As the number of cases and deaths from swine flu go up in Mexico, and the US, Canada and other countries also report cases of the disease, but so far no deaths, other countries begin to take measures to contain the outbreak amid fears that this could be the start of a new global flu pandemic.
According to El Norte, a leading daily Mexican newspaper, the Mexican government’s latest announcement is that 103 have died of flu, which the authorities suspect was swine flu, but this has not yet been confirmed through lab tests. According to other media reports, 20 of the deaths so far have been confirmed as swine flu.
Mexico’s health minister, José Angel Córdova told Televisa network on Sunday evening that the suspected death toll had gone up from 81 on Saturday, and suspected cases of swine flu has gone up to 1,600, with about 1,000 of those people now recovered and released from hospital.
Córdova said the government has declared a state of “sanitary alert”. In Mexico City and some states the authorities have closed schools and day care centres. Businesses are still open but employers have been asked to be sympathetic about absences and latecomers because people will struggle with childcare.
Hundreds of public events were cancelled in Mexico City on Sunday: two First Division football matches played to empty stadiums, church services were suspended, and many entertainment and culture events were cancelled. Restaurants in the city are being asked to shut early and limit customers to 50.
People have started using surgical masks, many of which are being handed out by government officials. Mexico City Mayor Marcelo Ebrard said they would shut down the metro if cases continue to rise: it transports about 4 million people a day, said the Washington Post.
On Sunday, the US government declared a state of public emergency after reporting 20 laboratory confirmed human cases of swine influenza A/H1N1. 8 of them in New York, 7 in California, 2 in Texas, 2 in Kansas and 1 in Ohio.
Acting head of the US Centers for Disease Control, Richard Besser, said that while the virus appeared to be the same strain as that infecting people in Mexico, the effect has been milder, reported the Financial Times. All 20 people had mild flu-like symptoms and only 1 of them had to be kept in hospital.
According to the World Health Organization (WHO), preliminary lab tests on the 20 cases found that the viruses had the same genetic pattern, and the virus is being described as a new subtype of A/H1N1 not previously seen in pigs or humans.
The New York Times reported that Secretary for Homeland Security Janet Napolitano told a news conference in Washington on Sunday that the emergency declaration was a standard measure to make sure that funds can be released and emergency measures taken without delay. She likened it to getting ready incase a hurrican strikes, but hopefully it will not.
There are also reports of confirmed cases in Canada, and suspected cases in New Zealand, Spain and Israel. No deaths have been reported outside Mexico, and most of the patients have made a full recovery.
The WHO Emergency Committee, which was formed in 2005, met on Saturday for the first time to discuss the outbreak. Under the advice of the Committee, the Director General urged all countries to ” intensify surveillance for unusual outbreaks of influenza-like illness and severe pneumonia“.
The WHO Emergency Committee said that based on the evidence so far, the “current situation constitutes a public health emergency of international concern”, although there are still many unanswered questions.
According to the Financial Times, Dr Keiji Fukuda, the WHO’s assistant director-general for health security, said the committee will be reviewing the situation again on Tuesday, and will then decide whether to raise the current pandemic alert phase from 3 to 4. It has been at phase 3 for some years, but in response to a different virus, the much deadlier H5N1 Avian flu virus.
Under the WHO pandemic flu phase system, phase 3 means “an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people”, but human to human transmission has not led to sustained community outbreaks. After that is phase 4, which indicates sustained human to human community level transmission, phase 5 means it has spread to sustained level in at least one other country in the WHO region and the world should prepared for global pandemic, and phase 6 is global pandemic is under way.
A BBC News report earlier this morning said that health officials are warning that the UK should expect to see cases of swine flu. Two people are still undergoing tests in Lanarkshire after they came back from Mexico with flu-like symptoms.
Health Protection Agency Chief Executive Justin McCracken told the BBC that because of the way the strain is spreading across America, it was sensible to prepare for it in the UK as well.
“We are already mobilising things in the UK in case the virus comes over here. I definitely think we have enough of the drugs,” said McCracken, adding that he did not think at this stage it was necessary to declare a state of emergency.
The UK and France are rated by the WHO as the two countries that are best prepared for an outbreak, said the BBC report.
Health Secretary Alan Johnson said the UK has a stockpile of flu drugs ready. The drugs, believed to be mostly Tamiflu, deal with the virus very effectively, he said, because “we know from Mexico”.
Also, as soon as the strain is confirmed, then the UK government can set in motion pre-existing arrangements to make vaccines, he added.
The Foreign and Commonwealth Office is not currently advising people against travelling to affected areas of Mexico and the US, said the BBC.
By declaring a state of emergency in the US, the government can now release a quarter of the national stockpile of 50 million courses of anti-flu medication, and also allow some unapproved tests and drugs to be given to children, said the New York Times.
In Hong Kong, where memories of the SARS outbreak are still strong, the government has implemented much stricter measures. Travellers have been told to avoid Mexico and anyone arriving with a high temperature who has been to any city with a confirmed case is being detained and sent to hospital for testing. They are only released if the test is negative.
According to the Associated Press, passengers coming off planes at Narita International Airport near Tokyo, Japan, are being scanned by thermographic devices that can detect a person’s temperature from a few feet away.
Many other Asian countries are also using thermal scanners to screen out passengers with high temperatures, said a Reuters AlertNet report early this morning.
Although there is no evidence that swine flu can be caught from pig products, Russia has banned meat imports from Mexico and other Latin American countries, as well as several states in the US; while Thailand has banned all pork imports from the US and Mexico, reported the Washington Post.
According to the US Centers for Disease Control and Prevention (CDC), the symptoms of swine flu are similar to the symptoms of regular human flu and include “fever, cough, sore throat, body aches, headache, chills and fatigue“.
Some people also report having diarrhea and vomiting with swine flu, and like seasonal flu, the illness can make an underlying medical condition worse. Severe illness ((pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people, said the agency.
Sources: El Norte, Reuters, New York Times, BBC News, Associated Press, WHO, Washington Post, CDC.