SWINE FLU: Only 7 Swine Deaths Around World - Not 152 - Says WHO

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                                   Swine flu spreads to Germany amid Mexican lockdown
           





Marc Burleigh
April 29, 2009
MEXICO CITY
(AFP)

– The global swine flu outbreak spread further on Wednesday as Germany became the latest country to confirm cases on its soil while Mexico desperately tried to keep the lid on the virus.

With fears rising of easy transmission between people, authorities in Mexico City shut down bars, cafes, gyms, cinemas and tourist sites, including the world-famous Aztec and Mayan pyramids.

But as the Mexican government revised down its confirmed number of swine flu dead to seven from 20 after more rigorous testing was introduced, officials said more than 100 people were still suspected to have died from the virus and more than 1,600 were thought to be infected in the outbreak's epicentre.

And only hours after Costa Rica joined the list of affected countries, Germany became the eighth when it confirmed that it was dealing with three definite cases.

Officials at Berlin's Robert Koch Institute, responsible for disease control and prevention, said a 22-year-old woman was in hospital in Hamburg and that a 37-year-old woman and a man in his 30s were in separate hospitals in Bavaria.

While Mexico remained the only country to have recorded deaths from the virus, other nations announced their infection tallies had increased.

Authorities in Israel, New Zealand and Spain increased their confirmed cases of infection with the virus, believed to be a previously unseen amalgam of different flu viruses.

"We are dealing with a new strain of influenza," said Richard Besser, acting head of the US Centers for Disease Control (CDC).

The World Health Organization (WHO) has raised its warning level to Phase 4 on a 1-6 scale, which indicates the illness is being passed from person to person, although officials said much about the outbreak was still unknown.

"We don't have information on how it acts, how it transmits," said Gregory Hartl of the WHO, which was to convene experts from affected countries later Wednesday to review what is known about the illness.

Experts say the current virus -- a version of swine flu identified as A/H1N1 -- cannot be caught from eating meat from pigs, and instead are recommending simple hygiene procedures like washing hands.

Some have suggested that those who died in Mexico were treated too late or with insufficient drugs, or that perhaps the strain mutated into something less virulent when it left the country.

In addition to the health concern, there have also been worries that the outbreak will badly hurt the airline and travel industries, which have already been suffering because of the global economic slowdown.

Major European tour agencies and US cruise lines announced they were suspending trips to Mexico, while Argentina said it was barring flights from the country until next week.

Among those confirmed to have contracted the virus are a couple from Scotland who recently returned from honeymoon in Mexico's Cancun resort and a second set of Cancun honeymooners were quarantined in their own Edinburgh home on Wednesday as they awaited the results of swine flu tests.

WHO assistant director general Keiji Fukuda said it was "critical" to identify travellers from Mexico who might be infected with swine flu.

"It helps us to monitor the spread of the virus worldwide and how it is moving," Fukuda said.

US President Barack Obama is seeking 1.5 billion dollars from Congress to boost US efforts to contain the flu's spread, the White House said.

California declared a state of emergency and said they had detected a death in Los Angeles that might have resulted from the virus.

South Korean officials said the country had nine suspected cases of swine flu infection, but that four of those had turned out negative.

China meanwhile angrily rejected foreign media reports pointing to the country as the source of a deadly swine flu outbreak, saying they were baseless and aimed at tarnishing the nation's image.

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                                               Swine flu expected to come to Italy



                                             First suspected case reported in Venice






 (ANSA) -
Rome,
April 27, 2009

- A leading Italian expert said on Monday that it was inevitable that swine flu would sooner or later spread to Italy but added that there was no risk of a pandemic.

Genoa University virologist Pietro Crovari explained that ''there will not be a crisis because this is a 'normal' strain of the flu virus and different from the bird flu strain. Of course, the later it arrives the better''.

Crovari made his observations at the same time that Europe's first case of swine flu was confirmed in Spain, where there are 17 other suspected cases.

Italy currently has one suspected case, a 31-year-old woman from the Veneto region, who has been placed in quarantine in a Venice hospital but is said to be in good condition.

The woman had returned from San Diego, in southern California near the Mexican border, with a high fever and was hospitalised as a precaution.

A sample of her blood has been sent for testing at Padua University, which hosts Italy's top center for infectious diseases.

Italy, like many advanced countries, is at an advantage because many people are still protected by the general flu vaccine they took for the winter flu season.

The outbreak of swine flu began in Mexico where 103 people have died so far and there are another 1,614 suspected cases.

The flu quickly spread to the United States, where there are some 20 suspected cases.

European Health Commissioner Androulla Vassiliou has called for an emergency meeting of European Union health ministers to monitor the situation and the Czech Republic, which holds the EU rotating presidency, has scheduled a meeting for Thursday.

Vassiliou said on Monday that the EU was ready to take ''appropriate action'' to avoid teh spread of the flu.

According to Crovari, the virus in Mexico ''appears to have mutated by 60-70% but this is nothing new. This virus is an evolution of the H1N12 virus which was isolated in 1933''.

The fact that the virus has infected for the most part young adults, he observed, could be explained by the fact that the very young and the elderly are those most likely to have been vaccinated for the winter flu season.

''However, it is still too early to confirm this for sure,'' he added.

The Italian health ministry has set up a crisis coordination center and is said to be its examining a vaccination strategy.

On a European level, checks on arriving passengers have been stepped up at airports to identify anyone with flu symptoms, while EU health ministries are pooling information on suspected cases and vaccine stocks.

Europeans have also been advised to avoid travelling to areas where swine flu has been reported.

Elsewhere in Europe, four suspected cases in France and one in Britain have proved negative.

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                                              New flu: Fazio downplays fears



                                           Mexican woman hospitalised in Naples






 (ANSA)
- Rome,
April 29, 2009

- New flu will in all likelihood arrive in Italy but it appears to be less aggressive than normal seasonal flu, Welfare Undersecretary Ferruccio Fazio said on Wednesday.

''We expect to see the first confirmed cases in Italy quite soon but we are not alarmed given the clinical evolution of the flu in other countries,'' Fazio observed.

While there have been no confirmed cases in Italy yet, on Wednesday a resident of Salerno was transferred to a Naples hospital for tests and analyses on suspicion she had contracted the new flu.

The patient, a 63-year-old Mexican female university lecturer, was taken to Cotugno Hospital which hosts the regional center for infectious diseases.

''I'm optimistic because this virus does not appear to be very aggressive. Of course, there is always the risk of a mutation, but from what we have seen in the United States this flu is less aggressive than a normal winter influenza''.

Between 250,000 and 500,000 people die each year from seasonal flu.

A total of 159 people have died from flu in Mexico, where the outbreak originated, but the death rate has slowed considerably and Mexican authorities said Tuesday that only seven deaths can definitively be attributed to the specific variation of the new flu virus, which is apparently a mutated combination of swine, bird and human flu.

Until now there have been no deaths outside of Mexico, but on Wednesday there were reports of a first flu death in the United States, apparently a 23-month child.

Germany on Wednesday became the eighth country to report confirmed cases of the new flu. The others are Mexico, where the outbreak originated, the United States, Canada, New Zealand, Israel, Britain and Spain.

Fazio, who holds the portfolio for health, also said he was in favor of not calling the new flu 'swine flu', as it was originally named.

''I'm in favor of a name change because this new virus passes from man to man and pigs have nothing to do with it,'' he explained.

''While bird flu continues to pass between birds and to man, as recent cases in Egypt have shown, this flu is only passing from man to man and thus it makes no sense to call it 'swine' flu,'' he added.

The undersecretary said he was in favor of the World Health Organization (WHO) changing the name of the influenza to either 'new flu', as the European Union has, or 'Mexican flu', as some Asian countries and Israel have.

Pig farmers and major pork-producing countries have been pushing for an official name change to avoid a consumer backlash similar to the one which hit poultry sales during the bird flu scare.

According to Italian Agriculture Minister Luca Zaia, the media is blowing the risk of a pandemic out of proportion which is not only putting pork sales at risk but also opening the door to market speculation.

''What we are seeing is a media pandemic because by calling this swine flu there is a serious risk of major damage to a whole sector,'' Zaia observed.

According to the minister, there has been an 8% drop in pork sales and, if prices fall, ''people should stock up on the meat because it is perfectly safe to eat''.

Zaia also threw his support to have the WHO to officially change the flu's name and said he preferred 'Mexican flu'.

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                                      Egypt orders slaughter of all pigs over swine flu 
 





Apr 29, 2009
By MAAMOUN YOUSSEF
Associated Press Writer 
 CAIRO
(AP)

- Egypt began slaughtering the roughly 300,000 pigs in the country Wednesday as a precautionary measure against the spread of swine flu even though no cases have been reported here yet, the Health Ministry said.
The move immediately provoked resistance from pig farmers. At one large pig farming center just north of Cairo, farmers refused to cooperate with Health Ministry workers who came to slaughter the animals and the workers left without carrying out the government order.


"It has been decided to immediately start slaughtering all the pigs in Egypt using the full capacity of the country's slaughterhouses," Health Minister Hatem el-Gabaly told reporters after a Cabinet meeting with President Hosni Mubarak.

Egypt's overwhelmingly Muslim population does not eat pork due to religious restrictions. But the animals are raised and consumed by the Christian minority, which some estimates put at 10 percent of the population.

Health Ministry spokesman Abdel Rahman estimated there were between 300,000-350,000 pigs in Egypt.

Agriculture Minister Amin Abaza told reporters that farmers would be allowed to sell the pork meat so there would be no need for compensation.

In 2008, following fears over diseases spread by animals, Mubarak ordered all pig and chicken farms moved out of population areas. But the order was never implemented.

Pigs can be found in many places around Muslim world, often raised by religious minorities who can eat pork. But they are banned entirely in some Muslim countries including Saudi Arabia, Bahrain, Kuwait, Qatar, the United Arab Emirates and Libya.

In Jordan, the government decided Wednesday to shut down the country's five pig farms, involving 800 animals, for violating public health safety regulations.



Copyright 2009 The Associated Press.

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                          Toddler here from Mexico for treatment is first US death from Flu





By Maggie Fox
WASHINGTON,
April 29, 2009
(Reuters)

- A baby in Texas has died of the H1N1 flu strain, the first confirmed death outside Mexico from a virus which health officials fear could cause a pandemic as it spread to two more countries in Europe.

Nearly a week after the threat emerged in Mexico, where up to 159 people have died, a U.S. official said on Wednesday a 23-month-old had died in the state bordering Mexico. A health official said the baby was Mexican and was in the United States for medical treatment.

Richard Besser, acting head of the U.S. Centers for Disease Control and Prevention, said he expected more bad news even though most of the 65 U.S. cases of swine flu were mild.

President Barack Obama said the death showed it was time to take "utmost precautions" against the possible spread of the virus.

Germany reported its first three infections and Austria one, taking to nine the number of countries known to be affected.

"We have about 100 cases outside Mexico, and now you have one death. That is very significant," said Lo Wing Lok, an infectious disease expert in Hong Kong. 

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                                      Experts Say Panic Over Swine Flu Is Premature
         





HealthDay Reporter
Amanda Gardner
1 hr 46 mins ago
April 28, 2009
(HealthDay News)

-- As the death toll from swine flu in Mexico rises and new cases appear in the United States and elsewhere, it's easy to get caught up in a sense of mounting dread.


But experts in influenza and infectious disease say the exact level of danger from the virus is still far from certain.


"This is something of concern [but] I think we should hold back on calling it a real threat," said David Topham, co-director of the New York Influenza Center of Excellence, part of the University of Rochester Medical Center. "We always have to take these things seriously, but we have a very good system in place to respond."


Another expert agreed.


"The gravity of the situation will not be clear for a few more days till we find the extent of the cases and the number of countries involved and explain why we haven't had any deaths in the U.S," said Dr. Scott R. Lillibridge, a professor with the Texas A&M Health Science Center School of Rural Public Health in Houston and executive director of the university's National Center for Emergency Medical Preparedness and Response.


The real verdict on just how dangerous this outbreak might be will hinge at least partly on seeing how the disease spreads in the United States, along with expected announcements from the World Health Organization as to how many other countries are affected, the experts said.


So, as can happen in these situations, "the panic is a little bit undue," said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City. "There are many facts that we don't know."


Looming large among the unknowns: Why is the virus causing more severe illness in Mexico than in the United States? Why have the only deaths reported been in Mexico? Why is mortality concentrated among young, healthy adults? Will the swine flu acquire more lethality as time goes on? And will the virus have a seasonality to it, like the "regular" flu?


Most of these questions have no solid answers -- at least not yet -- but there are some intriguing possibilities.


The death rate from the swine flu in Mexico (149 by late Monday) hovers at about 7 percent of the more than 1,900 so far thought to be nfected -- a percentage that's alarmingly higher than the 1918 Spanish flu pandemic, which is thought to have killed about 2.5 percent of infected persons.


But this early in the outbreak, no one really knows the true extent of the Mexican outbreak, the experts noted, so that 7 percent figure might well be too high.


"We don't know the total number of people exposed," Topham said. "It could be many more people exposed, so we're only hearing about the ones who got really sick and died," he explained.


It's also not clear if all the deaths attributable to swine flu were actually caused by the virus.


"The strain in the U.S. seems to be the same as in Mexico, but in Mexico we've not had confirmation of all those hospitalizations or deaths," Lillibridge said. "We're comparing apples and oranges."


And to put things into perspective, even with the death toll in Mexico, the swine flu does not appear to be as dangerous as SARS (Severe Acute Respiratory Syndrome), which appeared seemingly out of nowhere in 2003.


"SARS had high human-to-human transmission, there was a high death rate and no treatment," Horovitz noted. With the swine flu outbreak, "we're not talking about anything like that," he said.


In fact, all 40 U.S. cases so far have been mild or the patients have recovered, the U.S. Centers for Disease Control and Prevention reported.


And, in absolute numbers, the death toll is still nowhere near the roughly 35,000 lives snatched each year by the regular "garden variety" seasonal flu, Horovitz pointed out.

But could this outbreak morph into something more alarming?

"We just don't know yet," said Dr. Mark Metersky, spokesman for the American College of Chest Physicians and a professor of pulmonary and critical care medicine at the University of Connecticut School of Medicine in Farmington. "It's early in the outbreak."

Metersky pointed to a 1976 outbreak of swine flu that erupted at Fort Dix, N.J., caused a scare, but then quickly petered out with one death.

Perhaps the most disturbing trend in the Mexican outbreak is the fact that it is primarily young adults who are dying. That's not typical, experts said.

"It is usually people who are weakest, at extremes of age, very young and very old who succumb to influenza and this is a little bit scary because this is a pattern we saw in the [flu] pandemic in 1918," Metersky said.

On the upside, there's a good chance that swine flu may not stick around for long in northern climes, at least not this year. "This will probably have seasonality similar to the one of the regular flu," Topham said. He pointed out, however, that the regular winter flu is never quite gone, because as it wanes from the Northern Hemisphere, it re-establishes in the Southern one.

U.S. health officials declared a public health emergency Sunday in response to the swine flu outbreak, and the number of confirmed cases nationwide had doubled by Monday to 40. The 20 new cases all came from the New York City high school that had previously reported eight cases of the infectious disease.

Some of the U.S. cases, all of which so far have been mild, involved people who had recently returned from trips to Mexico.

Meanwhile, in Mexico, believed to be the source of the outbreak, authorities continued to take dramatic steps over the weekend -- including suspending public gatherings -- to try to contain the swine flu outbreak.

U.S. health officials have reported that they have 50 million doses of the antiviral flu medication Tamiflu. A quarter of those doses were being released to states, if needed.

"The benefits of antivirals are twofold," Lillibridge explained. "In treatment, to shorten the illness and promote recovery at an earlier time and to prevent complications. Second, it can be used in prevention. If you have been exposed to someone who has swine flu, [the drugs are] 70 to 90 percent effective if taken early enough."

Steps have also been taken to perhaps devise a vaccine against this strain of swine flu.

Swine flu is a respiratory disease of pigs caused by type A influenza. Swine flu does not normally infect humans. However, human infections do occur, usually after exposure to pigs. Symptoms resemble those of the regular flu, including sore throat, coughing and fever. The strain of swine flu circulating in North America appears to be a combination of pig, bird, and human flu strains, experts say. 

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                                                Science takes aim at the swine flu







YAHOO NEWS
Peter N. Spotts
– Mon Apr 27, 2009


Governments confronting a new strain of swine flu from Mexico have an unprecedented set of scientific tools to help them. The result is steady improvement in dealing with outbreaks like the current one.

Yet experts say a lack of clear communication in Mexico about the status of the outbreak and what people could do to protect themselves was perhaps a major factor in how the strain spread throughout the country and the world.

In the US, public-health officials said Monday they have identified 40 cases, with one person hospitalized. But "things are working well, from what I can see," says Peter Hotez, who heads the department of microbiology, immunology, and tropical medicine at George Washington University in Washington.

The faster speed of communications helps: Word of a problem gets out much more quickly than it did 20 years ago. But science, too, has improved its ability to identify an illness's origins, assess its susceptibility to existing vaccines, and model the trajectory the outbreak could take, experts say.

Researchers say they have increased their capacity to recognize and understand the nature of the biological agents involved. Even six years ago in the case of SARS, scientists needed only a relatively short time – six weeks – to characterize the agent involved, says Myron Cohen, director of the University of North Carolina's Institute of Global Health and Infectious Diseases. And SARS was something no one had seen before. Previously, that process might have taken years.

As for the outbreak of illness in Mexico: "Look how quickly we understood that it was an influenza agent, which in many ways is reassuring," Dr. Cohen says. "The ability to gain information on the agent and its pedigree is really quite remarkable."

Moreover, there are more labs and equipment that can do the work. When US labs reportedly required extra paperwork to analyze samples of the flu agent, public-health officials in Mexico simply sent the samples to labs in Canada. In California, the first diagnosed cases of swine flu from the Mexican outbreak were uncovered by researchers developing new test kits physicians could use in their offices, according to Richard Besser, acting director of the Centers for Disease Control and Prevention (CDC) in Atlanta during a briefing Monday.

In the US, officials already have started moving vaccines out of stockpiles and to healthcare providers. At this point, the CDC has released about 25 percent of that stockpile.

If the outbreak becomes more serious than it currently appears, Dr. Besser says, "doctors will have what they need."

For all the technological progress, however, more needs to be done, say some specialists.

Though the technology now exists to respond quickly – reducing the time it takes to design and evaluate a new or modified vaccine, it will take money to put the technologies in place, says Dr. Hotez.

Early detection remains an issue in some parts of the world, as well. The outbreak's origins in Mexico, for example, are largely a mystery. "We do not know how long this virus has been circulating and capable of human-to-human transmission," says Ted Cohen, an assistant professor of medicine at Brigham and Women's Hospital in Boston. "Certainly, the wide geographic distribution of cases indicates that our detection systems were not able to contain the virus where it initially emerged."

"This delay undoubtedly has limited our ability to respond to this potential crisis with travel restrictions or others methods that might have potentially prevented the long-distance spread of this pathogen," he adds.

Lessons from the past also show clearly that keeping people well-informed and apprised of developments is the best thing to do. "But it's not a lesson all governments have learned," says David Ozonoff, a communicable-disease specialist at Boston University.

He points to Mexico, which, he says, has been "authoritarian on one hand and not very informative on the other" with the public. The situation is compounded by a general lack of public trust in anything government officials say, he adds.

The United Nations' World Health Organization (WHO) generally has done a good job responding to the outbreak, Dr. Ozonoff says, but has underplayed the outbreak's severity. During the weekend, it hovered at 3 on the agency's 1-to-6 scale – even when it was clear by the scale's definitions that the outbreak was a 4 or 5, he says. "There are consequences" to higher ratings, he says, which include trade and travel restrictions. Today, the WHO raised the severity of the outbreak to Level 4.

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                                 Only 7 swine flu deaths around world, not 152, says WHO






April 29, 2009
The Sydney Morning Herald
 

A member of the World Health Organisation (WHO) has dismissed claims that more than 150 people have died from swine flu, saying it has officially recorded only seven deaths around the world.

Vivienne Allan, from WHO's patient safety program, said the body had confirmed that worldwide there had been just seven deaths - all in Mexico - and 79 confirmed cases of the disease.


"Unfortunately that [150-plus deaths] is incorrect information and it does happen, but that's not information that's come from the World Health Organisation," Ms Allan told ABC Radio today.

"That figure is not a figure that's come from the World Health Organisation and, I repeat, the death toll is seven and they are all from Mexico."


Ms Allan said WHO had confirmed 40 cases of swine flu in the Americas, 26 in Mexico, six in Canada, two in Spain, two in Britain and three in New Zealand.

Ms Allan said it was difficult to measure how fast the virus was spreading.

She said a real concern would be if the flu virus manifested in a country where a person had had no contact with Mexico, and authorities were watching all countries for signs of that.

"There is no pattern that has emerged at this stage to be able to say that it is spreading in a particular way or it is spreading into a particular country ... the situation is continuing to evolve," she said.

She said the WHO was not recommending against overseas travel, but urged those who felt sick to stay home and others to ensure they kept their hands clean.

No decision had yet been made about vaccinations.

"This virus is not airborne, it's caused by droplets ... so it's not a time for worry. It's a time to be prepared," Ms Allan said.