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Author Topic: H1N1 - Swine Flu - Novel Flu - Information  (Read 100990 times)
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Mere
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« Reply #60 on: April 30, 2009, 09:52:37 AM »

http://www.msnbc.msn.com/id/30491891//

New health threat system was slow to alert
Scores were dead before authorities were fully aware of swine flu outbreak

By David Brown
 
updated 5:52 a.m. ET, Thurs., April 30, 2009
WASHINGTON - Despite huge efforts in the past six years to make the reporting of disease outbreaks fast and automatic, there were significant delays in bringing Mexico's swine flu outbreak to the full attention of international authorities.

News of an outbreak of severe respiratory illness in Mexico burst into public consciousness last Friday, April 24.

That was 18 days after public health authorities there started looking into unusual cases of pneumonia in their country, eight days after Mexican authorities notified the World Health Organization of the growing outbreak and four days after the events came to the full attention of the Centers for Disease Control and Prevention in Atlanta.

Officials involved in pandemic preparedness at the U.S. Department of Health and Human Services, which oversees the CDC, did not learn of the Mexican outbreak until the day the rest of the world did, April 24. They did know, however, that the CDC was investigating six rare cases of swine influenza in California and Texas.

As Mexican health authorities were finding cases of unusual illness, they at least once officially notified the WHO's regional office in Washington, the Pan American Health Organization (PAHO), of a possibly brewing epidemic. People in the WHO's Geneva headquarters also received several urgent warnings from a biosurveillance firm, Veratect, based in Kirkland, Wash.

The delay in making the global health community aware happened despite the adoption in 2005 of international health regulations requiring nations to report to the WHO within 24 hours any disease outbreak that is serious, unusual, at risk of spreading internationally or potentially disruptive of trade. By the time international authorities became fully aware of the outbreak, there were about 800 cases and at least 50 deaths, and the virus was unknowingly being carried into other countries.

What seems apparent is that the world health community's newly rebuilt, well-oiled — but never used — mechanism for warning the world about pandemics may have given nations far less lead time than intended.

Please note:  This is a much longer article that you can read by using the above link.

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« Reply #61 on: April 30, 2009, 10:21:56 AM »

Swine flu in Alabama

Dozens of schools were closed and athletic activities halted Thursday as state and local officials tried to stop, or at least slow, the outbreak of the swine flu in Alabama and prepare for the possibility of more closings.


http://www.myfoxal.com/

State Health Officer Dr. Williamson gave morning press conference.  All school athletic events cancelled until further notice.
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« Reply #62 on: April 30, 2009, 10:25:09 AM »

http://www.myfoxal.com/dpp/news/20090430_Swine_flu_in_Alabama

Better link to above information.
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« Reply #63 on: April 30, 2009, 10:31:56 AM »


This is perhaps one of the most interesting articles.  It is a timeline documented by Veratect, a company that is worth reading about.  You can find information about them on line.  While much of the article is printed below, you might want to read from the link.

http://biosurveillance.typepad.com/biosurveillance/2009/04/swine-flu-in-mexico-timeline-of-events.html

Biosurveillance
Operational topics in biosurveillance



April 24, 2009
Swine Flu in Mexico- Timeline of Events
Introduction

At Veratect, we operate two operations centers based in the United States (one in the Washington, DC area and one in Seattle, WA) that provide animal and human infectious disease event detection and tracking globally.  Both operations centers are organizationally modeled after our National Weather Service using a distinct methodology inspired by the natural disaster and meteorology communities.  Our analysts handle information in the native vernacular language and have been thoroughly trained in their discipline, which include cultural-specific interpretation of the information.  We are currently partnered with 14 organizations that provide us with direct ground observations in 238 countries.  We are a multi-source, near-real time event detection and tracking organization with years of experience in this discipline.

March 30

Veratect reported that a 47-year-old city attorney for Cornwall was hospitalized in a coma at Ottawa General Hospital following a recent trip to Mexico.  Family members reported the individual voluntarily reported to the hospital after gradually feeling ill upon returning from his trip on 22 March.  The source stated that the hospital did not know the cause of illness.  The case was reportedly on a respirator and awaiting a blood transfusion, but sources did not provide symptoms or a suggested cause of illness. This information was available in our web portal to all clients, including CDC and multiple US state and local public health authorities, however no one had connected this man’s illness with a potential crisis in Mexico.

We have learned this case tested negative according to Canadian officials.  The only value this event would have had would have been to tip someone to take a closer look at where this individual traveled in Mexico, possibly stumbling on reports of 'unusual respiratory disease- we have absolutely no indication anyone did this, or if they did they found anything to prompt closer scrutiny.  We certainly didn't.

April 2

Local media source Imagen del Golfo reported that state health officials recorded a 15% increase in disease over an unspecified period in the highland areas of Veracruz, which includes La Gloria. The increase was primarily due to higher levels of upper respiratory disease and gastroenteritis. Specifically, officials noted an increase in pneumonia and bronchial pneumonia cases. Health officials attributed the increase to seasonal climate changes.

I would like to be clear here- we are aware local media sources apparently reported this on April 2nd, but we ourselves did not nor posted it on April 2nd.

April 6

Veratect reported local health officials declared a health alert due to a respiratory disease outbreak in La Gloria, Perote Municipality, Veracruz State, Mexico.  Sources characterized the event as a "strange" outbreak of acute respiratory infection, which led to bronchial pneumonia in some pediatric cases. According to a local resident, symptoms included fever, severe cough, and large amounts of phlegm. Health officials recorded 400 cases that sought medical treatment in the last week in La Gloria, which has a population of 3,000; officials indicated that 60% of the town’s population (approximately 1,800 cases) has been affected. No precise timeframe was provided, but sources reported that a local official had been seeking health assistance for the town since February.

Residents claimed that three pediatric cases, all under two years of age, died from the outbreak. However, health officials stated that there was no direct link between the pediatric deaths and the outbreak; they stated the three fatal cases were "isolated" and "not related" to each other.

Residents believed the outbreak had been caused by contamination from pig breeding farms located in the area. They believed that the farms, operated by Granjas Carroll, polluted the atmosphere and local water bodies, which in turn led to the disease outbreak. According to residents, the company denied responsibility for the outbreak and attributed the cases to "flu." However, a municipal health official stated that preliminary investigations indicated that the disease vector was a type of fly that reproduces in pig waste and that the outbreak was linked to the pig farms. It was unclear whether health officials had identified a suspected pathogen responsible for this outbreak.

And to be crystal clear, the way we used this information was to simply flag an event as worthy of closer scrutiny and higher awareness, as there was absolutely no proof of true involvement of this company in the outbreak- a proper epidemiological investigation is required to prove such links. 

Local health officials had implemented several control measures in response to the outbreak. A health cordon was established around La Gloria. Officials launched a spraying and cleaning operation that targeted the fly suspected to be the disease vector. State health officials also implemented a vaccination campaign against influenza, although sources noted physicians ruled out influenza as the cause of the outbreak. Finally, officials announced an epidemiological investigation that focused on any cases exhibiting symptoms since 10 March.

This information was available in our web portal to all clients, including CDC and multiple US state and local public health authorities.

We do know, after checking our web site logs, that the Pan American Health Organization, the WHO Regional Office of the Americas, accessed this specific report in our system on April 10th and again on April 11th.

April 16

Veratect reported the Oaxaca Health Department (SSO) indicated that an unspecified number of atypical pneumonia cases were detected at the Hospital Civil Aurelio Valdivieso in Reforma, Oaxaca State, Mexico.  No information was provided about symptoms or treatment for the cases.  NSS Oaxaca reported that rumors were circulating that human coronavirus was spreading at the hospital; sources did not provide any response to these statements from the hospital or health officials.   

Laboratory samples were sent to Mexico City for analysis; results were expected to be released sometime next week.  According to NSS Oaxaca, health officials had intensified preventive measures aimed at mitigating further spread of the disease.  Sources reported that the SSO also implemented a sanitary cordon around the hospital.         

This information was pushed to CDC in an email alert notification provided by Veratect on April 16 and April 17:

"16 Apr 2009 4:14 PM GMT     Respiratory Disease     Detailed     Mexico (Reforma, Oaxaca)  Reforma: Atypical Pneumonia Cases Reported at Hospital", sent at "April 16, 2009 10:08:06 AM PDT" and again at "April 17, 2009 10:08:06 AM PDT" to CDC and at "April 16, 2009 10:27:13 AM PDT" to the California State Department of Health.

April 20

Veratect was urgently asked to provide access to the VeraSight Global platform on 20 April by a client in the US public health community, and indicated they had received word from their counterparts in Canada that Mexican authorities had requested support.  This client speculated whether notification of all southern U.S. border states’ public health authorities should be done and were confused as to why the CDC had not issued an advisory.  Veratect contacted the CDC Emergency Operations Center to sensitize them about the situation in Mexico. CDC indicated they were already dealing with the crisis of recently detected H1N1 swine influenza in California and possibly Texas.

April 21

Veratect reported the Oaxaca Health Department (SSO) confirmed two adults died from atypical pneumonia at the Hospital Civil Aurelio Valdivieso in Oaxaca, Oaxaca State, Mexico.  One of the cases was a 39-year-old female; the other case was an adult male of unspecified age.  After the deaths, the hospital established a quarantine in the emergency room due to initial concerns that avian influenza was responsible for the cases.  However, the SSO subsequently stated that neither avian influenza nor coronaviruses, including that which causes severe acute respiratory syndrome (SARS), were the source of infection.  Additionally, the SSO denied the cases represented an epidemic.  According to local sources, the SSO indicated that the atypical pneumonia cases were caused by an unspecified bacterial pathogen and were treatable with antibiotics.  Sources indicated a total of 16 additional patients exhibited signs of respiratory infection; none of these patients exhibited complications.           

Veratect sources indicated the 39-year-old female was treated at the hospital for five days before dying on 13 April.  This case was reportedly immunocompromised; in addition to acute respiratory symptoms, she also had diabetes and diarrhea.  The SSO contacted 300 people that had been in contact with the woman; sources stated that between 33-61 contacts exhibited symptoms of respiratory disease, but none showed severe complications.  The SSO characterized the incident as an "isolated case;" they noted that over 5,000 cases of pneumonia occur annually in Oaxaca. 

Another local source reported the SSO launched surveillance measures in the former residential areas of the two fatal cases and in other targeted geographic areas.  No additional information was provided regarding the second fatal case at the hospital.   

Veratect reported that the Oaxaca State Congress Permanent Committee on Health had undertaken an investigation into the cases.  The committee inspected the Hospital Civil Aurelio Valdivieso on 20 April.  The director of the medical school at the University Autónoma "Benito Juárez" de Oaxaca (UABJO), along with other medical academics, publicly requested that national health authorities investigate the cases of atypical pneumonia.  No information was provided indicating that national health authorities plan to investigate the matter.  The director of the medical school also requested the SSO furnish evidence showing that the cases were negative for avian influenza, SARS, and other severe pathogens; his request was echoed by readers commenting on an online user forum.         

Veratect also reported the National Ministry of Health issued a health alert due to a significant increase in influenza cases during the spring season in Mexico.  Officials indicated that there have been 14 influenza outbreaks throughout the country.  The most heavily affected states are Baja California, Chihuahua, Distrito Federal (Mexico City), Hidalgo, Tlaxcala, and Veracruz.  Local case counts were not provided. 

Officials stated that 4,167 probable cases of influenza, 313 of which were confirmed, have been reported throughout the country in 2009.  Case counts for suspected and confirmed influenza cases have tripled in 2009 as compared to the equivalent time period in 2008.  The National Institute of Respiratory Diseases recorded two fatal cases of influenza in 2009, but specific dates and locations were not provided.   

Health officials stated they were unsure precisely why the incidence of influenza had increased.  However, they believed the increased presence of influenza B, in combination with influenza A, was a contributing factor.  In response, officials advised anyone exhibiting influenza symptoms to avoid self-medication and seek medical care immediately.  Officials had also enhanced epidemiological surveillance for influenza.  Lastly, health officials had focused efforts on providing antiviral medications and influenza vaccinations to the most vulnerable segments of the population.  According to the Mexican Ministry of Health, 44.3% of the national population was vaccinated against influenza in 2005-2006.

Veratect sensitized the International Federation of Red Cross who in turn requested broader access be provided to the Pan-American Disaster Response Unit (PADRU).  Veratect moved to notify several US state and local public health authorities, providing the caveat the situation in Mexico remained unclear due to pending laboratory results.  Veratect reached out to World Health Organization (WHO) operations, informing them the Veratect team was on an alert posture and available for situational awareness support.  They indicated they and their subordinate, the Pan American Health Organization (PAHO) were now aware of the situation but had no further information.  Veratect also extended contact to the British Columbia Center for Disease Control and offered assistance in tracking the events in Mexico.  All contacts indicated laboratory results were pending.

April 22

Veratect reported the Oaxaca Health Department (SSO) indicated 16 employees at the Hospital Civil Aurelio Valdivieso in Oaxaca, Oaxaca State, Mexico had contracted respiratory disease.  However, the SSO denied these cases were connected to the recently identified cases of atypical pneumonia at the hospital.  No information was provided indicating how many employees work at the hospital or whether the number of respiratory disease cases was higher than average.  The source reported that "fear" persisted among hospital physicians concerning the possible presence of a deadly bacteria or virus circulating in the hospital.  One anonymous hospital employee criticized hospital management as "unfair" for not providing clear information regarding the first fatal atypical pneumonia case.

An additional source reported the cause of the atypical pneumonia cases remained unknown; it stated that bacteria or virus could have caused the cases.  In contrast, according to an 18 April report, the SSO indicated that the atypical pneumonia cases were caused by an unspecified bacterial pathogen and were treatable with antibiotics.  The reason for this discrepancy was unclear at this time.

The Instituto Mexicano del Seguro Social (IMSS), a national health entity, had now joined the SSO in responding to the cases; reports did not indicate the Mexican National Ministry of Health had joined in the response efforts.  The IMSS extended the sanitary cordon surrounding the hospital.  Patients exhibiting flu-like symptoms would be sent to the hospital’s epidemiology department for further study.  IMSS instructed physicians to hospitalize respiratory disease patients immediately if they meet certain standards for severity of symptoms.  Lastly, the hospital’s emergency room would remain closed for an additional 15 days so that cleaning and preventive disinfection could be carried out.

Veratect also reported the Mexican Ministry of Health indicated that an "unusual" outbreak of laboratory-confirmed influenza caused five deaths from 17-19 April 2009 in Mexico City, Mexico.  The deaths occurred at the following three hospitals: el Hospital de la Secretaría de Salud (2), el Institute Nacional de Enfermedades Respiratorias (2), and el Hospital Ángeles del Pedregal (1).  According to unofficial sources, the fatal case count was higher than that provided by officials.  There were currently 120 influenza cases hospitalized throughout Mexico City.  National health officials indicated that influenza vaccines were sold out in Mexico City and that they were attempting to acquire additional supplies of the vaccine.   

At this point, the Mexican Health Secretary reportedly stated there was an influenza epidemic in Mexico City and throughout the rest of the county.  In response to the cases, the official stated health authorities would launch a public awareness and vaccination campaigns.  He stated that 400,000 vaccines would be administered, primarily to medical staff; it was unclear whether these efforts would be focused on Mexico City or any other geographic area.  Health officials also ordered the provision of special masks, gloves, and gowns for medical personnel that were in contact with influenza cases.   

A total of 13 fatal cases of influenza were reported in Mexico City in the past three weeks.  However, several other media sources reported that the 13 deaths were recorded since 18 March 2009; the reason for this discrepancy was unclear.  Sources reported a total of 20 fatal cases of influenza throughout Mexico over the disputed timeframe.  The other cases were located in San Luis Potosí (4), Baja California (2), and Oaxaca (1).  The Director of Epidemiology at the National Center for Epidemiological Surveillance and Disease Control characterized the outbreak as "quite unusual."

No information was provided indicating that the strain of influenza itself was unusual.  Rather, several sources indicated that it was "unusual" to record this many fatal influenza cases during this time of year.  Influenza cases normally peak from October to February, while these cases had occurred during Mexico’s spring season.

Canada announced a national alert for travelers returning from Mexico with respiratory disease, beginning a campaign of public media announcements. Potentially ill contacts were identified returning from Mexico and isolated in Canada.  Internet blogs begin to spin up.  CDC indicates concern about the events unfolding in Mexico.  Veratect sensitizes the US community physician social network managed by Ozmosis.

April 23

Veratect reported the Secretary General of the Oaxaca Ministry of Health Workers Union confirmed that a doctor and a nurse from the Hospital Civil Aurelio Valdivieso in Oaxaca, Oaxaca State, Mexico were under observation for suspected "atypical" pneumonia.  This contradicted statements made by the Oaxaca Health Department (SSO) on 22 April that 16 hospital employees contracted respiratory disease, but none of the cases exhibited atypical pneumonia. 

The union official stated that a review by the Oaxaca State Board of Medical Arbitration indicated that the hospital faced serious difficulties caused by overcrowding; he stated that overcrowded conditions created a "breeding ground" for the spread of various epidemics.  According to the official, the hospital has 120 beds but the number of patients hospitalized had at times surpassed 240.       

Other sources reported that the Department of Livestock, Fisheries, Rural Development, and Feed (SAGARPA) declared on 20 April that Oaxaca, Mexico was free of avian influenza.  SAGARPA stated that authorities should remain vigilant in monitoring for the disease among birds.   

Canadian local health officials stated that a Rouge Valley resident with influenza-like illness was being monitored at Scarborough Centenary Hospital in Scarborough, Ontario.  The precaution was being taken in accordance with an alert issued by the Ministry of Health asking hospitals to watch for severe respiratory illnesses in travelers returning from Mexico.  Despite the warning, the Ministry had indicated that evidence is not suggestive of a novel pathogen or influenza strain, according to the source.  A representative for the Rouge Valley Health System stated that this case is being monitored related to the alert.  The source did not specifically indicate symptoms or that the person had traveled to Mexico.  No additional information regarding the case, including age or health status, was reported.   

The source stated that hospital employees were asking any patients admitted to the hospital if they had recently traveled to Mexico, which according to the source was a popular tourist destination for Durham-region residents.

Additional Canadian sources indicated Southlake Regional Health Centre officials treated a patient with influenza-like illness (ILI) who recently returned from Mexico.  The Ministry of Health recently notified Southlake, in addition to health units across the country, that an outbreak of severe respiratory disease was affecting areas of Mexico; ill travelers returning from that region with ILI symptoms were encouraged to be monitored.  Sources did not provide any specific information about the case, including age or current treatment status.  Information regarding the individual’s travel to Mexico was also not provided, including destinations and duration of time in country.

The Public Health Agency of Canada (PHAC) noted that an Ontario resident who returned from Mexico on 22 March experienced severe respiratory illness, but has fully recovered and was not considered connected to the current situation.  Veratect recently reported on 30 March that a public official from Cornwall, Ontario was hospitalized with an unknown illness following a trip to Mexico; however, it is unclear if the cases are related, or if this was the case referenced by PHAC officials.   

Veratect assesses the situation and notes the following:

Affected areas:

Oaxaca, Distrito Federal, San Luis Potosí, Baja California

Distance to nearest international airport:

•    Oaxaca airport, located approximately 150 miles from Reforma, is connected via non-stop air traffic to Houston
•    Mexico City (Distrito Federal) airport is connected via non-stop air traffic to many cities in the US, Canada, Europe and Latin America, with the most outbound traffic to Los Angeles, Frankfurt, Houston, Dallas, and Amsterdam
•    San Luis Potosí airport is connected via non-stop air traffic to Dallas and Houston
•    Mexicali airport in Baja California is connected via non-stop traffic to Los Angeles
•    Veracruz airport is connected via non-stop air traffic to Houston

Large mass gatherings:

Semana Santa (April  ~April 3 – 12, Palm Sunday to Easter Sunday), which is Mexico’s second largest holiday.  Mexico’s population is approximately 90% Catholic, which results in substantial population migration patterns during this time period.  For instance, in Ixtapalapa (in Mexico City), one million people visit for Semana Santa.  Other well-known sites for the holiday include Pátzcuaro, San Cristobal de las Casas (Chiapas), and Taxco.  Veratect notes substantial population migration has just occurred that could facilitate the spread of respiratory disease.

Civil Unrest:

The recent surge in organized crime and drug-related violence in Mexico, including homicides, kidnappings, extortion, and theft, has disproportionately impacted Mexican states along the Pacific Coast and U.S.-Mexico border.  This factor may confound situational awareness of respiratory disease in Mexico and contribute to problems in epidemiological investigation and response measures.  Baja California is one of five states within this region that currently accounts for more than 75 percent of Mexico's drug-related homicides, and has recorded high levels of drug seizures and police corruption cases. Veracruz, a state with high drug cartel activity in the Gulf of Mexico, has recorded little violence, while the state of Oaxaca to the southwest, recently recorded the assassination of a political party leader. Mexico City, in the center of the country, recently arrested a major drug cartel leader, and recorded few homicides this month. The levels of unrest in Hidalgo, San Luis Potosi, and Tlaxcala, however, are very low, and have not reported a single homicide related to organized crime in the past month.


Veratect issues notification to additional public health authorities in two states.  Veratect reaches out to the Pan American Health Organization emergency operations team but is unable to establish contact.  Veratect notes no publicly available English language reporting from ProMED, HealthMap, FluNET, CDC, ECDC, or WHO about the unfolding events in Mexico.  Many of Veratect’s clients, including Canadian, ask why an alert has not been issued by the US to sensitize their healthcare community.

April 24

Veratect continues to process a dramatic increase in reporting on the situation in Mexico.

WHO requests access to the Veratect system.  Veratect is aware of laboratory samples from Mexico are positive for “swine flu” H1N1, a novel virus.  World media are now aware of the situation in Mexico.  CDC issues a press statement, as does WHO.

Veratect notifies the private US clinical laboratory community and activates a Twitter feed (twitter.com/veratect) to enable more rapid updating of information.


Note....there are further comments and questions by other individuals at the end of this
information.  Please use link above to access.
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« Reply #64 on: April 30, 2009, 11:05:38 AM »

http://www.cdc.gov/swineflu/

109 confirmed
11 states
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« Reply #65 on: April 30, 2009, 11:06:58 AM »

http://www.cdc.gov/swineflu/

109 confirmed
11 states


U.S. Human Cases of Swine Flu Infection
(As of April 30, 2009, 10:30 AM ET)  States # of laboratory confirmed cases Deaths
Arizona 1   
California 14   
Indiana 1   
Kansas 2   
Massachusetts 2   
Michigan 1   
Nevada 1   
New York 50   
Ohio 1   
South Carolina 10   
Texas 26 cases 1 death
TOTAL COUNTS 109 cases 1 death
International Human Cases of Swine Flu Infection
See: World Health Organization 
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« Reply #66 on: April 30, 2009, 11:09:54 AM »

The above post did not format correctly.  Texas should show 26 cases and 1 death.
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« Reply #67 on: April 30, 2009, 11:21:52 AM »

http://www.pandemicflu.gov/index.html

Join us at 1:00PM EDT for a Webcast on H1N1 Flu

HHS Secretary Sebelius and DHS Secretary Napolitano will host a Webcast to answer questions from the American people regarding the H1N1 flu on Thursday at 1:00 PM EDT. They will be joined by Acting Director of CDC, Dr. Besser. The Webcast can be viewed at www.hhs.gov and www.cdc.gov. Submit questions for the webcast by emailing hhsstudio@hhs.gov.
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« Reply #68 on: April 30, 2009, 04:40:42 PM »

http://www.bizjournals.com/atlanta/stories/2009/04/27/daily90.html

Ga. gets first confirmed case of swine flu
Atlanta Business Chronicle

A 30-year-old woman visiting Georgia has become the Peach State’s first confirmed case of swine flu.

The U.S. Centers for Disease Control and Prevention and the office of Gov. Sonny Perdue confirmed Georgia’s first case of H1N1 flu. The unnamed woman is at a hospital in LaGrange.

“I want to stress that it is an isolated case appearing in a woman visiting our state for an event who had also recently traveled to Mexico,” Perdue said in a statement to the press. “The state of Georgia has worked diligently over the past several years to prepare for a situation like this, and we are partnering with local and federal officials to respond appropriately. I encourage Georgians to follow the advice of public health professionals and take the recommended precautions to protect themselves and their families. At this stage, the simplest things -- washing hands and using disinfectants -- can be the most effective safeguards.”
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« Reply #69 on: April 30, 2009, 07:10:07 PM »

Masks sell out and airport fever checks for swine flu

Article from: The Courier-Mail

Renee Viellaris, Stefanie Balogh, Janelle Miles and Peter Michael

May 01, 2009 12:00am

SHOPS are running out of surgical masks, with people panic buying amid fears of a swine flu outbreak as Australia ramps up its border security.

While no cases have so far been confirmed in Australia, it appears many people believe it is only a matter of time.

More than 100 Australians have been tested for the potentially deadly virus, as federal and state governments prepare to step up a co-ordinated crisis plan.

In Queensland, Brisbane, the Gold Coast and Cairns were among eight Australian airports that would begin screening for elevated body temperature, which helps identify the sick.

The World Health Organisation (WHO) says the world has to look out for outbreaks of the swine flu virus in the southern hemisphere, as the region heads into the winter months.

WHO acting assistant director-general Keiji Fukuda pointed out the swine flu virus had been behaving like a typical influenza virus.

As such, it could have a bigger impact on countries that are heading into winter.

Chemists on the NSW Central Coast and parts of Sydney were reportedly running out of masks.

Health officials said there was no need for drastic action at this stage.

In Mexico, the embassy has told all Australians to gather two weeks worth of supplies, while local authorities have shut down places where people gather such as cinemas and restaurants for at least a week.

Australian Jesse Inglis said from his apartment in Mexico City that supermarkets and pharmacies were virtually the only stores open and all staff wore surgical masks and gloves.

He said the local Burger King was open but not allowing anyone to sit down inside. Instead, meals were brought out to take away.

"It's as though all life in Mexico is dying," Mr Inglis said.

"It's paralysed the city, a lot of silence on the street now. The mayor of the city has just shut down absolutely everything. People are in a bit of a panic."

Back home, all passengers entering the country will have to fill out health declaration cards. However, those who lie about being ill will not be penalised.

Premier Anna Bligh said the State Government was working hard to ensure Queensland was ready.

"Now is the time for us to be working very hard to ensure we are prepared for this and ready to respond if we do see this escalate," Ms Bligh said after a Council of Australian Government's meeting in Tasmania yesterday.

"Given the incubation time is around seven to 10 days, I think the next couple of weeks will give us a much clearer picture of what we can expect here in Australia and in Queensland."

Queensland Health director-general Mick Reid, who worked in China during the deadly SARS outbreak, said the state's medical system was "ready and prepared".

Queensland Health placed nurses at Brisbane, Cairns and Gold Coast airports as border surveillance measures were stepped up to detect sick people arriving.

Thermal scanners will be used at the airports to identify passengers who have fevers.

Also, pilots of all international flights – not just those from the Americas – are required to report any people who were ill.

Late yesterday, 19 people in Queensland were awaiting test results for swine flu, a type of influenza A.

The final two passengers on the same flight as three New Zealanders who have tested positive to swine flu were tracked down and given a course of the anti-viral drug Tamiflu.

Police had to be called in to help find the pair, who were on a Los Angeles to Auckland flight with the NZ cases and then travelled on to Brisbane on Saturday.

Health authorities in NSW said they had been inundated with people concerned about swine flu, with 85 people currently being tested for the virus.

Mr Reid said "millions and millions" of doses of anti-viral drug Tamiflu had been stockpiled in major hospitals.

"We have more than adequate supplies and if there is an outbreak, more supplies can be flown in within a matter of hours," he said.

On a tour of Cairns International Airport and Cairns Base Hospital yesterday morning, Mr Reid said airline pilots flying into Australia were obliged to assess and report any passengers with flu-like symptoms.

Under new quarantine measures, officials have the power to detain and hold people with flu-like symptoms.

Medical experts said any confirmed cases were likely to be isolated in home or hotel detention unless they needed urgent medical attention. Infectious disease specialist Enzo Binotto said isolation wards had been identified within the state's hospitals in the event of a pandemic.

Mr Rudd said leaders would do "whatever necessary" to keep the disease from spreading and urged Australians to wash their hands.

Aussie tourists in Mexico left without masks

AUSTRALIAN tourists in Mexico are going without protective face masks as supplies in the capital dwindle.

With a full-blown flu pandemic imminent, Aussie backpackers have to gamble their health with every sightseeing trip.

Sydney ski shop worker Ellen Smith, 25, arrived in Mexico City this week to find pharmacies were out of masks.

She and fellow traveller Josh had no choice but to scrub up as often as they could.

"We're being really vigilant about washing our hands and hand-to-mouth contact – normal precautions against the flu," Ms Smith said.

Officials in the Mexican capital have issued masks to about one in five of the city's 20 million residents in a bid to halt the spread of swine flu. They are also handing out disinfectant wipes on the streets.

But some tourists have had to scour the city for a mask.

The Courier-Mail tried to buy masks from four pharmacies in the city yesterday. All had sold out.

World Vision this week warned of a shortage.

"Most places have run out of masks and similar products since everyone is trying to get them," World Vision's emergency director in Mexico City, Aldo Pontecorvo, said.

"Also, the type of mask most people are using needs to be changed every four hours or so to be useful, so this also creates the needs for many, many masks per person."

Ms Smith feared becoming stranded. "We're mainly worried about other countries closing their borders and being stuck here," she said.

Fellow traveller Teboni Carlisle, 25, from Melbourne, learned of the outbreak the night before she arrived.

Although she wears a mask, she said she felt unaffected by the threat. "People tell you to worry about it but we haven't really seen anything much except people walking around in masks," she said.

People who cancelled overseas trips because of swine flu stood to lose their money, the Insurance Council of Australia said yesterday.

"Most (travel insurance) policies do not cover cancellation as a result of government prohibiting or advising against travel to a particular destination or changing a travel advice," the ICA said.

 
http://www.news.com.au/couriermail/story/0,23739,25411132-952,00.html
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« Reply #70 on: April 30, 2009, 07:44:24 PM »

http://media.myfoxal.com/live/index.html

Dr Williamson State Health Officer and Mayor of Birmingham giving the second live press conference today.  We have two confirmed cases in Madison and 1 in Montgomery County right now and yet are not listed on WHO list.

Next press conference is for 11 a.m. tomorrow.

Why do they have two press conferences in one day and keep telling us not to panic?
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« Reply #71 on: April 30, 2009, 08:47:19 PM »

http://www.thepath.fm/news/newsitem.cfm?id=36615

Ohio, Indiana and Kentucky Dealing With Swine Flu Cases

INDIANAPOLIS (AP) Indiana's health department has received more test results on suspected swine flu cases, but no new instances of the illness have yet been confirmed.

Health department spokeswoman Melissa Dexter says the agency has decided to only release to the public the number of confirmed cases of the virus because it doesn't want to cause panic.

So far, Indiana has had one confirmed swine flu case _ that of a University of Notre Dame student who has since recovered.

Dexter said today the state will release no further information on how many suspected swine flu samples are being analyzed.

On Tuesday, the state health commissioner said Indiana had submitted about 30 suspected swine flu viral samples to the Centers for Disease Control and Prevention for analysis.

Swine-flu worries in Ohio have prompted a parochial school near Cleveland to close until Monday.

St. Felicitas School in Euclid called off Thursday and Friday classes after a student's mother reported she has flu-like symptoms. Swine flu has not been confirmed and the mother hasn't been to the school since developing symptoms.

Officials say the school with an enrollment of a little over 400 is acting out of caution and will sanitize the building.

There's been only one confirmed case of swine flu in Ohio, a 9-year-old boy who is recovering at his home in Elyria southwest of Cleveland. His school called off classes for this week.

Kentucky Gov. Steve Beshear says a woman who is hospitalized in Georgia with the swine flu is from Warren County.

Beshear said officials from the Barren River Health District are investigating to determine whether any contact of the patient may be ill or in need of treatment.

The head of Georgia's Division of Public Health said Thursday a 30-year-old woman from Kentucky who had traveled to LaGrange in west Georgia had fallen ill. She had been in Cancun, Mexico earlier this month.

Swine flu has symptoms nearly identical to regular flu _ fever, cough and sore throat _ and spreads like regular flu, through tiny particles in the air, when people cough or sneeze.

People with flu symptoms are advised to stay at home, wash their hands and cover their sneezes.
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« Reply #72 on: April 30, 2009, 10:15:04 PM »

http://www.fda.gov/cdrh/ppe/masksrespirators.html

 
FDA > CDRH > Personal Protective Equipment > Masks and N95 Respirators


Masks and N95 Respirators

On this page:

About surgical masks and surgical N95 respirators
When to use surgical masks and surgical N95 respirators
Types of masks and respirators used in patient care
Choosing between surgical masks and surgical N95 respirators
Non-medical respirators

What you should know before using surgical masks and surgical N95 respirators

Find all FDA-cleared surgical masks and surgical N95 respirators

About surgical masks and surgical N95 respirators


Surgical masks and surgical N95 respirators are disposable devices that cover the mouth and nose during medical procedures. They help protect the caregiver and patient against microorganisms, body fluids, and small particles in the air.

Surgical masks and surgical N95 respirators are regulated by the Food and Drug Administration (FDA). FDA evaluates the performance of these devices in areas including fluid resistance and filtration efficiency to ensure that they are at least as safe and effective as similar devices already on the market. FDA encourages manufacturers to follow specific performance standards for their masks, and FDA also requires that these products be produced using good manufacturing practices.

Respirators may also be certified by NIOSH (the National Institute for Occupational Safety and Health) in accordance with regulations in 42 CFR part 84. When a mask is both cleared by FDA as a surgical mask and certified by NIOSH as an N95 respirator mask, FDA calls it a "surgical N95 respirator."

For more information, see FDA’s Role in Regulating PPE.



When to use surgical masks and surgical N95 respirators

Use surgical masks and surgical N95 respirators to cover your mouth and nose when you may be splattered by or exposed to someone else’s body fluids (such as blood, respiratory secretions, vomit, urine or feces).



Types of masks and respirators used in patient care

Surgical masks

include masks labeled as surgical, laser, isolation, dental, or medical procedure masks
help protect against microorganisms, body fluids, and large particles in the air
are designed to cover the mouth and nose loosely; not sized for individual fit
help prevent exposure to the wearer’s saliva and respiratory secretions
are made of soft materials and are comfortable to wear
are usually packaged in boxes of single-use masks

Surgical N95 respirators

are surgical masks that are designed to protect against small droplets of respiratory fluids and other airborne particles in addition to all the protection of surgical masks
fit closely to form a tight seal over the mouth and nose
require fit-testing and must be adjusted to your face to provide intended effectiveness
may be uncomfortable due to tight fit
are usually packaged as single devices or in boxes of single-use devices
 

Choosing between surgical masks and surgical N95 respirators

CDC recommends the use of surgical masks or surgical N95 respirators based on the ways that specific diseases are transmitted. For more information about CDC recommendations, see Infection Control in Healthcare Settings.

Choose a surgical mask to

help protect yourself if you may be splattered by someone else's body fluids (such as blood, respiratory secretions, vomit, urine or feces).
help protect others if you are performing surgery, are caring for an open wound, or if you are sick.
 
Choose a surgical N95 respirator to provide the same protections as a surgical mask AND

help protect yourself if you will be exposed to very small particles (e.g., fine aerosolized droplets) such as those produced by coughing.
care for persons with known or suspected pulmonary and laryngeal tuberculosis per Occupational Safety and Health Administration (OSHA) regulations.

Non-medical respirators

FDA regulates as devices those respirators and other articles that are intended for use in preventing or treating infectious disease. There are a variety of respirators available for various occupational exposures that do not make medical claims and are not regulated by FDA. Many of these respirators are intended to filter out particles of dust and mist from wood, metal, and masonry work. Non-medical respirators are available from many sources including hardware stores and online. Non-medical respirators may look very similar to one another and to respirators that are regulated by FDA. However, there are differences among these respirators and between these non-medical respirators and respirators that have been cleared by FDA as surgical N95 respirators.

Only respirators that have passed specific testing by NIOSH may be labeled as NIOSH-certified. Each NIOSH-certified respirator contains a rating, such as N95, which refers to its certified level of filtration efficiency. If a non-medical respirator is not labeled as NIOSH-certified, it has not been evaluated by the government to determine whether or not it works.

Although NIOSH-certified nonmedical respirators have met filtration efficiency requirements, they are not subject to the additional requirements of FDA-cleared surgical N95 respirators (i.e. fluid and flammability resistance).

Additional Information About Respirators for Public Health Emergencies
 

What you should know before using surgical masks and surgical N95 respirators
The use of surgical masks and surgical N95 respirators alone will not fully protect you from acquiring an infection. Other infection control practices such as hand-washing, isolating infected patients, and practicing appropriate coughing etiquette, are also important to minimize your risk of infection.
 
Surgical N95 respirators must be fit properly. A surgical N95 respirator that has not been fitted properly may leave unprotected gaps between the respirator and your face. These gaps will impair the respirator’s effectiveness. Facial hair or unusual facial features make it difficult to fit surgical N95 respirators properly.
 
Be aware that surgical masks are not fit-tested to your face and may leave unprotected gaps between the mask and your face.
 
Be aware that masks lose their protective properties and must be changed when they become wet from saliva or respiratory secretions.

Know that surgical masks and surgical N95 respirators are not tested against specific microorganisms and should not claim to prevent specific diseases.

See CDC recommendations for using surgical masks and surgical N95 respirators in the care of patients needing isolation precautions (Guidelines for Isolation Precautions in Hospitals).

Never reuse surgical masks or surgical N95 respirators.
Never wash or disinfect surgical masks or surgical N95 respirators.
Never share surgical masks or surgical N95 respirators with others
.

See About PPE for information on disposing of surgical masks and surgical N95 respirators.


Find all FDA-cleared surgical masks and surgical N95 respirators
FDA’s  website lets you search for medical devices that FDA has cleared or approved, including personal protective equipment.

Search for all FDA-cleared surgical masks

Search for all FDA-cleared surgical N95 respirators


CDRH Home Page | CDRH A-Z Index | Contact CDRH | Accessibility | Disclaimer
FDA Home Page | Search FDA Site | FDA A-Z Index | Contact FDA | HHS Home Page

Center for Devices and Radiological Health / CDRH
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« Reply #73 on: May 01, 2009, 11:29:28 AM »


http://www.cdc.gov/h1n1flu/ 


H1N1 Flu (Swine Flu)
H1N1 Flu website last updated May 1, 2009, 11:00 AM ET


U.S. Human Cases of H1N1 Flu Infection
(As of May 1, 2009, 11:00 AM ET) 

States
# of laboratory confirmed cases Deaths

Arizona 4   
California 13   
Colorado 2   
Delaware 4   
Illinois 3   
Indiana 3   
Kansas 2   
Kentucky 1   
Massachusetts 2   
Michigan 2   
Minnesota 1   
Nebraska 1   
Nevada 1   
New Jersey 5   
New York 50   
Ohio 1   
South Carolina 16   
Texas 28 1
Virginia 2   
TOTAL COUNTS 141 cases 1 death

International Human Cases of Swine Flu Infection
See: World Health Organization 

CDC continues to take aggressive action to respond to an expanding outbreak caused by H1N1 (swine flu). CDC’s response goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by this emergency.

CDC continues to issue and update interim guidance daily in response to the rapidly evolving situation. Early this morning, CDC provided interim guidance on school closures. Supplies from CDC’s Division of the Strategic National Stockpile (SNS) are being sent to all 50 states and U.S. territories to help them respond to the outbreak. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against this new virus.

Response actions are aggressive, but they may vary across states and communities depending on local circumstances. Communities, businesses, places of worship, schools and individuals can all take action to slow the spread of this outbreak. People who are sick are urged to stay home from work or school and to avoid contact with others, except to seek medical care. This action can avoid spreading illness further.
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« Reply #74 on: May 01, 2009, 11:33:25 AM »

CDC: H1N1 Flu (Swine Flu) Infections Alert for Institutions of Higher Education

CDC has identified cases of H1N1 influenza virus infection in people in a number of states. CDC is working with local and state health agencies to investigate these cases.

The same virus has been found in people in Mexico, the United States and Canada and is being reported in other countries as well. Symptoms for H1N1 flu have included fever, headache, upper respiratory tract symptoms (cough, sore throat, rhinorrhea), myalgia, fatigue, vomiting, or diarrhea.    Illnesses among persons infected with H1N1 flu virus have mostly been treated at home, but some cases have been hospitalized and deaths have been reported.  It is anticipated that many more cases, including cases that require hospitalizations and some that result in death, will occur.  Most people will not have immunity to this new virus and, as it continues to spread, more cases are expected in the coming days and weeks. 

Read full article>>


 

For more information on H1N1 situation, please visit PandemicFlu.gov



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« Reply #75 on: May 01, 2009, 11:36:05 AM »

CDC: H1N1 Flu (Swine Flu) Infections Alert for Institutions of Higher Education

CDC has identified cases of H1N1 influenza virus infection in people in a number of states. CDC is working with local and state health agencies to investigate these cases.

The same virus has been found in people in Mexico, the United States and Canada and is being reported in other countries as well. Symptoms for H1N1 flu have included fever, headache, upper respiratory tract symptoms (cough, sore throat, rhinorrhea), myalgia, fatigue, vomiting, or diarrhea.    Illnesses among persons infected with H1N1 flu virus have mostly been treated at home, but some cases have been hospitalized and deaths have been reported.  It is anticipated that many more cases, including cases that require hospitalizations and some that result in death, will occur.  Most people will not have immunity to this new virus and, as it continues to spread, more cases are expected in the coming days and weeks. 

Read full article>>


 

For more information on H1N1 situation, please visit PandemicFlu.gov



--------------------------------------------------------------------------------



The link to the above article is:  http://www.cdc.gov/h1n1flu/college-alert.htm

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« Reply #76 on: May 01, 2009, 11:44:22 AM »

http://wwwn.cdc.gov/travel/contentSwineFluMexico.aspx

CDC: Updated Travel Health Warning: H1N1 Flu (Swine Flu) and Severe Cases of Respiratory Illness in Mexico -- Avoid Nonessential Travel to Mexico


Current Situation
As of April 28, 2009, the Government of Mexico has reported 26 confirmed human cases of  H1N1 flu (swine flu), including seven deaths. Investigation is continuing to clarify the spread and severity of the disease in Mexico. The World Health Organization (WHO), the Global Alert and Response Network (GOARN), and the Centers for Disease Control and Prevention (CDC) have sent experts to Mexico to work with health authorities. CDC has confirmed that seven of 14 respiratory specimens sent to CDC by the Mexican National Influenza Center are positive for influenza A (H1N1) and are similar to the swine influenza viruses recently identified in the United States.

On April 25, the WHO Director-General declared this event a Public Health Emergency of International Concern under the rules of the International Health Regulations. CDC and state public and animal health authorities are currently investigating the outbreak in the United States. Click here to see today’s case count. Some of the U.S. cases have been linked to travel to Mexico. CDC is concerned that continued travel by U.S. travelers to Mexico presents a serious risk for their health and the health of others during travel and after they return to the United States.

Read full article>>   Use link above


 

For more information on H1N1 situation, please visit PandemicFlu.gov







 
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« Reply #77 on: May 01, 2009, 11:53:27 AM »

http://www.emergencyemail.org/newsemergency/anmviewer.asp?a=368&z=1

The above link is to Government Issued Guidance on Facility Closure: School Dismissal
and Childcare

The article is dated May 1, 2009 and can be read from the above link.

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« Reply #78 on: May 01, 2009, 12:04:54 PM »

Mere,

Thank you for staying on top of all the updates.

One thing that concerns me greatly is that there are three confirmed cases in Alabama as of yesterday and hundreds of specimens sent for testing.  And yet, Alabama is not even listed on the CDC list of states with confirmed cases.


Now this could happen if the testing was done here instead of sending to the CDC and there is a lag in reporting.  But if this is the case here, I have to wonder if there are not many more cases in many more states also not listed.

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« Reply #79 on: May 01, 2009, 12:11:53 PM »

http://news.yahoo.com/s/ap/20090501/ap_on_he_me/med_swine_flu

AP:  MEXICO'S EPIDEMIOLOGY BOSS FAULTS WHO
By Andrew O. Selsky, AP Writer - 21 Minutes ago
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