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100-plus swine flu cases confirmed outside Mexico

The number of confirmed cases in the U.S. reaches 67; new cases also reported around the globe. An official of the WHO says a pandemic is not inevitable, and is likely to be mild if it does occur.

April 29, 2009|Thomas H. Maugh II

As isolated outbreaks of swine flu continue to be confirmed around the world, with new cases reported Tuesday in Canada, Israel, France, New Zealand, Costa Rica and South Korea, Gov. Arnold Schwarzenegger proclaimed a state of emergency and the White House asked Congress for an additional $1.5 billion to fight the outbreak.

State health officials have been aggressively working to address the crisis, and the proclamation is one more step in that effort, not an indication that the outbreak in California has become more severe.

In the U.S. and elsewhere, officials are holding their breath to see whether the virus' spread will turn into something more severe or, as many hope, peter out. Meanwhile, like Schwarzenegger, they are responding aggressively.

President Obama, in a letter to Congress, asked for the $1.5 billion with "maximum flexibility to allow us to address this emerging situation." The letter said the money could go toward stockpiling antiviral medicine, vaccine development, disease monitoring and diagnosis, and assisting international efforts to limit the spread of swine flu.

"In our opinion, this is about prudent planning moving forward," White House Press Secretary Robert Gibbs told reporters.

Also Tuesday, Homeland Security Secretary Janet Napolitano said she was forming a swine flu task force to coordinate U.S. efforts and noted that the government had made 12 million doses of antiviral drugs available to states. She said her agency was resisting calls from Capitol Hill to screen inbound air travelers from Mexico and those crossing at border checkpoints.

"Our focus is not on closing the border or conducting exit screening," she said. "It is on mitigation."

The total number of confirmed swine flu cases in the United States had reached 68 as of late Tuesday afternoon and more than 100 worldwide, not counting the still-unknown number of cases in Mexico. At least some of the new cases appear to have come from human-to-human transmission outside Mexico.

Such community transmission is one of the early earmarks of a pandemic, and if it continues to be observed, experts predicted, the World Health Organization is likely to raise its alert to Level 5, from elevated Level 4. Such an increase might involve more travel restrictions and stronger efforts to control the spread of the virus.

At a Tuesday morning news conference in Geneva, Dr. Keiji Fukuda, assistant director-general of the WHO, said a pandemic was not inevitable, but that if one did occur it was likely to be mild -- a conclusion drawn from the lack of deaths outside Mexico.

But he cautioned that the 1918 Spanish flu pandemic, which killed millions worldwide, also started out mild. In the spring of that year, a mild pandemic petered out, only to return with a vengeance in the fall.

"I think we have to be mindful and respectful of the fact that influenza moves in ways we cannot predict," he said.

Moreover, he added, it is unlikely that health authorities will be able to limit the current outbreak's spread. "At this time, containment is not a feasible option," he said.

One ray of good news is that the outbreak may be leveling off in Mexico, where the first cases appeared. Mexican Health Minister Jose Angel Cordova said Tuesday that the number of new suspected cases of swine flu had declined from 141 on Saturday to 119 on Sunday and 110 Monday.

At least 159 people have died in Mexico from influenza and its complications, and more than 2,000 cases have been reported. It is not clear, however, what proportion of those deaths and cases are attributable to swine flu. So far, only 26 of the deaths have been firmly linked to the virus.

Mexican authorities ordered all restaurants in Mexico City to begin serving only take-out food in an effort to limit spread of the virus, and they closed down archaeological sites in an effort to limit assemblies of people. Officials had already requested that bars, movie theaters, pool halls, gyms and churches in the capital close. Schools nationwide are closed until May 6.

The Mexico City Chamber of Commerce estimated that Mexico City is losing approximately $60 million a day from reduced tourism, trade and other business.

Mexican authorities were still trying to pinpoint where the disease started. They say they have found no infected pigs in the country, although a boy who lives near a pig farm in the state of Veracruz was confirmed to have contracted the disease as early as April 1. His community is also a largely migrant community, with people traveling to and from the U.S. regularly.

"Where did the virus come from? We don't know. Did someone come from California or did someone go from Mexico to California? We don't have that information," Cordova said.

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