Swine flu appears in more countries

MEXICO CITY – The swine flu epidemic crossed new borders yesterday with the first cases confirmed in the Middle East and the Asia-Pacific region, as world health officials said they suspect American patients may have transmitted the virus to others in the United States.

Most people confirmed with the new swine flu were infected in Mexico, where the number of deaths blamed on the virus has passed 150.But confirmation that people had become infected outside Mexico would indicate that the disease was spreading beyond travellers returning from the country, World Health Organisation spokesman Gregory Hartl told reporters yesterday in Geneva.Hartl said the source of some infections in the United States, Canada and Britain was unclear.Hartl said WHO was waiting for US authorities to announce that a number of students at a New York high school have passed the virus on to one another after their return from a spring vacation in Mexico. ‘I think we might have one other instance in the US,’ he said.Pressed by reporters to elaborate, he declined, saying it was up to US authorities to provide further information.Possible scenarios include students getting infected who did not travel to Mexico, or students who travelled there but became infected only after returning to the United States, or family members getting infected from returning students.WHO calls this ‘community transmission’ and says it’s a key test for gauging whether the spread of the virus has reached pandemic proportions. The swine flu has already spread to at least six countries besides Mexico, prompting WHO officials to raise its alert level on Monday.’At this time, containment is not a feasible option,’ said Keiji Fukuda, assistant director-general of the World Health Organization.WHO raised the alert level to Phase 4, meaning there is sustained human-to-human transmission of the virus causing outbreaks in at least one country. Monday was the first time it has ever been raised above Phase 3.Flu deaths are nothing new in the United States or elsewhere. The Atlanta-based Centres for Disease Control and Prevention estimates that about 36 000 people died of flu-related causes each year, on average, during the 1990s in the United States. But the new flu strain is a combination of pig, bird and human viruses that humans may have no natural immunity to.New Zealand reported yesterday that 11 people who recently returned from Mexico contracted the virus. Tests conducted at a WHO laboratory in Australia had confirmed three cases of swine flu among 11 members of the group who were showing symptoms, New Zealand Health Minister Tony Ryall said.Officials decided that was evidence enough to assume the whole group was infected, he said.Israel’s Health Ministry confirmed yesterday the region’s first swine flu case in the city of Netanya. The patient, 26, recently returned from Mexico and had contracted it. A hospital official said the patient had recovered, but will remain hospitalised until the health ministry approves his release.Another suspected case has been tested at another Israeli hospital but results are not in, the ministry said.Meanwhile, a second case was confirmed yesterday in Spain, Health Minister Trinidad Jimenez said, a day after the country reported its first case. The 23-year-old student, one of 26 patients under observation, was not in serious condition, Jimenez said.With the virus spreading, the US prepared for the worst. President Barack Obama said the outbreak is ‘not a cause for alarm,’ but the US stepped up checks of people entering the country and warned Americans to avoid nonessential travel to Mexico.’We anticipate that there will be confirmed cases in more states as we go through the coming days,’ Homeland Security Secretary Janet Napolitano said on NBC’s ‘Today’ show yyesterday.The Food and Drug Administration late on Monday issued emergency guidance that allows certain antiviral drugs to be used in a broader range of the population in case mass dosing is needed to deal with a widespread swine flu outbreak.The European Union health commissioner suggested that Europeans avoid nonessential travel both to Mexico and parts of the United States. Canada warned Tuesday against nonessential travel to Mexico. Russia, Hong Kong and Taiwan said they would quarantine visitors showing symptoms of the virus.Mexico, where the number of deaths believed caused by swine flu rose by 50 percent on Monday to 152, is suspected to be the center of the outbreak. But Mexican Health Secretary Jose Angel Cordova late on Monday said no one knows where the outbreak began, and implied it may have started in the U.S.’I think it is very risky to say, or want to say, what the point of origin or dissemination of it is, given that there had already been cases reported in southern California and Texas,’ Cordova told a press conference.Dr Nancy Cox of the CDC has said she believes the earliest onset of swine flu in the US was on March 28. Cordova said a sample taken from a 4-year-old boy in Mexico’s Veracruz state in early April tested positive for swine flu. However, it is not known when the boy, who later recovered, became infected.A decision by WHO to put an alert at Phases 4 or 5 signals that the virus is becoming increasingly adept at spreading among humans. Phase 6 is for a full-blown pandemic, characterised by outbreaks in at least two regions of the world.Fifty cases – none fatal and most of them mild – were confirmed in the United States. Including the New Zealand, Israeli and new Spanish reports, there were 92 confirmed cases worldwide on Tuesday. That included six in Canada, one in Spain and two in Scotland.Amid the alarm, there was a spot of good news. The number of new cases reported by Mexico’s largest government hospitals has been declining the past three days, Cordova said. – Nampa-AP