Swine flu: Latest updates

The bishops are stopping parishioners receiving communion wafers on the tongue, communion wine from the chalice and from shaking hands at the sign of peace at masses in New Zealand.

In a statement, the bishops, who are meeting in Palmerston North, said they hoped they would not have to take stronger action, and reinforced the need for priests and other clergy working for the church to practise good hygiene procedures.

SWINE FLU MAP

12.37pm: Health authorities are working on setting up a specialised influenza assessment centre outside of Auckland's international airport.

The centre would provide space and facilities for those entering the country with flu symptoms to be checked out in isolation.

Director-General of Health Stephen told media today discussions were taking place over the establishment of a community-based influenza assessment centre in the Auckland region.

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A decision was likely over the next 24-hours on a preferred site for such a centre.

"Middlemore (hospital) is obviously in much closer vicinity to the airport and has available clinical space," he said.

Health staff at the centre would undertake clinical assessments away from the airport and in relative isolation.

"We will also have conversations with chairs (of DHBs) and CEOs across the rest of the country, alerting them to thinking about and planning for perhaps the development of more community-based assessment centres..."

The centres might need to be brought into play as the swine flu situation evolved, he said.

11.53am: Australia's pandemic preparedness plan in response to the global swine flu outbreak is already in full swing, the federal government says.

The World Health Organisation (WHO) on today raised its flu alert level to phase five out of six, signalling that a pandemic was "imminent".

WHO Director General Margaret Chan called on all countries to immediately activate their pandemic preparedness plans.

Following the announcement, Health Minister Nicola Roxon said Australia had already done so.

"We are ahead of the game, if you like, in those situations," she told ABC Radio.

Cabin crews were making announcements on all incoming flights to Australia requesting people with flu-like symptoms to identify themselves and health declaration cards must now be completed at border entry points.

Ms Roxon said the government had also rolled out a series of public health advertisements regarding the potentially deadly virus in local print media, and thermal scanners had been deployed to airports around the nation but would not be used until recommended by the nation's chief medical officer.

Anyone who has travelled to Mexico or North America in the last seven days should contact Healthline (0800 611 116) for information. They should seek medical advice if they are displaying flu-like symptoms.

Polk parents receive swine flu letter

CEDARTOWN — Letters regarding the swine flu went home Wednesday to Polk County parents.

Buddy Harrison, Polk County School System

director of student services, said the letters originated with the state and offer guidelines and recommendations to prevent the swine flu.

No cases have been reported in Georgia. One death, that of a toddler boy in Texas, has been linked to the infection.

SWINE FLU MAP

Harrison said the letters are purely precautionary.

Harrison said prevention guidelines are “common sense” things like washing hands regularly, covering your mouth when you cough and regularly disinfecting objects used by multiple people such as telephones and computer keyboards.

Visit www.thepolkfishwrap.com for more news.

Flu 'will kill people in Europe'

The European Commission's most senior health official has warned that thousands could die in a swine flu pandemic.

Robert Madelin, Director-General for consumer health policy, said it was not a question of if people would die but how many.

He was speaking after attending talks earlier with EU ambassadors preparing for an emergency meeting of EU health ministers to decide long-term strategy for dealing with the outbreak.

SWINE FLU MAP

Mr Madelin said there was confidence that Europe was well prepared for a pandemic.

But asked if people could die he replied: "Every year 2,500 people die of the flu in Europe. The question now is not whether people will die, but whether it will be thousands, tens of thousands or hundreds of thousands."

Mr Madelin said existing vaccines and anti-viral drugs might not be sufficient to deal with the swine flu outbreak, but, thanks to scientific advances in the last two years and reduced red tape, a specific vaccine to deal with the new specific threat could be ready in 200 days (just under 7 months).

But he warned: "Even with a vaccine you are aiming at a moving target, but I think people (EU officials) feel quite pleased about the co-ordination so far and the willingness to get on with the work."

Mr Madelin said the Commission was not recommending that ministers impose any travel bans, but governments would need to discuss quantities of vaccines which could be required and ways to keep people informed about developments.

"Our response needs to be calm, educated and sensible," he said.

He added: "There are very straightforward things that can be done, such as ensuring basic levels of hygiene and minimum economic disruption caused by any pandemic."

Swine Flu conference LIVE STREAMING

In the latest swine flu news, we have a words that a live converence will be held.

By WTOC Staff

SAVANNAH, GA (WTOC) - On Thursday afternoon representatives from the Chatham County Health Department, CEMA, Chatham County Commission as well as several hospitals will be addressing what they can do to prepare for and protect Chatham County from the swine flu.

There will be a news conference at 1pm on Thursday, April 30 and WTOC.com is streaming the entire meeting live.

Be sure to join us to hear what city officials, city leaders and businesses have to say.

SWINE FLU MAP

Be sure to visit our swine flu map showing latest swine flu outbreak in different states in the United States.

Swine Flu Map

The cases in the U.S., like those in Canada, have been milder than Mexico, but "as we continue to look for cases, we expect to see more cases in a broader spectrum — and that is what we are seeing," said Dr. Besser.

View 2009 Swine Flu (H1N1) Outbreak Map in a larger map

The disease originated in pigs. But health authorities in the U.S. are going to start referring to it as the 2009 H1N1 virus, rather than swine flu, to halt any misconception that it can be spread by eating pork.

Ordinary influenza normally claims 36,000 lives in the United States, which prompted reporters to ask why there has been so much attention paid to this particular virus.

American health officials explained that it is a virus that has never been seen before, which means there is no background immunity in the population, and it is spreading from human to human. That means it has the potential to become a pandemic.

"At the start of an outbreak, you don't know what the course is going to look like," Dr. Besser said. "You don't know if this is a virus that is going to fizzle out in a couple of weeks or one that is going to become more or less severe in the diseases it causes."

The American border will remain open. But, as in Canada, customs officials will be actively looking of people who are sick.

With reports from Karen Howlett, The Associated Press and The Canadian Press

WHO raises pandemic alert

Swine flu pandemic alert. Swine flu photos and pictures.

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The World Health Organization has raised its pandemic alert for swine flu to the second highest level, meaning that it believes a global outbreak of the disease is imminent.

WHO says the phase 5 alert means there is sustained human-to-human spread in at least two countries.

Swine Influenza

It also signals that efforts to produce a vaccine will be ramped up. WHO has confirmed human cases of swine flu in Mexico, the United States, Canada, Britain, Israel, New Zealand and Spain.

Mexico and the United States have reported deaths.

WHO Director-General Margaret Chan made the decision today to raise the alert level from phase 4 — signifying transmission in only one country — after reviewing the latest scientific evidence on the outbreak.

Dr. Chan urged international cooperation and encouraged countries to view the raised alert level as an opportunity to ramp up efforts to contain the virus.

"It really is all of humanity that is under threat during a pandemic," Dr. Chan said.

Meanwhile in Ontario, there are three new confirmed cases, bringing the provincial total to seven. British Columbia also reported three new cases, bringing the total to 19 confirmed cases in Canada.

Officials at the B.C. Centre for Disease Control say all the new cases are in the Vancouver region.They say five of the six cases were people who were travelling recently in Mexico, but health officials say the transmission link in one of case is unclear.

One person in B.C. was hospitalized overnight but nationwide, all cases have been described by health officials as mild.

Dr. David Williams, Ontario's acting Chief Medical Officer of Health, said at a media briefing that two of the individuals who tested positive on Wednesday recently travelled to Mexico. He said it is still not clear whether the third individual visited Mexico.

All seven individuals in the province live in the suburbs surrounding Toronto, are in their twenties and suffered mild symptoms.

"I'm not surprised at all," with the number of cases, Dr. Williams told reporters.

"I expect some more as the days go on."

Earlier in the day, the World Health Organization said it was moving closer to raising the pandemic alert level once again as the swine flu outbreak continued to hop from one country to the next and claimed its first life outside of Mexico, the epicentre of the disease.

"It's clear that the virus is spreading and we don't see any evidence of this slowing down at this point," Dr. Keiji Fukuda, WHO acting assistant director-general, said in a conference call from Geneva.

Government officials confirmed the first U.S. death from the new H1N1 swine flu today - a 23-month-old child who died in Texas. It is the first death from swine flu reported outside Mexico, the country hardest hit by the influenza outbreak.

"This is quite sad news," Dr. Richard Besser, the acting director of the Atlanta-based Centers for Disease Control, told a morning teleconference.

"As a parent, as a pediatrician, I am moved by this and my heart goes out to the family in Texas who is dealing with this situation."

The official number of those infected in the United States climbed to 91 today from 64 the day before, and there are now confirmed cases in 10 states, up from five on Tuesday. But, said Dr. Besser, those numbers are out of date even as they are being released.

Germany confirmed its first cases of swine flu today: a 22-year-old woman hospitalized in Hamburg, a man in his late 30s at a hospital in Regensburg, north of Munich, and a 37-year-old woman from another Bavarian town. All three had recently returned from Mexico. And Austria health ministry said a 28-year-old woman who recently returned from a month-long trip to Guatemala via Mexico City and Miami has the virus but is recovering.

The WHO raised the pandemic level to 4 on Monday, the first time since the system was devised four years ago. Level 6 is a full-blown pandemic.

Swine flu is suspected of killing more than 150 people in Mexico and sickening over 2,400 there. The city's mayor said the outbreak seemed to be stabilizing and he was considering easing the citywide shutdown that closed schools, restaurants, concert halls and sports arenas.

But as fear and uncertainty continued around the world, nations took all sorts of precautions, some more useful than others.

Britain closed a school after a 12-year-old girl was found to have the disease. Egypt slaughtered all its pigs and the central African nation of Gabon became the latest nation to ban pork imports, despite assurances that swine flu was not related to eating pork.

Cuba eased its flight ban, deciding just to block flights coming in from Mexico. Asian nations greeted returning airport travellers with teams of medical workers and carts of disinfectants, eager to keep swine flu from infecting their continent.

And in the House of Commons in Ottawa, the human resources director said extra cleaning is being done in high-traffic areas and places where the public can visit, just in case. Additional hand sanitizer stations are also being installed.

Both Canada and United States this week issued advisories, urging that all unnecessary trips to Mexico be cancelled or postponed.

Until today's death in the United States, the cases outside of Mexico have been relatively mild. The swine flu virus has similar symptoms as seasonal influenza, including fever and joint aches.

Dr. Fukuda said health officials are at a loss to explain why those in Mexico are suffering more severe symptoms than others elsewhere in the world.

US closes 100 schools as swine flu spreads

WASHINGTON - The swine flu outbreak began taking a toll on the US overnight, spreading to 11 states and closing schools amid confirmation of the first US death - a Mexican toddler who was visiting Texas with his family.

In California, dozens of Marines were confined after one came down with the disease.

Some 100 schools were closed, and more might need to be shut down temporarily, President Barack Obama said, declaring, "This obviously is a serious situation."

Swine flu death toll

The total confirmed cases in the US rose to nearly 100, with many more suspected.

The Geneva-based World Health Organisation sounded its own ominous alarm, raising its alert level to one notch below a full-fledged global pandemic.

Said WHO Director General Margaret Chan: "It really is all of humanity that is under threat during a pandemic."

Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention, said in Atlanta there were confirmed cases in ten states, including 51 in New York, 16 in Texas and 14 in California. In other swine flu news.

The CDC also counted scattered cases in Kansas, Massachusetts, Michigan, Arizona, Indiana, Nevada and Ohio.

State officials in Maine said laboratory tests had confirmed three cases in that state, not yet included in the CDC count.

And the Pentagon said a Marine at the Twentynine Palms base in California had been confirmed to be ill with swine flu and was isolated, along with his roommate.

A Marine spokesman at the Pentagon, Major David Nevers, said the sick Marine was doing well and his condition continued to improve. Nevers said about 30 others who had been in contact with the sick Marine would be held apart for five days as well as to see if they show symptoms.

In Mexico, where the flu is believed to have originated, officials said Wednesday that the disease was now suspected in 159 deaths - though the WHO has so far confirmed only seven were from swine flu - and nearly 2,500 illnesses.

The first death in the United States from the flu was a Mexico City toddler who travelled to Texas with his family to visit relatives.

Texas' health director, Dr David Lakey, told a news conference that it was "highly likely" that the boy contracted the disease in Mexico before his trip to the US.

Officials in Brownsville were trying to trace his family's trip to find out how long they were in the area, who they visited and how many people were in the group, said Cameron County Judge Carlos Cascos.

The boy, who was 23 months old, had "underlying health issues" before he flew to Matamoros, Mexico, on April 4 and crossed into Brownsville to visit relatives, state health officials said.

Swine Flu News

Mexico death toll stabilizes as epidemic spreads

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The toll from the swine flu epidemic appears to be stabilizing in Mexico, the health secretary said late Tuesday, with only seven more suspected deaths. But an outbreak of the virus at a New York school showed it is capable of repeated jumps between humans - meaning it can keep spreading around the world.

The new virus is suspected in 159 deaths and 2,498 illnesses across Mexico, said Health Secretary Jose Cordova, who called the death toll "more or less stable" even as hospitals are swamped with people who think they have swine flu. And he said only 1,311 suspected swine flu patients remain hospitalized, a sign that treatment works for people who get medical care quickly.

The positive news came even as the first two countries announced travel bans on flights from Mexico, the center of the epidemic, and as confirmed cases were reported for the first time as far away as New Zealand and Israel, joining the United States, Canada, Britain and Spain.

The United States stepped up surveillance at its borders and swarned Americans to avoid non-essential travel to Mexico. Canada, Israel and France issued similar travel advisories. And Cuba became the first country to impose an outright ban on travel to the epicenter of the epidemic.

Argentina soon followed with its own ban, and ordered 60,000 visitors who arrrived from Canada, Mexico and the U.S. in the past 20 days to contact the Health Ministry.

Meanwhile, Mexico was eliminating reasons for tourists to visit. On Tuesday, the pyramids and all other archaeological sites were put off limits nationwide and restaurants in the capital were closed for all but take-out food in an aggressive bid to stop gatherings where the virus can spread.

Experts on epidemics said these kinds of government interventions are ineffective, since this flu - a never-before-seen blend of genetic material from pigs, birds and humans to which people have no natural immunity - is already showing up in too many places for containment efforts to make a difference.

Outside Mexico, confirmed cases were reported for the first time as far away as New Zealand and Israel, joining the United States, Canada, Britain and Spain. The U.S. Centers for Disease Control and Prevention said the U.S. has 66 confirmed cases in five states, with 45 in New York, one in Ohio, one in Indiana, two in Kansas, six in Texas and 11 in California.

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

Instead, they say, governments should do more to provide medical help to people with swine flu symptoms, since the virus is proving to be treatable if diagnosed early.

U.S. officials stressed there is no need for panic, noting that flu outbreaks are quite common every year. The CDC estimates about 36,000 people in the U.S. alone died of flu-related causes each year, on average, in the 1990s.

Cordova said many of the people crowding hospital waiting rooms complaining of swine flu symptoms actually suffered from other ailments - and many of those suspected of having the virus were treated and sent home.

"You can see the total of new cases," Cordova said, pointing to bar charts that showed a rise and fall. "In the last days there has been a drop."

Cordova said that with U.S. help, new testing facilities in Mexico will soon have the capacity to test 150 samples a day for the new strain of swine flu. Currently, it must send samples to the CDC or Canadian labs, which is the main reason why only 26 of the 159 deaths have been definitively confirmed to be swine flu.
Associated Press Writers Sara Kugler, Cristian Salazar, Marcus Franklin and Samantha Gross in New York; Istra Pacheco, Peter Orsi, Julie Watson and E. Eduardo Castillo in Mexico City; Mike Stobbe in Atlanta; Mary Clare Jalonick, David Espo, Philip Elliott

Swine flu fear catching fast in weak world economy

NEW YORK -- The swine flu outbreak is unleashing a side effect the global economy is in no condition to handle: fear.

Travelers are canceling or delaying trips to Mexico, Cuba banned all flights to its neighbor and Argentina announced Tuesday a five-day ban on flights arriving from Mexico. China, Russia and South Korea have banned imports of some North American pork, despite assurances that the flu is not spread through meat. Investors just starting to regain their nerve have again caught the jitters.

The threat of a pandemic comes just as the world economy is showing the barest glimmerings of what analysts say might be the light at the end of what remains a long, dark tunnel. And now this.

"This is just another negative shock when the economy can least afford another negative shock," said Jay Bryson, global economist at Wachovia Corp.

So far, fear of the flu is at least as responsible for the economic disruption as the disease itself.

The number of confirmed cases in the United States climbed to 66, and federal officials warned that deaths were likely. 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 disease.

Economists remember well the financial damage the SARS outbreak inflicted in 2003. An epidemic of that scale or greater could inflict severe damage on a global economy already badly listing.

"On top of a synchronized global financial and economic crisis, an outbreak of swine fever is the last thing we need just now," Neil MacKinnon, chief economist at The ECU Group PLC, based in London, wrote this week.

There are already early signs that swine flu fear is taking an economic toll.

In Mexico City, canceled events and closed movie theaters, night clubs, museums and other establishments are costing at least $57 million a day, according to city's Chamber of Trade, Services and Tourism.

That's a 36 percent drop in revenue generated by tourism and services in the Mexican capital, chamber president Arturo Mendicuti said.

Royal Caribbean Cruises suspended stops at Mexican ports indefinitely, and Carnival Cruise Lines canceled Mexico port calls through May 4. Norwegian Cruise Line canceled the Norwegian Pearl's final two calls in Mexico this week and said its schedules do not include any other ports in Mexico until the end of September 2009.

In Chicago, traders bid down the price of pork futures Tuesday for a second straight day, reflecting what analysts say are consumer worries about catching the virus from meat. The drop in prices came even as China - the third-biggest market for exports of U.S. pork - banned shipments of the meat from California, Texas and Kansas, along with those from Mexico. Russia and South Korea have announced similar measures.

The bans caused consternation for U.S. pork farmers, despite assurances from public health agencies that the flu isn't spread by eating meat.

"We have everybody ... all saying pork is safe to eat and that this isn't in the swine herd, definitely not in the U.S. swine herd," said Dave Warner, of the National Pork Producers Council. "I think the economics right now is being driven by fear of what could happen, rather that what really is happening."

Agriculture Secretary Tom Vilsack even pushed to change the name of swine flu to protect the hog market.

Canada's swine flu cases jump to 13, all mild

VANCOUVER, British Columbia (Reuters) - The number of confirmed cases of swine flu in Canada increased to 13 on Tuesday, as Canadians were urged to avoid unnecessary travel to Mexico and tour operators postponed flights between the countries.

Ontario, the country's most populous province, confirmed its first four swine flu cases, and Alberta said it now had two cases. British Columbia, which already had two cases, said it now had three.

"Thankfully all of these cases have been mild," said Federal Health Minister Leona Aqlukkag.

Provincial health officials said all the people who have contracted the flu had recently traveled to Mexico, which is a popular holiday destination for Canadians.

Canada has predicted the number of confirmed swine flu cases in the country would increase as screening continued.

"It's only a matter of time given the number of people who come and go to Mexico," said David Williams, Ontario's acting chief medical officer.

The Public Health Agency of Canada advised citizens to avoid nonessential travel to Mexico because of the deadly flu outbreak there, echoing an advisory issued by the United States on Monday. Some 159 Mexicans have died in the outbreak.

Canada has also increased the screening of people returning from Mexico.

Tour operator Transat AT said it was postponing its flights to Mexico until June 1, and would maintain flights or add flights from Mexico until May 3 to bring back customers and employees.

The Montreal-based company also said it was postponing flights from France to Mexico until May 31.

Calgary-based WestJet Airlines Ltd said it will cease service to Cancun, Cabo San Lucas, Mazatlan and Puerto Vallarta, effective May 4. It said it planned to resume service to the latter three destinations on June 20.

Air Canada said it will suspend all operations to Cancun, Cozumel and Puerto Vallarta until June 1, but maintain flights to Mexico City.

And even though health officials say people cannot get swine flu from eating pork, Canada's hog farmers are worried about the name association. The Canadian Pork Council issued a statement asking government officials to stop calling the virus the swine flu and instead call it North American influenza.

(Additional reporting by Scott Haggett, David Ljunggren and Jeffrey Hodgson; Editing by Eric Walsh and Todd Eastham)

Mexico Ministry Suspects 159 Deaths From Swine Flu

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April 28 (Bloomberg) -- Mexico’s government raised the number of deaths suspected to be caused by swine flu to 159 and officials said the rate of fatalities is stabilizing.

Hospitalizations for suspected cases of the illness have declined, Mexican Health Minister Jose Cordova said today at a news conference in Mexico City. There are 1,311 people in the hospital with flu symptoms, he said. The Health Ministry’s fatality estimate increased from 152 yesterday.

Government officials have ordered schools shut nationwide until May 6 and have told some businesses to close as the suspected death toll climbs from the flu outbreak. Authorities have told people not to gather in large groups and to avoid shaking hands and kissing hello to contain the virus.

Most cases are still limited to Mexico City and the states of Mexico and San Luis Potosi.

Canada, the European Union, Argentina, Israel, the U.S. and some Asian countries have advised their citizens against travel to Mexico, threatening the country’s economy. Tourism generated revenue of $13.3 billion last year.

To contact the reporter on this story: Crayton Harrison in Mexico City at tharrison5@bloomberg.net
Last Updated: April 28, 2009 22:53 EDT

U.S. stays on guard as flu cases grow

The number of confirmed U.S. cases of swine flu is rising, but no cases have been reported in Florida even as some concerned people are stocking up on masks and medicine.

BY FRED TASKER AND ANDRES VIGLUCCI

The number of confirmed U.S. swine flu cases rose from 45 to 66 on Tuesday as health officials warned that at least some American fatalities are likely.

None of the confirmed cases was in Florida, and the number of U.S. cases remains small compared with the outbreak's epicenter, Mexico, where about 150 people are reported to have died from the new, highly contagious viral strain.

Still, some worried South Floridians carried out a run on prescription anti-viral drugs, surgical masks, gloves and even gowns at medical supply shops and pharmacies.

Three cruise lines, including Miami-based Carnival, canceled stops at popular ports in Mexico over swine flu concerns, though some competitors said there is little reason for concern because their ships are carefully sanitized.

And President Obama asked Congress on Tuesday to add $1.5 billion to his 2009 supplemental budget request to help fight the outbreak.

U.S. public health officials stressed there is no need to take drastic measures, such as avoiding crowds, but advised people to undertake common-sense precautions, especially frequent handwashing and covering mouth and nose with a tissue when coughing or sneezing.

NO IMMUNITY

They did stress that swine flu was certain to spread because people have no immunity to the novel strain and no vaccine as yet exists.

''This is something people should keep an eye on and keep informed,'' said Dr. Vincent Conte, chief physician for the Miami-Dade Health Department. ``Right now, it hasn't reached a panic stage where you should avoid neighbors, public events, shopping malls.''

At least seven people with swine flu were hospitalized in the United States, including two in New York City, where 44 of the nation's confirmed cases are concentrated -- most at a Catholic school where some students recently returned from a spring break trip to Mexico. The city's health commissioner said ''hundreds'' more schoolchildren were ill with what was likely swine flu.

Some U.S. fatalities are probably inevitable, a top federal health official said Tuesday.

''As we continue to investigate cases here, I expect that we will see deaths in this country,'' said Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention, during a Washington, D.C., news conference.

GROWING THREAT

Besser's prediction reflects the growing threat posed by the virus and the inability of health officials both here and abroad to contain its spread around the world. At least seven countries have confirmed cases of swine flu and officials in Israel, New Zealand, Spain and Canada announced new infections on Tuesday as the virus continues to migrate across Europe and parts of the Middle East.

''No single action that somebody takes, whether it be the government, a community, a family or an individual, will halt this. But the combined actions that we all take together will reduce the impact on our communities and on our health,'' Besser said.

In a letter to Congress, President Barack Obama said the money he requested could be used to help boost stockpiles of antiviral medications, develop a swine flu vaccine or assist international efforts to stem the outbreak.

Some in South Florida weren't waiting, however.

At Surgical World, a medical supplies store in Hollywood, manager Alicia Hubbard reported brisk sales of surgical masks, latex gloves and even a few operating-room isolation gowns of the type worn by surgeons.

Many Hundreds of Kids Sick, Possible Swine Flu

New York Mayor Michael Bloomberg says these illnesses are separate from the outbreak at a private school in Queens.

Wow. It keeps getting worse! More shocking reports keep coming out about the seriousness of the swine flu outbreak here in the U.S. Now New York Mayor Michael Bloomberg says two people are hospitalized with suspected swine flu, and the city's Health Commissioner says "many hundreds" of schoolchildren are sick -- all with suspected cases of swine flu.

Bloomberg says these illnesses are separate from the outbreak at a private school in Queens. If they are found to be swine flu, they would be the first in the U.S. connected to the outbreak. The mayor says the hospitalized are a child in the Bronx and an adult in Brooklyn.
swine flu outbreak in new york

Getty Images

The U.S. has more than 60 reported cases of swine flu, mostly in New York City. Now the Los Angeles County Coroner is also investigating two deaths they suspect to be related to swine flu and Governor Schwarzenegger has declared a state of emergency to help deal with the outbreak.

In related news, Carnival Corp. has announced they have suspended stops at Mexican ports for their cruises. The company says it canceled Mexico stops for three ships scheduled to visit the country Tuesday. It hasn't yet announced a decision on future stops there.

Other cruise lines, including Royal Caribbean International and Norwegian Cruise Line, are trying to calm nervous travelers by emphasizing the cleanliness of their ships. Royal Caribbean says it's monitoring the situation, but telling passengers not to worry because the outbreaks are inland, not in the Mexican coastal cities popular with cruise tourists.

Cuba has also become the first country to suspend all flights to and from Mexico as a precaution.

With a few simple steps, you can protect yourself and your family. ML's pediatrician Dr. Cara Natterson says:

1. Hand washing, hand washing, hand washing. We put our hands in our mouths often; our kids do so even more. By washing our hands regularly -- especially before eating -- we reduce the likelihood that we will ingest the virus that causes swine flu.

2. If your child doesn't feel well, keep him home. This protects others from catching whatever your child has, and it protects your child from picking up a new infection. When we are sick and our immune system is busy fighting one infection, we may be more susceptible to another. For this reason, being out and about -- at school or work or even just running errands -- while sick is not a good idea. (However, there is no need to keep healthy kids home from school at this point in time.)

3. Cover your mouth when coughing or sneezing. Teach your children to cough into their elbow (by pulling the entire arm across the face). This way, when they cough, the germs that come out aren't on their hands, ready to be smeared onto doorknobs, desks, countertops, and so on.

Mexico's Mystery: Why Is Swine Flu Deadlier There?

The swine flu virus continued its gradual global march on Tuesday, prompting countries to strengthen efforts to stem its spread, while President Barack Obama asked Congress for $1.5 billion in supplementary spending to prepare for a possible swine flu pandemic and installed the newly confirmed Secretary of Health and Human Services, Kathleen Sebelius, to help lead the fight against the disease. In the U.S., the caseload rose to 67 across five states — 45 of them in New York City, where health officials are investigating two new possible outbreaks at city schools — with more virus samples awaiting laboratory confirmation. New Zealand and Israel also confirmed its first cases, while Canada, the U.K. and Spain saw small upticks in their swine flu caseloads.

Several countries tightened border controls and discouraged travel to affected areas — Cuba suspended all flights to and from Mexico — but the World Health Organization kept the pandemic alert level at phase 4, still two phases below a full pandemic. Outside Mexico, the apparent epicenter of the A/H1N1 virus, there have been no deaths confirmed from the flu and relatively few hospitalizations, and health officials continued to preach the need for a calm response. "What we see in the United States, or have been seeing so far, has been milder," said Richard Besser, the acting director for the Centers for Disease Control. (See pictures of the swine flu in Mexico.)

But Mexico seems to be experiencing a very different — and much scarier — outbreak than the rest of the world. More than 2,000 suspected swine flu cases have now been reported in several Mexican states, with more than 150 deaths. Those numbers are still preliminary and are expected to rise as blood samples from Mexican patients continue to be tested for the A/H1N1 swine flu virus. Lack of laboratory capacity to run the time-consuming blood tests has so far held up the confirmation of cases there.

On Tuesday the government of Mexico City ordered gyms, discos, theaters and all sit-down restaurants (excluding those that serve only take-out) closed until at least May 6, in an effort to limit public gatherings and the spread of the virus. As epidemiologists swarm the country in an effort to trace its spread, the big question remains: Why is the disease seemingly so much more deadly in Mexico than anywhere else? "This will be the object of a great deal of research and attention," said Keiji Fukuda, the World Health Organization's (WHO) interim director-general for health, safety and environment. "But we can't say why there seems to be a difference." (See the 5 things you need to know about swine flu.)

The WHO will convene an expert panel on April 29, which will attempt to answer that question, but one way to begin is to look at where the virus originated. Epidemiologists appear to be honing in on a possible ground zero in the Mexican Gulf Coast state of Veracruz, in a town called Perote, which is home to a large pig farm owned by the U.S. company Smithfield Foods. Flu-like cases began popping up there in early April, before the first confirmed case in Mexico on April 13.

But the truth is that even though the virus is referred to as swine flu, researchers do not yet know for sure that the A/H1N1 virus actually originated in pigs. There's been no evidence yet of pigs getting sick, in either Mexico or in the U.S. (Despite several countries' bans on pork imports, it's important to remember that the disease cannot be contracted by eating pork.) The original reservoir for flu viruses is actually wild birds, which can spread infection to domestic birds and people — as we saw with the H5N1 avian flu in Asia — and to pigs. Pigs make particularly good biological mixing bowls, since they can be infected by bird, swine and human flu viruses and provide a hospitable environment for the viruses to swap genes and create entirely new strains in a process called reassortment. That is what may have happened with the A/H1N1 swine flu virus, which contains genes from bird, pig and human flu viruses. "When you get a large concentration of pig farms, people, wild bird and poultry, these things do happen," says Peter Daszak, the president of the Wildlife Trust and an expert on emerging diseases.

In recent years, since the ongoing H5N1 bird flu virus first surfaced, health officials have focused mostly on Asia as the breeding ground for the world's next pandemic flu virus. But Daszak points out that Mexico, where people, pigs and poultry can exist in close proximity, is an overlooked hotspot for new viruses. Given the booming global livestock trade — more than 1.5 billion live animals have been shipped to the U.S. from all over the world in the past decade — it's possible that the A/H1N1 virus originated in an Asian bird that was exported to Mexico, where it may have reassorted in a pig before infecting people. Far more investigation is still needed, but it's clear that while U.S. officials were looking for flu exports from Asia, they should have also improved surveillance in their southern neighbor. "I think it might have been possible to prevent it," says Daszak. "We should be paying more attention to our own backyard."

Now that the swine flu virus seems well established in human beings, containment is no longer an option. The public health response must be to slow the spread, which means getting a better handle on the virus. While the difference in severity in cases between Mexico and the U.S. would suggest that there are different viruses affecting the two countries, researchers have genetically sequenced swine flu viruses from both Mexican and American victims, and "we see no difference in the viruses infecting sick people and less sick people," said Fukuda. Even if there were genetic differences, it wouldn't necessarily mean much — scientists still don't know exactly which genes do what on flu viruses.

The Mexican deaths may also be attributable to some underlying co-infection or health problem that is simply not present in the U.S. cases — but that will require more investigation to uncover.

It's possible also that A/H1N1 began life in Mexico especially virulent — that country has apparently been grappling with the virus for weeks longer than the U.S. — and evolved to become less dangerous by the time it crossed the border. That would not be an unusual evolutionary device, since viruses that are too deadly cannot survive if they kill off their host before they get the chance to spread. "It's fairly common in epidemics to see a tradeoff between the ability to cause severe death and transmissibility," says Steven Kleiboeker, a virologist and the chief scientific officer for ViraCor Laboratories. The A/H1N1 virus may be attenuating itself as it spreads from person to person, becoming easier to catch but less dangerous. (Read: "CDC Readies Swine Flu Vaccine.")

The WHO, however, says that so far the virus appears to have stayed relatively stable during the chains of transmission, so it may not be mutating much. Still, the virus's current relatively weak state does not guarantee that it won't return later much more virulent — exactly what happened in the 1918 flu pandemic, which killed at least 50 million people worldwide. As the flu season comes to an end in the Northern Hemisphere, it may lead to a natural petering out of new swine flu cases in the U.S. But the strain may continue to circulate aggressively in the Southern Hemisphere, which is just now entering its flu season, then return to the north next winter.

Any conclusions now will be premature, because we still don't know what we're looking at. Experts predict we'll eventually begin to see fewer new cases in Mexico, as lab results separate real swine flu infections from normal respiratory disease. Officials also anticipate more cases in the U.S., as well as fatalities, as the nationwide investigation deepens. "We expect to see more cases and we expect to report on them," says Besser. "As this moves forward, I fully expect that we will see deaths from this infection." As Besser himself has pointed out, swine flu is going to be a marathon, not a sprint — and we've only just gotten started.

Read: "How to Deal with Swine Flu: Heeding the Mistakes of 1976."

World flu fears sharpen as more cases detected

MEXICO CITY (AFP) — Airlines and tour operators suspended flights to Mexico as new cases of a deadly strain of swine flu were confirmed across the globe and officials warned of more fatalities.

The United States cautioned it may soon see its first deaths from the virus, which thus far has proved fatal only in Mexico.

Mexico has revised downwards its confirmed death toll from swine flu to seven, from 20, Health Minister Jose Angel Cordova told reporters.

US health authorities on Tuesday raised sharply the number of confirmed US cases to at least 65, and California declared a state of emergency.

Costa Rica became the first Central American nation to detect a confirmed case, while Europe, Israel and New Zealand increased their counts.

The World Health Organization (WHO) said it would convene experts from affected countries on Wednesday, and they would give a briefing on what is known about the disease.

The body has increased its official level of alarm but not declared an outright pandemic, despite the spread of the flu from Mexico to seven other countries.

But it was clear many companies and authorities were already treating the emergency as a global issue.

"Swine flu is an international problem now, it's crossed two continents, it's got to be dealt with by international agreements," British Prime Minister Gordon Brown told reporters in Poland.

The United States named nine countries that have erected trade barriers to US pork and swine imports amid the swine flu epidemic despite experts' insistence that the virus -- a version of swine flu identified as A/H1N1 -- could not be caught from eating meat from pigs.

Seven countries had imposed bans on pork and pork products from the United States: China, Ukraine, Kazakhstan, Philippines, Thailand, United Arab Emirates and Ecuador, Nefeterius McPherson, a spokeswoman for US Trade Representative Ron Kirk, told AFP.

China, which has the world's largest pig population, and South Korea have banned live swine from the US, McPherson said, and Russia has banned all meat products from five states: California, Texas, Kansas, New York and Ohio.

US and WHO officials were reportedly debating whether to change the common name for the virus from "swine flu" to another nomenclature, possibly "North American flu" to dissociate it from perceptions it was spread through contact with animals and animal products.

The governments of Australia, Britain, Canada, France, Sri Lanka and Switzerland became the latest to advise against travel to Mexico, while Cuba suspended all flights to and from Mexico until Friday.

A Canadian airline, Air Transat, said it was halting flights to Mexico until June 1, and French and British travel firms announced they, too, were suspending trips to the country. Germany's leading tourism group TUI said Monday it would cancel Mexico City visits until May 5.

US President Barack Obama is seeking 1.5 billion dollars from Congress to boost US efforts to contain the flu's spread, the White House said.

The urgency given to his move came as authorities in California declared their state of emergency and said they had detected a death in Los Angeles that might have resulted from the virus. Another suspect death was found to not be flu-related.

World oil prices dropped further Tuesday to just under 50 dollars a barrel, extending a decline seen Monday on fears the flu would sap a nascent recovery from the global financial crisis. US stocks also dipped on the fears.

In Mexico, the capital ordered the closure of all venues where people congregate, including eateries, bars, gyms and cinemas, in a further clampdown against the disease.

The country's federal government had already closed schools and restricted the opening of bars and restaurants as it grapples with a toll of 20 confirmed flu deaths and the deaths of another 132 likely due to the virus.

Mexico has more than 1,600 cases of patients suspected to be infected with swine flu, overwhelming its health system.

Amid the strenuous reactions to the flu, questions were being asked about particularities of this flu virus, namely: Why have all the confirmed deaths so far been in Mexico? And how easily can the virus spread?

"We don't have information on how it acts, how it transmits," said Gregory Hartl of the World Health Organization.

Theories included the patients who died in Mexico being treated too late or with insufficient antiviral drugs, or that, possibly, the H1N1 viral strain had mutated into a less virulent form as it moved out of Mexico, according to John Oxford, a top virologist at the Royal London Hospital.