Swine Flu is Public Health Emergency, With New U.S. Cases

26 april 2009--The World Health Organization declared a deadly new strain of swine flu to be a "public health emergency of international concern," as health officials identified possible new cases in two additional U.S. states and called the disease widespread.

Several children at a school in the New York City borough of Queens may have been infected, and two people were confirmed with the disease in Kansas, according to reports from local health departments. The U.S. Centers for Disease Control and Prevention said it expects to find more cases soon throughout the country.

Swine Flu Strain Hits U.S. Cities

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The World Health Organization has stepped up operations after eight school kids in New York and two other people in Kansas tested positive for a strain of the swine flu.

In Geneva, WHO Director-General Margaret Chan warned Saturday that the virus had the potential to cause a pandemic, but cautioned that it was too early to tell whether it would erupt into a global outbreak. Following an emergency meeting Saturday, a WHO panel declared the developments thus far a public health emergency and urged governments around the world to intensify surveillance for unusual outbreaks of flu-like illness and severe pneumonia. But the panel held off on raising a global pandemic alert, saying it needed more information before making a decision.

Mexican health authorities said the death toll from the new strain of A/H1N1 swine flu remains at 20, and they are continuing to investigate whether more than 1,000 others were infected with the mysterious bug, which attacked in three geographically diverse areas of the country and is taking its heaviest toll in young adults.

The CDC said early Saturday afternoon the number of confirmed cases of the new flu in the U.S. remained at eight, but it expects to identify more soon. A statement from the Kansas Department of Health and Environment Saturday afternoon said the CDC had additionally confirmed swine flu infection in two people, bringing the U.S. total to 10.

In New York City, further testing will be required to know whether more than 100 of roughly 2,700 students at St. Francis Preparatory School in Queens were ill with swine flu when they missed school last week, said Thomas Frieden, the city's health commissioner. Health officials have interviewed most of the ill students or their families; all reported mild symptoms, and none required hospitalization.

The health department has tested nine samples taken from ill students, eight of which have been classified "probable human swine influenza," Dr. Frieden said. Local testing confirmed that the samples were influenza type A, which occurs in both humans and swine, and the samples did not match common subtypes of human influenza. Under current CDC definitions, cases of influenza type A that do not match subtypes of human influenza are considered probable swine flu, pending confirmation by the CDC.

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The samples have been sent to the CDC for additional testing, Dr. Frieden said. Results could be available as soon as tomorrow. If swine flu is confirmed, the health department will recommend that the school cancel classes on Monday to reduce the risk of further spread.

The city health department is also investigating a report of about 30 children who became ill at a day-care center in the Bronx. But Dr. Frieden emphasized that the status in that case remains unclear and may turn out to be unrelated to swine flu.

The CDC has sent teams to California, Texas, and Mexico to assist with investigations. Confirmed cases include six children and adults in San Diego and Imperial Counties in Southern California. Two 16 year-old boys in Guadalupe County near San Antonio, Tex., were also found to have had the disease. Only one of the cases, a 41 year-old woman, was hospitalized, and the others had only mild disease, the CDC said.

It's unclear so far why U.S. cases identified so far are mostly mild, while Mexico has experienced severe disease, Dr. Schuchat said, though expanded surveillance is likely to yield more clues.

The CDC is also taking initial steps toward preparing a vaccine should that become necessary, but producing enough for a mass vaccination program could take months, Dr. Schuchat cautioned.

President Felipe Calderon urged Mexicans to remain calm and reassured them that government has plenty of antiviral medicines to treat the outbreaks. Two antiviral medications, marketed as tamiflu and relenza, both work against the bug, according to the CDC.

In Mexico City, blue surgical masks proliferated and entrepreneurs were selling them on the streets. Two soccer games scheduled for Sunday are expected to be played in front of empty stadiums but broadcast on TV.