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Lauran Neergaard | | Wednesday, April 29, 2009


WASHINGTON -- A 23-month-old Texas toddler became the first confirmed swine flu death outside of Mexico as authorities around the world struggled to contain a growing global health menace that has also swept Germany onto the roster of afflicted nations. Officials say the death was in Houston.

"Even though we've been expecting this, it is very, very sad," Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention, said Wednesday of the infant's death. "As a pediatrician and a parent, my heart goes out to the family."

President Barack Obama said this morning that Americans should know the government is doing all it can to control virus. Obama also says schools should consider closing if the spread of the swine flu virus worsens.

Canada, Austria, New Zealand, Israel, Spain, Britain and Germany also have reported cases of swine flu sickness. Deaths reported so far have been limited to Mexico, and now the U.S.

As the United States grappled with this widening health crisis, Besser went from network to network Wednesday morning to give an update on what the Obama administration is doing. He said authorities essentially are still "trying to learn more about this strain of the flu." His appearances as Germany reported its first cases of swine flu infection, with three victims.

"It's very important that people take their concern and channel it into action," Besser said, adding that "it is crucial that people understand what they need to do if symptoms appear.

"I don't think it (the reported death in Texas) indicates any change in the strain," he said. "We see with any flu virus a spectrum of disease symptoms."

Asked why the problem seems so much more severe in Mexico, Besser said U.S. officials "have teams on the ground, a tri-national team in Mexico, working with Canada and Mexico, to try and understand those differences, because they can be helpful as we plan and implement our control strategies."

Sixty-six infections had been reported in the United States before the report of the toddler's death in Texas.

The world has no vaccine to prevent infection but U.S. health officials aim to have a key ingredient for one ready in early May, the big step that vaccine manufacturers are awaiting. But even if the World Health Organization ordered up emergency vaccine supplies - and that decision hasn't been made yet - it would take at least two more months to produce the initial shots needed for human safety testing.

"We're working together at 100 miles an hour to get material that will be useful," Dr. Jesse Goodman, who oversees the Food and Drug Administration's swine flu work, told The Associated Press.

The U.S. is shipping to states not only enough anti-flu medication for 11 million people, but also masks, hospital supplies and flu test kits. President Barack Obama asked Congress for $1.5 billion in emergency funds to help build more drug stockpiles and monitor future cases, as well as help international efforts to avoid a full-fledged pandemic.

"It's a very serious possibility, but it is still too early to say that this is inevitable," the WHO's flu chief, Dr. Keiji Fukuda, told a telephone news conference.

Cuba and Argentina banned flights to Mexico, where swine flu is suspected of killing more than 150 people and sickening well over 2,000. In a bit of good news, Mexico's health secretary, Jose Cordova, late Tuesday called the death toll there "more or less stable."

Mexico City, one of the world's largest cities, has taken drastic steps to curb the virus' spread, starting with shutting down schools and on Tuesday expanding closures to gyms and swimming pools and even telling restaurants to limit service to takeout. People who venture out tend to wear masks in hopes of protection.

The number of confirmed swine flu cases in the United States rose to 66 in six states, with 45 in New York, 11 in California, six in Texas, two in Kansas and one each in Indiana and Ohio, but cities and states suspected more. In New York, the city's health commissioner said "many hundreds" of schoolchildren were ill at a school where some students had confirmed cases.

The WHO argues against closing borders to stem the spread, and the U.S. - although checking arriving travelers for the ill who may need care - agrees it's too late for that tactic.

"Sealing a border as an approach to containment is something that has been discussed and it was our planning assumption should an outbreak of a new strain of influenza occur overseas. We had plans for trying to swoop in and knockout or quench an outbreak if it were occurring far from our borders. That's not the case here," Besser told a telephone briefing of Nevada-based health providers and reporters. "The idea of trying to limit the spread to Mexico is not realistic or at all possible."

"Border controls do not work. Travel restrictions do not work," WHO spokesman Gregory Hartl said in Geneva, recalling the SARS epidemic earlier in the decade that killed 774 people, mostly in Asia, and slowed the global economy.

Authorities sought to keep the crisis in context: Flu deaths are common around the world. In the U.S. alone, the CDC says about 36,000 people a year die of flu-related causes. Still, the CDC calls the new strain a combination of pig, bird and human viruses for which people may have limited natural immunity.

Hence the need for a vaccine. Using samples of the flu taken from people who fell ill in Mexico and the U.S., scientists are engineering a strain that could trigger the immune system without causing illness. The hope is to get that ingredient - called a "reference strain" in vaccine jargon - to manufacturers around the second week of May, so they can begin their own laborious production work, said CDC's Dr. Ruben Donis, who is leading that effort.

Vaccine manufacturers are just beginning production for next winter's regular influenza vaccine, which protects against three human flu strains. The WHO wants them to stay with that course for now - it won't call for mass production of a swine flu vaccine unless the outbreak worsens globally. But sometimes new flu strains pop up briefly at the end of one flu season and go away only to re-emerge the next fall, and at the very least there should be a vaccine in time for next winter's flu season, Dr. Anthony Fauci, the National Institutes of Health's infectious diseases chief, said Tuesday.

"Right now it's moving very rapidly," he said of the vaccine development.

Besser appeared on NBC's "Meet the Press," CNN and CBS's "The Early Show."




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Related Topics: PPE and Infection Control, Airway and Respiratory

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