US flu deaths seen as likely as outbreak spreads
WASHINGTON –(AP)– Federal officials warned on Tuesday that swine-flu related deaths were likely in the United States as the disease that killed scores in Mexico continued to spread across the world and governments intensified steps to battle the outbreak.
The number of confirmed cases in the United States was raised to 64, but states and cities were reporting more suspected cases. In New York, the city’s health commissioner said “many hundreds” of schoolchildren were ill at a school where some students had confirmed cases.
President Barack Obama asked Congress for $1.5 billion in emergency funds to fight the fast-spreading disease.
Cuba banned flights to Mexico, where public life is being altered dramatically by illness.
So far, no deaths linked to the disease have been reported outside Mexico.
But Richard Besser, acting director of the Centers for Disease Control and Prevention, said in Atlanta: “I fully expect we will see deaths from this infection.
That was echoed by U.S. Homeland Security Secretary Janet Napolitano. “It is very likely that we will see more serious presentations of illness and some deaths as we go through this flu cycle,” she said.
Napolitano added that in a normal seasonal influenza season, about 35,000 deaths are linked to the flu.
Besser said the U.S. has 64 confirmed cases across five states, with 45 in New York, one in Ohio, two in Kansas, six in Texas and 10 in California.
New York has the largest number of swine flu cases, with a heavy concentration at a Catholic school in Queens section of New York City, where students recently went on a spring break trip to Mexico.
There also were indications that the outbreak may have spread beyond the school, with two people hospitalized and officials closing a school for autistic kids down the street. Those two hospitalizations are in addition to the five hospitalizations announced by the CDC, including three in California and two in Texas.
“It is here and it is spreading,” New York City Health Commissioner Thomas Frieden said. “We do not know whether it will continue to spread.”
Meanwhile, swine flu was ruled out as the cause of one of two recent deaths being investigated by the Los Angeles County coroner’s office. Coroner’s Assistant Chief Ed Winter said Tuesday that lab testing is still pending in the case of the second fatality, but that swine flu is not now suspected.
Cuba banned flights to Mexico, where swine flu is believed to have killed more than 150 people. Mexico City, one of the world’s largest cities, cracked down even further on public life, closing gyms, swimming pools and pool halls and ordering restaurants to limit service to takeout. Earlier, the city shut down schools, state-run theaters and other public places.
Confirmed swine-flu cases rise, CDC says
Mexico’s death toll rises to 152; WHO raises alert level
To vaccinate or not to vaccinate
OTTAWA — To vaccinate or not to vaccinate.
That is one of a host of difficult questions that Canadian public-health officials will face if the swine-flu outbreak escalates into a full-blown pandemic.
In 1976, then U.S. president Gerald Ford ordered a national vaccination campaign in response to an outbreak of swine flu at a military base in New Jersey. In the end, only one person died from swine flu, while roughly 25 people died from a rare neurological syndrome believed to have been a side-effect of the vaccine. The program, now considered a case study in how not to handle a flu outbreak, cost roughly $500 million U.S. in today’s dollars.
Working with the World Health Organization, an international network of scientists is racing to develop a vaccine for the new swine-flu strain. Canada is one of the few countries in the world that has a drug manufacturer on contract to supply the vaccine once it is developed.
But the Public Health Agency of Canada estimates it will take as long as six months to produce a vaccine, and some experts believe it could take even longer.
“When everybody talks about six months, that’s with no glitches. You start to get glitches, and all of a sudden you’re fighting to solve problems,” said Earl Brown, a flu specialist at the University of Ottawa’s faculty of medicine.
Until a vaccine is ready, the primary line of defence will be the government’s national stockpile of antiviral drugs. Unlike a vaccine, antivirals do not immunize patients from a flu strain, but they can relieve the symptoms, and some experts believe they can prevent infection and slow the spread of a pandemic.
Canada has stockpiled two antiviral drugs, Tamiflu and Relenza. The stockpile contains roughly 55 million doses, which officials say is enough to treat the Canadians who will require medical treatment during a pandemic. But Canadian officials and medical experts warn the current swine-flu strain could become resistant to such antivirals if the drugs are used on a wide scale too early.
“The good news so far is that the antivirals are working,” said Dr. Robert Ouellet, president of the Canadian Medical Association. He cautioned that Canadians who haven’t been exposed to the outbreak shouldn’t look to antivirals as a preventive measure.
“Some people will be afraid and will ask to have antivirals right now, even if they don’t have the disease. . . . This is not something we should do.”
Even with the stockpile, federal and provincial officials and health-care workers will have to decide on the fly how to co-ordinate testing for the flu, as well as how to distribute and administer the antivirals.
“That’s a big thing. You’ve got all this stuff in the warehouse, but you have to get it into people’s bodies,” said Brown, of the University of Ottawa.
The logistical challenges would be even more daunting if a mass vaccination program becomes necessary. The Public Health Agency admits there would be many unknowns in the event of a pandemic, including the nature and severity of the flu strain, the availability and safety of a vaccine, and the tone of the public’s reaction.
For one thing, the government will have to decide who gets the vaccine first, a potentially explosive decision. The agency has identified several categories of people who would likely be first in line, including health-care workers, emergency responders and “key societal decision makers,” but it says the decision would depend on the nature of the pandemic.
Despite such challenges, health officials and pandemic experts insist Canada is better prepared than it was during the SARS outbreak of 2003, which killed 44 Canadians and cost the economy an estimated $1.5 billion.
The outbreak prompted the creation of the Public Health Agency, which now co-ordinates Canada’s pandemic plan.
“I think Canada is really well positioned. Because of SARS, we prepared ourselves at multiple levels. We’re one of the only global jurisdictions that offers a seasonal flu vaccine, which is remarkable,” said Eleanor Fish, an immunology researcher and University of Toronto professor.
Pandemic-preparedness money stripped from stimulus
WASHINGTON – Congress stripped nearly $900 million to combat an influenza pandemic from the economic-stimulus package earlier this year as part of last-minute negotiations to gain GOP support for the plan.
Now, with the spread of a potentially deadly strain of the swine flu, public-health advocates and liberal bloggers are sharply criticizing the move. Key Democratic lawmakers, including Iowa Sen. Tom Harkin, vowed Monday to fight for increased funding in the coming weeks.
“It was a short-sighted decision,” Robert Pestronk, executive director of the National Association of County and City Health Officials, said of the cut. The lack of federal funds and recession-fueled budget cuts at the state level have “reduced the ability of state and local governments to cope” with spreading swine-flu infections, he said.
At the center of the debate: Maine Sen. Susan Collins, who was one of three Republicans to back President Obama’s $787 billion stimulus package. She opposed inclusion of the pandemic-preparedness money during a floor debate on the legislation, arguing it would not jump-start the economy.
In the end, Congress agreed to trim more than $100 billion from the stimulus package, including $870 million in flu spending.
On Monday, John Nichols, blogging for the liberal magazine “The Nation”, accused Collins of “just playing politics, in the exceptionally narrow and irresponsible manner that characterized the Republican response to the stimulus debate.”
Collins spokesman Kevin Kelley defended the senator’s actions and called the criticism “politically motivated.”
“Sen. Collins always maintained that, though very worthwhile, this funding should go through the regular appropriations process since it did not meet the test of stimulus spending,” Kelley said in a statement. He said there was no evidence that federal efforts to deal with the swine flu outbreak have been hampered.
Collins was not the only lawmaker to criticize the spending. In February, as the Senate neared final approval of the stimulus bill, Sen. Charles Schumer, D-N.Y., noted that “all those little porky things,” including flu pandemic money, had been removed.
The money would have been the last installment of a $7.1 billion program initiated by then-president George W. Bush four years ago to prepare for a threat of a global influenza outbreak. A key goal: to make enough vaccine by 2011 to cover every American within six months of a pandemic virus being identified. Congress has approved more than $6 billion for the program.
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