Bracing For The Flu

Md. Opens Command Center To Track Predicted Arrival Of Virus That Has Killed Scores In Mexico And Is Slowly Moving Across U.s.

April 28, 2009|By Kelly Brewington and Stephanie Desmon | Kelly Brewington and Stephanie Desmon, and

Officials advised Monday against most travel to Mexico, the center of an outbreak of swine flu suspected of killing almost 150 people there and sickening at least 50 through its spread to the United States.

The acting director of the Centers for Disease Control and Prevention said cases of the virus in the U.S. have been mild - none has been reported in Maryland - but warned that more serious cases could emerge.

"I wouldn't rest on the fact that we have only seen cases in this country that are less severe," Dr. Richard Besser told reporters.

He said officials were reacting "aggressively," including releasing 11 million courses of anti-viral drugs from a national strategic stockpile and sending kits to some states to enable them to test for the disease locally.

On Monday, a day after federal authorities announced a public health emergency, President Barack Obama told a group of scientists that while the outbreak is a cause for concern, it is "not a cause for alarm."

Later in the day, the State Department issued an alert advising U.S. citizens to avoid nonessential travel to Mexico.

Maryland health officials said they are working with hospitals and health departments, bracing for what they predict will be the inevitable stricken patient.

"We will have a case here in Maryland," said state health Secretary John M. Colmers. "I don't think there's any doubt of that. What we don't know is how extensive it will be and whether or not it will be as virulent as what we are seeing in Mexico. That's why we must continue to monitor the situation."

Worries about the outbreak set doctors' phone lines ablaze, led to reports of runs on surgical masks in some cities and roiled the economy, sending stocks lower on fears that the tourism industry could be further hobbled by restrictions brought on by swine flu.

Globally, the World Health Organization raised its alert level but stopped short of calling the outbreak a pandemic.

In Mexico, the illness has infected about 2,000 people and is suspected of claiming about 150 lives, although not all deaths have been confirmed as resulting from flu. It has shut schools, closed churches and emptied streets in Mexico City. One case has been confirmed in Spain and one is suspected in France, prompting European officials to warn citizens against visiting the U.S. and Mexico.

The CDC's Besser called that warning, in the case of the U.S., "quite premature."

Domestic cases have been reported in New York, Texas, California, Ohio, New Jersey and Kansas, according to the CDC. As of Monday, a total of 28 confirmed cases were from one New York City school.

Officials know that this flu appears to be spreading from person to person, but they are not sure how virulent it is. Younger people in Mexico have died from it, but not the babies and older people who are most endangered by seasonal flu.

This year's flu shots are ineffective against the strain, but CDC scientists are considering whether to develop a vaccine that includes the strain for the fall, a difficult undertaking.

"Over the course of the next week or two, we'll know a whole lot more," Besser said.

The new virus is part human, part avian and part porcine. "It has a mix of new genes," said Dr. Ruth Karron, director of the Center for Immunization Research and the Johns Hopkins Vaccine Initiative at the Johns Hopkins Bloomberg School of Public Health. "It's a virus that humans have not previously been exposed to, so there's no immunity to this flu. We're broadly susceptible to this flu."

Flu experts have been on high alert in recent years, trying to prepare for the next unanticipated strain.

"We were all thinking about bird flu," Karron said. "We were looking to Asia for the development of the next pandemic strain, and here we have a swine flu outbreak in the Americas. It's not where we were expecting to see it."

Still, she said, past outbreaks have made the country "much better prepared."

At the Johns Hopkins Medical campus, a team of about 75 people has been working around the clock for the past 56 hours, drawing on existing disaster plans to devise a strategy for dealing with swine flu, said Dr. Gabe Kelen, director of Hopkins' Office of Critical Event Preparedness and Response.

But preparing for the unknown is tricky, particularly in a vast medical complex, said Kelen. Among the decisions the hospital must make: how to screen patients, protect health care workers and determine whether there is enough anti-viral supply, and, if a higher level of preparedness is needed, how to get that message out.

Public health officials appear to be taking measured steps and choosing their words carefully, he said.

"We want to be prepared should this turn out ugly, but we don't want to alarm anyone either," he said. "We are being pre-emptive within reason."

The hospital has begun preparing for the possibility of infections here. Admitted patients and visitors to the emergency room and outpatient clinics were being screened for symptoms of the influenza-like illness.

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