Flu Outbreak Information

May 1, 2009 12:00:00 AM PDT
The latest Flu information from ABC News. Swine Flu Interactive Timeline - Click here
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Local Flu Resources California Department of Public Health Hotline:
(888) 865-0564
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Reducing the Risk

To reduce the risk of illness and transmission of influenza virus, both seasonal and swine flu, residents should:
  • Cover coughs or sneezes - angle into elbow or use tissue (dispose of tissue in trash).
  • Wash hands often with soap and water or use an alcohol-based hand sanitizer, especially after coughs or sneezes.
    Avoid touching eyes, nose or mouth.
  • Try to avoid close contact with sick people.
  • If symptoms of the flu arise, stay home from work or school and limit contact with others to reduce the spread of infection.
  • Residents should contact their health care provider if symptoms of influenza occur and seek medical care if symptoms worsen.
Residents should call 911 if any of the following emergency warning signs are present:

In children:
  • Fast breathing or trouble breathing
  • Bluish skin color
  • Not drinking enough fluids
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and worse cough
  • Fever with a rash
In adults:
  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting
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CDC Resources -----------------------------------------------------------------------------------------------

Swine Flu Related Links

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LATEST DEVELOPMENTS

  • WHO confirms 331 cases in 11 countries
  • CDC confirms 141 cases in 19 states
  • School closings: more than 288,000 students in 21 states
  • CDC issues guidance on school closings
  • NYC schools make plans to reopen
  • Pres. Obama says government is preparing for the worst
  • Continental Airlines cuts flight capacity to Mexico by 50%
  • Transatlantic flight diverted after passenger complained of flu-like symptoms
  • Prescriptions for antiviral drugs up 900% since last week
  • New poll: 46% concerned about the flu; 17% avoiding Mexican restaurants
  • New details about the boy who died of swine flu in Texas
  • 300 hotel guests quarantined in Hong Kong
  • Pork industry plans ad campaign, asks the media to stop calling it "swine flu"
  • Preventive measure of the day: no high-fives at kids' soccer games


THE NUMBERS

The World Health Organization says there are 331 confirmed cases in 11 countries, including 10 deaths.
(Discrepancy alert: Yesterday WHO said 12 countries; today Peru was dropped from the list)

WHO tally by country
Mexico ? 156, including 9 deaths
US ? 109, including 1 death (NOTE: this is yesterday's CDC total; today it's 141)
Austria ? 1
Canada ? 34
Germany ? 3
Israel ? 2
Netherlands ? 1
New Zealand ? 3
Spain ? 13
Switzerland ? 1
United Kingdom ? 8

Later, 3 more countries reported their first confirmed cases: France, Hong Kong and Denmark
Suspected cases under investigation in at least 15 other countries


MEXICO
WHO confirms 156 cases in Mexico, including 9 deaths
Mexico says it has confirmed 300 cases and 12 deaths.  It also says there are 2,955 suspected cases and 176 deaths possibly related to swine flu.
Health Minister Jose Angel Cordova says he is encouraged by a drop in hospital admissions of patients with flu symptoms.


THE UNITED STATES
CDC confirms 141 cases in 19 states (up from 109 cases in 11 states yesterday)
The CDC warns its numbers will be almost instantly outdated as more test results come in from around the country. 

CDC tally by state
AZ      4
CA      13
* CO    2
* DE    4
* IL    3
IN      3
KS      2
* KY    1
MA      2
MI      2
* MN    1
* NE    1
NV      1
* NJ    5
NY      50
OH      1
SC      16
TX      28
* VA    2
* = state added to the list on Friday
The CDC says the average age is 17.  Age range: 1 to 81 years old.


US SCHOOL CLOSINGS
School closings: more than 288,000 students in 21 states.  More than 171,000 students in Texas alone.
(If you'd like a complete list of school closings, please email me or Grace Huang)


NYC Update -- NYC has had no new confirmed cases in the past approximately 24 hours.  Depending on the weekend's developments, St. Francis Prep in Queensewhere about a third of the 2700 students came down with flu-like symptoms and 45 cases were confirmed as swine flu -- is likely to re-open Monday. Public School 177 in Queens is slated to reopen on Wednesday, barring unforeseen developments.

CDC ISSUES GUIDANCE ON SCHOOL CLOSINGS
Suggestions include:

  • If a school dismisses students or a childcare facility closes, they should dismiss students for a minimum of 14 days. This length of time is recommended because children are likely to be infectious for about 7 ? 10 days after the onset of illness.  
  • If a school dismisses students or a childcare facility closes, school or childcare related gatherings should also be cancelled. Parents and students should be encouraged to avoid congregating in large numbers outside of the school setting.   (Brian Hartman)

PRES. OBAMA: FLU MAY RUN ITS COURSE
The president spoke after Friday's Cabinet meeting:

"We don't know for certain that this will end up being more severe than other seasonal flus that we have.  And it's been noted, I think, before that you have over 36,000 people die on average every year from seasonal flus. You have 200,000 hospitalizations. It may turn out that H1N1 is -- runs its course like ordinary flus, in which case we will have prepared and we won't need all these preparations."

FIRST US VICTIM PUBLICLY IDENTIFIED, MOVEMENTS TRACKED

San Antonio Express-News reports:
       The Mexico City toddler who became the nation's first confirmed swine flu death dined at Houston restaurants and shopped with family at the Galleria mall before showing signs of the illness in Brownsville, Cameron County Judge Carlos Cascos said.

     Cascos called a news conference Wednesday to shed light on the child's time in the United States, during which he could have contracted or spread the virus.

     The boy was identified Thursday as Miguel Tejada Vazquez, one of six children belonging to a large, "well-to-do" family, according to Greg Compean, owner of Compean Funeral Home in Houston.

     "It was very devasting and difficult for the family," Compean said of the boy's death. "This was a very nice family, a family of means, a well-to-do family."
Compean said the boy's father is an architect. Miguel was on vacation with his mother, two brothers, visiting a family friend in Brownsville. The group came to Houston on April 5 because the boy's mother had a scheduled doctor's appointment at Texas Medical Center.

    A date of birth given to Compean put the boy's age at 21 months. Texas and city health officials have previously listed the boy's age at 22 and 23 months.
Full story: http://www.mysanantonio.com/news/Official_details_toddlers_movements_before_swine_flu_death.html   


QUARANTINE AT HONG KONG HOTEL
The Wall Street Journal is reporting that about 300 Hong Kong hotel guests and staff at the Metropark Hotel have been quarantined for seven days, after it was determined the patient who was infected was staying there.  Guests at the hotel are free to move within the hotel, but can't leave and are being encouraged to stay in their rooms and minimize contact with others.  http://blogs.wsj.com/health/2009/05/01/tracking-the-flu-outbreak-friday/


FLIGHT DIVERTED
A United Airlines flight from Germany to Washington-Dulles was diverted to Boston after a passenger complained of flu-like symptoms.  245 passengers and 6 crew on board.  Not clear what caused the woman's symptoms.


FLIGHT REDUCTIONS
Continental Airlines reduces total capacity to Mexico by 50 percent

Continental continues to serve all 29 of its Mexico destinations; reductions are being implemented by using smaller aircraft on flights to Mexico or by reducing the frequency of flights to any one destination. Prior to these reductions, Continental operated an average of 450 weekly flights to the country.

This travel industry website has posted an interview with Ken Pomerantz, head of MLT Vacations, which is a major wholesaler of vacation packages to Mexico. http://www.travelpulse.com/Home.aspx  Among his comments: cancellations for Mexico up 30%   (Gary Langer)

SPIKE IN PRESCRIPTIONS FOR ANTIVIRAL DRUGS
Prescription tracker SDI says US antiviral prescriptions increased almost 900% nationwide on Monday, April 27, compared to the average daily volume earlier in the month.  In New York, prescription volume increased to more than 14 times the daily April average in that area on Monday and rose even higher to 15 times the daily norm on Tuesday. Los Angeles saw the most dramatic increase so far, with daily prescription volume on April 27 increasing 16-fold to the highest point it has reached on any single day in the past two flu seasons. Prescription volume remained at a similar level on Tuesday, with volume 13 times higher than normal.  (Dan Arnall)

DRUG STOCKPILES INADEQUATE
   With a swine flu outbreak spreading across the nation, more than half the states have yet to stockpile the number of flu-treatment doses recommended by the federal government, an Associated Press survey found.

   States that are falling short cite budget constraints, or say it's better to spend health-care funds on preventing the spread of disease than on antiviral medicines that may or may not work on a particular flu strain.

   "You don't have any guarantee that if you purchase a large amount of drugs that they would be effective in the future," said Gwenda Bond, a spokeswoman for the Kentucky Cabinet for Health and Family Services. "Drugs do have a shelf life, and so you don't want to spend a lot of money on drugs that may expire before you need them."

The Washington Post reports, Many States Do Not Meet Readiness Standards   Washington DC, Maryland and 26 other states are 10 million dosages short of the levels that the federal government has determined they should have in their stockpiles for a pandemic.  Federal agencies, which under the plan are expected to create their own stockpiles, are also falling short.


WHY MORE DEATHS IN MEXICO?
The New York Times reports, part of the reason may be issues in the Mexican health care system:

     One important factor may be the eclectic approach to health care in Mexico, where large numbers of people self-prescribe antibiotics, take only homeopathic medicine, or seek out mysterious vitamin injections. For many, only when all else fails do they go to a doctor, who may or may not be well prepared.

     "I think it has to do with the culture, the idiosyncrasies of Mexicans," said Dr. Nicolas Padilla, an epidemiologist at the University of Guanajuato. "The idea is that I don't go to the doctor until I feel very bad."

     There also are logistical reasons that compel Mexicans to steer clear of hospitals. At overcrowded public facilities, they complain, they are often turned away, treated by indifferent doctors or made to wait endlessly.

     Full story: http://www.nytimes.com/2009/05/01/health/01oaxaca.html?_r=1&hp

NO HIGH-FIVES
One suburban New York youth soccer league emailed parents, "We?advise that until further notice teams refrain from the traditional handshake at the end of the game.  In order to show sportsmanship, teams can line up as they do now and say nice game to each other without the high five or handshake." (Kate Felsen)

POLL: 46% CONCERNED ABOUT GETTING SWINE FLU
From Gary Langer: National poll on swine flu by the Harvard School of Public Health. Good quality data. Interviews were conducted Wednesday night. (+/-3.5)

46 percent of Americans are concerned about catching swine flu in the next year. Fewer, 20 percent, are "very" concerned about it.  53 percent not concerned. (Note the time frame, "during the next 12 months.")

In response to the outbreak 59 percent say they have washed their hands or used a hand sanitizer more frequently.

  • 25 percent have avoided crowded places
  • 20 percent, avoided people they think may have recently visited Mexico
  • 17 percent, avoided Mexican restaurants or grocery stores
  • 8 percent, worn a face mask
  • 5 percent, purchased a face mask
  • 5 percent, talked with their doctor about swine flu
  • 4 percent of those with children under 18 have kept them home from school or day care
  • 1 percent, gotten a prescription for or purchased antivirals such as Tamiflu or Relenza
  • 83 percent correctly say you can get swine flu from close contact with someone else who has it.
  • 34 percent think you can get it from coming in contact with pigs
  • 29 percent think you can get it from an infected person who's more than 30 feet away
  • 13 percent think you can get it from eating pork
  • 20 percent both know the phrase "H1N1 virus" and correctly identify it as swine flu.


AD CAMPAIGN: PORK IS SAFE
National Pork Board announces it is getting ready to launch a national advertising campaign to let customers know that eating pork is safe.  Preliminary plan is for ads to appear in newspapers with national reach, regional papers and online, especially sites targeted to people who make food purchases.  Ads should begin next week.  (Charlie Herman)


LOBBYING FOR A NAME CHANGE
The National Pork Producer's Council has sent an email to many broadcasters "respectfully" requesting we stop calling it the swine flu and using video of pigs when talking about the story.  From the release:  

     By continuing to refer to the current influenza as "swine" flu, your organization not only is misinforming the public but is causing concern among consumers about the safety of pork. We have had preliminary reports of negative effects on consumer demand for our product.

     Irresponsible reporting on this issue could cost many hard-working pork producers their livelihoods. Since September 2007, U.S. pork producers have lost an average of $20 per hog marketed. By linking the current flu with swine, the pork industry's economic crisis is being exacerbated, with pork producers losing an estimated minimum $3 million for each of the past four days. We expect there will be producers who go out of business.

     By continuing to call the current influenza "swine" flu, you are inflicting unwarranted economic pain on thousands of farm families involved in the U.S. pork industry. Please stop referring to Influenza A as "swine" flu.    (Brian Hartman)

The World Health Organization says it will stop using the term "swine flu" to avoid confusion over the danger posed by pigs. WHO spokesman Dick  Thompson says the name change comes after the agriculture industry and the U.N. food agency expressed concerns that the term "swine flu" was misleading consumers and needlessly causing countries to order the slaughter of pigs.  He told reporters in Geneva "we're going to stick with the technical scientific name H1N1 influenza A."

Ann Compton notes that  www.CDC.gov has dropped most (not quite all) of its "Swine Flu" headlines and replaced them with "H1N1 Flu." 
Top US officials, including Pres. Obama and DHS Secretary Janet Napolitano, also showing a preference for "H1N1" over "swine flu."

U of DELAWARE OUTBREAK
Many campus events cancelled after 4 cases were confirmed among students at the University of Delaware in Newark.  400 students treated for flu-like symptoms Wed & Thurs at the University's health center or a special clinic set up on campus to help handle the outbreak.

MEXICO CLOSING NON-ESSENTIAL OFFICES AND BUSINESS THRU MAY 5
President Felipe Calderon ordered government offices and businesses not essential to the economy shut down for five days from Friday and told people to stay indoors as Mexico fights a deadly and spreading flu virus. He wants all government offices and private businesses that are not crucial to the economy to stop work from May 1-5 to avoid further infections from the new swine flu virus. The government said supermarkets, food stores, hospitals, financial services firms, telecomunications and public transport businesses and other essential services would operate normally, but other companies will be asked to close up and some government ministries will shut their doors.

FLU DRUGS
Roche donating more antiviral drugs:  The maker of Tamiflu previously donated a stockpile of 5 million doses to the WHO, which is now begun distributing them to developing countries most in need.  Some are being sent to Mexico.  Roche is scaling up production and will donate more.
Tamiflu & Relenza antiviral drugs:  DHS Secretary Napolitano says the federal government continues shipping antiviral drugs from the federal stockpile to states in need.  The shipments should be complete by Sunday, May 3.  Federal health officials say 25% of the US stockpile of antivirals are being shipped to states.
Vaccine development: The world has no vaccine to prevent against swine flu infection but U.S. health officials aim to have a key ingredient for one ready in early May. At that point, some manufacturers would have to switch over from producing regular seasonal-flu vaccine to make the H1N1 version instead.  The NYT reports today that federal officials have not yet made a decision on whether the swine flu is enough of a threat to warrant vaccine production, but a full 600 million doses, enough to provide the required two shots for each American, could be finished by January.


WASHINGTON RESPONSE
PRES. OBAMA REQUESTS $1.5 BILLION IN FUNDING

The White House is asking Congress for $1.5 billion to fight a swine flu outbreak.  President Obama sent a letter to lawmakers on Tuesday, asking them for a supplemental spending plan to build drug stockpiles and monitor future cases.  Obama says the money will also help international efforts to control the outbreak.

STATE DEPARTMENT
Hillary Clinton spoke about flu measures Thursday in her opening statement to the Senate Appropriations Committee:
''We have established an influenza monitoring group within our Operations Center. We are tracking how other governments are responding to the threat and what assistance we might offer. We are constantly reviewing and refining our advice to Americans traveling or living abroad."

TRAVEL ALERT: Monday evening the State Department issued a Travel Alert, recommending that Americans avoid non-essential travel to Mexico.  Note that in State Dept jargon a Travel Alert is slightly less alarming than a Travel Warning.  Additional info at the State Department website: www.travel.state.gov (Kirit Radia)
Canada and the EU have also advised against non-essential travel to Mexico.

ECONOMC IMPACT
IMF CHIEF ECONOMIST SAYS SWINE FLU IMPACT WILL BE 'QUITE DRASTIC' 

The economic impact from the swine flu outbreak could be "quite drastic" in some countries, the International Monetary Fund's chief economist said on Thursday.  Addressing the Washington-based Carnegie Endowment for International Peace, IMF chief economist Olivier Blanchard said it was clear that tourism volumes will be affected.

CHINA SENDING AID TO MEXICO
On Wednesday, China's Commerce Ministry said Wednesday the government is providing $5 million in humanitarian assistance to Mexico, for masks, gloves, disinfectants, infrared thermal scanners and other equipment. The ministry separately advised Chinese citizens to postpone business trips to Mexico and to take precautions when traveling to other affected places. China's Health Ministry says no cases of swine flu have been reported.

MEXICO ? THE GROWING COST
Local business groups say the closure of restaurants and other businesses will cost Mexico City about $110 million a day


MEXICO TOURISM:  Mexico had 21.4 million international visitors in 2006 (most recent figures), contributing more than $12 billion to the Mexican economy. (source: UN World Tourism Organization)

ALERT LEVEL HOLDING STEADY AT "5" ? NOT YET A FULL-BLOWN PANDEMIC
WHO deputy director-general, Dr. Keiji Fukuda, said Thursday there is no reason consider increasing the pandemic alert level at this time ? it is holding steady at "Phase 5."  It was increased from "4" to "5" on Wednesday. On Monday, it went from "3" to "4," the first time it had been raised above "3" since the system was adopted in 2005.

Phase 5 ? The virus has spread into at least two countries and is causing even bigger outbreaks. Declaration of Phase 5 is a strong signal
    that a pandemic is imminent.

Phase 6 ? More outbreaks in at least two regions of the world; the pandemic is under way.

WHO points out that the word "pandemic" has nothing to do with the severity of the disease; it is simply a matter of geographic spread.   You can have both mild and severe pandemics.

PREVIOUS FLU OUTBREAKS
An average flu season kills about 36,000 people in the US. Typically between 5% and 20% of the population becomes ill during flu season.
The world generally experiences at least two flu pandemics each century.  Historically, the 20th century saw 3 pandemics of influenza:

  • 1918 ? at least 675,000 U.S. deaths and up to 50 million deaths worldwide
  • 1957 -- at least 70,000 U.S. deaths and 1-2 million deaths worldwide
  • 1968 ? about 34,000 U.S. deaths and 700,000 deaths worldwide
    (ABC News Medical Unit)

SWINE FLU Q&A, RESOURCES AND MORE
Find answers to many questions at: www.abcnews.go.com/Health/SwineFlu/   Every show should push viewers to this special section at ABCNews.com.

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