President Barack Obama. (AP Photo/Gerald Herbert)By Tom Randall
April 28 (Bloomberg) -- Swine flu probably sickened hundreds of students, staff and family at three New York schools, Mayor Michael Bloomberg said. President Barack Obama asked Congress for an additional $1.5 billion for the outbreak.
The virus toll has been worst in four states in Mexico, the only country to record deaths. The U.K., Israel, Canada, New Zealand and Spain also have confirmed cases. The World Health Organization said it’s watching New York to see whether the virus has become rooted in a second country, a finding that would boost the agency’s pandemic alert system.
At least five U.S. states have confirmed outbreaks, including New York with 45, California with 10, Texas 6, Kansas 2, and Ohio 1, the U.S. Centers for Disease Control and Prevention reported on its Web site today. The U.S. can expect hospitalizations and deaths, and businesses and schools should plan for a pandemic, said Richard Besser, acting head of the Atlanta-based CDC. Today’s 64 confirmed cases is a 60 percent increase from yesterday.
“This is a new strain that we haven’t seen before, which is why we are taking some extra precautions,” New York’s Bloomberg told reporters today. The city has asked the CDC to investigate the spread while the local officials provide services for the sickest. “So far, the swine flu here looks like the garden-variety influenza that we see here every year,” Bloomberg said.
New York Cases
New York, America’s largest city, has about 45 confirmed cases, most originating at St. Francis Preparatory School in Queens, Bloomberg said. At P.S. 177, a public school for autistic children, 82 students have called in sick, he said. Six students are being tested at Ascension school in Manhattan’s Upper West Side, the mayor said. Most family and staff suspected of having the flu haven’t been tested, Bloomberg said.
Two other people, a woman in Brooklyn and a boy in the Bronx, were hospitalized with suspected cases associated with travel to Mexico, Bloomberg said.
Five people with confirmed swine flu cases have been hospitalized in the U.S., Besser said.
WHO raised its global pandemic alert yesterday, saying the disease is no longer containable and health authorities need to prepare for outbreaks. It’s the first time the warning has been raised to a level 4 since the six-step system was adopted in 2005. It had been at level 3 since 2007, when it was elevated for an outbreak of avian flu.
A pandemic, rated 6 on WHO’s alert system, is an unexpected outbreak of a new contagious disease that spreads from person to person across borders. In such cases, almost no one has natural immunity.
Better Coordination
White House press secretary Robert Gibbs said Obama requested more money today to help build stockpiles of anti- viral drugs, work on vaccines and coordinate the U.S. response with other governments.
The money is meant “to ensure we have the resources available” at federal, state and local levels to deal with any wider spread of the virus, Gibbs said.
The biggest concern is whether the virus is spreading outside Mexico, said Keiji Fukuda, WHO’s assistant director- general for health security and environment on a conference call today with reporters.
WHO is tracking the speed and ferocity of the New York- based transmissions with U.S. and state health officials to determine how the flu may spread in the future, Fukuda said.
Too Early to Say
“There is definitely the possibility that this virus can establish that kind of community-wide outbreak capacity in multiple countries,” Fukuda said. “It’s a very serious possibility, but it’s still too early to say that it’s inevitable.”
California Governor Arnold Schwarzenegger today declared a state of emergency to help the most populous U.S. state, with 37 million people, prepare for an outbreak. California health officials said today on the state’s Web site they had confirmed an 11th case, though the added instance was not reflected in the CDC data.
Schwarzenegger ordered state agencies to use whatever government personnel, equipment and facilities needed to help the California Department of Public Health. He also authorized the agency, along with the state’s Emergency Medical Services Authority, to enter contracts with private companies without competitive bids.
No Need for Alarm
“While there is no need for alarm, it is the governor’s top priority to limit the swine flu’s spread as quickly and effectively as possible,” Schwarzenegger’s press secretary Aaron McLear said in a statement.
More than 152 people have died in Mexico with suspected swine flu, and the number of worldwide cases confirmed by laboratory tests reached 79, officials said. Japan today suspended visa-free entry for Mexican nationals, while Asian countries, including Singapore and South Korea, are screening air passengers. The Geneva-based WHO isn’t recommending travel restrictions. restricting movement of people or goods,” Chan said.
The Mexican government requested that bars, movie theaters and churches close in Mexico City. It also extended its school closure to May 6 and may shut down more activities.
“We’re in a pre-pandemic phase and it’s going to be hard to know until we’re much further along what this is going to progress to,” Besser, the acting CDC head, said today in an interview. “Given the case in Mexico, where we’re seeing much more severe disease, I would expect we’re going to find hospitalized individuals and, unfortunately, I expect we will see deaths in this country.”
Defining a Pandemic
Scientists are trying to determine why swine flu, a respiratory disease caused by a type-A influenza virus, has been more severe in Mexico.
“In terms of defining a pandemic, there is no requirement that it cause severe disease,” said Arnold Monte, a scientist at the University of Michigan in Ann Arbor. “It doesn’t have to be killing millions. The virus may be bad in terms of the likelihood of getting infected, but not necessarily in terms of severity.”
The World Bank, in a worst-case scenario published in October, said a flu pandemic that’s similar in scope to the 1918 outbreak known as the Spanish flu could kill 71 million people worldwide and push the economy into a “major global recession” costing more than $3 trillion.
WHO’s raised level indicates health officials need to prepare for a pandemic, though it isn’t inevitable, Fukuda said.
Dynamic Situation
“The situation is very fluid, very dynamic, and it is rapidly evolving,” said Tim Uyeki, an epidemiologist in the CDC’s flu division. “The cases in the U.S. don’t have any links to contact with pigs. This appears to be ongoing human-to-human transmission.”
Production of influenza vaccine for seasonal outbreaks, which U.S. health officials have said is ineffective against the new flu, should continue, Fukuda said. The WHO is working with companies to prepare for a swine-flu vaccine, and would help produce it if the outbreak becomes a pandemic, he said.
The U.S. Food and Drug Administration signed emergency authorizations yesterday that will permit the CDC to use an unapproved lab test for swine flu and more dosing options than currently recommended for influenza treatments Tamiflu, sold by Swiss drugmaker Roche Holding AG, and Relenza, from London-based GlaxoSmithKline Plc.
Antiviral Stockpiles
There are enough stockpiles of Tamiflu to meet current demand, said Roche spokesman Terence Hurley. Roche has the capacity to manufacture, over one year, enough courses of treatment for 400 million people, Hurley said by telephone.
Glaxo has increased production of its antiviral Relenza and is in contact with the WHO and CDC, said a Glaxo spokeswoman, Sarah Alspach.
U.S. officials yesterday recommended that nonessential travel to Mexico be avoided and the European Union told travelers to avoid outbreak areas.
Governments in Asia heightened their alert for the spread of the virus. Japan advised its own citizens to defer trips to the Latin American nation.
South Korea raised its national disaster level to yellow from blue, the lowest on its scale, after it found one suspected case of swine flu, the health ministry said today.
Airport Screening
Cambodia is installing thermal scanners at its two international airports to identify passengers who show symptoms of swine flu, joining Australia, Japan, Malaysia, Singapore and South Korea among nations screening air travelers.
Swine flu results in symptoms similar to those of seasonal influenza, such as fever, lethargy and cough, and may also cause nausea, vomiting and diarrhea, according to the CDC.
Swine-flu viruses aren’t transmitted by food, and eating properly handled and cooked pork is safe, according to the CDC. There’s no evidence the disease is spread by exposure to “pork or pigs,” WHO’s Fukuda said.
Indonesia said today it will destroy all imported pork and swine products and fumigate agricultural goods bought from Canada, the U.S. and Mexico as a precaution.
China, the world’s top pork consumer, banned imports of swine products from Mexico and parts of the U.S. The Philippines also barred pork product imports from Canada, the U.S. and Mexico.
If the world is facing a pandemic, “this is a nice, gentle pandemic,” said John Oxford, a virologist at Queen Mary’s School of Medicine in London. “Virulence seems low.”
To contact the reporter on this story: Tom Randall in New York at trandall6@bloomberg.net.
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