By LAURAN NEERGAARD, AP Medical Writer Lauran Neergaard, Ap Medical Writer – 9 mins ago
WASHINGTON – A 23-month-old Texas toddler became the first confirmed swine flu death outside of Mexico as authorities around the world struggled to contain a growing global health menace that has also swept Germany onto the roster of afflicted nations.
"Even though we've been expecting this, it is very, very sad," Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention, said Wednesday of the infant's death. "As a pediatrician and a parent, my heart goes out to the family."
President Barack Obama said this morning that Americans should know the government is doing all it can to control virus. Obama also says schools should consider closing if the spread of the swine flu virus worsens.
Canada, Austria, New Zealand, Israel, Spain, Britain and Germany also have reported cases of swine flu sickness. Deaths reported so far have been limited to Mexico, and now the U.S.
As the United States grappled with this widening health crisis, Besser went from network to network Wednesday morning to give an update on what the Obama administration is doing. He said authorities essentially are still "trying to learn more about this strain of the flu." His appearances as Germany reported its first cases of swine flu infection, with three victims.
"It's very important that people take their concern and channel it into action," Besser said, adding that "it is crucial that people understand what they need to do if symptoms appear.
"I don't think it (the reported death in Texas) indicates any change in the strain," he said. "We see with any flu virus a spectrum of disease symptoms."
Asked why the problem seems so much more severe in Mexico, Besser said U.S. officials "have teams on the ground, a tri-national team in Mexico, working with Canada and Mexico, to try and understand those differences, because they can be helpful as we plan and implement our control strategies."
Sixty-six infections had been reported in the United States before the report of the toddler's death in Texas.
The world has no vaccine to prevent infection but U.S. health officials aim to have a key ingredient for one ready in early May, the big step that vaccine manufacturers are awaiting. But even if the World Health Organization ordered up emergency vaccine supplies — and that decision hasn't been made yet — it would take at least two more months to produce the initial shots needed for human safety testing.
"We're working together at 100 miles an hour to get material that will be useful," Dr. Jesse Goodman, who oversees the Food and Drug Administration's swine flu work, told The Associated Press.
The U.S. is shipping to states not only enough anti-flu medication for 11 million people, but also masks, hospital supplies and flu test kits. President Barack Obama asked Congress for $1.5 billion in emergency funds to help build more drug stockpiles and monitor future cases, as well as help international efforts to avoid a full-fledged pandemic.
"It's a very serious possibility, but it is still too early to say that this is inevitable," the WHO's flu chief, Dr. Keiji Fukuda, told a telephone news conference.
Cuba and Argentina banned flights to Mexico, where swine flu is suspected of killing more than 150 people and sickening well over 2,000. In a bit of good news, Mexico's health secretary, Jose Cordova, late Tuesday called the death toll there "more or less stable."
Mexico City, one of the world's largest cities, has taken drastic steps to curb the virus' spread, starting with shutting down schools and on Tuesday expanding closures to gyms and swimming pools and even telling restaurants to limit service to takeout. People who venture out tend to wear masks in hopes of protection.
The number of confirmed swine flu cases in the United States rose to 66 in six states, with 45 in New York, 11 in California, six in Texas, two in Kansas and one each in Indiana and Ohio, but cities and states suspected more. In New York, the city's health commissioner said "many hundreds" of schoolchildren were ill at a school where some students had confirmed cases.
The WHO argues against closing borders to stem the spread, and the U.S. — although checking arriving travelers for the ill who may need care — agrees it's too late for that tactic.
"Sealing a border as an approach to containment is something that has been discussed and it was our planning assumption should an outbreak of a new strain of influenza occur overseas. We had plans for trying to swoop in and knockout or quench an outbreak if it were occurring far from our borders. That's not the case here," Besser told a telephone briefing of Nevada-based health providers and reporters. "The idea of trying to limit the spread to Mexico is not realistic or at all possible."
"Border controls do not work. Travel restrictions do not work," WHO spokesman Gregory Hartl said in Geneva, recalling the SARS epidemic earlier in the decade that killed 774 people, mostly in Asia, and slowed the global economy.
Authorities sought to keep the crisis in context: Flu deaths are common around the world. In the U.S. alone, the CDC says about 36,000 people a year die of flu-related causes. Still, the CDC calls the new strain a combination of pig, bird and human viruses for which people may have limited natural immunity.
Hence the need for a vaccine. Using samples of the flu taken from people who fell ill in Mexico and the U.S., scientists are engineering a strain that could trigger the immune system without causing illness. The hope is to get that ingredient — called a "reference strain" in vaccine jargon — to manufacturers around the second week of May, so they can begin their own laborious production work, said CDC's Dr. Ruben Donis, who is leading that effort.
Vaccine manufacturers are just beginning production for next winter's regular influenza vaccine, which protects against three human flu strains. The WHO wants them to stay with that course for now — it won't call for mass production of a swine flu vaccine unless the outbreak worsens globally. But sometimes new flu strains pop up briefly at the end of one flu season and go away only to re-emerge the next fall, and at the very least there should be a vaccine in time for next winter's flu season, Dr. Anthony Fauci, the National Institutes of Health's infectious diseases chief, said Tuesday.
"Right now it's moving very rapidly," he said of the vaccine development.
Besser appeared on NBC's "Meet the Press," CNN and CBS's "The Early Show."
SOURCE OF THIS SADDENING NEWS
" A very young victim for this outbreak is saddening. Hopefully, the vaccine will be ready sooner. Hope no more deaths. Let us all join in praying that the flu stops harming humanity."
MEXICO CITY – Mexico's president assumed new powers Saturday to isolate people infected with a deadly swine flu strain as authorities struggled to contain an outbreak that world health officials warned could become a global epidemic.
New cases of swine flu were confirmed in Kansas and California and suspected in New York City. But officials said they didn't know whether the New York cases were the strain that now has killed up to 81 people in Mexico and likely sickened 1,324 since April 13, according to figures updated late Saturday by Mexico's health secretary.
Tests have confirmed swine flu as the cause of death in 20 of the cases.
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.
Two dozen new suspected cases were reported in Mexico City alone, where authorities suspended schools and all public events until further notice. More than 500 events, including concerts and sports games, were canceled in the metropolis of 20 million.
Mexican authorities ordered schools closed in the capital and the states of Mexico and San Luis Potosi until May 6, and the Roman Catholic Church announced the cancellation of Sunday masses in the capital.
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. But officials said it was designed to free health workers from possible legal reprisals and to speed disease control efforts.
A team from the Centers for Disease Control had arrived in Mexico to help set up detection testing for the swine flu strain, something Mexico previously lacked.
The U.S. Embassy said the U.S. has not imposed travel constraints to and from Mexico but is suspending the processing of visas and other services through Wednesday to avoid creating crowds.
It issued an earlier message advising U.S. citizens to avoid large crowds, shaking hands, greeting people with a kiss or using the subway.
While suspected swine flu cases have been reported in about 16 Mexican states, Health Secretary Jose Cordova said "it has not spread to the entire country."
WHO Director-General Margaret Chan said the outbreak of the never-before-seen virus has "pandemic potential." But she said it is still too early to tell if it would become a pandemic.
WHO lays out three criteria necessary for a global epidemic: The virus is able to infect people, can readily spread person-to-person and the global population has no immunity to it.
Early detection and treatment are key to stopping any outbreak. WHO guidance calls for isolating the sick and blanketing everyone around them with anti-viral drugs such as Tamiflu.
Now, with patients showing up all across Mexico and its teeming capital, simple math suggests that kind of response is impossible.
Mexico appears to have lost valuable days or weeks in detecting the new virus.
Health authorities started noticing a threefold spike in flu cases in late March and early April, but they thought it was a late rebound in the December-February flu season.
Testing at domestic labs did not alert doctors to the new strain, and Cordova acknowledged Mexican labs lacked the necessary profiling data to detect the previously unknown strain.
The first death occurred in southern Oaxaca state on April 13, but Mexico didn't send the first of 14 mucous samples to the CDC until April 18, around the same time it dispatched health teams to hospitals looking for patients with severe flu or pnuemonia-like symptoms.
Those teams noticed something strange: The flu was killing people aged 20 to 40. Flu victims are usually either infants or the elderly. The Spanish flu pandemic, which killed at least 40 million people worldwide in 1918-19, also first struck otherwise healthy young adults.
Even though U.S. labs detected the swine flu in California and Texas before last weekend, Mexican authorities as recently as Wednesday were referring to it as a late-season flu.
But mid-afternoon Thursday, Mexico City Health Secretary Dr. Armando Ahued said, officials got 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," Cordova said.
Asked why there were so many deaths in Mexico, and none so far among the 11 cases in the United States, Cordova noted that the U.S. cases involved children — who haven't been among the fatal cases in Mexico, either.
"There are immune factors that are giving children some sort of defense, that is the only explanation we have," he said.
Another factor may be that some Mexican patients may have delayed seeking medical help too long, Cordova said.
Some Mexicans suspected the government had been less than forthcoming. "They always make a big deal about good things that happen, but they really try to hide anything bad," Mexico City paralegal Gilberto Martinez said.
Airports around the world were screening travelers from Mexico for flu symptoms. But containing the disease may not be an option.
"Anything that would be about containing it right now would purely be a political move," said Michael Osterholm, a University of Minnesota pandemic expert.
Scientists have warned for years about the potential for a pandemic from viruses that mix genetic material from humans and animals.
This swine flu and regular flu can have similar symptoms — mostly fever, cough and sore throat, though some of the U.S. 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.
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.
Mexican authorities did lay to rest one persistent doubt, after Mexican museum director Felipe Solis died this week, just days after accompanying U.S. President Barack Obama on a tour of National Anthropology Museum on April 16. Cordova said Solis had a pre-existing illness and died of pneumonia unrelated to influenza.
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Associated Press Writers David Koop in Mexico City; Frank Jordans in Geneva; Mike Stobbe in Atlanta; Malcolm Ritter in New York; and Maria Cheng in London contributed to this report.
" This is a very disturbing news. In the Philippines, an order was given to strictly check all passengers at the NAIA who came from swine flu locations. With a new pandemic such as this, adding to the world economic crisis, what else is next? We can only hope for the best. "
