Swine Flu Pandemic Declared Imminent as World Alert Raised

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By Tom Randall

April 29 (Bloomberg) -- The World Health Organization warned the first influenza

pandemic since 1968 is " imminent " and urged stepped-up preparations after swine

flu was confirmed in at least nine countries and 11 U.S. states.

WHO raised the level of its six-tier alert system to 5, indicating little time

remains for countries to complete emergency plans. U.S. cases jumped to 94, from

64 yesterday, with hundreds of suspected cases at New York schools. President

Barack Obama asked Congress for $1.5 billion for an outbreak and warned parents

to prepare for school closings.

Mexico, where the toll is highest, said 159 people may have died. Egypt ordered

the immediate slaughter of the country's pigs, numbering as many as 400,000,

said a spokesman for the country's mission to the United Nations. French Health

Minister Roselyne Bachelot will ask European transport ministers to suspend

flights to Mexico, she told reporters in Paris today. Development of a vaccine

is being hastened, U.S. officials said.

" It is all of humanity that is under threat during a pandemic, " Margaret Chan,

WHO director-general, said at a news conference in Geneva. " The biggest question

right now is this: How severe will the pandemic be? All countries should

immediately now activate their pandemic plans. "

Sanofi-Aventis SA , Baxter International Inc. and GlaxoKline Plc are

talking with world health authorities about how to speed production of a vaccine

to meet the global outbreak.

Vaccine Makers on `Alert'

" A strain has been identified, " U.S. Health and Human Services Secretary

Kathleen Sebelius said at a news conference in Washington. " Manufacturers are on

the alert. Once the testing protocol is done and the dosage protocol is done,

they are ready to begin production, should that be necessary. "

Baxter will receive a sample of the swine flu virus " in the next couple days, "

said Bona, a spokesman for the Deerfield, Illinois, company, in a

telephone interview today.

" We are in constant discussions with the government about how and if we should

go ahead, " Donna Cary, a spokeswoman for Sanofi's Sanofi-Pasteur unit in

Swiftwater, Pennsylvania, said today in an interview. London-based Glaxo and

Novartis AG of Basel, Switzerland, also are talking with health regulators, said

spokesmen for the companies.

Obama said officials should consider closing schools where flu cases are

suspected and parents should plan for contingencies. Texas Governor Rick

declared a disaster, a " preemptive " measure to facilitate emergency preparations

and seek federal reimbursement. California Governor Arnold Schwarzenegger

declared a state of emergency yesterday.

Pigs are Safe

While the virus originated in pigs, infections in people aren't related to

exposure to the animals and properly prepared pork remains safe to eat, said

Keiji Fukuda, WHO assistant director-general for health security and

environment. The disease, spreading like the seasonal flu, is `unlikely' to

stop, Fukuda said.

" It's clear that deaths and serious illnesses can occur in other countries, but

more are occurring in Mexico, " Fukuda said. " We don't know the reason for that

right now. " The genetic strains around the world that have been tested are

" remarkably consistent and remarkably similar to each other, " he said.

Scientists are trying to determine why swine flu, a respiratory disease of pigs

caused by a type-A influenza virus, has been more severe in Mexico. The new flu

results in symptoms similar to those of seasonal influenza, such as fever,

lethargy and coughing, and may also cause nausea and vomiting, according to the

CDC. It appears to be causing more diarrhea than seasonal flu, WHO said.

Death in U.S.

The first death in U.S. was a 22-month-old boy from Mexico City who was brought

to Texas Children's Hospital in Houston last weekend, the state health

department said today in a statement. The boy had " several underlying health

problems, " the statement said.

The U.S. can expect more hospitalizations and deaths, Sebelius said today in her

first press conference after being confirmed secretary of Health and Human

Services. Hand-washing and hygiene are among the most effective ways to control

the outbreak, she said.

" We have been preparing all along as if this is going to stage 6, " Janet

Napolitano, U.S. Homeland Security secretary, said today at a news conference in

Washington. " Our preparations are for a situation in which this does become a

full-fledged pandemic. "

Second Time

WHO raised its global pandemic alert twice this week. It's the first time the

warning has been raised above a 3 since the six-step system was adopted in 2005.

It had been at level 3 since 2007, when it was elevated for an outbreak of avian

flu.

A stage 5 warning is " a strong signal that a pandemic is imminent " with little

time left for preparation, according to the WHO Web site. A pandemic, rated 6 on

WHO's alert system, is an unexpected outbreak of a new contagious disease that

spreads from person to person across borders. In such cases, almost no one has

natural immunity.

Every year in the U.S., 5 percent to 20 percent of the population gets seasonal

flu. The virus affects the nose, throat and lungs, and peaks from late-November

through March, according to the CDC. About 200,000 Americans are hospitalized

annually from the seasonal flu, and 36,000 die, said the CDC Web site. A

widespread outbreak of a new strain could increase deaths and sicken millions

worldwide, world health officials said.

Sports Canceled

Athletic, academic and music competitions were canceled for more than 1 million

students in Texas until May 11, according to the Texas University

Interscholastic League, the largest inter- school organization of its kind in

the world.

The New York cases originated from students at St. Francis Preparatory School in

Queens. A group from the Roman Catholic school returned recently from a trip to

Cancun, health officials said. New York accounts for 51 of the 91 confirmed

cases in six states, U.S. officials said.

At P.S. 177, a public school for autistic children in New York near St. Francis

in Queens, 82 students have called in sick and, and six students are being

tested at Ascension school in Manhattan's Upper West Side, Mayor

Bloomberg told reporters yesterday. Most family and staff suspected of having

the flu haven't been tested, the mayor said.

Two other people, a woman in Brooklyn and a boy in the Bronx, were hospitalized

with suspected cases associated with travel to Mexico, Bloomberg said.

Speed, Ferocity

White House press secretary Gibbs said Obama requested more money

yesterday to help build stockpiles of anti- viral drugs, work on vaccines and

coordinate the U.S. response with other governments.

The money is meant " to ensure we have the resources available " at federal, state

and local levels to deal with any wider spread of the virus, Gibbs said.

The biggest concern is whether the virus is establishing itself outside Mexico,

said WHO's Fukuda, on a conference call today with reporters.

" There is definitely the possibility that this virus can establish that kind of

community-wide outbreak capacity in multiple countries, " Fukuda said. " It's a

very serious possibility, but it's still too early to say that it's inevitable. "

California Emergency

California Governor Arnold Schwarzenegger declared a state of emergency to help

the most populous U.S. state with 37 million people prepare for an outbreak.

Schwarzenegger ordered state agencies to use whatever government personnel,

equipment and facilities needed to help the health department. He also

authorized the agency, along with the state's Emergency Medical Services

Authority, to enter contracts with private companies without competitive bids.

The outbreak in Mexico City prompted the local government yesterday to order a

halt to dining service at all 35,000 restaurants.

U.S. officials recommended that nonessential travel to Mexico be avoided and the

European Union told travelers to avoid outbreak areas. Malaysia today asked the

WHO to ban outbound travel from Mexico by people who are ill.

Senate Majority Leader Harry Reid urged calm. He said a vaccine will probably be

developed by the time next flu season starts in North America.

An experimental vaccine for swine flu may be tested in people within a couple of

months, according to Fauci, director of the U.S. National Institute of

Allergy and Infectious Diseases. Reference strains for the virus have been

distributed and a pre-planned development process is under way, Fauci said at a

press conference today in Washington.

Swine vs. Seasonal

Production of influenza vaccine for seasonal outbreaks, which U.S. health

officials have said is ineffective against the new flu, should continue, Fukuda

said.

Japan suspended visa-free entry for Mexican nationals. Countries including

Australia, Singapore and South Korea are screening air passengers, and Taiwan

advised against visiting Mexico.

Australia is testing 112 people for swine flu, and 90 airline passengers showing

flu symptoms have been detained through medical checks for further tests.

Authorities are searching for 15 people who were on a plane from Mexico two days

ago with New Zealanders who have been affected, Health Minister Nicola Roxon

said.

Imports Suspended

South Korea will suspend imports of live hogs from North America starting today,

the Ministry for Food, Agriculture, Forestry and Fisheries said. Indonesia said

April 27 it will destroy all imported pork and swine products and fumigate

agricultural goods bought from Canada, the U.S. and Mexico as a precaution.

China, the world's top pork consumer, banned imports of swine products from

Mexico and parts of the U.S.

WHO isn't recommending travel restrictions.

Scientists are trying to determine why swine flu, a respiratory disease of pigs

caused by a type-A influenza virus, has been more severe in Mexico. The disease

results in symptoms similar to those of seasonal influenza, such as fever,

lethargy and coughing, and may also cause nausea, vomiting and diarrhea,

according to the CDC. It appears to be causing more diarrhea than seasonal flu,

the WHO said.

Worst Case

The World Bank, in a worst-case scenario published in October, said a flu

pandemic that's similar in scope to the 1918 outbreak known as the Spanish flu

could kill 71 million people worldwide and push the economy into a " major global

recession " costing more than $3 trillion.

The U.S. Food and Drug Administration signed emergency authorizations April 27

that will permit the CDC to use an unapproved lab test for swine flu and more

dosing options than currently recommended for influenza treatments Tamiflu, sold

by Swiss drugmaker Roche Holding AG, and Relenza, from Glaxo.

The New York City mayor is founder and majority owner of Bloomberg News parent

Bloomberg LP.

To contact the reporter on this story: Tom Randall in New York at

trandall6@....

Last Updated: April 29, 2009 17:10 EDT