Canada Has First Global Case of Flu From Human to Pig (Update1)

By Greg Quinn

May 2 (Bloomberg) -- Canada reported the world’s first case of the swine flu jumping to pigs from a human, probably after a farm worker in the province of Alberta became ill during a trip to Mexico.

About 10 percent of the Alberta farm’s 2,200 pigs showed symptoms of the same H1N1 strain that has spread across the globe. They are recovering “on their own,” said Dr. Brian Evans, executive vice president of the Canadian Food Inspection Agency.

“This is the first detection that has been made,” of the virus moving from a human to a pig, Evans told reporters in Ottawa today. The animals have been quarantined and there is no risk to the food supply, he said.

There are 85 people in Canada who have contracted swine flu, Chief Public Health Officer Dr. David Butler-Jones said at the press conference. Most have reported mild symptoms.

EGYPT-Holding the first suspected case of swine flu

citizen of the province of the West is coming from Mexico ..
احتجاز أول حالة اشتباه بأنفلونزا الخنازير
السبت، 2 مايو 2009 - 23:11 Saturday, May 2, 2009 - 23:11

Detained hospital admitted Tanta's first suspected case of swine flu at the level of the Republic of the Egyptian citizen coming from Mexico, named Hani El-Shazly Center of Kfar Altabanip Smonod (39 years), living in the vicinity of the farm village, where he was detained Bhmyat Tanta medical examination was carried out by putting it under Note severe extreme to declare a state of emergency within the hospital and medical devices, especially since the suspect is coming from Mexico, where the disease is serious.
. The hospital immediately by giving the right drugs and taking blood samples, survey hours and sent to the central Ministry of Health laboratories, and samples were taken from a contact from his family and sent to central laboratories to demonstrate the extent of illness or not.

At the same time, the province of Western high state of alert within the hospitals, fever hospitals, and medical devices at the county level to detect any suspected cases of bird flu or avian flu swine flu.

Alberta pigs believed to be infected with swine flu: source

OTTAWA — "The Canadian Press has learned federal officials are set to announce the swine flu virus is believed to have infected pigs in Alberta. A government source says the animals were thought to be infected by a farm worker who had recently been to Mexico and fell ill upon his return. This may be the first time this particular swine flu virus has been found in pigs."

The World Health Organization has insisted there is no evidence that pigs are passing the virus to humans, or that eating pork products poses an infection risk. Genetic testing shows the pigs in Alberta were infected with the same virus responsible for cases in California, Mexico and other countries around the world. Official confirmation of the pigs' infection is expected at a news conference scheduled for Saturday afternoon in Ottawa.

The federal government, meanwhile, has expanded its swine-flu prevention campaign to Facebook, Twitter and YouTube, with a new "citizen-readiness campaign."
hattip Rikk

Govt. officials confirm 705 swine flu cases worldwide

The worldwide tally for the fast-spreading swine flu, or H1N1 influenza virus, stands at 705 cases Saturday.

In his weekly radio and Internet address, President Obama said his administration is acting "quickly and aggressively" to avert "the potential for a pandemic" of the new flu strain. In Hong Kong, officials quarantined 350 people inside a hotel after a guest came down with the first reported case of the virus in Asia. The ailing guest, a tourist from Mexico, was hospitalized in stable condition.

France reported its first two confirmed cases on Friday.

Speaking on TF1 television, French Health Minister Roselyne Bachelot said the patients, a 49-year-old man and a 24-year-old woman, both recently returned from Mexico. They have been hospitalized at two Paris hospitals and are "doing well," she said.

Bachelot also said another patient hospitalized at a third Paris hospital likely has the virus, but it has not been officially confirmed yet. Bachelot said all three had received anti-viral treatments.

She said the "form (of the virus) in our country appears benign" but did not rule out that the French cases could prove more serious. "This virus has killed (people) in Mexico. ... Therefore we must take all necessary precautions."

In the United States, Obama used his Saturday address to highlight efforts his administration is making to curtail spread of the disease, but also to reassure Americans. "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," the president said.

The government had 50 million courses of the treatment on hand, Obama said, and has begun making deliveries to states from that stockpile. He added that federal officials have purchased 13 million more doses of the medicine over the last few days.

In his address, the president referred to the virus by its scientific name, H1N1, and avoided the more commonly used "swine flu." Some analysts have blamed swine flu panic for a steep drop in pork prices this week. According to survey by the Harvard Opinion Research Program at the Harvard School of Public Health, 13% of Americans believe, incorrectly, that it is possible to get the flu strain from eating pork.

The virus was nicknamed swine flu because it originated from pigs. But it has now mutated into a form that passes easily between people. Obama noted in his Saturday address that the contagion has nothing to do with animals.

"This is a new strain of the flu virus, and because we haven't developed an immunity to it, it has more potential to cause us harm," the president said. "Unlike the various strains of animal flu that have emerged in the past, it's a flu that is spreading from human to human. This creates the potential for a pandemic, which is why we are acting quickly and aggressively."

Schools across the country continued to close because of concerns over actual or suspected cases. More than 430 schools were closed as of Friday, affecting as many as 250,000 student in Texas, Alabama, New York, California, South Carolina, Connecticut, Minnesota, Illinois, Indiana, Wisconsin, Arizona, Ohio, Utah, Washington state, Michigan, Maine and Maryland. That was about 100 more schools reported closed than reported on Thursday.

While emphasizing at a Friday news conference that the closures to date represent a tiny fraction of the almost 100,000 schools in the country, Education Secretary Arne Duncan instructed teachers, parents and students to be prepared if their school does close.

To teachers, Duncan said: "Think about reworking upcoming lesson plans so students can do their schoolwork at home if necessary."

To parents: "Learn about what they're learning at school. Keep them on task."

And to students: "Don't fall behind your peers at other schools that are still in session. Keep working hard."

A flight from Germany to Washington was diverted to Boston because a passenger complained of flu-like symptoms.

Airport spokesman Phil Orlandella says United Airlines Flight 903 was being diverted Friday afternoon after a 53-year-old female passenger told flight attendants about her symptoms. He said the flight from Munich had 245 passengers and six crewmembers. The flight had been scheduled to land at Washington Dulles International Airport later Friday.

It isn't yet clear what caused the woman's symptoms or whether she might be suffering from swine flu.

Still, the flu was beginning to look a little less ominous. New York City officials reported Friday that the virus still has not spread beyond a few schools.

New York City Mayor Michael Bloomberg said the illness so far had proven to be "a relatively minor annoyance." City health officials said they have found few signs that the local outbreak of swine flu is spreading beyond a few pockets or getting more dangerous. The city has 50 cases, the most of any city in the United States.

Meanwhile, prescriptions for antiviral, flu-fighting drugs increased nine-fold on Monday compared to daily sales for the previous month, according to the healthcare information company SDI. Sales began to go up on Friday, April 24, the day after the CDC reported cases of the H1N1 influenza in the United States. They have remained high since then, SDI reports.

Clinics and hospital emergency rooms in New York, California and some other states are seeing a surge in patients with coughs and sneezes that might have been ignored before the outbreak.

The World Health Organization is working on creating a vaccine against the H1N1 viru, says Marie-Paul Kieny, WHO's Director of the Initiative for Vaccine Research.

"Vaccines are an extremely effective protection against influenza," she says. In the case of seasonal influenza, vaccines protect millions of people each year against death.

Therefore, it is "critically important" to create a vaccine against the H1N1 virus, she says.

However, that takes time. Testing by the U.S. Centers for Disease Control and Prevention has shown that the flu virus for next year's seasonal influenza, which is currently in the early stages of production, does not provide protection against this newly-evolved strain.

Creating a new flu vaccine from scratch will take between four to six months and there's really no way to speed up the process and still make it safe and ensure the vaccine is effective, Kieny says.

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

"I don't want anybody to have false expectations. The science is challenging here," Vanderwagen told reporters. "Production can be done, robust production capacity is there. It's a question of can we get the science worked on the specifics of this vaccine."

Worldwide, the number of confirmed cases reached 659, according to the Associated Press, citing data from the Centers for Disease Control, WHO and government officials. Officially, the WHO lists the worldwide count of confirmed swine flu cases at 615.

In the U.S., the confirmed number of swine flu cases has topped 150. The CDC confirms 141, and states are confirming at least a dozen more. Cases now are confirmed in New York, Texas, California, South Carolina, Kansas, Massachusetts, Indiana, Ohio, Arizona, Michigan, Nevada, New Jersey, Delaware, Maine, Colorado, Georgia, Illinois, Virginia, Florida, Connecticut, Kentucky, Missouri, Nebraska and Minnesota.

The Harvard School of Public Health survey shows Americans appear to be responding to calls to increase hand washing. Fifty-nine percent of Americans said they were washing their hands or using hand sanitizer more frequently.

Despite public health officials' messages that only people who are sick with flu-like symptoms need to stay home, 15% of Americans said they were avoiding areas where many people are gathered, such as sporting events, malls or public transportation.

Other responses include 8% who said they were wearing face masks; 4% who have kept children home from school or daycare; and 1% who said they were getting a prescription for antiviral medications.

The survey was conducted on Wednesday, April 29, on a representative national sample of 1,067 adults. The margin of error was plus or minus 3.6 percentage points.

In global news:

No new deaths from swine flu were reported overnight in Mexico's capital for the first time since the emergency was declared a week ago, said Mexico City Mayor Marcelo Ebrard.

A large number of Sundays sexy girl wear a mask, an exhibition in Mexico, efforts to promote smoke-off.

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1 of of 11

周日一众性感女郎戴上口罩，在墨西哥一个展览会努力促销吸客。 A large number of Sundays sexy girl wear a mask, an exhibition in Mexico, efforts to promote smoke-off.

Travel Bulletin Health : Swine Influenza

This Bulletin is current for Sunday, 03 May 2009.
The Bulletin was issued on Saturday, 02 May 2009, 09:19:06, EST.

This Travel Bulletin should be read in conjunction with the Travel Advisory for your destination.

On 28 April 2009, the Department of Foreign Affairs and Trade reissued the travel advisory for Mexico to advise Australians to reconsider their need to travel to Mexico due outbreaks of swine influenza. Australians who do not have essential business in Mexico should consider leaving. Australians intending to remain in Mexico should ensure that they have access to adequate supplies of food, water and other essentials.

On 24 April 2009 the World Health Organization (WHO) advised Australia of cases of outbreaks of a new strain of swine influenza in Mexico and the United States. Cases have since been confirmed in Canada, New Zealand, Israel, Spain, the United Kingdom, Austria, Germany, the Netherlands, Denmark, Hong Kong and Switzerland. Outbreaks may occur in other countries. The WHO is providing regular updates on the location and number of confirmed cases on its website.

On 29 April 2009, the WHO raised the level of the influenza outbreak from phase 4 to phase 5 (of 6). The change to a higher phase of pandemic alert means that there is human-to-human spread in two countries in one WHO region. More information is available on the WHO website.

Governments in affected countries are taking appropriate measures and are being supported by the WHO. Most of those who have contracted the virus have experienced mild symptoms and then recovered. There have been confirmed deaths in Mexico.

Border control measures

Currently, there are no restrictions on regular travel and no borders have been closed. However some airlines may cancel flights to affected areas and there may be delays at airports and border crossings. Some countries (including Australia) have put in place screening measures on flights from affected areas. Travellers may be asked to declare their state of health at international airports prior to travel. Some countries are also implementing new quarantine measures for all travellers who have recently visited Mexico. For more information, contact the embassy or consulate of the country you plan to visit.

Countries may implement enhanced border control measures for both arriving and departing passengers. These measures can also be applied to passengers who are transiting through a country. Some countries have adopted quarantine measures for those exhibiting flu-like symptoms. You should follow the instructions of local border control, law enforcement or health authorities. {SNIP}

Influenza A(H1N1) - update 9

2 May 2009 -- The situation continues to evolve. As of 06:00 GMT, 2 May 2009, 15 countries have officially reported 615 cases of influenza A(H1N1) infection.

Mexico has reported 397 confirmed human cases of infection, including 16 deaths. The 241 rise in cases from Mexico compared to 23:30GMT of 1 May reflects ongoing testing of previously collected specimens. The United States Government has reported 141 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (34), China, Hong Kong Special Administrative Region (1), Denmark (1), France (1), Germany (4), Israel (2), Netherlands (1), New Zealand (4), Republic of Korea (1), Spain (13), Switzerland (1) and the United Kingdom (13).

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

Related links

Influenza A(H1N1) web site
Daily updates will be posted on this site.

Missing guests at swine flu hotel

HONG KONG, May 2, 2009 (AFP) - Hong Kong officials were Saturday trying to track down 50 people who never returned to a city hotel after it was placed under quarantine when a Mexican guest tested positive for swine flu.

The city was put on its highest health alert after the 25-year-old man was found to be carrying the A(H1N1) virus on Friday, the first confirmed case of swine flu in Asia.

The government made the extraordinary move of quarantining around 300 guests and staff at the four-star Metropark hotel for seven days.

But Thomas Tsang, controller of the Centre for Health Protection, said officials were still trying to trace 50 guests who may have left the hotel before it was isolated and have not returned.

Tsang added that seven more people had been tested on suspicion of contracting swine flu since the confirmed case.

Two, including one child who was on the same flight as the Mexican, had tested negative while the results of the five others were still awaited, Tsang told reporters.

A spokesman for the Dutch Foreign Ministry in The Hague told AFP that three Dutch nationals staying at the Metropark had been hospitalised.

"One of the three had an elevated body temperature. I do not know the reason for the hospitalisation of the others, but it is probably the same," said Herbet Brinkman, adding three other Dutch nationals were also at the hotel.

Hong Kong officials said they could not confirm the nationalities of those being tested. Reports have said Canadians, French, Swiss and Chinese nationals were among those staying at the hotel in the city's Wanchai bar district.

The Mexican man was admitted to hospital in Hong Kong on Thursday night after flying into the city from Mexico, via Shanghai.

He went to hospital suffering from a fever and tested positive on Friday for the flu virus. He was in a stable condition, authorities have said.

Two travelling companions and a Hong Kong friend were also placed in quarantine, although Health Secretary York Chow said they had shown no flu symptoms.

Around 10 passengers who sat near the 25-year-old Mexican on China Eastern Airlines flight MU 505 from Shanghai and the two taxi drivers who drove him after he arrived in Hong Kong have all been located and their cases were being investigated, Tsang said.

China said Saturday it was to put all passengers on the man's flight from Mexico to Shanghai into quarantine, after suspending all flights from the Latin American country on Friday.

Despite the sealing of the hotel - and with the memory of the deadly 2003 SARS outbreak still fresh in people's minds - Hong Kong residents remained cautiously calm.

Amy Wong, who was one of the many people stocking up on protective face masks at a pharmacy near the quarantined hotel, said she was buying the medical equipment "just to be safe."

"There is nothing to be scared of. We have experience of this," she said.

SARS killed close to 300 people in Hong Kong and residents have been quick to step up hygiene measures since swine flu began to spread around the globe.

Protective face masks were much more common on public transport and in restaurants Saturday. Sales of disinfectants have also spiked, while offices have been warned to step up cleaning measures.

However, the city's residents did not stay indoors.

The annual Cheung Chau Bun Festival, which marks the end of an 18th Century plague on one of the city's outlying islands, was still bustling with visitors.

The decision to close the Metropark Hotel has drawn criticism.

"It is stupid to lock up the hotel, as most people in the hotel did not contact (the infected man) at all," infectious diseases expert Lo Wing-lok told the South China Morning Post.

"I believe this is going to be an international joke."

In South Korea, authorities Saturday confirmed the second case in Asia, as several European countries also said they had fresh incidences of the virus.

Mexico's government has confirmed 16 people have died from swine flu, with 381 infected.
hattip PABLOMORGAN

A girl with 43 degrees of temperature

Hattip Aquarius

his comments ..This is from Poresto.net, a Mexican Newspaper.... I've been reading about the 1918 flu and vomiting blood was a common symptom. This is the first I've heard about it with this flu. Could it be mutating or is that just a pnemonia symptom?

A girl with 43 degrees of temperature

Denuncian falta Whistleblower de atención médica Healthcare Por Santos Gabriel Us Aké For Santos Gabriel Us Aké Decenas de personas acudieron ayer a las clínicas públicas por tener fiebre o algún síntoma que les preocupa, pero lo peor de todo es que algunos no recibieron atención médica, entre ellos los menores Demiyairel Cordero y Víctor Andrés, según denunciaron sus padres por separado; mientras tanto, las clínicas del Seguro Social no dieron consulta externa ayer, por ser día inhábil, y solamente atendieron a quienes tenían síntomas de gripe. Dozens of people came yesterday to public clinics for fever or any symptoms that worry, but the worst part is that some did not receive medical care, including children Demiyairel and Victor Andrés Cordero, as reported by their parents separate, while Meanwhile, the Social Security clinics gave no consultation yesterday, as non-working day, and only those who attended were flu symptoms. Jesús Cordero Cabrera, angustiado y con su hija enferma Demiyairel en brazos, denunció que desde hace cuatro días le dieron un jarabe en el Hospital General “Jesús Kumate Rodríguez”, pero continuó con fiebre, incluso ha vomitado sangre, y lo peor de todo fue que ayer se negaron a atenderla de nuevo. Jesús Cordero Cabrera, distressed and with his sick daughter in her arms Demiyairel, reported that for four days gave a syrup at the General Hospital "Jesus Kumate Rodriguez," but continued with fever, even vomited blood, and worst of all was yesterday refused to meet again. Respondió que tiene 43 grados centígrados de temperatura, tiene tos, y señaló que a pesar de que el director del nosocomio ordenó que atiendan a su hija, el médico cuyo nombre no precisó se negó a prestar el servicio. Has responded to 43 degrees centigrade temperature, coughing, and noted that although the hospital director ordered to serve his daughter, the doctor whose name did not refused to provide the service. Ante esta situación, preocupado por la influenza humana, decidió acudir a la Jurisdicción Sanitaria Número Dos a presentar su queja. In this situation, concerned about the human influenza, he decided to attend the Sanitary Jurisdiction Number Two to file your complaint. Por su parte, Laura Serracino trajo también a su hijo Víctor Andrés al Hospital General, y denunció que no quisieron atenderlo sino que lo mandaron al Centro de Salud de la Región 516. For its part, Laura Serracino also brought his son Victor Andres General Hospital and reported that they would not attend but sent him to the Health Center of Region 516. Explicó que desde hace cuatro días se niegan a atenderlo en la Sala de Urgencias con el argumento de que su fiebre aún no es muy alta. He explained that for four days refused to attend the emergency room on the grounds that his fever is still not very high. Ella manifestó su preocupación por esta situación, y mostró la hoja para que vaya al Centro de Salud de la Región 516. She expressed concern about this situation and showed the leaf to go to the Health Center of Region 516. El Hospital General “Jesús Kumate Rodríguez” trabajó normalmente ayer debido a la contingencia sanitaria contra la influenza humana, y el próximo cinco de mayo no habrá consulta externa sino solamente urgencias. General Hospital "Jesús Rodríguez Kumate" normally worked yesterday due to health contingency against human influenza, and next May there will be five outpatient emergencies only. Mientras tanto, de acuerdo a un recorrido realizado en las clínicas del Instituto Mexicano del Seguro Social (IMSS), se constató que por ser día inhábil no prestó servicios para consulta externa en general. Meanwhile, according to a tour conducted in clinics of the Instituto Mexicano del Seguro Social (IMSS), which was found to be non-working day did not provide outpatient services in general. El Seguro Social no apoyó la disposición federal de trabajar normalmente, sino solamente atendía a quienes tengan fiebre, congestión nasal o malestar general en el cuerpo. Social Security did not support the provision of federal work normally, but only those who have cared for fever, nasal congestion and general malaise in the body. Y las áreas de urgencias todas laboraron como de costumbre en los días feriados. And the areas of emergency all worked as usual on holidays. Por ejemplo, en la Unidad de Medicina Familiar, del Hospital General de Zona del IMSS de la avenida Cobá, había alrededor de seis personas con síntomas de gripe esperando su turno de atención. For example, in the Family Medicine Unit, Hospital General de Zona IMSS Cobá the avenue, there were about six people with flu symptoms waiting their turn for attention.

Dozens of people came yesterday to public clinics for fever or any symptoms that worry, but the worst part is that some did not receive medical care, including children Demiyairel and Victor Andrés Cordero, as reported by their parents separate, while Meanwhile, the Social Security clinics gave no consultation yesterday, as non-working day, and only those who attended were flu symptoms.

Jesús Cordero Cabrera, distressed and with his sick daughter in her arms Demiyairel, reported that for four days gave a syrup at the General Hospital "Jesus Kumate Rodriguez," but continued with fever, even vomited blood, and worst of all was yesterday refused to meet again.

Has responded to 43 degrees centigrade temperature, coughing, and noted that although the hospital director ordered to serve his daughter, the doctor whose name did not refused to provide the service.

. In this situation, concerned about the human influenza, he decided to attend the Sanitary Jurisdiction Number Two to file your complaint.

. For its part, Laura Serracino also brought his son Victor Andres General Hospital and reported that they would not attend but sent him to the Health Center of Region 516.

. He explained that for four days refused to attend the emergency room on the grounds that his fever is still not very high. She expressed concern about this situation and showed the leaf to go to the Health Center of Region 516.

General Hospital "Jesús Rodríguez Kumate" normally worked yesterday due to health contingency against human influenza, and next May there will be five outpatient emergencies only.

Meanwhile, according to a tour conducted in clinics of the Instituto Mexicano del Seguro Social (IMSS), which was found to be non-working day did not provide outpatient services in general.

Social Security did not support the provision of federal work normally, but only those who have cared for fever, nasal congestion and general malaise in the body. And the areas of emergency all worked as usual on holidays.

For example, in the Family Medicine Unit, Hospital General de Zona IMSS Cobá the avenue, there were about six people with flu symptoms waiting their turn for attention.

However, it was not possible to contact patients, or photograph, as private security agents denied access.

Warden Message

U.S. Consulate General Hong Kong

May 2, 2009

This Warden Message alerts U.S. citizens to the latest information regarding human cases of 2009-H1N1 Influenza, called human swine flu in previous Hong Kong government messages. The Hong Kong Government reported on May 1 the first confirmed case of H1N1 Influenza in Hong Kong. The patient is a Mexican national who arrived on Thursday April 30 and spent that night at the Metropark Hotel in Wanchai. He checked himself into a hospital Friday after becoming ill. The Hong Kong Government has raised the Influenza Pandemic Alert Level to the highest level -“Emergency”.

The Consulate reminds U.S. citizens that most cases of influenza are not 2009-H1N1 Influenza. Any questions or concerns about influenza or other illnesses should be directed to a medical professional. Although the Consulate cannot provide medical advice or provide medical services to the public, a list of hospitals and doctors can be found on our website at http://hongkong.usconsulate.gov/acs_medical.html.

For further information about the H1N1 situation in Hong Kong, please see the Hong Kong Government’s Centre for Health Protection website at http://www.chp.gov.hk/index.asp?lang=en.

[snip]
Thanks PIXIE!

Director of Health issues isolation order to control human swine flu

The Director of Health, Dr PY Lam, had ordered Metropark Hotel in Wan Chai to be isolated starting yesterday (May 1) to prevent the spread of human swine flu (Influenza A H1N1), a Government spokesman said.

The order was issued following the confirmation of the first human swine flu (H1N1) in Hong Kong which involved a 25-year-old Mexican man. The man stayed in the hotel after arriving from Mexico via Shanghai on April 30.

The order, designed to protect the health of the community as a whole, was issued by the Director of Health under Section 25 of the Prevention and Control of Disease Ordinance (Cap 599).

The order requires all staff and lodgers to be remained in the hotel. Some of them will be removed to Lady Maclehose Holiday Village, a designated isolation camp, today (May 2). They will be quarantined for a period of seven days.

Public health personnel from the Centre for Health Protection (CHP) of the Department of Health have conducted health inspections for people staying in the hotel. Those who have developed flu-like symptoms will be sent to hospital for treatment.

Staff of the Food and Environment Hygiene Department will conduct thorough cleasning and disinfection in the hotel.

"We do understand that the measures that we have now taken will cause lodgers great inconvenience. But because of the very special circumstances that we now face, we have no choice but resort to this exceptional measure and we sincerely ask for their forbearance, understanding and support in joining the community's fight against this disease." the spokesman said.

Meanwhile, CHP has started tracing people with opportunities to have contact with the patient.

Travellers boarding AeroMexico (flight no. AM98) from Tijuana to Shanghai on April 29 or China Eastern Airlines (flight no. MU505) from Shanghai to Hong Kong on April 30, or those stayed in the hotel on the same day and have left are urged to call the CHP hotline 2125 1111 to facilitate prompt investigations by the health authority.

Ends/Saturday, May 2, 2009
Hattip Helblindi

Detention of suspected bird flu case of the lake

السبت، 2 مايو 2009 - 16:24 Saturday, May 2, 2009 - 16:24



Leaders moved the security escort of Veterinary Medicine
and
Health
to
clean up the house of the infected


The hospital admitted the detention of Damanhour woman on suspicion of being infected with bird flu symptoms after an outbreak of avian flu are similar to the high temperature, sore throat and difficulty in breathing, where blood samples were taken for analysis in the central laboratory in Cairo, to demonstrate the positive sample.

Major-General received the Director Majdi Abu Amar security lake, a notification from the hospital admitted the detention of Damanhour morning Ebrahim Zainuddin (30 years old), a housewife and resident Biitay powder suspected of being infected with bird flu, the leadership moved immediately to the security escort of Veterinary Medicine and Health to clean up the house and the houses surrounding the infected, as well as contact them.

Examination of a dead pig

Examined by a special committee of veterinary medicine a pig yesterday morning after he was found dead in the area of land in Giza General. And targeted examination to determine the cause of death, it is natural or is there a suspected flu death in pigs, and will be announcing the result of During the examination days.

Suspected case of bird flu infection in Port Said

Suspected case of bird flu infection in Port Said
السبت، 2 مايو 2009 - 15:31 Saturday, May 2, 2009 - 15:31



Infected live poultry purchased by
the
slaughter of chickens
and
cleaned house


Hospital diets detained in Port Said, the citizenship of suspected bird flu disease, bird flu, called Ms. Muhammad Ali (53 years) and a housewife living in the district, Omar bin al-Khattab flowers.

Citizenship has been felt in the high temperature, sore throat and pain of the bones and muscles, so I went to the medical status of the jewel which was initiated by turning it into a fever hospital, where the temperature and 39 and a half of them complained of symptoms, which is similar to the symptoms of avian influenza.

Were immediately taken samples of blood and the throat of the survey and send it to the Department of Central Laboratories Ministry of Health, has been moved to a hospital in Port fevers all the security organs, Dr.. Just leave the Director of the Department of Preventive Medicine, Directorate of Health Affairs in Port Said.

Isolation procedure was a precautionary measure to the family medical situation aside, has been reported infected in the words that they bought live chickens from a market vendor kindergarten Arab district, where the slaughter of chickens and cleaned her house and was on the second day the high temperature.

		World
		WHO confirms 615 swine flu cases
		16:18 02/ 05/ 2009

MOSCOW, May 2 (RIA Novosti) - The World Health Organization (WHO) on Saturday said the number of human cases of the swine flu virus A (H1N1) had risen to 615 from 365.

The WHO, who raised its alert level for a pandemic from 4 to 5, said 17 people had died of the disease - 16 in Mexico and one in the U.S.

Mexico's health minister said on Saturday that 397 people had been diagnosed with the virus in the Central American country. U.S. health authorities said 141 people in the U.S. had been confirmed with the infection.

Although the illness has so far claimed few lives, the outbreak has sparked a number of dramatic media reports suggesting future death tolls "could" be in the tens of thousands or even millions.

The global health body also said well-cooked pork and pork products carry no risk of infection from the virus.

The head of Russia's Flu Research Institute said in an interview with RIA Novosti on Thursday that Russian scientists could create a vaccine to combat swine flu in three months.

22 detention of a citizen on suspicion of bird flu in 6 provinces

- «Egyptian today» 2 / 5 / 2009
Detained in hospital diets 6 provinces about 22 cases, yesterday and the day before yesterday, on suspicion of bird flu patients, and was executed about 8000 birds suspected of being infected with the disease.

In Menoufia, detained hospital fevers Shebin new case on suspicion of her, following the emergence of symptoms of the infection. "Said Dr Hesham Atta, Deputy Minister of Health Menoufia:« The situation of a woman named Madiha Mohammad Abdel Wahab (39 years old), housewife, from the village of Centna stone, of the seven Swimming Center, which is raising domestic birds ».

In the lake, held 5 Damanhour hospital admitted cases, yesterday, on suspicion of contracting the disease, namely: Mohamed Mohamed Moussa, «20 years», a resident of Kafr al-Dawar counterpart, Mahmoud Allam «7 years» Ragheb and his brother «8 years», staying Bazbp Dalilah the village of Kom-Qanatir, Obouhms of the Center, and accepted Mr. «29 years», resides in the village of Kom Ombo Boboualemtamir and Stip Alcolmy «30 years» resident Abu Almtamir.

In Dakahlia, was detained in Mansoura Chest Hospital on Monday, including two children, 7 cases of suspected bird flu patients, namely: the Secretary of Fathi Razeq «40 years», from the village of the stadium and the status of Belkas Chadia Abdasameea Mr. «39 years» from the village of dead slaves built the status of Sweden Fahim Mahmud Gharib «40 years» from the village of Mansoura and the status of Talpanp Ebtisam Sollymy Jabr «33 years» from the village of Union Bmit Slsell and Mohammad Shilbaya «48 years» Alsnellowin of the city, in addition to the two children, gave Mr. Ibrahim Abboud «3 years» from the village of stone Ooic the status of Egypt and Ahmed Abdel Rahman and the «two and a half», from the village of Alhawwal Balsnellowin.

In the West, the hospital admitted Tanta detained, Musa Mohamed Ahmed, «20 years», from the village of Lake counterpart, Ahmed Rizk, «24 years», from the village of al-Muhsin Awaid Hmaa Alexandria, recruits meeting Sunday attended by the central security forces, Riza Ibrahim «22 years», Warbah the house of the village of Tanta Sptas Center and Suhair Wahab «45 years», housewife, and the livelihood of Nabil Abd «12 years» student, and Hanan veil «36 years» housewife and a resident of a dead gazelle Balsntp.

In Kafr el-Sheikh, was arrested Abdullah verses hospital diets «68 years», from the village of Shin's meeting Sunday attended by the Center for Qtor.

In Damietta, he was detained hospital diets Suhair Farghali Hidayat housewife from the village of Albesasitp of the Damietta Center, and the benefit of different Abdalmqsod dead from the village of Kafr Saad Oboghalb status.

In Suez, the Governor Seif Eddin Galal, to prevent the breeding of birds in the home, and non-entry of live poultry from neighboring provinces and to emphasize the lack of circulation in the market only to sell only poultry slaughtered, "said Dr Adel Abbas, Under-Secretary, Department of Veterinary Medicine Suez, had been executed about 2440 birds in the campaigns, extensive and diverse, on Saturday.

In Fayoum, able to control supply, control of the 5800 District of birds, including the 3000 duck with a foreign strain, with all the difficulty in breathing, accompanied by a certificate of non-health benefit free of avian flu, were to form a committee from the Directorate of Supply moved to the dump health Kom Ooshim culled birds seized

Health: No injuries swine flu

Following the increase in suspected cases in the provinces ..


Health: No injuries swine flu


السبت، 2 مايو 2009 - 14:10
Saturday, May 2, 2009 - 14:10


Assurances of the Ministry of Health that there were no injuries swine flu

Dr. Abdel Rahman Shahin, spokesman of the Ministry of Health, there have been no confirmed case of swine flu positive so far, not even any new cases of bird flu.
He pointed out that most suspected cases of avian influenza, whether or pigs, which were recorded during the last week is just the negative of the situation caused by extreme fear, which seized control of the citizens in the recent period, appealing to the media to raise awareness of the need to work so as not to get panicked citizens.

This came after the registration of many of the hospitals in governorates of suspicion of the citizens went to the hospital, confirming the disease, but the central factor analysis confirmed that it specialized ordinary flu symptoms from the first phase the result of daily changes in the atmosphere.

In contrast, Abdel-Rahman Shaheen, said that people went to hospitals in a healthy phenomenon in any case of suspected symptoms, calling upon the citizens need to go to the nearest hospital if any suspected symptoms.

Department of Epidemiology: an innocent pigs of influenza in Egypt

3 vets, a soldier and other suspects, some in a town where pigs are raised
Department of Epidemiology: an innocent pigs of influenza in Egypt

السبت، 2 مايو 2009 - 13:02
Saturday, May 2, 2009 - 13:02

Birds are still the first source of danger in Egypt


Dr. Saber Abdel Aziz, director general of the Directorate General of epidemics, there are 3 cases of suspicion of infection, doctors and veterinary bird flu occurred two days ago, one of the farms are compelling, but not confirmed after the injury.

Abdul Aziz said that an innocent pigs so far of any injuries or any suspected cases, because the swine flu did not enter Egypt.

He pointed out that the concern which controls the citizens, which is forcing them to go to the hospital to check, which is recorded as a suspected case.
The other hand, said Dr. Ibrahim Abanndary director of the Preventive Medicine Authority veterinary services to the final statistics of the number of pigs in Egypt revealed the existence of 156 thousand pigs in 8 governorates, namely Cairo, where the number of pigs Qalubia 63466 and 25668 and 28020, Giza


October 6, Helwan 17750 and 20694 and the lake, 457, Menya, Sohag, 151 and 75 in the Monastery of Lecy our father and the Archbishop surged.

Denied Abanndary have been raised about the disposal of the pigs are in the same places for animals, massacres, and said that there is a special ward of the pigs are not allowed to mix with the meat and other meat animals.

For his part, Dr. Abdul-Qader Abed Director of the Department of Health on Monday announced that the preservation of the state of emergency, and a series of intensive meetings, daily meetings with all leaders in the county health directors and public and private hospitals to follow up on any changes, in addition to the distribution of publications to guide the citizens.

Abid said that the hospitals to deal seriously with any case of avian flu, who tend to any citizen or pigs.

He pointed out that the hospitals were equipped to receive emergency cases.



For his part, Dr. Maher Mohamed, the head of the Department of Veterinary Medicine, Helwan had been taking samples from the pigs and the maintenance of the existing outcome was negative.

In the governorate of Minya detained Mallawi hospital fevers, patience of Ibrahim Abd El-Naim (28 years) Sharafiyah Bamahrs village on suspicion of being infected with bird flu, samples were taken and sent to the laboratory in Cairo, and that is the case of a suspected fourth of its kind in three days, and the second is the status of Mallawi .

This is the fourth case 4 in three days and the second case the status of Mallawi, which has raised concern among the citizens, for fear that the suspects avian infected pigs, as pigs are at the center of the village of Mallawi village, Deir, Deir Abu Hns Albercp.

In Fayoum, hospital doctors suspected fever cases in the central security soldiers and a child, a baby with bird flu, had been detained in hospital and take samples for their analysis of the central labs, the Ministry of Health.

The citizen Hanafi Taha Ahmed (21 years) from the Central Security Forces Fayoum, Giza Governorate, and live, have reached a fever to a hospital suffering a sharp rise in temperature, showing symptoms of bird flu.
Also entered the hospital, children's diets Fayyoum Mr. Hassan Juma, aged one and a half from the village of compromise Psonors, and developed the same symptoms.

Doctors in the hospital suspected the two cases of bird flu, has been sampling them to be sent to labs central Ministry of Health, to make sure they got sick or not.

WHO: Influenza A(H1N1) - update 9

2 May 2009 -- The situation continues to evolve. As of 06:00 GMT, 2 May 2009, 15 countries have officially reported 615 cases of influenza A(H1N1) infection.

Mexico has reported 397 confirmed human cases of infection, including 16 deaths. The 241 rise in cases from Mexico compared to 23:30GMT of 1 May reflects ongoing testing of previously collected specimens. The United States Government has reported 141 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (34), China, Hong Kong Special Administrative Region (1), Denmark (1), France (1), Germany (4), Israel (2), Netherlands (1), New Zealand (4), Republic of Korea (1), Spain (13), Switzerland (1) and the United Kingdom (13).

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities. There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

HK: Feral pigeon confirmed positive for H5N1 virus

Saturday, May 2, 2009

A spokesman for the Agriculture, Fisheries and Conservation Department (AFCD) said today (May 2) that a dead feral pigeon found in Tuen Mun was confirmed to be H5N1 positive after a series of laboratory tests.


Under the present avian influenza surveillance programme on dead wild birds, the feral pigeon carcass was collected on April 27 at Leung Tak Street, Tuen Mun.

To prevent congregation of feral pigeons causing environmental hygiene problems, people should not feed them.

The Food and Environmental Hygiene Department and the Leisure and Cultural Services Department will continue to take stringent enforcement action against feral bird feeders making public areas and parks dirty.

"The public can call 1823 Call Centre for follow up if they come across suspected sick or dead birds, including carcasses of wild birds and poultry," the spokesman said.

Members of the public are reminded to observe good personal hygiene.
hat-tip Ironorehopper

Swine Flu Outbreak Illuminated By Avian Flu Research

ScienceDaily (Apr. 30, 2009) — A new study by University of Maryland researchers suggests that the potential for an avian influenza virus to cause a human flu pandemic is greater than previously thought. Results also illustrate how the current swine flu outbreak likely came about.

As of now, avian flu viruses can infect humans who have contact with birds, but these viruses tend not to transmit easily between humans. However, in research recently published in the Proceedings of the National Academy of Sciences, Associate Professor Daniel Perez from the University of Maryland showed that after reassortment with a human influenza virus, a process that usually takes place in intermediary species like pigs, an avian flu virus requires relatively few mutations to spread rapidly between mammals by respiratory droplets.
-snip-
Though it comes from a different strain of avian flu than the one that contributed to the hybrid virus now causing the swine flu outbreak, Perez's research virus is similar in origin to the swine flu virus, in that both involved a combination of avian and human influenza viruses.

Perez infected ferrets (considered a good model for human influenza transmission) with the virus he created, and allowed the virus to mutate in the species. Before long, healthy ferrets that shared air space but not physical space with the infected ferret had the virus, showing that the virus had mutated to spread by respiratory droplets.

When the genetic sequences of the mutant virus and original hybrid virus were compared, the only differences were five amino acid mutations, three on the surface, and two internally. Two of the surface mutations were determined to be solely responsible for supporting respiratory droplet transmission. Because so few mutations were necessary to make the hybrid H9N2 transmissible this way, they concluded that after an animal-human hybrid influenza virus forms in nature, a human pandemic of this virus is potentially just a few mutations away.

-snip-

"This is just the tip of the iceberg," said Perez. "Many more studies have to be done to see which combinations of mutations cause this type of transmission before we can design the appropriate vaccines."

Perez will be talking this week with the NIH and the CDC to discuss his team's role in researching the current swine flu virus strain. Perez will likely do studies related to vaccine development, virus transmission between humans and animals, and the pathogenesis of the virus.

-snip-

First genetic analysis of swine flu reveals potency

The H1N1 flu continues to spread around the world, with cases now confirmed from more than a dozen countries, from Hong Kong to Canada.

Yet the first genetic analysis of how well this virus transmits from person to person concludes that it spreads barely well enough to keep itself going.

The analysis also suggests the virus may have started circulating as long ago as January. But because there have been so few cases to analyse, the calculation is uncertain. It could have started more recently, or as far back as September.

Nicholas Grassly of Imperial College London and Andrew Rambaut of the University of Edinburgh, UK, have analysed the rate of spread. Their analysis is based on the small mutations that have accumulated in almost two dozen genetic sequences produced so far, from viruses collected from patients in Mexico and the US.

Freely available

In contrast to H5N1 bird flu, all the genetic sequences of this H1N1 are being posted on bulletin boards like GISAID, where scientists can access them and compare preliminary analyses.

The GISAID system was set up in 2006 by scientists who protested that H5N1 sequences were not being made freely available.

"The limited sampling so far gives rise to considerable uncertainty in the estimate," cautions Rambaut. But if the rate at which genes mutate is about the same for this virus as for other H1N1 viruses, the number of mutations that have accumulated so far suggests it has been circulating since January – or even September 2008.

Weak virus

If the new virus spreads from one infected person to the next at about the same speed as ordinary flu, that gives an idea of how many cases there may have been in that time. A mathematical model permits the calculation of an important variable called R₀ – the number of additional people infected, on average, by each case. If R₀ is less than one, an infection dies out.

Grassly also cautions that the estimate is very preliminary. But with the data available now, he gets an R₀ of 1.16 – enough for the virus to keep going, but only just.

This could be good news. In epidemiological theory, at least, the lower the R₀, the easier it may be to snuff the virus out by further hindering its spread.

But it may be too early for celebrations. The 1918 flu pandemic, caused by another H1N1 virus, started with a mild, early wave in spring and early summer. The flu lab at the Los Alamos National Laboratory in the US estimates that the R₀ of the 1918 virus in spring was only 1.45. That shot up, they estimate, to 3.75 when the virus began its lethal second wave the following autumn.

Much may now depend on how quickly the new H1N1 virus from swine adapts to people.

Hong Kong isolates hotel after 1st swine flu case

[Overreaction??? This is what we were seeing during their H5N1 human outbreak earlier this year. I would think the memories of the outbreak in January of this year would be more fresh in their minds, than SARS outbreak of 2003.......hey, it's not deadly, it's symptoms are no more than the usual seasonal flu....or didn't you guys get the "memo"?]

By DIKKY SINN and MIN LEE, Associated Press Writers Dikky Sinn And Min Lee, Associated Press Writers – 16 mins ago

HONG KONG – Hong Kong quarantined hundreds of hotel guests and workers Friday after a tourist from Mexico tested positive for swine flu, Asia's first confirmed case of the disease. With memories of 2003's deadly SARS outbreak still fresh, the government moved quickly to track those exposed to the infected man and contain the potential spread of the disease.

Health workers wearing full body suits and masks wiped the tables, floor and windows in a room at the Metropark Hotel as guests in other rooms waved to photographers. It wasn't immediately clear if the room being cleaned was where the patient stayed.

Later Friday, more than 20 guests wearing masks walked from the hotel to ambulances that took them away. S.K. Chuang, a consultant to Hong Kong's Center for Health Protection, said the guests had shown respiratory symptoms and were taken to hospitals.

Police officers wearing gloves and masks guarded the Metropark Hotel and officials ordered a weeklong quarantine of the some 200 guests and 100 staff, all of whom were to be treated with the antiviral drug Tamiflu. The 25-year-old man who tested positive was isolated at a hospital and was in stable condition Friday.

Officials also began tracking down people the patient came into contact with on his journey to Hong Kong. China suspended flights from Mexico to Shanghai, the state-run Xinhua News Agency reported Saturday morning.

The man, who was not identified, flew from Mexico to Shanghai on AeroMexico flight AM 98, then on to Hong Kong on China Eastern Airlines flight MU 505. He developed a fever after arriving in the territory Thursday afternoon, Hong Kong leader Donald Tsang told reporters.

While the man did not leave his flight in Shanghai, the case still raises concerns about the introduction of the virus on mainland China. Health experts fear the disease will be more difficult to contain if it begins to spread through Asia's densely populated countries.

Officials were attempting to track down the 140 other passengers on the flight, paying special attention to passengers who sat near him, and urged the taxi drivers who drove him to contact health officials, Secretary for Food and Health York Chow told reporters.

The patient, who was traveling with two other people, took taxis from Hong Kong's airport to his hotel and from the hotel to the hospital, but did not venture out otherwise, Chow said.

The two other travelers and a friend the man met with with during his stay have been isolated in a hospital but have not shown symptoms of illness, Chow said.

Twenty-four Taiwanese citizens were on the flight from Shanghai to Hong Kong and traveled on to Taiwan on six separate flights Thursday, the island's Department of Health said. The passengers were urged to contact Taiwanese health officials immediately.

The Mexican did not appear ill when he passed through Shanghai, but China will track down the other passengers on the flight from Mexico to Shanghai and quarantine them for seven days, the country's Ministry of Health said in a statement Friday.

In contrast to its tough measures Friday, the Hong Kong government was accused of responding slowly when severe acute respiratory syndrome spread in 2003 from southern China.

An infected doctor who checked into a Hong Kong hotel later died, but not before infecting a Hong Kong resident and 16 other hotel guests. Those guests spread the virus internationally. SARS eventually killed more than 770 people, including 299 in Hong Kong.

"Given the current situation, I'd rather err on the side of caution than miss the opportunity to contain the disease," Tsang said.

But the Hong Kong leader also urged calm, saying that all public activities would proceed as normal. [LOL!]

Even before the swine flu case emerged, Hong Kong officials had stepped up precautions, screening visitors for fever and ordering air travelers to fill out health declaration forms. [Yes, and you're not telling why. Could it have something to do with a train into Russia??? Information is all here at the blog]

The government also launched a citywide cleanup. Public toilets are being cleaned every two hours and escalators in wet markets are wiped down every hour.

WHO will take vaccine gamble with swine flu

[I am definitely getting the impression that they are mostly concerned about this Swine Flu mutating into a more deadly strain this Fall. The last sentence says it all. So if they are willing to go to these lengths, they must feel it has a good chance of evolving.]

LONDON — When World Health Organization officials ask vaccine manufacturers to start producing vaccine to fight swine flu in a few weeks, they will be taking a calculated risk.

Flu vaccine companies can only make one vaccine at a time: seasonal flu vaccine or pandemic vaccine. Production takes months and it is impossible to switch halfway through if health officials make a mistake.

While some countries like the United States may be better prepared than others – American officials say production for next year's vaccine batch is so advanced they're nearly finished – the situation for many other countries is unknown.

-snip-

"It's a big decision...We've never done this before," said Marie-Paule Kieny, director of WHO's Initiative for Vaccine Research.

-snip-

But if swine flu evolves into a more deadly strain, more shots may be needed to protect wider swathes of the population. Another possible complication is that the pandemic vaccine will be made using the strain available now; whether that will work if the virus mutates isn't certain.

At the moment, WHO has a bit of breathing space. The key component for the pandemic vaccine, the "seed stock" from the swine flu virus, will not be available for a few weeks.

-snip-

Recent work on H5N1 vaccines, the bird flu strain many thought would ignite the next pandemic, may also help. John Treanor, a vaccines expert at the University of Rochester said that adjuvants developed during H5N1 research may come in handy now.

He said public health officials were indeed facing a vaccine dilemma. "There is only a certain amount of capacity for vaccine manufacturing," he said. "One has to make some well-reasoned choices, sometimes based on incomplete information."

CDC/MMRW: Outbreak of Swine-Origin Influenza A (H1N1) Virus Infection --- Mexico, March--April 2009

April 30, 2009 / 58(Dispatch);1-3

In March and early April 2009, Mexico experienced outbreaks of respiratory illness and increased reports of patients with influenza-like illness (ILI) in several areas of the country. On April 12, the General Directorate of Epidemiology (DGE) reported an outbreak of ILI in a small community in the state of Veracruz to the Pan American Health Organization (PAHO) in accordance with International Health Regulations. On April 17, a case of atypical pneumonia in Oaxaca State prompted enhanced surveillance throughout Mexico. On April 23, several cases of severe respiratory illness laboratory confirmed as swine-origin influenza A (H1N1) virus (S-OIV) infection were communicated to the PAHO. Sequence analysis revealed that the patients were infected with the same S-OIV strain detected in two children residing in California (1). This report describes the initial and ongoing investigation of the S-OIV outbreak in Mexico.

Enhanced Surveillance

On April 17, in response to the increase in reports of respiratory illness, DGE issued a national epidemiologic alert to all influenza-monitoring units and hospitals (Table 1). The alert asked hospitals to report all patients with severe respiratory illness and recommended collection of diagnostic respiratory specimens from these patients within 72 hours of illness onset. On April 18, DGE staff visited 21 hospitals throughout the country to confirm the apparent increase in illness incidence.

After laboratory confirmation of S-OIV infection on April 23, DGE developed case definitions. A suspected case was defined as severe respiratory illness with fever, cough, and difficulty breathing. A probable case was defined as a suspected case in a patient from whom a specimen had been collected and tested positive for influenza A. A confirmed case was defined as a probable case that tested positive for S-OIV by real-time reverse--transcription polymerase chain reaction (RT-PCR). Health-care officials were contacted and asked to provide retrospective and ongoing data for persons having illness consistent with these case definitions and seeking care on or after March 1.

During March 1--April 30, a total of 1,918 suspected* cases were reported, including 286 probable and 97 confirmed cases (Figure). A total of 84 deaths were reported. A majority of case-reports were for hospitalized patients, reflecting the concentration of surveillance efforts within hospitals. However, DGE also received reports from sites conducting routine seasonal influenza surveillance of patients with ILI. Of 1,069 patients with suspected and probable cases for whom information was available, 755 were hospitalized, and the remaining 314 were examined in outpatient settings or emergency departments. Suspected or probable cases were reported from all 31 states and from the Federal District of Mexico. The four areas with the most cases were Federal District (213 cases), Guanajuato (141), Aguascalientes (93), and Durango (77). In other states, the number of suspected or probable cases ranged from two to 46. Suspected and probable cases were identified in all age groups. Mexico routinely monitors seasonal influenza in a network of outpatient facilities throughout the country. Fifty-one influenza A positive specimens from six states were collected during January 4--March 11 in this surveillance network. All of these specimens tested negative for S-OIV at CDC.

Confirmed Cases of S-OIV Infection

As of April 30, DGE surveillance activities, focusing on patients with severe respiratory disease, had identified 97 patients with laboratory-confirmed S-OIV infection, including seven persons who had died. The first of the 97 patients reported onset of illness (any symptom) on March 17, and the most recent patients reported onset on April 26. Laboratory confirmation of S-OIV infection for the most recent 73 of these 97 cases was reported on the evening of April 29. Collection of additional information on these 73 cases is ongoing. Of the 24 patients for whom demographic and clinical information is available, 20 (83%) were hospitalized, three were examined in outpatient settings, and one had illness that was not medically attended. Patients ranged in age from <1 class="callout">Table 2); 15 (62%) patients were female. Patients with confirmed S-OIV infection were identified in four states: Federal District (15 cases), Mexico State (seven), Veracruz (one), Oaxaca (one). Of the seven deaths, six occurred in Federal District, and one occurred in Oaxaca.

Among the 16 patients with complete clinical records, 15 reported fever, 13 reported cough, 10 reported tachypnea, and nine reported dyspnea. In addition, seven of 16 patients reported either vomiting or diarrhea. Of these seven patients, two reported vomiting only, two reported diarrhea only, and three reported both. Eight of 16 patients were admitted to intensive-care units; of these, seven required mechanical ventilation, and six subsequently died after developing acute respiratory distress syndrome. Twelve of 15 patients with radiography records available had confirmed pneumonia. Three of the 16 patients had underlying health conditions. Information on the duration of hospitalization before death was available for six patients and ranged from 1 to 18 days (median: 9 days).

Prevention and Control Measures

On April 24, the Council for General Hygiene convened with the President of the Mexican Republic and decreed the closure of all schools in the Federal District and metropolitan area of Mexico City. Incoming and outgoing airport passengers were informed of the outbreak and advised to seek care immediately should they experience symptoms of ILI. Other measures included 1) disseminating educational messages regarding respiratory hygiene through mass media; 2) distributing masks and alcohol hand-sanitizer to the public; and 3) discouraging large public gatherings, including church services, theater events, and soccer games. On April 25, a national decree allowed for house-isolation of any person with a suspected case, and on April 27, school closures were mandated throughout the country.

Reported by: General Directorate of Epidemiology, Ministry of Health, Mexico; Pan American Health Organization; World Health Organization; Public Health Agency of Canada; CDC (United States).

Editorial Note:

Understanding the epidemiology and clinical profiles of recent cases of S-OIV infection in Mexico can help inform regional, national, and global control measures in response to the emergence of S-OIV infection. Important areas for investigation worldwide include evidence of person-to-person transmission, the geographic distribution of disease, the clinical spectrum of disease, and the effectiveness of mitigation strategies.

Previous instances of human-to-human transmission of other swine viruses have been reported to result in small clusters of disease and limited generations of disease transmission (2,3). Several findings indicate that transmission in Mexico involves person-to-person spread with multiple generations of transmission. Patients with probable and laboratory-confirmed disease have presented over a period of 4 weeks. Limited contact tracing of patients with laboratory-confirmed disease also has identified secondary cases of ILI.

The clinical spectrum of S-OIV illness is not yet well characterized in Mexico. However, evidence suggests that S-OIV transmission is widespread and that less severe (uncomplicated) illness is common. Patients with confirmed disease have been identified in several states, and suspected cases have been identified in all states, which suggests that S-OIV transmission is widespread. In addition, several countries are reporting S-OIV infection among persons who have travel histories involving different parts of Mexico in the 7 days before illness onset. To date, case-finding in Mexico has focused on patients seeking care in hospitals, and the selection of cases for laboratory testing has focused on patients with more severe disease. Therefore, a large number of undetected cases of illness might exist in persons seeking care in primary-care settings or not seeking care at all. Additional investigations are needed urgently to evaluate the full clinical spectrum of disease in Mexico, the proportion of patients who have severe illness, and the extent of disease transmission.

To expedite confirmation of disease in additional patients, the World Health Organization (WHO) Influenza Collaborating Center in Atlanta, Georgia, has placed the genetic sequence of S-OIV from California in GenBank.† Specific primers for S-OIV have been developed and will be distributed through the WHO Global Influenza Surveillance Network to reference laboratories throughout the world. As of April 26, the National Laboratory for Public Health in Mexico has capacity to perform PCR for S-OIV.

The epidemiologic characteristics of this outbreak underscore the importance of monitoring the effectiveness of community mitigation efforts, nonpharmaceutical interventions, and clinical management practices in anticipation of a possible pandemic.

References

1. CDC. Swine influenza A (H1N1) infection in two children---Southern California, March--April 2009. MMWR 2009;58:400--2.
2. Wells DL, Hopfensperger DJ, Arden NH, et al. Swine influenza virus infections. Transmission from ill pigs to humans at a Wisconsin agricultural fair and subsequent probable person-to-person transmission. JAMA 1991;265:478--81.
3. Myers KP, Olsen CW, Gray GC. Cases of swine influenza in humans: a review of the literature. Clin Infect Dis 2007;44:1084--8.

Putting Swine Flu in Perspective

May 1, 2009
By Miranda Hitti
WebMD Health News
Reviewed by Louise Chang, MD


excerpt:

7 Facts to Consider if You're Fearful About Swine Flu

7 Reasons Not to Over Worry

After a solid week of scary headlines about swine flu, it's time to take a step back, take a deep breath, and regain perspective. Here are seven points to consider:

1. Most swine flu cases have been mild, so far. Severe cases have been seen mainly in Mexico, for reasons that aren't yet clear. But most swine flu patients have recovered without being hospitalized.
2. You're not defenseless against swine flu. Simple things -- washing your hands, not touching your mouth, eyes, or nose, and trying to avoid close contact with sick people -- can go a long way toward reducing your risk.
3. Most swine flu cases so far have been pretty much like normal, seasonal flu. Swine flu and seasonal flu share symptoms, and spread the same way.
4. How much do you worry about seasonal flu? Maybe you should give garden-variety flu a little more respect. In a typical U.S. flu season, an average of 36,000 people die of flu or flu complications, and about 200,000 people are hospitalized. Swine flu hasn't come anywhere close to that.
5. Swine flu's future is unknown. No one knows where swine flu is headed -- for better or for worse. "You don't know if it's going to fizzle out in a couple weeks or become more or less virulent or severe in the diseases it causes," CDC Acting Director Richard Besser, MD, said on April 29. "If we could see into the future [that] would be absolutely wonderful, but that's not the case. That's why we're being aggressive" in seeking to limit swine flu's impact on human health.
6. The world is more prepared than ever. Remember bird flu? When that was the "it" virus several years ago, the global health community ramped up its pandemic preparations. As a result of that work, "the world is better prepared for an influenza pandemic than at any time in history," WHO Director-General Margaret Chan said on April 29.
7. Pandemics aren't all deadly." If the World Health Organization declares swine flu a pandemic, that's all about the spread of the virus -- not the severity of the illness. In the past, some pandemics have been mild, while others have been severe, notes WHO spokesman Gregory Hartl, adding that "people should act with common sense, not with panic."

Reporter Bill Hendrick contributed to this report.

Swine Flu Suspected in Thousands, With ‘Less Severe’ Illness

[I'm only going to give excerpts to the very contradictory statements in this article...the whole situation is becoming very mixed. Might move to Phase 6, but as stated in the previous post, it appears to be as contagious as the average seasonal flu, and they did not find the genes that made the 1918 pandemic so deadly.]

Last Updated: May 1, 2009 15:35 EDT
By Tom Randall
Excerpts:

Geneva-based WHO raised the six-tier pandemic alert to 5 on April 29 and may move soon to the highest level, declaring the world’s first influenza pandemic since 1968. WHO urged countries to make final preparations against the disease, formally called H1N1. While initial cases have been similar to seasonal flu, the new strain may flash across the globe, preying on a population with no natural immunity, said the U.S. Centers for Disease Control and Prevention.
-snip-
“We need to prepare for the long term,” President Barack Obama said today in Washington. “Even if it turns out that the H1N1 is relatively mild on the front end, it could come back in a more virulent form during the actual flu season.”
-snip-
New York health officials will test for swine flu only in patients with a severe illness or where there may be a cluster of cases, said the New York City health commissioner, Thomas Frieden, at a news conference today. All of the 49 confirmed cases and more than 1,000 likely infected New Yorkers have had mild symptoms similar to those of seasonal flu, he said.
-snip-
“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 today on ABC News. “But we have to be careful not to overrely on that information, because these flu viruses always evolve.”
-snip-
The U.S. will spend $251 million to buy 13 million courses of antiviral treatments to replenish its stockpile, said Health and Human Services Secretary Kathleen Sebelius.

Jose Cordova, the health minister in Mexico, said yesterday the number of H1N1 flu cases confirmed by laboratory tests climbed to 312 from 260, and the death toll remained at 12. Deaths from the virus will probably rise, he said.
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Seasonal Strains

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. It appears to be causing more diarrhea than seasonal flu, WHO said.
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CDC: Swine Flu Lacks Deadly Genes

Audio for this story will be available at approx. 7:00 p.m. ET

All Things Considered, May 1, 2009 · The Centers for Disease Control and Prevention said Friday the swine flu virus appears to be about as contagious as the average seasonal flu. In examining the virus, it also did not find the genes they think made the infamous 1918 flu so deadly. Dr. Sylvie Briand, acting director of the Global Influenza Program for the World Health Organization, offers her insight.

Three confirmed cases of flu in US Marines: corps

2 hours ago

WASHINGTON (AFP) — Tests show that a total of three US Marines have fallen ill with swine flu in California, the corps said on Friday.

Two new cases were reported Friday at Camp Pendleton base outside San Diego as the US military said it was closely monitoring the situation to protect the health of its troops, who often live in close quarters.

"Two service members at Marine Corps Base Camp Pendleton have been confirmed with H1N1 flu virus," said a statement from the base.

"The service members are isolated and are being treated as outpatients. Both individuals are recovering and no additional personnel have been quarantined," it said.

On Wednesday, the military reported the first confirmed case of the flu at another marine base in southern California, Twentynine Palms.
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