Concern that the world could be on the brink of the first influenza pandemic in more than 40 years escalated Sunday as France, Hong Kong, New Zealand and Spain reported potential new cases in which people had been infected with A/H1N1 flu and Canada confirmed several new cases.
In the U.S., where 20 such infections have been confirmed, federal health officials declared a public-health emergency and are preparing to distribute to state and local agenciesa quarter of the country's 50 million-dose stockpile of antiviral drugs. Meanwhile, in hard-hit Mexico, where more than 80 people have died from what is believed to be swine flu, the government closed all public schools and canceled hundreds of public events in Mexico City.
Though the World Health Organization (WHO) is referring to the situation as a "public-health emergency of international concern," the apparent emergence in several countries of an entirely new strain of H1N1 flu virus has led some scientists to believe that it is only a matter of time before the WHO declares pandemic status, a move that could prompt travel bans to infected countries. "We are clearly seeing wide spread," says Michael Osterholm, a pandemic risk expert who runs the University of Minnesota's Center for Infectious Disease Research and Policy. "There is no question." (Read about the vaccine being prepared in case of a pandemic.)
Health officials in Washington were quick to point out Sunday that none of the 20 cases identified in the U.S. so far has been fatal; all but one of the victims has recovered without needing to be hospitalized. Officials also noted that only one American has been infected so far who had not recently traveled to Mexico - a woman in Kansas got sick after her husband returned from a business trip in that country, where he became ill - but that could change as more intensive disease surveillance begins. "As we continue to look for more cases, I expect we're going to find them," said acting Centers for Disease Control (CDC) director Richard Besser.
In the U.S., where cases have also been found in California, Texas, and New York City, the declaration of a public-health emergency is part of what federal officials termed an "aggressive response" to the outbreaks. In addition to releasing from the national stockpile some 12.5 million doses of the antiviral drugs Tamiflu and Relenza - which scientists say has so far been effective against the H1N1 swine flu virus - the Department of Homeland Security will begin "passive surveillance" to screen people entering the U.S. Any traveler coming from a country with a confirmed human swine flu infection will be questioned, checked for symptoms and potentially isolated if they are found ill. Though the CDC has issued public warnings about the more serious outbreak in Mexico, there are no recommendations from Washington against traveling to the neighboring country.
That is in contrast to the more extreme actions of some other governments, including Hong Kong, where officials on Sunday urged residents to avoid going to Mexico. Hong Kong officials also ordered the immediate detention in a hospital of anyone who arrives with a fever above 100.4 F, respiratory symptoms and a history of traveling over the past seven days to a city with a confirmed case of swine flu infection.
But Washington officials Sunday did their best not to overstate the situation and emphasized that their response wasn't out of the ordinary. "I wish we could call it declaration of emergency preparedness, because that's really what it is in this context," said Secretary of Homeland Security Janet Napolitano. "We're preparing in an environment where we really don't know ultimately what the size or seriousness of this outbreak is going to be."