http://www.bloomberg.com/apps/news?pid=20601124&sid=ab1UPXgmE538&refer=home

WHO Expecting to Move to Top Pandemic Alert for Flu

May 2 (Bloomberg) -- The World Health Organization probably will go to phase 6, the highest step on its pandemic alert scale, even as some reports say many cases of swine flu show symptoms no more severe than seasonal flu, health officials said.

The WHO isn’t seeing sustained community transmission of the virus, known formally as influenza A H1N1, outside of North America, said Michael Ryan, the WHO’s director of global alert and response, at a news conference today in Geneva where the UN health agency is based.

Still, swine flu has reached 16 countries, most recently Costa Rica, and there’s evidence the new virus is spreading in five nations among people unconnected to Mexico where cases were first reported. The health minister in Mexico said today the country has no new deaths attributed to the H1N1 virus commonly known as swine flu.

“At this stage we have to expect that phase 6 will be reached; we have to hope that it won’t be reached,” Ryan said. “I would still propose that a pandemic is imminent.”

International health experts said the world is now closer to another influenza pandemic than at any time since 1968, when the last of the previous century’s three pandemics occurred. The WHO hasn’t had a single phase 6 alert since it introduced the system in 2005. Before this week, the system had been at phase 3 since 2007, when it was elevated for an outbreak of avian flu, according to the WHO Web site.

Tracked One Week

In little more than a week, world health authorities have tracked the emergence of swine flu from an outbreak in Mexico and a few cases in Texas and California to the brink of the first influenza pandemic since 1968. Thousands of cases were suspected. At least 433 U.S. schools closed yesterday, a hotel was quarantined in Hong Kong and Continental Airlines Inc. cut seating capacity on flights to Mexico in half.

The virus is already at pandemic level, according to Ira Longini, a researcher at the University of Washington in Seattle who advises the U.S. government on flu.

“The definition of a pandemic is that the new virus has spread to several countries and is transmissible,” Longini said in an interview yesterday. “It’s hard to imagine it’s not going to continue to spread in some form.”

The number of confirmed dead from the H1N1 virus in Mexico is 16, unchanged from yesterday, said Mexico’s health minister Jose Cordova at a news conference in Mexico City. While Cordova said today the number of Mexico’s confirmed cases, including the deaths, rose to 443 from 397 yesterday, WHO’s Web site today said the confirmed count for Mexico is 397.

Stabilization

“We are in a stabilization phase,” Cordova said. “Still, it is too soon to say we are past the most complicated moment.”

The U.K., U.S., Germany, Canada and Spain each confirmed cases in people who didn’t travel to Mexico, where the virus has struck hardest. The expanding wave of sickness has been similar to seasonal flu, though health authorities are taking no chances with a virus that may flash across the globe, infecting a population with no natural immunity, said the U.S. Centers for Disease Control and Prevention.

“Even though we might be seeing only mild cases now, we cannot say what will happen in the future,” Gregory Hartl, a spokesman for the World Health Organization, told reporters yesterday. “If at the end of the day it remains a mild pandemic or if we can somehow avert the worst of the disease or stop the worst of the disease, then that’s fantastic. We will have done our job well.”

South Korea

South Korea confirmed its first case today, in a 51-year- old nun who returned home April 26 after a week-long period of aid activities in Morelos, Mexico, health authorities in the North-Asian nation said. They’re treating a 44-year-old colleague as a “probable” infection and the nation’s first case of human-to-human transmission. Costa Rica said it had two confirmed cases.

A Tokyo laboratory is testing to determine if a baby at a U.S. military base in Japan is infected.

Hong Kong, France and Denmark confirmed their first cases yesterday. Hong Kong declared a public-health emergency after detecting the virus in a 25-year-old traveler from Mexico, and cordoned off the hotel in which he was staying, confining guests and staff.

The Geneva-based WHO raised its six-tier pandemic alert to 5 on April 29. Stage 6 would signal a pandemic and alert governments to enact plans against the disease.

Cases Rising

Laboratory tests verified that at least 658 people in North America, Europe, Asia and New Zealand had the illness, with 16 deaths in Mexico, according to WHO’s Web site. Canada officials reported 17 new cases confirmed today in Nova Scotia, bringing the total there to 31.

New York officials said they suspect more than 1,000 cases, so many that the government has stopped testing all but the sickest there.

“We will also continue investing in every resource necessary to treat this virus and prevent a wider outbreak,” President Barack Obama said today in his weekly radio and Internet address. “The good news is that the current strain of H1N1 can be defeated by a course of antiviral treatment that we already have on hand.”

$1.5 Billion Requested

Obama said while the strain of the flu, or H1N1, hasn’t been as virulent in the U.S. as in Mexico, Americans must prepare for the possibility of a resurgence. He’s asked lawmakers for $1.5 billion to battle an outbreak and develop a vaccine to prevent the virus from surfacing later this year during flu season.

Evidence suggests “transmission is widespread, and that less severe illness is common,” the Atlanta-based CDC said in a report yesterday. In Mexico, where WHO said nine of the world’s 10 confirmed deaths from the virus occurred, “a large number of undetected cases of illness might exist in persons seeking care in primary-care settings or not seeking care at all,” the CDC report said.

New York Tests

New York health officials will test for swine flu only in patients with a severe illness or if there’s a cluster of cases, Health Commissioner Thomas Frieden said at a news conference yesterday. All of New York’s 49 confirmed cases and the more than 1,000 suspected have had symptoms similar to those of seasonal flu, he said.

In the U.S., at least 433 schools closed yesterday in 17 states, leaving parents to find other arrangements for 245,449 students, according to the Education Department. Five colleges closed, the department said in an e-mail.

The CDC raised its flu count to 160 cases in 21 states, including the only U.S. fatality, a 22-month-old child who died April 27 at a Houston hospital.

The new influenza strain, a conglomeration of genes from swine, bird and human viruses, poses the biggest threat of a flu pandemic since 2003, when the H5N1 strain killed millions of birds and hundreds of people, William Schaffner, an influenza expert at Vanderbilt University School of Medicine in Nashville, Tennessee, said in an interview yesterday.

More Mild Cases

“In Nashville, we are getting the sense that out in our community there is a lot of relatively mild influenza illness among children and increasing among their parents -- much of this is suspected to be H1N1,” Schaffner said. “By now our usual influenza season is over by weeks, but that’s clearly not the case.”

The 2003 avian flu killed more than half of the people who got it. It didn’t spread from person to person and only infected 421 people. The Spanish flu of 1918, another version of bird flu, killed as many as 50 million people in one of history’s deadliest outbreaks.

“There are some genetic tests that have shown the virus we’re dealing with right now does not have the factors that we think made the 1918 virus so bad,” said Julie Gerberding, former head of the CDC, in an interview yesterday on ABC News. “But we have to be careful not to over-rely on that information, because these flu viruses always evolve.”

Batches of seed virus are being developed for potential vaccine production, according to WHO. Paris-based Sanofi-Aventis SA, Baxter International Inc. of Deerfield, Illinois, and GlaxoSmithKline Plc of London are talking with world health authorities about producing shots, the agency said.

Manufacturers Proceeding

“It seems most likely that the manufacturers will proceed and we will certainly support them,” Marie-Paule Kieny, WHO’s vaccine director, told reporters in Geneva.

Production of vaccines against the new H1N1 influenza will be completed “in parallel with or after the seasonal vaccine is produced,” Nancy Cox, chief of the flu division at the CDC’s Center for Immunization and Respiratory Disease, at a news conference today in Atlanta.

Jose Cordova, the health minister in Mexico, said yesterday the number of H1N1 flu cases confirmed by laboratory tests climbed to 381 and the death toll rose to 16. Deaths will probably continue, he said.

Flights Cut

Continental Airlines Inc. cut seating to Mexico in half, AirTran Holdings Inc. trimmed two weekly flights and Delta Air Lines Inc. began using smaller planes as swine flu concerns reduced travel.

WHO’s statistics, which lag behind those reported by national and local agencies, confirmed cases in the U.S., Mexico, Canada, the U.K., Austria, Germany, the Netherlands, Denmark, Switzerland, Spain, Israel, Hong Kong and New Zealand. France and South Korea have also confirmed cases.

The three main seasonal flu strains -- H3N2, H1N1 and type- B -- cause 250,000 to 500,000 deaths a year globally, according to WHO. The new flu’s symptoms are similar, including fever and coughing, nausea and vomiting, according to the CDC.

Authorities advised hand-washing, hygiene and staying home if sick as the most effective ways to control the outbreak.

Please don't be overly alarmed...the CDC said that the Pandemic Alert is more to convey how widespread the virus is, rather the virulence level.  So don't fall out of the boat yet.

Wolfmanjack wrote: about 10-15 min after i posted this they stelth nerfed the wording of that and changed it.. The post i made above was the original before the stealth nerf.

We have a real problem here. I am using some stealthy engines with nice full buffer cores and tonight is one of the busiest spin nights in disease data history.  We hard core posters need to stay on this. The virus is the virus and I am still getting one on one reports from people on what this stuff is doing globally. i just did a thread rant on this. I watching pages change by the minute- no joke. And old pages - especially numbers.. ripping through Yahoo, AOL, even Google- which I use none of.

Tip of the iceberg. Over the last few days some real special stuff like - no Avian in the virus- it can't be found in pigs and better yet IS IMPOSSIBLE to spread from pigs to people. This is a designer virus. It's custom. And a guy at CDC is making another one just like it to see how it works.

You do not want to go to 6 during a global recession and some are just about to have their Schwanstuckers removed for being so verbal. I was hearing this spin from people inside the loop two days ago. This was rehearsed, planned, and executed. They are going to have to fill in the other countries that this custom virus is not going to mutate in at least a 2% problem and it already spreads very fast.

Just my 2 cents. I empathize. 19 deaths. Armed guards at the hospitals at a city with millions- people wearing masks everywhere..WHO up to level 5- Homeland talking a Pandemic is near to inevitable.

We need to stay on this one. When wave 2 comes- then everyone will be sedated and not take it seriously.

Medclinician

Thanks for keeping on top of things, medclinician. You are on a roll!! I think there's a big PROBLEM with all this info, too, and I'm glad I'm not the only one that's seeing it. Thank you to everyone that is here, for all the info. Keep it coming!!

We are definitely on a news standstill here too. This is wierd.

Swine Flu Outbreak Not a Pandemic, Yet

05.03.09, 09:00 AM EDT

WHO officials say cases continue to climb, but geographic spread not wide enough for highest alert

SUNDAY, May 3 (HealthDay News) -- Although the number of swine flu cases continued to climb Sunday, the World Health Organization said there is no clear sign yet that the scope of the outbreak has reached pandemic proportions.

That doesn't mean it won't, however.

"At the present time, I would still propose that a pandemic is imminent because we are seeing transmission to other countries," Dr. Michael J. Ryan, director of the World Health Organization (WHO) global alert and response team, said in a teleconference from Geneva on Sunday. "We have to expect that Phase 6 will be reached. We have to hope that it is not."

As of Sunday morning, the WHO Web site was reporting 787 confirmed cases of swine flu in 17 countries. Mexico has reported 506 cases, with 19 deaths, while the United States has confirmed 160 cases in 21 states.

Currently, the outbreak is gauged a Level 5, meaning the disease is spreading throughout communities in at least two countries in one of WHO's six regions, in this case the United States and Mexico. To reach Phase 6, the geographic spread of the disease would have to occur in at least one other country in another region.

In a strange twist on Saturday, swine flu was discovered for the first time in pigs. WHO officials reported on the organization's Web site that the virus had been detected in sick pigs on a farm in Alberta, Canada. Until now, it was not known whether the virus could infect pigs, even though its genetic makeup clearly points to its having originated in that animal. However, in this case a human appears to have infected the livestock, not the other way around, the WHO reported. A worker on the farm had traveled to Mexico, come back to Canada and fallen ill. The swine are now under quarantine. WHO officials stressed that the swine flu cannot be transmitted through the consumption of pork products.

And the swine flu continued to spread across the United States on Saturday, as federal health officials reported there are now 160 confirmed cases in 21 states, with 13 hospitalizations and one death.

"We have information that this novel virus continues to spread with increasing cases and increased states affected, and we are acting actively and aggressively. Our highest priority is the health and safety of the American public," Dr. Anne Schuchat, interim deputy director for the science and public health program at the U.S. Centers for Disease Control and Prevention, said during a teleconference Saturday. "We have seen times when things appear to be getting better and then get worse again. With a new virus like this, we don't know how it's going to behave or change over time."

Since schools are the focus of many of the outbreaks, the CDC has issued new recommendations for school closings.

Because children may shed the virus longer than adults, the agency is now recommending that affected schools remain closed for two weeks instead of one, Schuchat noted. However, what individual communities decide to do is up to them and their own analysis of the situation, she added.

The U.S. Education Department said Friday that more than 430 schools had closed, affecting about 245,000 children, the Wall Street Journal reported.

Nancy Cox, chief of the influenza division of the National Center for Immunization and Respiratory Diseases at the CDC, did deliver some welcome news on the nature of the virus itself on Friday. She said during a teleconference that a preliminary analysis of the H1N1 strain finds it lacks certain "virulent characteristics" that made the 1918 flu pandemic strain so deadly.

And the new Secretary of Health and Human Services, Kathleen Sebelius, has made the decision to buy 13 million more courses of antivirals to replenish the antiviral stockpile, Schuchat said. "We don't know if we are going to need them, we just wanted to be ready," she said.

In addition, the United States has shipped 400,000 regimens of antivirals to Mexico, believed to be the source of the global outbreak, at the request of the Mexican government, Schuchat added.

Meanwhile, President Barack Obama has urged Americans to stay calm, noting that it was not clear whether the global outbreak of the never-before-seen flu strain was any worse than "ordinary flus." But, he added, agencies across the U.S. government are preparing for the worst, according to the AP.

Asia also announced its first case, in Hong Kong. Officials there quarantined an entire tourist hotel where the victim, a traveler from Mexico who entered via Shanghai, had stayed Thursday night before getting sick, according to the New York Times. On Saturday, South Korea reported its first case of swine flu.

Meanwhile, scientists were racing to produce a vaccine against the new flu strain, but the shots -- if needed at all -- wouldn't be available until fall at the earliest, U.S. health officials have said.

"We think 600 million doses is achievable in a six-month timeframe" from that fall start, U.S. Health and Human Services Assistant Secretary Craig Vanderwagen told lawmakers last week.

On Friday, U.S. health officials told reporters that six countries -- the United States, Canada, the Netherlands, Mexico, Germany and New Zealand -- have all shared samples of the virus for testing to further the vaccine effort.

"The good news is that the genes of all of the viruses we have examined to date are 99 to 100 percent identical," Cox said. "This means that it will be somewhat easier for us to produce an influenza vaccine."

"We are aggressively taking the very early steps that are necessary for vaccine manufacture should a decision be made go ahead and ramp up to full-scale production," Cox added.

The current plan is to have vaccine manufacturers complete production of next year's seasonal flu vaccine, then, if necessary, switch to the production of the H1N1 vaccine, Schuchat said.

The flu strain is a combination of pig, bird and human viruses, prompting worries from health officials that humans may have no natural immunity to the pathogen.

Meanwhile, the U. S. Food and Drug Administration and the Federal Trade Commission warned consumers Friday to avoid Internet sites and other promotions that offer products claiming to diagnose, prevent, treat or cure the swine flu virus.

"Consumers who purchase products to treat the novel 2009 H1N1 virus that are not approved, cleared or authorized by the FDA for the treatment or prevention of influenza risk their health and the health of their families," Michael Chappell, acting FDA Associate Commissioner for Regulatory Affairs, said in a news release. "In conjunction with the Federal Trade Commission, the FDA has developed an aggressive strategy to identify, investigate and take regulatory or criminal action against individuals or businesses that wrongfully promote purported 2009 H1N1 influenza products in an attempt to take advantage of the current flu public health emergency."

As with the previously tested strains of the swine flu virus, new testing has found that the pathogen remains susceptible to the two common antiviral drugs Tamiflu and Relenza, according to the CDC.

U.S. Human Cases of H1N1 Flu Infection (As of May 2, 2009, 11:00 AM ET) States # of laboratory confirmed cases Deaths Arizona 4   California 24   Colorado 2   Connecticut 1   Delaware 4   Florida 2   Illinois 3   Indiana 3   Kansas 2   Kentucky* 1   Massachusetts 8   Michigan 2   Minnesota 1   Missouri 1   Nevada 1   New Jersey 7   New York 50   Ohio 1   South Carolina 13   Texas 28 1 Virginia 2   TOTAL (21) 160 cases 1 death *Case is resident of Ky. but currently hospitalized in Ga. Source: U.S. Centers for Disease Control and Prevention

More information

For more on swine flu, visit the U.S. Centers for Disease Control and Prevention.

ME163 wrote: ok, So we are going to be bushwaked if we are not prepared for it. wave 2 is going to come this fall and that means all hell break loose. lets prep....

I FULLY AGREE! Annie