Sunday, April 26, 2009

Pandemic Feared as Mexican Swine Flu Spreads. One Israeli Hospitalized.


One Israeli is hospitalized right now with the flu, but it is not clear whether it is the same swine flu that has affected Mexico and spread to the US and New Zealand.

This swine flu is bad news. First, because it is not just a swine flu. It is a mixture of avian, swine, and human flu viruses—which means that birds can carry it. Birds that are, right now, returning to the Northern US states after wintering in Mexico.

Also, this is the time when Mexican laborers flood the Southern States in order to get work picking crops, and flood the Northern states in order to help with Spring planting.

Also, the flu virus, which was not reported until now but showed up in late March and early April, may have been passed to thousands upon thousands of vacationing “Spring Break” students—not just the few students in Queens, but a LOT of students.

I find this virus interesting for a few reasons. First, it is hitting at a very unusual time. Second, it is a previously unknown virus which contains swine, bird, and human forms.

Third, it is especially virulent, and more deadly to healthy young people than it is to infants and elderly.

I know I am probably just paranoid, but if a terrorist wanted to send a biological weapon to the US but bypass any US controls, it would make sense to introduce that biological weapon in Mexico.

Mexico has an overburdened state medical system, a concentrated population base, and their heath department is chronically understaffed.

Once a biological agent is introduced into Mexican culture and established, then it is guaranteed to move into the US population, especially in the Spring.

Whether G-d or humanity has created this strain, it sounds especially dangerous and especially deadly. I am hoping that it can be contained and dealt with quickly, and that no more lives will be endangered by it.

Keep safe. No matter where you are in the world, this virus can spread to you. There is so much international travel and so much international movement that no corner of the world is immune from a pandemic.

Until our scientists can find a treatment/cure for this illness, remember to wash your hands for at least 20 seconds under warm water with soap every time you touch something someone else has touched, you are preparing food, or you are are in a situation where you need to assist children or elderly people.

Make sure you sanitize keyboards, phones, refrigerator handles, and computer mouse units at work and school with something that can kill viruses—like straight alcohol (which won’t harm your electronics); make sure your employer, school, or yeshiva encourages people to stay home if they are ill (no matter what!), and make sure that you are careful to wash your hands before eating (that includes washing your hands with soap and water if you touch the handles of a washing cup or the faucet handles at the washing cup sink! There are a lot of ill people touching the handles of that cup and faucet, and most cups and faucets haven’t been washed in a LOOOONG time. If you need to wash in public, use a disposable plastic cup and a layer of paper towels to turn on/off the faucet. It is a lot safer!)

Here’s the symptoms of the flu, from the CDC:

  • What are the signs and symptoms of swine flu in people?
  • The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.

Here is the webpage about the flu from WHO .


Israeli in hospital amid swine-flu fears
Apr. 26, 2009
judy siegel and ap , THE JERUSALEM POST /servlet/Satellite?cid=1239710785388&pagename=JPArticle%2FShowFull

Amid growing international fears over the spread of a deadly flu-like virus, 25 Israeli tourists returning from Mexico were examined on Sunday, and one of them, who has a fever, was being held at the Laniado Hospital in Netanya.

The 26-year-old man was being held in quarantine while medical staff waited for his test results.

The Health Ministry said over the weekend that health funds and hospitals should renew their awareness of swine flu.

The Ministry instructed doctors to take special notice of patients suffering from acute respiratory illnesses, who have a temperature higher than 38 degrees Celsius and who complain of coughing, throat aches, mucus or shortness of breath.

Anyone who develops such symptoms up to seven days after returning from Mexico or after being in close vicinity to a person diagnosed with swine flu is requested to seek medical treatment.

The Foreign Ministry decided not to issue a warning against traveling to Mexico, but recommended that any Israeli staying in Mexico or who intends to visit the country in the near future, read the instructions published by the Health Ministry and avoid crowded places.

Also Sunday, New Zealand's health minister said ten students who had just returned from Mexico have tested positive for influenza. He said the cases were "likely" to be swine flu.

Tony Ryall said there was "no guarantee" the students had swine flu, but that health officials were taking precautions.

The group from New Zealand's largest high school returned to the northern city of Auckland on Saturday on a flight from Los Angeles. Thirteen students and one teacher were unwell and one student had to be hospitalized, said Auckland Regional Public Health Services director Dr. Julia Peters.

Meanwhile in the UK, the BBC reported that test results of a British Airways crew member who was taken to a hospital after also developing such symptoms came out negative, meaning that he was not carrying the deadly virus.

At least 81 people have died from severe pneumonia caused by a flu-like illness in Mexico, according to the World Health Organization, which declared the virus a public health emergency of "pandemic potential."

Mexico has closed schools, museums, libraries and theaters in a bid to contain the outbreak, which may have sickened about 1,000 people there.

Some of those who died are confirmed to have a unique version of the A/H1N1 flu virus that is a combination of bird, pig and human viruses, WHO said.

US authorities said 11 people were infected with swine flu, and all recovered or are recovering and at least two were hospitalized.

"It would be prudent for health officials within countries to be alert to outbreaks of influenza-like illness or pneumonia, especially if these occur in months outside the usual peak influenza season," WHO Director-General Margaret Chan said in Geneva on Saturday.

"Another important signal is excess cases of severe or fatal flu-like illness in groups other than young children and the elderly, who are usually at highest risk during normal seasonal flu," she said, adding, "the situation is evolving quickly."

In Asia, Japan's biggest international airport stepped up health surveillance, while the Philippines said it may quarantine passengers with fevers who have been to Mexico. Health authorities in Thailand and Hong Kong said they were closely monitoring the situation.

China said anyone experiencing flu-like symptoms within two weeks of arriving in the country from swine-flu affected territories was required to report to authorities.

Australia's Department of Health and Aging urged anyone who had returned from Mexico with influenza-like symptoms since March to seek advice from their doctors.

Malaysia and other Asian nations said they were awaiting further advice from WHO.

At Tokyo's Narita airport - among the world's busiest with more than 96,000 people using it daily - officials installed a device at the arrival gate for flights from Mexico to measure the temperatures of passengers.

A Health Ministry official said the government will monitor conditions of people returning from Mexico with their consent.

Agriculture Minister Shigeru Ishiba appeared on TV to calm consumers, saying it was safe to eat pork.

"Whether it's domestic or imported pork, pork is sanitized when being shipped" to supermarkets, Ishiba told TV Asahi. "It's perfectly safe to eat pork."

Asia has grappled in recent years with the H5N1 bird flu virus, which has killed at least 257 people worldwide since late 2003, according to WHO. Nearly 45 percent of the global bird flu deaths have occurred in Indonesia, with 115 fatalities.

Swine fever is a respiratory disease in pigs caused by the Type A flu virus. It is more common at the end of the fall and during the winter, much as regular flu affects humans.

Ordinarily, swine flu does not affect humans, although a small number who participate in pig fairs or work in the pig-processing industry will come down with it.

This virus is a mix of human, pig and bird strains that prompted 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.

Chan said the outbreak of this never-before-seen virus is a very serious situation and has "pandemic potential."

But she said it is still too early to tell if it would become a worldwide outbreak.

"The situation is evolving quickly," Chan said in a telephone news conference in Geneva. "A new disease is by definition poorly understood."

Scientists have warned for years about the potential for a pandemic from viruses that mix genetic material from humans and animals.

Another reason to worry is that authorities said the dead so far don't include vulnerable infants and elderly. The Spanish flu pandemic, which killed at least 40 million people worldwide in 1918-19, also first struck otherwise healthy young adults.

This swine flu and regular flu can have similar symptoms - mostly fever, cough and sore throat, though some of the US 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 bring into use.

Experts at the WHO and the US 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 were probably 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.

But CDC officials dismissed the idea of trying that in the United States, and some expert said it's too late to try to contain spread of the virus.

They noted there had been no direct contact between the cases in the San Diego and San Antonio areas, suggesting the virus had already spread from one geographic area through other undiagnosed people.

"Anything that would be about containing it right now would purely be a political move," said Michael Osterholm, a University of Minnesota pandemic expert.

Mexican President Felipe Calderon 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.

But the government had said for days that its growing flu caseload was nothing unusual, so the sudden turnaround angered many who wonder if Mexico missed an opportunity to contain the outbreak.

"Why did it break out, where did it break out? What's the magnitude of the problem?" pizzeria owner David Vasquez said while taking his family to a movie Friday night, despite warnings to stay out of theaters.

Beginning in late March, when the flu season usually starts to taper off, health officials began recording a spike in cases - three times the normal number.

On April 16, Assistant Health Secretary Mauricio Hernandez noted "an unusual transmission period" of regular, seasonal flu.

Starting two days later, health teams were sent to hospitals looking for patients with severe flu or pneumonia-like symptoms. They noticed something strange: The flu was killing people aged 20 to 40, though flu deaths are nearly always among either infants or the elderly.

On Wednesday, Hernandez said testing was being carried out in Mexican labs, and hospitals were alerted to watch out for cases. But testing at Mexican labs did not alert doctors to the new strain - even though US authorities had detected cases in California and Texas by April 19.

Mexico City Health Secretary Dr. Armando Ahued said it wasn't until mid-afternoon Thursday that authorities received a call "from the United States and Canada, the most important laboratories in the field, telling us this was a new virus."

"That was what led us to realize it wasn't a seasonal virus ... and take more serious preventative measures," federal Health Secretary Jose Cordova said.

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 urged people to stay home if they feel sick and to avoid shaking hands or kissing people on the cheeks.

Outside Hospital Obregon in the capital's middle-class Roma district, a tired Dr. Roberto Ortiz, 59, leaned against an ambulance and sipped coffee Saturday on a break from an unusually busy shift.

"The people are scared," Ortiz said. "A person gets some flu symptoms or a child gets a fever and they think it is this swine flu and rush to the hospital."

He said none of the cases so far at the hospital had turned out to be swine flu.

Jose Donasiano Rosales, 69, got nervous on the subway and decided to get out one stop early.

"I felt I couldn't be there for even one more station," Donasiano said as he set up a rack to sell newspapers on a busy thoroughfare. "We're in danger of contagion. ... I'm worried."

The local Roman Catholic Church recommended that priests shorten Mass; place communion wafers in worshipers' 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.

Ahued, the capital's health secretary, said Mexico City may not be the epicenter of the outbreak - and could be appearing to the brunt simply because it is home to the most sophisticated medical centers.

"The country's best health care facilities are concentrated in the city," he said. "All the cases here get reported, that's why the number is so high."

The same virus also sickened at least eight people in Texas and California, though there have been no deaths north of the border, puzzling experts at the US Centers for Disease Control and Prevention.

A "seed stock" genetically matched to the new swine flu virus has been created by the CDC, said Dr. Richard Besser, the agency's acting director. If the government decides vaccine production is necessary, manufacturers would need that stock to get started.

The CDC says two flu drugs, Tamiflu and Relenza, seem effective against the new strain.

Roche, the maker of Tamiflu, said the company is prepared to immediately deploy a stockpile of the drug if requested. Both drugs must be taken early, within a few days of the onset of symptoms, to be most effective.

Mexico's Health Secretary Jose Angel Cordova said the country has enough Tamiflu to treat 1 million people - only one in 20 people in greater Mexico City alone - and that the medicine will be strictly controlled and handed out only by doctors.

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