Update: 68 dead of flu, 1004 infected in Mexico. Possibly 83 infected in the US.

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http://www.wbt.com/news/details.cfm?ap_id=D97P8SCO0

Mexico swine flu deaths spur global epidemic fears

MEXICO CITY, 04.25.2009

By MARK STEVENSON , Associated Press Writer

A unique strain of swine flu is the suspected killer of dozens of people in

Mexico, where authorities closed schools, museums, libraries and theaters in the

capital on Friday to try to contain an outbreak that has spurred concerns of a

global flu epidemic.

The worrisome new virus _ which combines genetic material from pigs, birds and

humans in a way researchers have not seen before _ also sickened at least eight

people in Texas and California, though there have been no deaths in the U.S.

" We are very, very concerned, " World Health Organization spokesman

Abraham said. " We have what appears to be a novel virus and it has spread from

human to human ... It's all hands on deck at the moment. "

The outbreak caused alarm in Mexico, where more than 1,000 people have been

sickened. Residents of the capital donned surgical masks and authorities ordered

the most sweeping shutdown of public gathering places in a quarter century.

President Felipe Calderon said his government only learned late Thursday, with

the help of international laboratories, what kind of virus Mexico is faced with.

" We are doing everything necessary, " he said after meeting with his Cabinet to

coordinate a response. " We understand the seriousness of the problem. "

The WHO was convening an expert panel to consider whether to raise the pandemic

alert level or issue travel advisories.

It might already be too late to contain the outbreak, a prominent U.S. pandemic

flu expert said late Friday.

Given how quickly flu can spread around the globe, if these are the first signs

of a pandemic, then there are probably cases incubating around the world

already, said Dr. Osterholm at the University of Minnesota.

In Mexico City, " literally hundreds and thousands of travelers come in and out

every day, " Osterholm said. " You'd have to believe there's been more

unrecognized transmission that's occurred. "

There is no vaccine that specifically protects against swine flu, and it was

unclear how much protection current human flu vaccines might offer. A " seed

stock " genetically matched to the new swine flu virus has been created by the

U.S. Centers for Disease Control, said Dr. Besser, the agency's acting

director. If the government decides vaccine production is necessary,

manufacturers would need that stock to get started.

Authorities in Mexico urged people to avoid hospitals unless they had a medical

emergency, since hospitals are centers of infection. They also said Mexicans

should refrain from customary greetings such as shaking hands or kissing cheeks.

At Mexico City's international airport, passengers were questioned to try to

prevent anyone with flu symptoms from boarding airplanes and spreading the

disease.

Epidemiologists are particularly concerned because the only fatalities so far

were in young people and adults.

The eight U.S. victims recovered from symptoms that were like those of the

regular flu, mostly fever, cough and sore throat, though some also experienced

vomiting and diarrhea.

U.S. health officials announced an outbreak notice to travelers, urging caution

and frequent handwashing, but stopping short of telling Americans to avoid

Mexico.

Mexico's Health Secretary Angel Cordova said 68 people have died of flu and

the new swine flu strain had been confirmed in 20 of those deaths. At least

1,004 people nationwide were sick from the suspected flu, he said.

The geographical spread of the outbreaks also concerned the WHO _ while 13 of

the 20 deaths were in Mexico City, the rest were spread across Mexico _ four in

central San Potosi, two up near the U.S. border in Baja California, and one

in southern Oaxaca state.

Scientists have long been concerned that a new flu virus could launch a

worldwide pandemic of a killer disease. A new virus could evolve when different

flu viruses infect a pig, a person or a bird, mingling their genetic material.

The resulting hybrid could spread quickly because people would have no natural

defenses against it.

Still, flu experts were concerned but not alarmed about the latest outbreak.

" We've seen swine influenza in humans over the past several years, and in most

cases, it's come from direct pig contact. This seems to be different, " said Dr.

Arnold Monto, a flu expert with the University of Michigan.

" I think we need to be careful and not apprehensive, but certainly paying

attention to new developments as they proceed. "

The CDC says two flu drugs, Tamiflu and Relenza, seem effective against the new

strain. Roche, the maker of Tamiflu, said the company is prepared to immediately

deploy a stockpile of the drug if requested.

Both drugs must be taken early, within a few days of the onset of symptoms, to

be most effective.

Cordova said Mexico has enough Tamiflu to treat 1 million people, but the

medicine will be strictly controlled and handed out only by doctors.

Mexico's government had maintained until late Thursday that there was nothing

unusual about the flu cases, although this year's flu season had been worse and

longer than past years.

The sudden turnaround by public health officials angered many Mexicans.

" They could have stopped it in time, " said Araceli Cruz, 24, a university

student who emerged from the subway wearing a surgical mask. " Now they've let it

spread to other people. "

The city was handing out free surgical masks to passengers on buses and the

subway system, which carries 5 million people each day. Government workers were

ordered to wear the masks, and authorities urged residents to stay home from

work if they felt ill.

Closing schools across Mexico's capital of 20 million kept 6.1 million students

home, as well as thousands of university students. All state and city-run

cultural activities were suspended, including libraries, state-run theaters, and

at least 14 museums. Private athletic clubs closed down and soccer leagues were

considering canceling weekend games.

The closures were the first citywide shutdown of public gathering places since

thousands died in the devastating 1985 earthquake.

Mexico's response brought to mind other major outbreaks, such as when SARS hit

Asia. At its peak in 2003, Beijing shuttered schools, cinemas and restaurants,

and thousands of people were quarantined at home.

In March 2008, Hong Kong ordered more than a half-million students to stay home

for two weeks because of a flu outbreak. It was the first such closure in Hong

Kong since the outbreak of SARS, or severe acute respiratory syndrome.

" It's great they are taking precautions, " said Lillian Molina, a teacher at the

Montessori's World preschool in Mexico City, who scrubbed down empty classrooms

with Clorox, soap and Lysol between fielding calls from worried parents.

U.S. health officials said the outbreak is not yet a reason for alarm in the

United States. The five people sickened in California and three in Texas have

all recovered.

It's unclear how the eight, who became ill between late March and mid-April,

contracted the virus because none were in contact with pigs, which is how people

usually catch swine flu. And only a few were in contact with each other.

CDC officials described the virus as having a unique combination of gene

segments not seen before in people or pigs. The bug contains human virus, avian

virus from North America and pig viruses from North America, Europe and Asia. It

may be completely new, or it may have been around for a while and was only

detected now through improved testing and surveillance, CDC officials said.

The most notorious flu pandemic is thought to have killed at least 40 million

people worldwide in 1918-19. Two other, less deadly flu pandemics struck in 1957

and 1968.

____

Associated Press Writers Cheng in London; Traci Carl in Mexico City; Mike

Stobbe in Atlanta, Georgia; and Malcolm Ritter in New York contributed to this

report.

(This version CORRECTS health secretary's name to Cordova sted Cordoba)