as covering their noses and mouths with a tissue when they cough or sneeze and washing their hands often with soap and water, or rubbing them with alcohol-based hand cleaners.
Also, please ask them to wear a surgical mask outside of the patient room.
Standard, Droplet and Contact Precautions should be used for all patient care activities and hand hygiene with soap and water, or hand sanitizer should be strictly adhered immediately after removing gloves and other equipment and after any contact with respiratory secretions.
Personnel providing care to or collecting clinical specimens from suspected or confirmed cases should wear disposable non-sterile gloves, gowns, and eye protection (e.g., goggles) to prevent conjunctival exposure.
CDC also made interim recommendations as follows:
- Personnel engaged in aerosol generating activities (e.g., collecting of clinical specimens, endotracheal intubation, nebulizer treatment, bronchoscopy, and resuscitation involving emergency intubation or cardiac pulmonary resuscitation) for suspected or confirmed swine flu cases should wear a fit-tested disposable N95 mask.
- Pending clarification of transmission patterns for this virus, personnel providing direct patient care for suspected or confirmed swine flu cases should wear a fit-tested disposable N95 mask when entering the patient room.
Although it is not known whether the sensitivity of rapid tests for human influenza A (H1N1) will be equivalent for swine influenza A (H1N1), please make every effort to obtain nasopharyngeal specimens from suspected cases for further investigation.
As for the treatment, only if influenza A is confirmed, use dual therapy with both oseltamivir (or zanamivir) and rimantadine (or amantadine) due to delay in confirmation of swine flu by CDC.
Prophylaxis with oseltamivir or zanamivir can be used only if there is an exposure to a confirmed case.
At this point there is no cause for alarm. This notice is just intended to ensure that we are prepared for the worst case scenario. If you have any questions regarding this issue, please contact infection control personnel or me. We will provide further updates. Thank you.
Yasuhiro Nakatani, M.D.
Chief, Infectious Diseases
Chair, Infection Control Committee
To all,
Most of you are aware that as of April 27, 2009, there have been 40 confirmed cases of swine influenza A (H1N1) reported in the US; 7 cases in California, 2 cases in Kansas, 1 case in Ohio, 2 cases in Texas, and 28 cases in New York City. Updates on swine flu are available at the CDC website:
http://www.cdc.gov/swineflu/
Although there have been no cases reported in Arizona, because we are a border state, we need to monitor, especially, our emergency, urgent care, and outpatient settings.
Please be advised that any patients with acute febrile respiratory illness, especially, those who recently visited Mexico, the states and the city listed above need to follow cough etiquette such as covering their noses and mouths with a tissue when they cough or sneeze and washing their hands often with soap and water, or rubbing them with alcohol-based hand cleaners.
Also, please ask them to wear a surgical mask outside of the patient room.
Standard, Droplet and Contact Precautions should be used for all patient care activities and hand hygiene with soap and water, or hand sanitizer should be strictly adhered immediately after removing gloves and other equipment and after any contact with respiratory secretions.
Personnel providing care to or collecting clinical specimens from suspected or confirmed cases should wear disposable non-sterile gloves, gowns, and eye protection (e.g., goggles) to prevent conjunctival exposure.
CDC also made interim recommendations as follows:
- Personnel engaged in aerosol generating activities (e.g., collecting of clinical specimens, endotracheal intubation, nebulizer treatment, bronchoscopy, and resuscitation involving emergency intubation or cardiac pulmonary resuscitation) for suspected or confirmed swine flu cases should wear a fit-tested disposable N95 mask.
- Pending clarification of transmission patterns for this virus, personnel providing direct patient care for suspected or confirmed swine flu cases should wear a fit-tested disposable N95 mask when entering the patient room.
Although it is not known whether the sensitivity of rapid tests for human influenza A (H1N1) will be equivalent for swine influenza A (H1N1), please make every effort to obtain nasopharyngeal specimens from suspected cases for further investigation.
As for the treatment, only if influenza A is confirmed, use dual therapy with both oseltamivir (or zanamivir) and rimantadine (or amantadine) due to delay in confirmation of swine flu by CDC.
Prophylaxis with oseltamivir or zanamivir can be used only if there is an exposure to a confirmed case.
At this point there is no cause for alarm. This notice is just intended to ensure that we are prepared for the worst case scenario. If you have any questions regarding this issue, please contact infection control personnel or me. We will provide further updates. Thank you.
Yasuhiro Nakatani, M.D.
Chief, Infectious Diseases
Chair, Infection Control Committee
Swine Flu Reaches Europe
http://www.cbsnews.com/stories/2009/04/27/world/main4970537.shtml
Seems like some overreaction right now but:
Europeans Urged To Avoid U.S., Mexico
EU Health Official Says Nonessential Travel Should Be Postponed As Outbreak Spreads
(AP) The top EU health official urged Europeans on Monday to postpone nonessential travel to parts of the United States and Mexico because of the swine flu virus, and Spanish health officials confirmed the first case outside North America.
Russia, Hong Kong and Taiwan said they would quarantine visitors showing symptoms of the virus amid a surging global concern about a possible pandemic.
World stock markets fell as investors worried that the deadly outbreak could go global and derail any global economic recovery. Airlines took the brunt of the selling
The virus was suspected in up to 103 deaths in Mexico, the epicenter of the outbreak with more than 1,600 cases suspected, while 40 cases - none fatal - were confirmed in the United States and six in Canada, the World Health Organization said.
"Today we've seen increased number of confirmed cases in several countries," WHO spokesman Paul Garwood told The Associated Press. "WHO is very concerned about the number of cases that are appearing, and the fact that more and more cases are appearing in different countries."
President Barack Obama said the threat of spreading infections is cause for concern but "not a cause for alarm."
The WHO set its pandemic alert level at level 3, which means there is an animal virus that occasionally causes human cases but that doesn't spread well between people. If the WHO raises it to 4 or 5, that signals that the swine flu virus is becoming increasingly adept at spreading between humans. That move could lead governments to set trade, travel and other restrictions aimed at limiting the disease's spread.
In Luxembourg, European Union Health Commissioner Androulla Vassiliou urged Europeans to postpone nonessential travel to parts of the United States and Mexico affected by swine flu, toning down earlier comments referring to all of North America.
"I meant a travel advisory, not a travel ban, for travel to Mexico City and those states in the United States where we have outbreaks" of swine flu, he said. "
The EU health commissioner only makes recommendations to the 27 member countries; they must make a final decision to set travel advisories through their foreign ministries.
Dr. Richard Besser, acting head of the Centers for Disease Control and Prevention in Atlanta, said the EU recommendation was not warranted. "At this point I would not put a travel restriction or recommendation against coming to the United States."
A top German holiday tour operator said it was suspending charter flights to Mexico City.
"These are early days. It's quite clear that there is a potential for this virus to become a pandemic and threaten globally,"
WHO spokesman Peter Cordingley told AP Television News. Spain's first swine flu case - confirmed by the WHO - was a young man in the town of Almansa who recently returned from Mexico for university studies and is responding well to treatment, said Health Minister Trinidad Jimenez.
Neither the young man nor any of the 20 other people under observation for the virus were in serious condition. Three New Zealanders recently home from Mexico were suspected of having swine flu.
Israel has put two people under observation, while France and Brazil have also reported suspected cases. Cordingley singled out air travel as an easy way the virus could spread, noting that the WHO estimates that up to 500,000 people are on planes at any time. Governments in Asia - with potent memories of SARS and avian flu outbreaks - heeded the warning amid global fears of a pandemic. Singapore, Thailand, Japan, Indonesia, and the Philippines dusted off thermal scanners used during the 2003 SARS crisis and were checking for signs of fever among passengers arriving from North America. South Korea and Indonesia introduced similar screening.
In Malaysia, health workers in face masks took the temperatures of passengers as they arrived on a flight from Los Angeles. Russia, Hong Kong and Taiwan said visitors returning from flu-affected areas with fevers would be quarantined.
Australian Health Minister Nicola Roxon said pilots on international flights would be required to file a report noting any flu-like symptoms among passengers before being allowed to land in Australia.
China said anyone experiencing flu-like symptoms within two weeks of arrival had to report to authorities. India will start screening people arriving from Mexico, the United States, Canada, New Zealand, Spain, Britain and France for flu-like symptoms, said Vineet Chawdhry, a top Health Ministry official. It also will contact people who have arrived from Mexico and other affected countries in the past 10 days to check for the symptoms, he said. Some officials cautioned that the checks might not be enough.
The virus could move between people before any symptoms show up, said John Simon, a scientific adviser to Hong Kong's Center for Health Protection. Thomas Tsang, controller for Hong Kong's Center for Health Protection, said the government and universities aim to develop a test for the new flu strain in a week or two that will return results in four to six hours, compared with existing tests that can take 2-3 days. China and Russia banned imports of pork and pork products from Mexico and three U.S. states that have reported cases of swine flu, and other governments were increasing their screening of pork imports. Indonesia, which was hit hardest by bird flu, said it was banning all pork imports. Lebanon's agriculture ministry also banned all imports of pork and pork products, excluding some canned products. It also says it will destroy any pork shipments to have entered Lebanon from a country declared infected with the swine flu virus by the WHO or countries with suspected cases. The CDC says people cannot get the flu by eating pork or pork products. Germany's largest tour operator, the Hannover-based TUI, suspended all charter flights to Mexico City through May 4. The suspension includes flights operated by TUI itself and also through companies 1-2 Fly, Airtours, Berge & Meer, Grebeco and L'tur. TUI said other holiday trips to Mexico would continue to operate but would not make stops in Mexico City "for the next few weeks." Japan's largest tour agency, JTB Corp., suspended tours to Mexico at least through June 30. Russian travel agencies said 30 percent of those planning to travel to Mexico in early May had already canceled. At Madrid's Barajas International Airport, passengers arriving from Mexico were asked to declare where they had been in Mexico and whether they had felt any cold symptoms. They were told to leave a contact address and phone number. "Where we were, there was no real alarm but we followed what was happening on the news and we're a little bit worried," said Spaniard Filomeno Ruiz, back from vacation in Cancun. Passengers were also urged to contact health authorities if they notice any symptoms in the 10 days following arrival. In the airport's baggage claim area, ground crews and police wore surgical face masks. Some travelers took precautions even though they had not been in Mexico. "Nobody has recommended it, but I've put the mask on out of precaution," said Roger Holmes of Britain, who was traveling to Tunisia from Madrid. "I'm not afraid, but it costs nothing to be careful." New Zealand Health Minister Tony Ryall said two students and a parent among a group of 15 who just came back from a class trip to Mexico had mild flu and were being tested for swine flu. On Sunday, officials said nine students and one teacher from a separate group that also were in Mexico "likely" have swine flu. All the New Zealand students and teachers along with their families had voluntarily quarantined themselves at home. Ryall said three small groups of returned travelers were being monitored after reporting flu symptoms following recent trips to North America. He gave no other details.
Seems like some overreaction right now but:
Europeans Urged To Avoid U.S., Mexico
EU Health Official Says Nonessential Travel Should Be Postponed As Outbreak Spreads
(AP) The top EU health official urged Europeans on Monday to postpone nonessential travel to parts of the United States and Mexico because of the swine flu virus, and Spanish health officials confirmed the first case outside North America.
Russia, Hong Kong and Taiwan said they would quarantine visitors showing symptoms of the virus amid a surging global concern about a possible pandemic.
World stock markets fell as investors worried that the deadly outbreak could go global and derail any global economic recovery. Airlines took the brunt of the selling
The virus was suspected in up to 103 deaths in Mexico, the epicenter of the outbreak with more than 1,600 cases suspected, while 40 cases - none fatal - were confirmed in the United States and six in Canada, the World Health Organization said.
"Today we've seen increased number of confirmed cases in several countries," WHO spokesman Paul Garwood told The Associated Press. "WHO is very concerned about the number of cases that are appearing, and the fact that more and more cases are appearing in different countries."
President Barack Obama said the threat of spreading infections is cause for concern but "not a cause for alarm."
The WHO set its pandemic alert level at level 3, which means there is an animal virus that occasionally causes human cases but that doesn't spread well between people. If the WHO raises it to 4 or 5, that signals that the swine flu virus is becoming increasingly adept at spreading between humans. That move could lead governments to set trade, travel and other restrictions aimed at limiting the disease's spread.
In Luxembourg, European Union Health Commissioner Androulla Vassiliou urged Europeans to postpone nonessential travel to parts of the United States and Mexico affected by swine flu, toning down earlier comments referring to all of North America.
"I meant a travel advisory, not a travel ban, for travel to Mexico City and those states in the United States where we have outbreaks" of swine flu, he said. "
The EU health commissioner only makes recommendations to the 27 member countries; they must make a final decision to set travel advisories through their foreign ministries.
Dr. Richard Besser, acting head of the Centers for Disease Control and Prevention in Atlanta, said the EU recommendation was not warranted. "At this point I would not put a travel restriction or recommendation against coming to the United States."
A top German holiday tour operator said it was suspending charter flights to Mexico City.
"These are early days. It's quite clear that there is a potential for this virus to become a pandemic and threaten globally,"
WHO spokesman Peter Cordingley told AP Television News. Spain's first swine flu case - confirmed by the WHO - was a young man in the town of Almansa who recently returned from Mexico for university studies and is responding well to treatment, said Health Minister Trinidad Jimenez.
Neither the young man nor any of the 20 other people under observation for the virus were in serious condition. Three New Zealanders recently home from Mexico were suspected of having swine flu.
Israel has put two people under observation, while France and Brazil have also reported suspected cases. Cordingley singled out air travel as an easy way the virus could spread, noting that the WHO estimates that up to 500,000 people are on planes at any time. Governments in Asia - with potent memories of SARS and avian flu outbreaks - heeded the warning amid global fears of a pandemic. Singapore, Thailand, Japan, Indonesia, and the Philippines dusted off thermal scanners used during the 2003 SARS crisis and were checking for signs of fever among passengers arriving from North America. South Korea and Indonesia introduced similar screening.
In Malaysia, health workers in face masks took the temperatures of passengers as they arrived on a flight from Los Angeles. Russia, Hong Kong and Taiwan said visitors returning from flu-affected areas with fevers would be quarantined.
Australian Health Minister Nicola Roxon said pilots on international flights would be required to file a report noting any flu-like symptoms among passengers before being allowed to land in Australia.
China said anyone experiencing flu-like symptoms within two weeks of arrival had to report to authorities. India will start screening people arriving from Mexico, the United States, Canada, New Zealand, Spain, Britain and France for flu-like symptoms, said Vineet Chawdhry, a top Health Ministry official. It also will contact people who have arrived from Mexico and other affected countries in the past 10 days to check for the symptoms, he said. Some officials cautioned that the checks might not be enough.
The virus could move between people before any symptoms show up, said John Simon, a scientific adviser to Hong Kong's Center for Health Protection. Thomas Tsang, controller for Hong Kong's Center for Health Protection, said the government and universities aim to develop a test for the new flu strain in a week or two that will return results in four to six hours, compared with existing tests that can take 2-3 days. China and Russia banned imports of pork and pork products from Mexico and three U.S. states that have reported cases of swine flu, and other governments were increasing their screening of pork imports. Indonesia, which was hit hardest by bird flu, said it was banning all pork imports. Lebanon's agriculture ministry also banned all imports of pork and pork products, excluding some canned products. It also says it will destroy any pork shipments to have entered Lebanon from a country declared infected with the swine flu virus by the WHO or countries with suspected cases. The CDC says people cannot get the flu by eating pork or pork products. Germany's largest tour operator, the Hannover-based TUI, suspended all charter flights to Mexico City through May 4. The suspension includes flights operated by TUI itself and also through companies 1-2 Fly, Airtours, Berge & Meer, Grebeco and L'tur. TUI said other holiday trips to Mexico would continue to operate but would not make stops in Mexico City "for the next few weeks." Japan's largest tour agency, JTB Corp., suspended tours to Mexico at least through June 30. Russian travel agencies said 30 percent of those planning to travel to Mexico in early May had already canceled. At Madrid's Barajas International Airport, passengers arriving from Mexico were asked to declare where they had been in Mexico and whether they had felt any cold symptoms. They were told to leave a contact address and phone number. "Where we were, there was no real alarm but we followed what was happening on the news and we're a little bit worried," said Spaniard Filomeno Ruiz, back from vacation in Cancun. Passengers were also urged to contact health authorities if they notice any symptoms in the 10 days following arrival. In the airport's baggage claim area, ground crews and police wore surgical face masks. Some travelers took precautions even though they had not been in Mexico. "Nobody has recommended it, but I've put the mask on out of precaution," said Roger Holmes of Britain, who was traveling to Tunisia from Madrid. "I'm not afraid, but it costs nothing to be careful." New Zealand Health Minister Tony Ryall said two students and a parent among a group of 15 who just came back from a class trip to Mexico had mild flu and were being tested for swine flu. On Sunday, officials said nine students and one teacher from a separate group that also were in Mexico "likely" have swine flu. All the New Zealand students and teachers along with their families had voluntarily quarantined themselves at home. Ryall said three small groups of returned travelers were being monitored after reporting flu symptoms following recent trips to North America. He gave no other details.
Do You Know Where Your Masks Are?
Well, here we are again. The old blog is under: http://pandemicfluteam.blogspot.com. There is a ton of information. As we review it we will see what made sense at that time and what does not now with the passage of time.
http://www.cbsnews.com/stories/2009/04/27/health/main4970352.shtml
Why Is Swine Flu A Killer Only In Mexico?
Experience Of One Victim's Family Raises Troubling Questions About Country's Response To Epidemic
CBS/AP) The 39-year-old bricklayer fell ill two weeks ago and became one of the first Mexicans to die of swine flu. But no health worker has come to his home outside Mexico City to offer medicine or ask about the neighbors' pigs.
In fact, Gerardo Leyva Lolis' widow says nobody even told her he died of swine flu until The Associated Press informed her the case had been confirmed by the director of the hospital where he was rushed last week.
The family's experience raises troubling questions about Mexico's response to the epidemic and one of its greatest mysteries: why the disease is killing people in Mexico, but so far nowhere else.
"I don't know what to think," Antonia Cortes Borbolla said Sunday, holding back tears in the two-room wood and cinderblock home she shared with her husband and their three teenage sons in this rural town of 18,000 located 40 miles outside Mexico City.
Their neighbors — three of whom keep pigs in their yards — had harsher things to say about the failure of Mexican health officials to provide medicine to protect those closest to the swine flu victim.
"Not even they know what's going on," Sandra Estrada said of the dead man's family. "If it was (swine flu), why haven't they taken measures to protect the family?"
Epidemiologists need details about victims to locate the source of a viral outbreak and to understand how it spreads. There are antiviral drugs, including Tamiflu, that have been shown to be effective, but they need to be taken within days of the first symptoms. Experts also suggest they be given to those in close contact with flu victims, even if they don't show symptoms, to make sure they don't unwittingly spread the virus.
Meanwhile, in the U.S., the White House says "don’t panic," yet the race is on to contain an outbreak of swine flu that has proven to be deadly in Mexico where there are now more than 100 deaths, with more than 1,600 suspected cases.
An official said New York City has 20 more confirmed cases of swine flu, raising the city's total to 28. The official says there are another 17 probable cases in New York City.
Speaking before the National Academy of Sciences, President Obama said he is "closely monitoring" the swine flu situation, getting regular updates from the various public health agencies grappling with the problem. Mr. Obama said Americans can expect regular updates from these agencies as well.
President Felipe Calderon announced an emergency decree Saturday authorizing health workers to isolate patients and enter and search their homes to combat this flu.
But no such effort has been made with Leyva's family. His widow said she has been asked little and told even less since his death on April 20.
The president's office referred all inquiries about the case to the federal health department, where a spokeswoman said she had no information. Victor Torres, assistant epidemiology director at the state health institute, told the AP he needed another day before he could talk about the case.
But details provided by his family suggest Leyva could have been infecting people all over the crowded capital and the surrounding state of Mexico.
Leyva's widow said he first noticed flu symptoms on April 13, and went to the local clinic in Xonacatlan. No one was available to give him a checkup, but he was given a shot and felt well enough the next day to make the 40-mile bus trip to Mexico City, taking subways to work despite a nasty cough.
Too sick to work again after that, he still had no medical care except for a penicillin injection his niece gave him. By the night of April 19, he was having trouble breaking and had an irregular heartbeat, and so his family took him to the nearby city of Toluca, where the poor can get discounted care at a large public hospital.
By 8 a.m. the next day, he was dead. His family was told the cause was a heart attack brought on by pneumonia.
Four days later, the Centers for Disease Control and Prevention in Atlanta announced that the flu killing people in Mexico matched a disturbing new virus detected in the U.S. that combines genetic material from humans, birds and pigs in a way scientists have never seen before — and that can be passed from human to human.
The news rocked Mexico's government, which had said for weeks that this year's higher flu caseload was nothing unusual. The toll has risen to more than 100 suspected deaths nationwide, with more than 1,600 people sickened. At least 40 swine flu cases — none fatal — have been confirmed in the United States and six in Canada.
CBS News correspondent Hari Sreenavasin reports that many schools, restaurants, daycare centers and other businesses were closed in the Mexican capital city Monday.
As news spread about the dangerous new strain, two nurses from the local clinic visited the family's home last Thursday to say Leyva may not have died from pneumonia after all, and that an epidemiologist at the hospital wanted to see his widow.
She went in on Friday, but said the doctor did not tell her that her husband's death had been confirmed as swine flu. She said he gave her a hug of condolence and urged her to buy an antiflu drug and vitamin C if anyone in her family felt sick.
As of Sunday, she hadn't heard from any other health worker. The local pharmacy had no such drugs to sell, and she didn't have money to buy them anyway. Since her family seemed healthy, she left it at that.
Dr. Carlos Aranza, director of the Adolfo Lopez Mateos hospital where Leyva died, said state laboratory tests confirmed that swine flu killed him, as well as another patient there, a 42-year-old woman identified only as Gregoria.
Aranza also said that while the hospital had no antiflu medication to give the widow at the time, it now has Tamiflu in stock for those who need it.
Experts on epidemics suggest Mexican health officials should be more proactive in seeking out people who came into close contact with the victims, and in insisting they take antiviral drugs to prevent the spread of contagion.
"No matter whether the patients lived or died, their families should be offered prophylactic antibiotics," said Dr. Richard Wenzel, past president of the International Society for Infectious Diseases. "There would be an expectation that should happen anywhere in the world. And if they have trouble getting the drug they should ask for it."
Meanwhile, Cortes is struggling more than ever to make ends meet. Without her husband, her only income is from a plywood stand in front of her house where she sells candy and soda. She said sales are slow because her neighbors fear she might have swine flu and are staying away.
"I sleep on the same mattress under the same covers that my husband used. What contagion are they talking about?" she said. "I don't want anyone singling me out, as some already have, saying, 'The Leyva Corteces have the virus."'
© MMIX, CBS Interactive Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.
http://www.cbsnews.com/stories/2009/04/27/health/main4970352.shtml
Why Is Swine Flu A Killer Only In Mexico?
Experience Of One Victim's Family Raises Troubling Questions About Country's Response To Epidemic
CBS/AP) The 39-year-old bricklayer fell ill two weeks ago and became one of the first Mexicans to die of swine flu. But no health worker has come to his home outside Mexico City to offer medicine or ask about the neighbors' pigs.
In fact, Gerardo Leyva Lolis' widow says nobody even told her he died of swine flu until The Associated Press informed her the case had been confirmed by the director of the hospital where he was rushed last week.
The family's experience raises troubling questions about Mexico's response to the epidemic and one of its greatest mysteries: why the disease is killing people in Mexico, but so far nowhere else.
"I don't know what to think," Antonia Cortes Borbolla said Sunday, holding back tears in the two-room wood and cinderblock home she shared with her husband and their three teenage sons in this rural town of 18,000 located 40 miles outside Mexico City.
Their neighbors — three of whom keep pigs in their yards — had harsher things to say about the failure of Mexican health officials to provide medicine to protect those closest to the swine flu victim.
"Not even they know what's going on," Sandra Estrada said of the dead man's family. "If it was (swine flu), why haven't they taken measures to protect the family?"
Epidemiologists need details about victims to locate the source of a viral outbreak and to understand how it spreads. There are antiviral drugs, including Tamiflu, that have been shown to be effective, but they need to be taken within days of the first symptoms. Experts also suggest they be given to those in close contact with flu victims, even if they don't show symptoms, to make sure they don't unwittingly spread the virus.
Meanwhile, in the U.S., the White House says "don’t panic," yet the race is on to contain an outbreak of swine flu that has proven to be deadly in Mexico where there are now more than 100 deaths, with more than 1,600 suspected cases.
An official said New York City has 20 more confirmed cases of swine flu, raising the city's total to 28. The official says there are another 17 probable cases in New York City.
Speaking before the National Academy of Sciences, President Obama said he is "closely monitoring" the swine flu situation, getting regular updates from the various public health agencies grappling with the problem. Mr. Obama said Americans can expect regular updates from these agencies as well.
President Felipe Calderon announced an emergency decree Saturday authorizing health workers to isolate patients and enter and search their homes to combat this flu.
But no such effort has been made with Leyva's family. His widow said she has been asked little and told even less since his death on April 20.
The president's office referred all inquiries about the case to the federal health department, where a spokeswoman said she had no information. Victor Torres, assistant epidemiology director at the state health institute, told the AP he needed another day before he could talk about the case.
But details provided by his family suggest Leyva could have been infecting people all over the crowded capital and the surrounding state of Mexico.
Leyva's widow said he first noticed flu symptoms on April 13, and went to the local clinic in Xonacatlan. No one was available to give him a checkup, but he was given a shot and felt well enough the next day to make the 40-mile bus trip to Mexico City, taking subways to work despite a nasty cough.
Too sick to work again after that, he still had no medical care except for a penicillin injection his niece gave him. By the night of April 19, he was having trouble breaking and had an irregular heartbeat, and so his family took him to the nearby city of Toluca, where the poor can get discounted care at a large public hospital.
By 8 a.m. the next day, he was dead. His family was told the cause was a heart attack brought on by pneumonia.
Four days later, the Centers for Disease Control and Prevention in Atlanta announced that the flu killing people in Mexico matched a disturbing new virus detected in the U.S. that combines genetic material from humans, birds and pigs in a way scientists have never seen before — and that can be passed from human to human.
The news rocked Mexico's government, which had said for weeks that this year's higher flu caseload was nothing unusual. The toll has risen to more than 100 suspected deaths nationwide, with more than 1,600 people sickened. At least 40 swine flu cases — none fatal — have been confirmed in the United States and six in Canada.
CBS News correspondent Hari Sreenavasin reports that many schools, restaurants, daycare centers and other businesses were closed in the Mexican capital city Monday.
As news spread about the dangerous new strain, two nurses from the local clinic visited the family's home last Thursday to say Leyva may not have died from pneumonia after all, and that an epidemiologist at the hospital wanted to see his widow.
She went in on Friday, but said the doctor did not tell her that her husband's death had been confirmed as swine flu. She said he gave her a hug of condolence and urged her to buy an antiflu drug and vitamin C if anyone in her family felt sick.
As of Sunday, she hadn't heard from any other health worker. The local pharmacy had no such drugs to sell, and she didn't have money to buy them anyway. Since her family seemed healthy, she left it at that.
Dr. Carlos Aranza, director of the Adolfo Lopez Mateos hospital where Leyva died, said state laboratory tests confirmed that swine flu killed him, as well as another patient there, a 42-year-old woman identified only as Gregoria.
Aranza also said that while the hospital had no antiflu medication to give the widow at the time, it now has Tamiflu in stock for those who need it.
Experts on epidemics suggest Mexican health officials should be more proactive in seeking out people who came into close contact with the victims, and in insisting they take antiviral drugs to prevent the spread of contagion.
"No matter whether the patients lived or died, their families should be offered prophylactic antibiotics," said Dr. Richard Wenzel, past president of the International Society for Infectious Diseases. "There would be an expectation that should happen anywhere in the world. And if they have trouble getting the drug they should ask for it."
Meanwhile, Cortes is struggling more than ever to make ends meet. Without her husband, her only income is from a plywood stand in front of her house where she sells candy and soda. She said sales are slow because her neighbors fear she might have swine flu and are staying away.
"I sleep on the same mattress under the same covers that my husband used. What contagion are they talking about?" she said. "I don't want anyone singling me out, as some already have, saying, 'The Leyva Corteces have the virus."'
© MMIX, CBS Interactive Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.
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