Schools walk delicate line in swine flu response

Administrators say classrooms are safe but keep close eye on spread

Live Blog: CDC Swine-Flu Update

By Jacob Goldstein

Richard Besser (pictured), the CDC's acting director,  is giving today's media update on swine flu. Here's what he's saying.

11:41 There are 109 confirmed cases in the United States. There are eleven states with confirmed cases, many more states with suspect cases. South Carolina has been added to the list of states with confirmed cases. (We’ll add a link later to the CDC page that lists cases.) Median age of patients is 16. Most recent confirmed onset is April 26, most onset dates have been after April 18.

11:43 Keep in mind a piece of context: Even routine, seasonal flu is associated with 36,000 deaths per year in the U.S. So more deaths from the swine flu are also likely.

11:44 CDC will be looking to see whether Texas's decision to close some schools proves an effective way to slow the spread of the disease.

11:45 Look for an article later today in the MMWR summarizing the data coming out of Mexico.

11:46 WHO raising pandemic alert level won't do much to change what's happening in the U.S. But it may prompt other countries that haven't yet been affected to step up their preparations.

11:47 Have completed deployments of pandemic stockpile goods to nine states. Deployments to all states should be complete by May 3. No shortages are being reported at this time.

11:47 There is now a lab up and running in Mexico that can confirm cases of the virus.

11:48 Side note: Like other officials, Besser is calling the virus H1N1.

11:49 CDC information outreach includes Twitter. Besser says CDC is 'twitting.' He adds: 'I've never twitted.'

11:52 How testing works: If a doctor suspects a case of possible swine flu, he or she takes a swab from your nose. A local lab tests to see if it is a commonly circulating strain of flu. If it is not, it's sent on to a state or national lab that can determine whether it is a case of swine flu.

11:55 In response to question about whether the disease is diminishing in Mexico: "It's premature for me to comment on the situation in Mexico." Trying to understand why the disease seems to be more severe in Mexico "is really the critical question."

11:56 Influenza travels very easily person to person. "What I expect to see here is ongoing transmission in states. I would love to see the same types of cases we’re seeing, which are primarily the less severe cases."

11:57 "It's premature to say anything about virulence." Researchers are looking at how virulent this strain is likely to be.

11:58 Preparedness: U.S. has been planning for a pandemic, but "microbes don't read the plan." Still, preparation for flu pandemic means state and local agencies start out with a basic level of understanding.

12:00 We are growing up the virus that would be used for manufacturing. We've isolated the standard strain. It hasn't been distributed to manufacturers yet. You have to grow the virus, and do some testing, before you can get into production.

12:01 The current plan is to complete the production of next year's seasonal vaccine, then manufacturers would switch over to making a vaccine against the swine flu. The final decision on that does not have to be made yet because CDC is still growing seed stock for swine flu vaccine. CDC wanted to ensure there was enough seasonal vaccine.

12:03 Computer modeling suggested that if you a potential pandemic strain starting at distant shores, and you quickly implemented strict entry screening, you might be able to delay the entry of a pandemic virus by a few weeks. But once a virus is already inside the country, as it is now, those measures don’t have any added value.

12:04 If this virus goes away, it will be hard to know whether it is likely to come back in more severe form or to go away and not come back.

12:05 A reporter asks about Biden's comment that he would tell his family members not to fly. Besser's answer: "I think flying is safe, going on the subway is safe. People should go out and live their lives."  But those with fever and flu-like symptoms should not fly.

12:08 Is there change as it moves through communities? "We are seeing slight changes in the genetic makeup of the virus." But it's too soon to tell what the impact of those changes will be. There has been no changed observed in the virus’s susceptibility to antiviral drugs.

In children emergency warning signs that need urgent medical attention include:

• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
• Fever with a rash

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting

Current Threat Level

May 1, 2009

• The United States government's national threat level is Elevated, or Yellow.
• For all domestic and international flights, the U.S. threat level is High, or Orange. See the Transportation Security Administration for up-to-date information on items permitted and prohibited on airlines.

Help your community members in need.
Help fill our flu pandemic pantry!
Stocking up now will make it easier for our community during a flu pandemic and other emergencies.

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SHOPPING LIST
Examples of food and nonperishables

• Ready-to-eat canned meats, fish, fruits, vegetables, beans, and soups
• Protein or fruit bars
• Dry cereal or granola
• Peanut butter or nuts
• Dried fruit
• Crackers
• Canned juices
• Bottled water
• Canned or jarred baby food and formula
• Pet food
• Other nonperishable foods

Examples of medical, health, and emergency supplies

• Thermometer
• Medicines for fever, such as acetaminophen or ibuprofen
• Fluids with electrolytes
• Soap and water, or alcohol-based (60%–95%) hand wash
• Vitamins
• Soap
• Manual can opener
• Tissues, toilet paper, and disposable diapers
• Garbage bags