U.S. Declares Public Health Emergency Over Swine Flu Outbreak

US declares public health emergency over swine flu outbreak

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Agence France-Presse
Published: Sunday April 26, 2009

The United States declared a swine flu outbreak a public health emergency Sunday as officials confirmed 20 cases in five US states and warned that they expected more in the coming days.

President Barack Obama is monitoring the spreading virus and has reviewed US capabilities to counter the deadly flu outbreak, which has killed up to 81 people in Mexico, White House homeland security advisor John Brennan told reporters.

Obama has ordered a "very active, aggressive, and coordinated response," Brennan said.

Richard Besser, the acting head of the Centers for Disease Control and Prevention (CDC), told a White House press conference that there were eight confirmed US cases in New York City, seven in California, two in Texas, two in Kansas and one in Ohio.

"As we look for cases of swine flu, we are seeing more cases of swine flu. We expect to see more cases of swine flu," said Besser.

"We're responding aggressively to try and learn more about this outbreak" and to implement measures to control its spread, he added.

"We've ramped up our surveillance around the country to try and understand better what is the scope, what is the magnitude of this outbreak."

Although there the government has not issued a warning against travel to Mexico, Besser said warnings could be increased "based on what the situation warrants."

Homeland Security Department Secretary Janet Napolitano said the US government would officially declare a public health emergency later on Sunday in response to the outbreak, adding that the declaration was "standard operating procedure."

The move allows government agencies to free up federal, state and local agencies and their resources in preventing the spread of the virus.

The declaration also allows officials to use medication and diagnostic tests and releases funds to purchase additional antiviral medication.

"All persons entering the United States from a location of human infection of swine flu will be processed through all appropriate CDC protocols," she added.

Suspected swine flu cases were being tested in Europe, the Middle East and Asia, after the new strain gain attention out of Mexico last week.

Health officials in Canada have reported a total of six confirmed cases of the potentially deadly virus.

World Health Organization (WHO) officials warned that the new strain, apparently born when human and avian flu viruses infected pigs and became mixed, could further mutate.

US immigration officials are looking for people with flu symptoms, said Napolitano.

"Travelers who do present with symptoms, if and when encountered, will be isolated per established rules," she said.

"They will be provided both with personal protective equipment and we'll continue to emphasize universal hand washing."

Similar emergency health declarations were issued for floods in recent months in the US states of Minnesota and North Dakota and President Barack Obama's inauguration in January.

Napolitano said the government intends to release a quarter of the national stockpile of 50 million doses of the antiviral drugs Tamiflu and Relenza. The drugs would be made available to all US states, especially those with confirmed cases of the flu.

The Pentagon, she added, "has procured and strategically pre-positioned" seven million treatment courses of the flu drug Tamiflu.

In Mexico, President Felipe Calderon urged citizens to consult a doctor if they present flu-like symptoms.

Speaking at a National Health Council event on Sunday, Felipe Calderon said it was necessary for Mexicans to "move fast, but to maintain calm and cooperate with the authorities."

Scramble to stop swine flu spread among travelers

http://news.yahoo.com/s/ap/swine_flu...93b3JsZARjcG9z

4/27/2009

WELLINGTON, New Zealand – Three more New Zealanders recently returned from Mexico are suspected of having swine flu and Spain announced the first confirmed case of the deadly virus in Europe on Monday, as countries rushed to screen travelers for fevers.

World Health Organization spokesman Peter Cordingley said the new virus was spreading quickly in Mexico and the southern United States, raising fears of a global pandemic.

"These are early days. It's quite clear that there is a potential for this virus to become a pandemic and threaten globally," Cordingley, WHO's spokesman for the Western Pacific, told AP Television News.

"But we honestly don't know," he added. "We don't know enough yet about how this virus operates. More work needs to be done."

As of late Sunday, the number of suspected swine flu cases in Mexico had climbed to 1,614, including as many as 103 deaths, according to Health Secretary Jose Angel Cordova. The United States has confirmed at least 11 cases of swine flu, and Canada six cases.

Spain's Health Minister Trinidad Jimenez said the confirmed case was found in a young man who recently returned from Mexico. The man is responding well treatment. Another 20 people in the country are suspected of having the disease.

Meanwhile, New Zealand was testing several students, their parents and teachers who were showing flu-like symptoms. Israel has put two people under observation, while France and Brazil have also reported suspected cases.

Cordingley singled out plane travel as an easy way the virus could spread, noting that the WHO estimates that up to 500,000 people are aboard planes at any time.

Governments in Asia — with potent memories of SARS and bird 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 at airports from North America. South Korea and Indonesia introduced similar screening.

In Malaysia, health workers wearing face masks took the temperatures of passengers as they arrived from a flight from Los Angeles.

Officials said travelers with flu-like symptoms would be given detailed health checks.

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 for passengers aboard their planes before being allowed to land in Australia.

China said anyone experiencing flu-like symptoms within two weeks of arrival had to report to authorities.

But some officials cautioned the checks might not be sufficient.

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.

"Border guardings, thermal imaging will not detect much of this flu when it eventually comes through because a lot of people will be incubating," he said.

In Hong Kong, Thomas Tsang, controller for territory's Center for Health Protection, said the government and universities aim to develop a quick test for the new flu strain in a week or two that will return results in four to six hours, compared to existing tests that can take two or three days.

Swiss drug company Roche Holding AG said it could deliver its 3 million packages of Tamiflu anywhere in the world within 24 hours.

In 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.

Results from a WHO-registered laboratory were expected within days.

All the New Zealand students and teachers along with their families had voluntarily quarantined themselves at home. In addition, Ryall said three small groups of returned travelers were being monitored after reporting flu symptoms following recent trips to North America. He gave no further details.

Prime Minister John Key said everyone showing flu symptoms was being treated with Tamiflu as a precaution. Other passengers and crew on the suspect flights were also being given the antiviral drug, said health department official Julia Peters.

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 — the country hardest hit by bird flu — said Monday it was banning all pork imports to prevent swine fever infections.

Many governments issued travel warnings for Mexico, including Hong Kong and South Korea. Japan's largest tour agency, JTB Corp., suspended tours to Mexico at least through June 30.

Many measures recalled those taken across Asia during the severe acute respiratory syndrome epidemic and used more recently to monitor bird flu.

Drawing on their fight against SARS, experts in Hong Kong warned that swine flu seems harder to detect early and may spread faster.

Obama Admin. Releases Stockpile of Antiflu Virus Drug
Tamiflu Has Shown to Be Effective Against Swine Flu

http://abcnews.go.com/Health/Coldand...7434061&page=1

By JOHN HENDREN
WASHINGTON, April 26, 2009

The Obama administration was "all hands on deck" today in response to the quickly escalating swine flu outbreak, with the declaration of a public health emergency and the release of the national antiflu drug stockpile.

Director of Homeland Security Janet Napolitano, center, in the White House Press Briefing Room during a news conference to discuss reported Swine Flu outbreaks, Sunday, April 26, 2009, in Washington. Standing behind her are White Press Secretary Richard Gibbs, right, and Dr. Richard Besser, left, Acting Director Center for Disease Control and Prevention.

Department of Homeland Security Secretary Janet Napolitano declared a national public health emergency, with swine flu now confirmed in at least 20 cases in five states. However, she said, the outbreak has not yet threatened to reach the lethal level it has in Mexico.

That declaration gives the head of the Department of Health and Human Services authority to take rapid measures -- including authorizing contacts and mobilizing the national disaster system -- to respond to the disease, including allowing the use of unapproved drugs. The agency currently is waiting for President Obama's designee, Kathleen Sebelius, to be approved by the Senate.

"It's all hands on deck and we're doing fine," White House Press Secretary Robert Gibbs said at a special briefing at the White House with the nation's top health and homeland security officials. "We're hopeful that we'll have a new secretary shortly."

The Obama administration has released 12.5 million of the nation's stockpile of 50 million courses of Tamiflu, a drug that has shown itself at least initially to be effective against the flu virus. The Pentagon has readied 7 million courses for military personnel.

The president has also activated a group of administration officials from several agencies to monitor the outbreak and develop a response. However, the State Department has not issued a travel advisory telling Americans not to travel to Mexico.

Centers for Disease Control acting director Dr. Richard Besser said the agency does not believe it can contain the outbreak beyond the five states it has reached so far.

There is still hope, however, that the spread of the swine flu, which has been shown to move from human-to-human contact, will be limited, particularly since the regular flu season is already winding down.

Nevertheless, he added, the strain appears to be the same one found in Mexico and more cases are expected.

To date only one of the 20 affected Americans has been hospitalized due to the virus, officials said.

"As we continue to look for cases, I expect that we're going to find them," Besser said, adding, "This is moving fast."

He said U.S. health officials don't view it as a sprint, "we view this as a marathon."

Obama is "very concerned" about the outbreak and is "monitoring closely" any news through regular briefings, said John Brennan, assistant to the president for Homeland Security.

The president himself brought a White House entourage to Mexico City, the heart of the outbreak, nine days ago, but Gibbs said he does not believe Obama or anyone who traveled with him have been tested or shown any signs of illness. The virus has an incubation period of only a couple days, he added.

Those most at risk are anyone who has traveled to the affected areas in Mexico.

Government officials advise regular hand-washing and urged Americans to stay at home if they have flulike symptoms, but Gibbs added that they should not overwhelm doctors' offices with requests for treatment if they are not showing symptoms.

There is "no issue with the food supply," Napolitano told reporters, "and you can't get it from eating pork."

Asked if the outbreak in the United States could reach the deadly level now seen in Mexico, Besser said that was impossible to answer.

"Every outbreak is unique," he said.

But there is no reason to suspect a bio-terror attack, Brennan told reporters.

The administration has found "nothing to suggest anything but a naturally occurring" event, he said.

Regular flu season precautions advised in current outbreak

http://www.cnn.com/2009/HEALTH/04/26...sks/index.html

4/27/2009

(CNN) -- As reports of swine flu continue to rise in the United States and around the world, the average American is probably asking, "How should I protect myself?"

U.S. health officials stress the importance of frequent hand washing during outbreaks of illness.

more photos » Health officials' advice is to follow common-sense precautions: Wash your hands, stay home if you're sick and listen to your local health authorities.

"Very frequent hand-washing is something that we talk about time and time again and that is an effective way to reduce transmission of disease," Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention, said Sunday at a White House briefing.

"If you're sick, it's very important that people stay at home. If your children are sick, have a fever and flu-like illness, they shouldn't go to school. And if you're ill, you shouldn't get on an airplane or another public transport to travel. Those things are part of personal responsibility in trying to reduce the impact. "

"In areas with no disease yet, a lot of what we can do sounds simple and repetitive but helps," said Dr. Anne Schuchat, interim deputy director of the CDC's Science and Public Health Program. In addition to washing hands often, she recommends covering your mouth when coughing and sneezing and avoiding touching your eyes and nose in case the virus is on your hands.

By midday Sunday, there were 20 confirmed cases in the United States. All infected U.S. patients have recovered. No one has died.

Mexico, however, has been hard hit: 86 deaths had been deemed "likely linked" to a deadly new strain of the flu virus by health authorities there. Viral testing has confirmed 20 cases, said Dr. Jose A. Cordova Villalobos, Mexico's health secretary, and Mexican authorities are investigating at least 1,000 cases of illness.

Cases also have been reported in New Zealand and Canada.

The World Health Organization calls the situation a "public health emergency of international concern," and the United States on Sunday declared a "public health emergency," likened by Homeland Security Secretary Janet Napolitano to preparations for a potential hurricane. No authorities are calling the outbreak a pandemic.

The CDC expects U.S. numbers will grow and recommendations will change depending on what happens in individual communities, said the CDC's Schuchat. The public should pay attention to what is happening nearby and heed the guidance of local health officials regarding school, work and public events.

Because so much is still unknown at this point, the main risk factor is people traveling to areas where cases have already been identified. "However this virus may already be in other places in the United States," CDC spokesman Tom Skinner told CNN. "With enhanced surveillance, we will see more cases and that is why it makes good sense to be proactive, by doing things we know are effective in reducing exposure." Explainer: Swine flu facts »

Schuchat noted swine flu symptoms are relatively general and nonspecific. "So many different things can cause these symptoms. it is a dilemma," she said. "It is a challenge that we are wrestling with. There is not a perfect test right now to let a person or doctor know exactly what this is."

U.S. travel to Mexico has not been restricted, but Schuchat specifically advised anyone who feels ill after returning from Mexico to see a doctor.

Unfortunately, since this is a new strain of influenza, the flu vaccine for this past flu season offers no protection. "However, we do have anti-virals that work against this swine flu," said Skinner, referring to oseltamivir (Tamiflu) and zanamivir (Relenza). "Someone who has [swine flu], if they are treated early, the anti-flu medicines work against this."

According to Skinner, health officials are still trying to figure out where exactly the virus originated, how transmissible it is and why it is mild in some cases and deadlier in others.

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