Is Tamiflu the only hope against this Flu Pandemic?

"Two antiviral medications, marketed as tamiflu and relenza, both work against the bug, according to the CDC."

By BETSY MCKAY, DAVID LUHNOW and JACOB GOLDSTEIN
from The Wall Street Journal
April 26, 2009

The World Health Organization declared a deadly new strain of swine flu to be a "public health emergency of international concern," as health officials called the disease widespread and governments took precautions to screen for the virus.

New Zealand said that 10 students "likely" have swine flu after a school trip to Mexico, as governments across Asia began quarantining those with symptoms of the deadly virus and some issued travel warnings for Mexico. The Israeli Health Ministry also said there is one suspected case in the country.

Several children at a school in the New York City borough of Queens may have been infected, according to reports from local health departments. The U.S. Centers for Disease Control and Prevention said it expects to find more cases soon throughout the country. The CDC confirmed an additional case in California, the state's seventh case, over the weekend. Two cases were confirmed in Kansas, and there have been two cases reported in Texas.

French Health Ministry officials said four possible cases of swine flu are under investigation, including a family of three in the northern Nord region and a woman in the Paris region. The four recently returned from Mexico. Tests on two separate cases of suspected swine flu proved negative, they said.

Spain's Health Ministry said three people who just returned from Mexico were under observation in hospitals in the northern Basque region, in southeastern Albacete and the Mediterranean port city of Valencia.

At least 81 people in Mexico have died from severe pneumonia caused by the flu-like illness, according to the World Health Organization. WHO Director-General Margaret Chan warned that the virus had the potential to cause a pandemic, but cautioned that it was too early to tell whether it would erupt into a global outbreak.

Following an emergency meeting Saturday, a WHO panel declared the developments thus far a public health emergency and urged governments around the world to intensify surveillance for unusual outbreaks of flu-like illness and severe pneumonia. But the panel held off on raising a global pandemic alert, saying it needed more information before making a decision.

Governments world-wide stepped up surveillance for the deadly virus. Officials at Tokyo's Narita airport installed a device at the arrival gate for flights from Mexico to measure the temperatures of passengers. Hong Kong and Taiwan said visitors to infected areas who have fevers will be quarantined -- a precaution the Philippines is also considering. The Chinese territory also joined South Korea in warning against travel to Mexico. Indonesia has increased surveillance at all entry points for travelers with flu-like symptoms -- using devices at airports that were put in place years ago to monitor for severe acute respiratory syndrome, or SARS, and bird flu. It said it was ready to quarantine suspected victims if necessary.

Mexican health authorities are continuing to investigate whether more than 1,300 people were infected with the mysterious bug, which attacked in three geographically diverse areas of the country and is taking its heaviest toll in young adults.

The CDC said it expects to find more cases throughout the U.S.

"The public health community has a number of active investigations of suspect illness going on," Anne Schuchat, the CDC's interim deputy director for science and public health programs, said in a telephone press conference. "I expect us to find more throughout the country."

"It's clear this is widespread, and that is why we have let you know we do not think we can contain this virus," she said. "We're likely to find it in other places."

In New York City, further testing will be required to know whether more than 100 of roughly 2,700 students at St. Francis Preparatory School in Queens were ill with swine flu when they missed school last week, said Thomas Frieden, the city's health commissioner. Health officials have interviewed most of the ill students or their families; all reported mild symptoms, and none required hospitalization.

The health department has tested nine samples taken from ill students, eight of which have been classified "probable human swine influenza," Dr. Frieden said. Local testing confirmed that the samples were influenza type A, which occurs in both humans and swine, and the samples did not match common subtypes of human influenza. Under current CDC definitions, cases of influenza type A that do not match subtypes of human influenza are considered probable swine flu, pending confirmation by the CDC.

The samples have been sent to the CDC for additional testing, Dr. Frieden said. Results could be available as soon as tomorrow. If swine flu is confirmed, the health department will recommend that the school cancel classes on Monday to reduce the risk of further spread.

The city health department is also investigating a report of about 30 children who became ill at a day-care center in the Bronx. But Dr. Frieden emphasized that the status in that case remains unclear and may turn out to be unrelated to swine flu.

The CDC has sent teams to California, Texas, and Mexico to assist with investigations. Confirmed cases include six children and adults in San Diego and Imperial Counties in Southern California. Two 16 year-old boys in Guadalupe County near San Antonio, Texas, were also found to have had the disease. Only one of the cases, a 41-year-old woman, was hospitalized, and the others had only mild disease, the CDC said.

It's unclear so far why U.S. cases identified so far are mostly mild, while Mexico has experienced severe disease, Dr. Schuchat said, though expanded surveillance is likely to yield more clues.

The CDC is also taking initial steps toward preparing a vaccine should that become necessary, but producing enough for a mass vaccination program could take months, Dr. Schuchat cautioned.

President Felipe Calderon urged Mexicans to remain calm and reassured them that government has plenty of antiviral medicines to treat the outbreaks. Two antiviral medications, marketed as tamiflu and relenza, both work against the bug, according to the CDC.

In Mexico City, blue surgical masks proliferated and entrepreneurs were selling them on the streets. And throngs of Mexicans -- some with just a fever -- rushed to hospitals.

Mexican soldiers and health workers patrolled airports and bus stations, looking for people showing symptoms. Hundreds of public events were called off to keep people from congregating and spreading the virus in large crowds. Markets and restaurants were nearly empty. Two soccer games scheduled for Sunday were expected to be played in front of empty stadiums but broadcast on TV.

Roman Catholic officials planned to hold mass later inside an empty Basilica of the Virgin of Guadalupe for broadcast over the airwaves.

—The Associated Press contributed to this article.
Write to Betsy McKay at betsy.mckay@wsj.com, David Luhnow at david.luhnow@wsj.com and Jacob Goldstein at jacob.goldstein@wsj.com
Click to read the article and comments