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Influenza A (H1N1) 0.4% resistant
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Swine flu spreads in 10 US states, Europe
WASHINGTON – Virulent swine flu spread to 10 U.S. states from coast to coast Wednesday and swept deeper into Europe, extending its global reach as President Barack Obama mourned the first U.S. death, a Mexican toddler who had traveled with his family to Texas. Total American cases surged to nearly 100, and Obama said wider school closings might be necessary.
The World Health Organization said the outbreak is moving closer to becoming a full-scale pandemic.
Dr. Keiji Fukuda, the organization's top flu expert, told reporters in Geneva that the latest developments are moving the agency closer to raising its pandemic alert to phase 5, indicating widespread human-to-human transmission. That's just one step below level 6, a full-fledged pandemic.
In Washington, Homeland Security Secretary Janet Napolitano was questioned closely by senators about whether the U.S. should close its border with Mexico, where the outbreak apparently began and the casualties have been the greatest. She repeated the administration's position that questioning of people at borders and ports of entry was sufficient for now and said closing borders "has not been merited by the facts."
Dr. Richard Besser, the acting chief of the Centers for Disease Control, said in Atlanta that there are confirmed cases now in ten states, with 51 in New York, 14 in California and 16 in Texas. Two cases have been confirmed in Kansas, Massachusetts and Michigan, while a single cases have been reported in Arizona, Indiana, Nevada and Ohio.
In a possible outbreak north of the Mexican border, the commandant of the Marine Corps said a Marine in southern California might have the illness and 39 Marines were being confined on their California base until tests come back.
Marine General James Conway told a Pentagon briefing an initial test indicated the sick Marine — who was not identified — might have swine flu but his illness did not appear life-threatening.
Obama said he wanted to extend "my thoughts and prayers" to the family of a nearly two-year-old Mexican boy who died in Houston, the first confirmed U.S. fatality among more than five dozen infections. Health officials in Texas said the child had traveled with his family from Mexico, to Brownsville on April 4 and was brought to Houston after becoming ill. He died Monday night.
"This is obviously a serious situation," and "we are closely and continuously monitoring" it, Obama said of the spreading illness.
Those sentiments were echoed by the Senate's top Republican. "This is a very worrisome situation and we're all following it very closely," said Minority Leader Mitch McConnell of Kentucky. "We stand ready to closely work with the administration to protect the American people as this situation unfolds."
Meanwhile, Egypt's government ordered the slaughter of all pigs in the country as a precaution, though no swine flu cases have been reported there. Egypt's overwhelmingly Muslim population does not eat pork, but farmers raise some 300,000-350,000 pigs for the Christian minority.
The disease is not spread by eating pork, and farmers were to be allowed to sell the meat from the slaughtered animals.
In fact, officials appeared to go out of their way on Wednesday to not call the strain "swine flu." Obama called the bug the "H1N1 virus."
"The disease is not a food-borne illness," Rear Adm. Anne Schuchat, CDC's interim science and public health deputy direct, told the Senate Homeland Security Committee.
She said the strain is particularly worrisome because "it's a virus that hasn't been around before. The general population doesn't have immunity from it."
People have various levels of protection against other more common types of flu because they are exposed to it over time, and that protection accumulates. She suggested that some older people might have more resistance to this particular strain than younger people because its traits might resemble outbreaks of decades ago.
Germany became the latest country to report swine flu infections. It reported four cases on Wednesday.
New Zealand's total rose to 14. Britain had earlier reported five cases, Spain four. There were 13 cases in Canada, two in Israel and one in Austria.
Obama said it is the recommendation of public health officials that authorities at schools with confirmed or suspected cases of swine flu "should strongly consider temporarily closing so that we can be as safe as possible."
He was underscoring advice that the CDC provided earlier to cities and states, and that some schools — most prominently in New York City — already have followed.
"If the situation becomes more serious and we have to take more extensive steps, then parents should also think about contingencies if schools in their areas do temporarily shut down, figuring out and planning what their child care situation would be," Obama advised.
He advised people to take their own precautions — washing hands, staying home if they are sick, and keeping sick kids home.
Obama said the federal government is "prepared to do whatever is necessary to control the impact of this virus." He noted his request for $1.5 billion in emergency funding to ensure adequate supplies of vaccines.
CDC for days has said people with flulike symptoms should stay home — but now also is stressing that other family members should consider staying home or at least limiting how much they go out until they're sure they didn't catch it.
Besser, the acting CDC director, called it "an abundance of caution," but stressed that it's voluntary and that the government hasn't urged actual quarantine, which isn't really effective with flu.
Human Infections with Swine Influenza A Virus:
On April 17, 2009, CDC and the California Department of Public Health determined that two cases of febrile respiratory illness occurring in children who reside in adjacent counties in southern California were caused by infection with a swine influenza A (H1N1) virus. On April 22, CDC confirmed an additional three cases of swine influenza among residents of the two counties, two adults and one adolescent. All case-patients had symptoms of ILI. Additional testing at CDC identified swine influenza A (H1N1). All five had self-limited ILI and have recovered; one required hospitalization. Two additional cases were identified from Texas and confirmed as swine influenza at CDC on April 23.
Of the five case-patients with swine influenza A (H1N1) infection from California, two are a father and daughter and other than the father-daughter, the five case-patients have no known epidemiologic link or contact with pigs. The two new case-patients from Texas are schoolmates and an epidemiologic investigation is currently underway.
The viruses from all seven cases are closely related genetically and contain a unique combination of gene segments that have not been reported in the United States or elsewhere. Viruses from 6 cases are all resistant to amantadine and rimantidine and sensitive to zanamivir and oseltamivir, and sensitivity testing is underway for the remaining virus.
Vaccination with seasonal influenza vaccine containing human influenza A (H1N1) would not be expected to provide protection against swine influenza A (H1N1) viruses.
Additional information on swine influenza is available at http://www.cdc.gov/flu/swine/index.htm
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