U.S. declares swine flu public health emergency

Government officials have declared a public health emergency in connection with the swine flu outbreak that has killed dozens in Mexico and sickened 20 in the U.S., said the nation’s director of Homeland Security Sunday.

Secretary Janet Napolitano also said border agents have been directed to begin passive surveillance of travelers from Mexico, with instructions to isolate anyone who appears actively ill with suspected influenza.

The number of cases confirmed in the United States by the federal Centers for Disease Control and Prevention is now 20, including eight New York City high school students. Other cases are in Ohio, California, Texas and Kansas. Patients have ranged in age from 9 to over 50.

“As we look for swine flu, we are seeing more cases of swine flu and we expect to see more cases of swine flu," said Dr. Richard Besser, acting director of the CDC, during a White House press conference Sunday. "We view this more as a marathon."

Napolitano said the emergency declaration is a warning, not an actual imminent emergency, similar to preparing for a hurricane.

"I wish we could call it a declaration of emergency preparedness,” Napolitano said.

Besser noted that compared to cases in Mexico, “what we’re seeing in this country is mild disease,” nothing that the U.S. cases would not have been detected without increased surveillance.

Government health officials expect to see more cases of swine flu in the U.S., including possibly serious infections, a senior CDC official said Sunday.

“We expect there to be a broader spectrum of disease here in the U.S.,” said Dr. Anne Schuchat, interim deputy director for the agency’s Science and Public Health Program. “I do fear that we will have deaths here.”

The CDC believes the virus is spreading person-to-person, Schuchat said. In the U.S., all the patients have recovered and only one patient was hospitalized.

Besser said he still can’t say why cases in U.S. are so much milder than the deadly cases in Mexico. There, the disease has killed up to 86 people and likely sickened up to 1,400 since April 13, said Mexico's health minister.

“The real important take away is that we have an outbreak of a new infectious disease that we’re addressing aggressively,” Besser said.

The incubation period for this virus is 24 to 48 hours, health officials said. President Barack Obama recently traveled to Mexico but the president’s health was never in any danger, said John Brennan, Assistant to the President for Homeland Security.

The president has received regular briefings from advisers on the swine flu outbreak and the White House readied guidance for Americans.

“The government can’t solve this alone; we need everybody to take some responsibility,” Napolitano said.

Besser urged Americans to practice frequent handwashing and to stay home if they feel sick. “If your children are sick, have a fever and flu-like illness, they shouldn’t go to school.”

The U.S. will begin screening travelers at the nation’s borders and isolating people who are actively ill with suspected influenza, Napolitano said. No travel restrictions are issued currently, but that could change, she said.

Health officials said the facts of the outbreak don’t yet warrant testing or quarantine of travelers from Mexico, but that that could change if the situation gets worse.

Officials said Sunday they are considering whether to begin manufacture of a vaccine.

“At this point, there is not a vaccine for this swine flu strain,” Besser said.

Deaths in Mexico
Symptoms in the New York cases have been mild, said New York City Health Commissioner Thomas Frieden. New York health officials said more than 100 students at the St. Francis Preparatory School, in Queens, recently began suffering a fever, sore throat and aches and pains. Some of their relatives also have been ill.

Some St. Francis students had recently traveled to Mexico, The New York Times and New York Post reported Sunday.

The World Health Organization chief said Saturday that the strain has "pandemic potential," and it might be too late to contain a sudden outbreak.

Monitoring possible cases
State infectious-diseases, epidemiology and disaster preparedness workers have been dispatched to monitor and respond to possible cases of the flu. Gov. David Paterson said 1,500 treatment courses of the antiviral Tamiflu had been sent to New York City.

The city health department has asked doctors to be extra vigilant and test patients who have flu symptoms and have traveled recently to California, Texas or Mexico.

Investigators also were testing children who fell ill at a day care center in the Bronx. Two families in Manhattan also have contacted the city, saying they had recently returned ill from Mexico with flu symptoms, Frieden said.

Frieden said New Yorkers having trouble breathing due to an undiagnosed respiratory illness should seek treatment but shouldn't become overly alarmed. Medical facilities near St. Francis Prep have already been flooded with people overreacting to the outbreak, he said.

Kansas health officials said Saturday that they had confirmed swine flu in a married couple living in the central part of the state after the husband visited Mexico. The couple, who live in Dickinson County, weren't hospitalized, and the state described their illnesses as mild.

"Fortunately, the man and woman understand the gravity of the situation and are very willing to isolate themselves," said Dr. Jason Eberhart-Phillips, the state health officer.

Swine flu is a respiratory disease of pigs caused by type A flu viruses, the CDC's Web site says. Human cases are uncommon but can occur in people who are around pigs. It also can be spread from person to person. Symptoms include a high fever, body aches, coughing, sore throat and respiratory congestion.

No immunity
Health officials are concerned because people appear to have no immunity to the virus, a combination of bird, swine and human influenzas. The virus also presents itself like other swine flus, but none of the U.S. cases appear to involve direct contact with pigs, Eberhart-Phillips said.