U.S. Declares Public Health Emergency Over Swine Flu
By KEITH BRADSHER and JACK HEALY
Published: April 26, 2009
American health officials on Sunday declared a publichealth emergency over increasing cases of swine flu, saying that they had confirmed 20 cases of the disease in the United States and expected to see more as investigators fan out to track down the path of the outbreak.
Although officials said most of the cases have been mild and urged Americans not to panic, the emergency declaration frees government resources to be used toward diagnosing or preventing additional cases, and releases money for more antiviral drugs.
“We are seeing more cases of swine flu,” said Richard Besser, acting director of the Centers for Disease Control, in a news conference in Washington. “We expect to see more cases of swine flu. As we continue to look for cases, I expect we’re going to find them.” Homeland Security Secretary Janet Napolitano, speaking at the same news conference called the emergency declaration “standard operating procedure,” and said it should be considered a “declaration of emergency preparedness.”
“Really that’s what we’re doing right now,” she said. “We’re preparing in an environment where we really don’t know ultimately what the size of seriousness of this outbreak is going to be.”
Officials said they had confirmed eight cases in New York, seven in California, two in Kansas, two in Texas and one in Ohio, and that the cases looked to be similar to the deadly strain of swine flu that has killed more than 80 people in Mexico and infected 1,300 more.
So far, there have been no deaths from swine flu in the United States, and only one of the people who tested positive for the disease has been hospitalized, officials said.
Still, officials said they expect more severe cases.
Other governments around the world stepped up their response to the incipient outbreak, racing to contain the infection amid reports of potential new cases from New Zealand to Hong Kong to Spain, raising concerns about the potential for a global pandemic.
Canada also confirmed four cases of the flu. Dr. Robert Strang, Nova Scotia’s chief public health officer, said on Sunday that four students who attend the same school in that province had what he describes as “very mild” cases of the flu, according to The Associated Press.
The United States said it would use “passive surveillance” in screening travelers from Mexico who would enter the country, isolating them only if they were ill. But other governments issued travel advisories urging people not to visit Mexico, the apparent origin of the outbreak, where 81 people have died and some 1,300 have been infected. China, Russia and others set up quarantines for anyone possibly infected. Some countries banned pork imports from Mexico, even though there is no link between food products and the flu, and others were screening air travelers for signs of the disease.
The World Health Organization reiterated that it considered the outbreak “a public health emergency of international concern” but said it would put off until Tuesday a decision on whether to raise the pandemic alert level.
Raising it to level 4 “would be a very serious signal that countries ought to be dusting off pandemic plans,” said Dr. Keiji Fukuda, deputy director general of the W.H.O. The W.H.O. is historically reluctant to declare pandemics in sensitive member countries.
In the United States, the C.D.C. confirmed that eight students of a high school in Queens had been infected with swine flu, the first confirmed cases in New York City, Mayor Michael Bloomberg said at a news conference on Sunday. Mr. Bloomberg said that all of the cases had been mild and hospitals in the city had not seen more patients with severe lung infections.
“So far there does not seem to be any outbreak,” Mr. Bloomberg said. “We don’t know if the spread will be sustained. What’s heartening is the people who tested positive have only mild illnesses.”
About 100 students at St. Francis Preparatory School in Fresh Meadows, Queens, became sick in the last few days, and some family members have also taken ill. Mr. Bloomberg said the school would be closed on Monday, and that officials would then reassess whether to reopen the school.
Other New York City schools will be open as usual on Monday, Mr. Bloomberg said.
Other cases of possible infection in New York turned about to be false alarms. Five of six children at a day-care center in the Tremont section of the Bronx who had shown some flu-like symptoms tested negative for swine flu, said Thomas Frieden, the city’s health commissioner.
On Sunday, the government of Hong Kong announced some of the toughest measures yet of any jurisdiction in response to the swine flu outbreak.
Officials urged residents not to travel to Mexico and ordered the immediate detention at a hospital of anyone who arrives with a fever and symptoms of a respiratory illness after traveling in the previous seven days through a city with a laboratory-confirmed outbreak.
The new policy, shaped by Hong Kong’s lasting scars as an epicenter of a SARS outbreak six years ago, has the potential to dampen air travel across the Pacific. Hong Kong has Asia’s busiest airport hub for international air travel, with Boeing 747s arriving around the clock from cities all over the United States and Canada, but not Mexico.
Ever since the 2003 outbreak of severe acute respiratory syndrome, Hong Kong has used infrared scanners to measure the facial temperature of all arrivals at its airport and border crossings with mainland China. Visitors are required to remove any hats to ensure accurate measurement, and children are checked with ear thermometers because the scanners are less reliable in measuring their faces.
Dr. Thomas Tsang, the controller of the Hong Kong government’s Center for Health Protection, said at a press conference on Sunday afternoon that any traveler who has passed through a city with laboratory-confirmed cases and who arrives in Hong Kong with a fever and respiratory symptoms will be intercepted by officials and sent to a hospital to await testing.
“Until that test is negative, we won’t allow him out,” he said.
An aide later said that the cut-off for having a fever would be 38 degrees Celsius, or 100.4 degrees Fahrenheit, and that it would take two or three days to obtain test results.
Dr. York Chow, Hong Kong’s secretary for health and food, asked residents to watch the news for reports of which states in the United States have outbreaks and discouraged travel to these states, but reserved his strongest warning for travel to Mexico.
“Do not travel to Mexico unless it is absolutely necessary,” he said.
The Hong Kong government will also amend its health regulations in the next couple days to make it mandatory for any health professional to alert the government of any suspected cases of swine flu, he said.
Hong Kong should “prepare for the worst” if the swine flu virus develops a clear ability to pass from person to person, Dr. Chow said, while adding that the risk from the virus was low if this did not happen.
One legacy of SARS is that Hong Kong may now be better prepared for a flu pandemic than practically anywhere else on the world. Fearing that SARS might recur each winter, the city embarked on a building program to enlarge its capacity to isolate and treat those infected with communicable respiratory diseases.
Hong Kong now has 1,400 beds for this purpose each equipped with mechanical ventilators for treating those with severe pneumonia or other respiratory difficulties. But only 80 to 100 of these beds are needed on any given day, so they have been used until now for patients with other medical problems, Dr. Chow said.
The city has also expanded its flu research labs, already among the best in the world and leaders in tracking the H5N1 avian flu influenza virus. The so-called bird flu virus, which kills an unusually high share of its victims, has periodically triggered fears over the past decade about a possible pandemic but is different from the H1N1 swine flu influenza virus now causing illnesses in Mexico and the United States.
Keith Bradsher reported from Hong Kong and Jack Healy from New York. Donald McNeil contributed reporting from New York.