Swine Influenza

Reeling from a rash of drug-world violence and the effects of the global recession, Mexico's tourism is now taking a beating from the swine flu outbreak that is suspected in the deaths of 149 people and prompted the closing of theme parks, soccer stadiums and other public places. The country's benchmark IPC stock index plunged 3.3% on Monday, and the peso slumped as the ramifications of the outbreak filtered through the business and tourist community.

Officials have distributed the H1N1 flu vaccine unevenly throughout Los Angeles County, with fewer doses going to medically underserved areas in the county's north and south, according to public health agency figures. While there is now a surplus of vaccine countywide, northern and southern areas received a smaller share of the roughly 3 million vaccine doses distributed by the county, mainly because they are home to fewer doctors, pharmacies and other health providers, experts said.

In years past, the nation's attempts to prevent flu-related deaths have focused on limiting transmission of the virus through widespread vaccination programs. This year, with school starting up well before a vaccine for the pandemic H1N1 influenza virus will be available, there will be little that can slow the spread of the virus for the next few months.

On a rainy January day, Karen Romo, 15, feeds her five younger brothers and sisters an early dinner and tidies the kitchen while waiting for her father to return from work. One of the children vacuums the living room, maneuvering around a large box of diapers. Another sibling holds the baby. When the father, Miguel, arrives home, he's carrying a couple of bags of groceries, enough for a day or two. He rubs his youngest son's head affectionately, and pulls the infant into his arms.

As the swine flu outbreak continued to spread to countries around the world, the World Health Organization on Wednesday took the unprecedented step of raising the infectious disease alert level to phase 5, setting the stage for increased efforts to combat the infection. The virus "must be taken seriously because of its ability to spread to every country in the world," WHO Director-General Dr. Margaret Chan said at a news conference in Geneva.

A crack appeared Thursday in a White House communications operation known for staying on message -- in the form of a vice president with a habit of speaking his mind. It happened when Joe Biden went on a morning talk show and, almost as if he hadn't gotten talking points, veered off the team's message about how to avoid swine flu. Biden said he was telling his family members to avoid confined spaces such as planes and subway trains.

Very few African Americans have used Los Angeles County's free H1N1 vaccine clinics, public health officials told county leaders Tuesday, raising concerns about outreach to a community that, as a group, has a high risk for serious flu complications. Dr. Jonathan E. Fielding, the county's public health director, expressed disappointment in the turnout by blacks but said he did not think the problem was a lack of clinic sites. "Some surveys suggest it's lack of willingness to come forward," Fielding said, "and some of that is historic."

Los Angeles County's free H1N1 flu clinics opened last week amid public health officials' promises to aggressively vaccinate people at highest risk, especially the uninsured. Instead, overwhelmed clinic staff began vaccinating many people who were not supposed to be first in line for protection, officials said Tuesday. "We thought it was important to get to as many people as quickly as possible," said Dr. Jonathan E. Fielding, the county's director of public health. "We were assuming that the private sector was going to be getting a lot more vaccine a lot faster than they did."

Officials have distributed the H1N1 flu vaccine unevenly throughout Los Angeles County, with fewer doses going to medically underserved areas in the county's north and south, according to public health agency figures. While there is now a surplus of vaccine countywide, northern and southern areas received a smaller share of the roughly 3 million vaccine doses distributed by the county, mainly because they are home to fewer doctors, pharmacies and other health providers, experts said.

International officials Saturday declared the swine flu outbreak in Mexico and the U.S. a "public health emergency" as new cases were reported on both sides of the border and fears grew of a possible global epidemic. The Mexican government indicated that the outbreak was more severe than originally acknowledged, announcing that more than 1,300 people are believed to have been infected.

You can't get the swine flu virus by pigging out on barbecue, even if the pigs you used for chow had the disease, the federal government has confirmed. A new study conducted by the U.S. Department of Agriculture provided "additional confirmation" that meat from pigs exposed to the H1N 1 virus did not have the virus in it. "This research provides additional reassurance for consumers about the safety of pork," Edward B. Knipling, research service administrator with the department, said in a statement this week.

California Latinos have been nearly twice as likely as whites to die of H1N1 flu since the pandemic began last spring, according to statewide figures released Thursday by the California Department of Public Health. Over the same months, blacks in the state have been 50% more likely to die of H1N1 flu than whites, the report said. "Not everybody has been impacted equally" by H1N1, said state epidemiologist Dr. Gilberto Chavez, who added that statistics have shown "very important racial disparities" in H1N1 mortality and hospitalization rates.

Virtually all communities in California now have an abundance of H1N1 vaccine, the state health officer said Thursday. Dr. Mark Horton said in a conference call that California has received about 15 million doses of the vaccine, approximately two-thirds of the supply the state is expected to get of the H1N1 vaccine this season. Almost all jurisdictions are reporting that they have enough vaccine to inoculate the general public, instead of just the priority groups most at risk for H1N1, also known as the swine flu. Numerous production delays last year affected communities nationwide, leading to long lines and complaints of poorly run vaccination clinics until supply caught up with demand.

California is one of only seven states where H1N1 influenza is still widespread, but a variety of indicators suggest that this wave of the pandemic is abating even here, Dr. Mark Horton, director of the state Department of Public Health, said at a news conference Thursday. Hospitalizations for flu declined last week for the third week in a row, and visits to physicians' offices for flu-like illnesses also dropped. The only indicator that did not drop was deaths from flu, but that typically lags a couple of weeks behind other indicators.

Vaccine maker MedImmune has voluntarily recalled 13 lots of vaccine against the pandemic H1N1 influenza because they have lost some potency since they were manufactured, the company said Tuesday. "This is not a safety issue," Norman Baylor, director of the Office of Vaccines Research and Review at the Food and Drug Administration, said in a conference call. "All lots passed pre-release testing for safety, purity and potency. There has just been a slight decrease in potency." The 13 lots recalled involved 4.7 million doses of the intranasal vaccine, which is based on a live, weakened virus, but officials believe most of them were administered in October and November when the product would have still been at full potency.

Veterinarians in White Plains, N.Y., have identified the first known case of pandemic H1N1 influenza in a dog -- a 13-year-old mixed-breed male who is now recovering. The dog was tested because his owner previously had swine flu. The virus has been found before in other pets, including at least three ferrets, several cats and pigs and a cheetah named Gijima at a wildlife preserve in Santa Rosa, Calif. A couple of the cats died, but most of the animals recovered. In each case, the virus is thought to have been transmitted to the animal by its owner or handler; there is no evidence of the virus being passed back to a human.

The start of the school year will undoubtedly bring a rise in H1N1 infections, health and education officials said Friday as they urged parents to practice such precautionary measures with their children as hand-washing and the "Dracula sneeze." Officials also said parents should not panic and keep healthy children home once flu breaks out on campuses. "I want to make sure parents are not afraid to send their children to school if they are well," said Dr. Jonathan Fielding, Los Angeles County's health officer.

Carnival Cruise Lines, the world's largest cruise line operator, announced Friday that it would resume visits to Mexican ports later this month. The decision came after the U.S. Centers for Disease Control and Prevention said it would no longer recommend that Americans avoid nonessential travel to the country because of the swine flu outbreak. The company, a unit of Carnival Corp., said its first cruise ship to return to Mexico would be the Carnival Holiday.

Australian researchers have shown that a single dose of vaccine against pandemic H1N1 influenza can provide effective immunity against the swine flu virus in infants and children, a finding that, if corroborated, could help damp the spread of the virus by reducing the logistical complications associated with the currently recommended regimen of two doses. Immunizing children plays a crucial role in preventing widespread outbreaks of flu and other infectious diseases because schools and camps provide a fertile breeding ground for viruses, which then spread into the community.