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Fears Of Flu Pandemic Grow, Governments Cautious

Posted on: Monday, 27 April 2009, 06:35 CDT

In response to what many medical experts believe could be the emergence of a global pandemic, health officials in the U.S. have declared a public health emergency effective Sunday, as 20 cases of swine flu were confirmed on American soil.

The world’s top flu virologists and epidemiologists have been in a race against time in their efforts to understand exactly how large of a threat the new A/H1N1 swine flu strain really is. 

By Sunday, researchers began to realize that they would need more information about the Mexican outbreak before they could venture any more precise predictions about the virus’ future behavior.  In particular, experts say they desperately need information on the earlier cases that occurred in the month or so before the outbreak was identified and when the virus was still off health officials’ radars.  These cases, they say, will help them determine whether the virus has mutated in recent weeks to become more deadly and/or infectious.

“We in a period in which the picture is evolving,” said Dr. Keiji Fukuda, the World Health Organization’s deputy director general.  “We need to know the extent to which it causes mild and serious infections.”

Until they have this information, explained Fukuda, the WHO’s panel of scientists will not be willing to categorize the outbreak as a “global pandemic” – although they have already called it a public health emergency and have begun operations from their emergency response center.

At a press conference on Sunday, Homeland Security Secretary Janet Napolitano referred to the emergency declaration as “standard operating procedure”, adding that a more appropriate title would have been a “declaration of emergency preparedness”, in what appeared an obvious attempt to allay public fears.

“It’s like declaring one for a hurricane,” explained Napolitano.  “It means we can release funds and take other measures.  The hurricane may not actually hit.”

By making an official emergency declaration, the U.S. government is able to free up additional funds for antiviral medications and to release one-quarter of the national reserve of 50 million doses of anti-flu drugs. 

The declaration also enables medical officials to administer previously unapproved drugs and tests to children.

While public health officials in the U.S. say they are expecting more cases and will continue to take all necessary precautions, they also point out that all of the American cases have thus far been relatively mild and that all of the patients have made a full recovery.  They have also emphasized the value of new global response mechanisms – put in place after the SARS and bird flu scares – in allowing them to quickly and aggressively respond the recent outbreaks.

GOVERNMENTS EXERCISING EXTREME CAUTION

A number of countries have already imposed travel bans and are drawing up plans to quarantine passengers returning from countries where outbreaks have occurred.  Border patrol guards and airport security officers will begin questioning international travelers about their health and detaining passengers who appear ill.

“This is moving fast and we expect to see more cases,” said Dr. Richard Besser of the Centers for Disease Control and Prevention at the Washington press conference with Ms. Napolitano.  “But we view this as a marathon.”

Dr. Besser advised Americans to be particularly diligent in observing standard disease-preventing measures such as regular hand washing and covering coughs and sneezes.  He did not, however, suggest that Americans should begin wearing protective masks or avoiding physical contact as Mexican officials have already done.

As of Sunday night, officials reported 20 confirmed swine flu cases in the U.S. –  eight in New York, seven in California, two in Kansas, two in Texas and one in Ohio.  Though researchers say that the virus appears to be genetically identical to the one found in Mexico that has likely killed 103 people and made another 1,600 ill, there have been no flu-related deaths in the U.S. and only one hospitalization.

The eight cases in New York were all students at the St. Francis Preparatory School in Fresh Meadows, Queens.

Canadian health officials have confirmed four cases in Nova Scotia and two in British Columbia – two provinces at opposite ends of the country.

Tests are also being carried out on individuals or groups in New Zealand, Australia, Spain, Brazil, Britain and Israel who became ill after returning from trips to Mexico.

Wary of taking actions that could hurt member nations, Dr. Fukuda says that WHO officials will meet in Geneva on Tuesday to decide if they will raise the emergency alert level to 4 – a move that would inevitably initiate more travel bans to Mexico, dealing a serious blow its tourist industry just as high travel season is about to begin.

A number of countries are already strongly advising citizens to avoid trips to Mexico, while Russia and several other nations have banned the import of pork from Mexico, despite the fact that the virus cannot be transmitting through consumption of pork products.  China, Hong Kong and Japan have also set up quarantine facilities for people they suspect of infection.

Still shell-shocked from the 2003 outbreak of SARS, Hong Kong officials have ordered the most stringent precautions of any nation thus far, requiring immediate detention of all passengers arriving with a fever above 100.4 degrees Fahrenheit if they have traveled through any city with a confirmed case of swine flu – including New York City.

As Hong Kong is home to Asia’s busiest international airport, many speculate that their safety measures could cause significant congestion at the airport and lead to serious disruptions in international travel.

Global fears of a pandemic outbreak has put international stock markets on edge as well, as economist around the world warn that continued spread of the disease could squelch the early signs of economic recovery witnessed in recent weeks.

On Monday morning, oil prices fell by 2 percent and Asian markets across the board took a downward dip.  European shares are also expected fall, overshadowing last week’s rally in U.S. equity prices.

"This will deepen the global recession and will probably have a contagion effect on export-led economies in Asia," commented Daniel Chan, senior investment strategist at DBS Bank in Hong Kong. "All sectors in the stock market may be affected except for health and drugs industries. The airline industry might be affected badly."

THE TIP OF THE ICEBERG

According to Dr. Martin Cetron, director of global migration and quarantine for the Centers for Disease Control, the most important bit of information that medical researchers need to determine right now is how many mild cases of the swine flu Mexico had before the outbreak turned deadly.

“We may just be looking at the tip of the iceberg, which would give you a skewed initial estimate of the case fatality rate,” he explained, hinting that there may have been tens of thousands of less severe infections surrounding the 1,300 more severe cases.  If this is in fact the case, then experts have reason to hope that the majority of future infections may be mild and relatively non-dangerous.

According to the CDC, the infamous viral outbreak of 1918 infected at least one third of the world’s 1.5 billion people, though only 50 million – about 10 percent of those infected – actually died from the disease.  Today, they say, the rate of death would be even lower thanks to the advances of modern medicine.

Dr. Cetron says that researchers have several hypotheses regarding why the Mexican outbreak has been so much deadlier than in other countries.  One feasible explanation would be that some other factor in Mexico has increased the virus’ killing potential, such as a co-infection with some other type of pathogen or distribution of a treatment that interacted negatively with the virus.

Flu experts say that there is an H1N1 human strain in the flu shots that were issued this year, though they confess that they do not yet know whether it will offer any protection against this new swine version.  All current H1N1 flues can be traced back to the original 1918 strain, though mutations in the virus’ genetic material have allowed it to adapt to different hosts and evade eradication year after year. 

The CDC says that genetic analysis of the new strain is currently underway. As virologists compare this novel variation against stored antibody samples from older viruses, they should be able to start work on the development of a new vaccine relatively soon.  The process, however, is time-intensive and experts warn that it could take months before a new treatment is available for distribution.

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On the Net:

• World Health Organization
• Department of Homeland Security
• CDC
• Image Courtesy Eneas De Troya - Wikipedia

Source: redOrbit Staff & Wire Reports

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