Ninety-four cases were reported in 11 U.S. states, with one confirmed death, and New York City officials said they suspected hundreds were infected. The WHO’s statistics, which lag behind those reported by national and local agencies, showed confirmed cases in the U.S., Mexico, Canada, Austria, Germany, Israel, Spain, the U.K. and New Zealand.
Disease trackers are trying to determine whether the new H1N1 influenza strain is spreading efficiently in Spain, said Dick Thompson, a spokesman for the WHO in Geneva. The agency needs evidence of sustained human-to-human transmission outside North America to declare the outbreak has become a pandemic.
Among the 10 cases in Spain, nine involve people who had traveled to Mexico, he said today. “The tenth confirmed to us that there’s some community transmission beginning,” he said. “The virus is becoming established in another area. It’s this new single case that is especially worrying.”
The last pandemic, 41 years ago, killed 1 million people and was mild compared with the global outbreak of 1918, which may have killed as many as 50 million.
‘Preemptive’ Measure
President Barack Obama asked Congress for $1.5 billion to battle an outbreak, and said parents should plan for school closings. Texas Governor Rick Perry declared a disaster, a “preemptive” measure to facilitate emergency preparations and seek federal reimbursement. California Governor Arnold Schwarzenegger declared a state of emergency.
“Every American should know that their entire government is taking the utmost precautions and preparations,” Obama said on a televised news conference last night. “This is a cause for deep concern, but not panic.”
Swine flu infections in people aren’t related to exposure to the animals, and properly prepared pork is safe to eat, said Keiji Fukuda, WHO assistant director-general for health security and environment. The disease, spreading like the seasonal flu, is “unlikely” to stop, Fukuda said.
Mexico Severity
“It’s clear that deaths and serious illnesses can occur in other countries, but more are occurring in Mexico,” Fukuda told reporters yesterday in Geneva. “We don’t know the reason for that right now.”
The genetic strains around the world that have been tested are “remarkably consistent and remarkably similar to each other,” he said. The three main seasonal flu strains -- H3N2, H1N1 and type-B -- cause 250,000 to 500,000 deaths a year globally, according to the WHO.
Scientists are trying to determine why swine flu, a respiratory disease caused by a type-A influenza virus, has been more severe in Mexico. The new flu results in symptoms similar to those of seasonal influenza, including fever and coughing, and may also cause nausea and vomiting, according to the CDC. It appears to be causing more diarrhea than seasonal flu, WHO said.
Hospitalizations and Deaths
The U.S. can expect more hospitalizations and deaths, Sebelius said yesterday in her first press conference after being confirmed secretary of Health and Human Services. Hand- washing and hygiene are among the most effective ways to control the outbreak, she said.
The first death in U.S. was a 22-month-old boy from Mexico City who was brought to Texas Children’s Hospital in Houston last weekend and died April 27, the state health department said yesterday in a statement. The boy had “several underlying health problems,” the statement said.
A Marine is recovering after being tested for the illness, and another 37 Marines are being “watched and tested” at a base in 29 Palms, California, Marine Corps Commandant General James Conway said at the Pentagon yesterday. The base, with 15,000 personnel, is located in the desert east of Los Angeles.
Three adults in Maine were confirmed as having the H1N1 swine flu virus, according to a release from Governor John E. Baldacci’s office, making it the 11th U.S. state with such cases.
‘Level of Calmness’
“We need to maintain a level of calmness so we will continue to manage this in a rational manner,” WHO’s Chan said. “Influenza viruses are notorious for rapid mutation and unpredictable behavior.”
WHO raised the level on its current pandemic alert system, adopted in 2005, twice this week. It had been at 3 since 2007, when it was elevated for an outbreak of avian flu.
A stage 5 warning is “a strong signal that a pandemic is imminent” with little time left for preparation, according to the WHO Web site. It’s based on the determination that the disease is established in communities in two countries in the same WHO region.
A pandemic is an unexpected outbreak of a new contagious disease that spreads from person to person across multiple borders. In such cases, almost no one has natural immunity.
“We think that we are in the process of moving toward” phase 6, Fukuda said. “I think at this point it is possible that we will move to seeing established transmission in other countries relatively quickly.”
Stage Six
“We have been preparing all along as if this is going to stage 6,” Janet Napolitano, U.S. Homeland Security secretary, said yesterday at a news conference in Washington. “Our preparations are for a situation in which this does become a full-fledged pandemic.”
Athletic, academic and music competitions were canceled for more than 1 million students in Texas until May 11, according to the Texas University Interscholastic League, the largest inter- school organization of its kind in the world. Maine shut a school and a daycare center, according to a statement from the governor’s office.
The outbreak in Mexico City prompted the local government to order a halt to dining service at all 35,000 restaurants. U.S. officials recommended that nonessential visits to Mexico be avoided and the European Union told travelers to avoid outbreak areas.
French Health Minister Roselyne Bachelot told reporters she would ask European transport ministers to suspend flights to Mexico.
No Travel Limits
WHO doesn’t recommend travel restrictions and said the focus should be on mitigating the outbreak.
U.S. Senate Majority Leader Harry Reid urged calm. He said a vaccine will probably be developed by the time next flu season starts in North America.
If a vaccine is needed, “the goal is to have one ready by September,” said U.S. Representative Peter King, a New York Republican.
An experimental vaccine for swine flu may be tested in people within a couple of months, according to Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases. Reference strains for the virus have been distributed and a pre-planned development process is under way, Fauci said at a press conference today in Washington.
Production of influenza vaccine for seasonal outbreaks, which U.S. health officials have said is ineffective against the new flu, should continue, Fukuda said.
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