WHO Raises Pandemic Level for Swine Flu, Mexican Death Toll Mounts

[Guest guest]

http://www.medscape.com/viewarticle/701983

WHO Raises Pandemic Level for Swine Flu, Mexican Death Toll Mounts

Lowes

April 27, 2009 — The World Health Organization (WHO) today raised its pandemic

alert level for swine influenza to phase 4, signifying human-to-human

transmission of a virus able to sustain communitywide outbreaks. Meanwhile, the

number of deaths attributed to swine flu in Mexico increased to 149 today while

the number of confirmed cases in the United States doubled to 40, and cases have

also been reported in Spain, Scotland, and Canada.

These developments came on day 2 of a public health emergency declared by the US

Department of Health and Human Services. While no one in the United States has

died from this new strain of influenza, now found in 5 states, and only 1

patient has required hospitalization, the acting director of the Centers for

Disease Control and Prevention (CDC) said in a news conference today that no one

should be surprised if the disease takes a greater toll.

" I expect that we'll see cases in other parts of the country, and that we'll see

a broader range in terms of the severity of the infection, " said Besser,

MD.

The states where swine flu cases have been confirmed are New York, Texas, Ohio,

California, and Kansas, the same roll call as on Sunday. The 20 additional cases

added to the tally Monday were among students at St. Francis Preparatory in

Queens, New York, where 8 cases were originally reported. Dr. Besser said that

the new cases do not represent any ongoing transmission of the swine flu virus,

but just additional testing of the students there.

The ages of the 40 confirmed cases in the United States range from 7 to 54

years, with the median at 16 years, according to Uyeki, MD, a medical

epidemiologist in the CDC's influenza division, who also held a news conference

today. While travel to Mexico figured into some of the cases, none of them

involved exposure to pigs. " It appears to be a human-to-human transmission, " Dr.

Uyeki said.

The single US patient who required hospitalization was not admitted on the basis

of just swine flu symptoms, which have mirrored those for seasonal influenza —

fever, coughing, a runny nose, and sore muscles, along with vomiting and

diarrhea in some cases, according to Dr. Uyeki. " This person was

immune-suppressed and had underlying medical problems that were likely involved

in her admission, " he said.

Dr. Uyeki, Dr. Besser, and other experts are still struggling to understand why

this new virus — swine influenza A (H1N1) — has had such deadly consequences in

Mexico, but such relatively benign ones here. The growing number of confirmed

cases in Mexico, now at 26, and suspected cases, now close to 2000, prompted Dr.

Besser to recommend Monday that US citizens refrain from nonessential travel to

Mexico for the time being. However, Dr. Besser said that a similar

recommendation from the health commissioner of the European Union about not

traveling to the United States was " premature. "

The swine flu outbreak has grown to global proportions, with confirmed cases now

in Spain (1), Scotland (2), and Canada (6) in addition to those in Mexico and

the United States. Mexico is the only country that has reported deaths related

to confirmed cases.

Responding to the outbreaks, WHO raised its pandemic alert level from a phase 3

to a phase 4 on today. This phase, part of a 6-level scale, indicates " that the

likelihood of a pandemic has increased, but not that a pandemic is inevitable, "

according to WHO. The next phase on the scale — 5 — marks a full-fledged

pandemic.

The CDC's Besser said that the decision by WHO would not cause the

United States to change its game plan in responding to the outbreak. " Our

actions are based on what's taking place in our country and our communities, " he

said.