Swine Flu Update for Sunday Evening, April 26, 2009

I subscribe to an electronic newsletter for healthcare professionals put out by the Center for Biosecurity at the University of Pittsburgh Medical Center. The Center is doing an excellent job of keeping us all updated on the most current information regarding swine influenza. Because I am receiving so many inquiries from concerned individuals about the outbreak, I am going to share with you an edited version of what I am reading from the Center, without including the reference citations (for the sake of brevity).

Here goes:

At a joint Centers for Disease Control and Prevention (CDC)/Department of Homeland Security (DHS) press conference held at the White House on April 26, Acting CDC Director Richard Besser announced that the CDC had confirmed 20 cases of swine flu in the United States: 7 in California, 2 in Texas, 2 in Kansas, 8 in New York City, and 1 in Ohio. Dr. Besser noted that although human-to-human transmission is still suspected, to date there has only been only one case of human-to-human transmission documented. This occurred when an individual in California traveled to Mexico and transmitted the virus to a spouse.

DHS Secretary Janet Napolitano announced the release of 25% of the 50 million treatment courses of antivirals in the Strategic National Stockpile (SNS) to states and cities. Priority for receipt of antivirals will be awarded to those states with confirmed cases of influenza to supplement that state’s stockpile. In addition, the Department of Defense has pre-positioned 7 million courses of antivirals. The locations of these antivirals were not announced in the press conference.

DHS is implementing passive surveillance for symptoms in individuals who are arriving at U.S. borders. This means that individuals arriving into the U.S. will be asked if they are or have been sick with flu-like symptoms. Travelers who present with symptoms will be isolated and medically evaluated according to existing federal procedure. Increased surveillance undertaken by the U.S. Department of Agriculture (USDA) has not indicated any problem with the U.S. food supply or with U.S. livestock health.

During the press conference, DHS Secretary Napolitano also announced that the Department of Health and Human Services (HHS) has declared a “public health emergency.” Specifically, HHS Acting Secretary Charles Johnson declared a public health emergency under section 319 of the Public Health Service Act (42 U.S.C. § 247d). This type of emergency declaration is standard procedure for HHS during a significant event. As Secretary Napolitano explained, the declaration enables HHS agency officials to take steps to prepare for and respond to an emergency, such as gaining access to federal assets (e.g., funding, medicines through the SNS, etc.) and implementing certain liability or regulatory protections (e.g., waivers of Emergency Medical Treatment and Active Labor Act [EMTALA] and sanctions for hospital emergency departments) if needed.

I mentioned in my post yesterday that the World Health Organization (WHO)
convened an expert panel on April 25, 2009 to discuss the possibility of raising the pandemic alert level from its current level 3, but decided against taking that action. Today, Reuters reported that a WHO spokesman indicated that the panel will reconvene on Tuesday after gathering more epidemiological evidence from Mexico.

New York City (NYC) Mayor Michael Bloomberg announced today that the 8 probable cases of swine flu from students at St. Francis Preparatory School in Queens, NY, have been confirmed by CDC laboratory tests as swine influenza. All 8 students with confirmed swine flu have recovered. Some students at the school apparently had recently been in Mexico.

Yesterday, the New York State Department of Health announced that it had shipped 1,500 treatment courses of oseltamivir to NYC to treat probable cases as well as individuals with underlying chronic health conditions who had been in contact with probable swine flu patients.

The Ohio Department of Health (ODH) announced and the CDC confirmed today a case of swine flu in a 9-year-old boy. According to the ODH, the patient “is considered to have a mild case of the disease and is recovering at home.”

The BBC reports that Mexico's Health Secretary, Jose Cordova, said a total of 1,324 people had been admitted in-hospital in Mexico with suspected symptoms since April 13 and were being tested for the virus. Eighty-one deaths are being linked to the virus, but there are only 20 confirmations of its presence in the deceased.

New Zealand's health minister said that 10 students who just returned from Mexico had tested positive for influenza and that the cases are "likely" to be swine flu. CNN reported that officials in New Zealand said 25 students and teachers at Auckland's Rangitoto College returned from a 3-week-long trip to Mexico via Los Angeles on April 25, 2009. Fourteen have shown flu-like symptoms.

The Canadian Press reported that Canadian health officials have confirmed 6 cases of swine flu in British Columbia and Nova Scotia. None have required hospitalization.

Unconfirmed cases have been reported in several other countries, including France, Spain, and Israel.