From NewYork Times
HONG KONG — Swine flu spread to Asia on Friday, as Hong Kong authorities announced the continent’s first case, a 25-year-old traveler who came from Mexico via Shanghai, and immediately quarantined an entire hotel where the traveler had stayed on Thursday night.
The case re-awoke memories of SARS, the severe acute respiratory syndrome that arrived in the territory six years ago, and raised concerns that the virus may have been introduced to
mainland China, although the man did not leave the airport while in Shanghai. Flu experts have warned that it would be harder to manage the disease if it becomes established in Asia’s densely populated countries.
Worldwide, the number of confirmed cases of what is now known as influenza A(H1N1) continued to climb. The Centers for Disease Control and Prevention raised its total number of confirmed cases in the United States on Friday to 141 cases in 19 states, up from 109 cases in 11 states a day earlier.
Hong Kong’s first confirmed arrived Thursday afternoon on a China Eastern flight, then checked into a local hotel and fell ill, health officials said in an evening press briefing. Hong Kong authorities responded quickly, quarantining the man at a local hospital, declaring a health emergency, and then quarantining all 200 guests at the hotel, the Metropark, for seven days — whether or not they had contact with the man.
About 100 members of the hotel staff are also being kept in the building, and will be moved to rural campgrounds that are being converted overnight into medical quarantine areas, authorities said. Health workers in blue uniforms and green surgical masks also arrived to distribute boxes of Tamiflu, which is used to shorten the duration of the flu, to hotel guests and staff.
“No one can enter or leave the hotel without the permission of a health officer,” said Dr. Lam Ping-yan, Hong Kong’s director of health.
Despite the alarm the epidemic has raised in Hong Kong and other areas, the epidemic has so far resulted in mild illness in many of those infected outside Mexico, and worldwide caused one death in the United States and fifteen in Mexico. There are 358 confirmed cases of infection in Mexico, believed to be the outbreak’s epicenter, and tests are continuing to see if more of 159 people who recently died of respiratory ailments had the flu, Mexican authorities said.
While it is not yet clear if this new virus is more lethal than seasonal flus, which kill an estimated 250,000 to 500,000 people worldwide each year, some scientists are beginning to argue that the A(H1N1) flu lacks some of the genetic earmarks of a highly lethal strain. Mexican health officials said Friday that the virus is responsive to treatment by Tamiflu and other antiviral medications if they are administered shortly after the disease’s onset, and reported that widespread closures mandated throughout the country appeared to be slowing the disease’s spread.
Yet most people will not have immunity to this new virus, and a vaccine is months away. And even a flu with a low percentage of lethality can cause a large number of deaths if vast swaths of populations are infected.
Worldwide, the number of confirmed cases rose from 257 to 331 Friday, the World Health Organization in Geneva reported.
The organization’s figures remained lower than the sum of confirmed cases reported by individual states and countries because the organization is bound by international rules to report only those cases confirmed to it by specific national laboratories, a spokesman said.
Governments and institutions around the world scrambled to ward off infection. Japan’s sumo wrestling authority will distribute antibacterial liquid hand soap and face masks to athletes and their families, media reports in Japan said. Hong Kong has begun requiring all arriving travelers to fill out health declarations before being allowed to enter the territory.
The Roman Catholic Church in New Zealand instructed priests Friday not to place communion wafers in worshippers’ mouths because of transmission risks, The Associated Press reported, and indigenous Maori were urged to stop using an ancient greeting that brings people nose-to-nose.
No new countries were added to a W.H.O. list released on Friday— Mexico, the United States, Canada, Spain, Britain, Germany, New Zealand, Israel, Austria, the Netherlands and Switzerland. Health officials in Peru, Costa Rica, Denmark have also reported confirmed cases, according to news services. Russia on Friday reported two suspected cases, Interfax reported.
“This is a rapidly evolving situation,” said Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention. “It is a situation filled with uncertainty.”
The Marine Corps said late Thursday that two service members at Camp Pendleton, California, have been confirmed as having swine flu, The A.P. reported, and both were recovering after being isolated. The cases brought the number of confirmed instances of the illness in California to 13.
In Britain, a worker from the National Health service, Graeme Pacitti, 24, who fell ill after being in contact with a Scottish couple who honeymooned in Mexico, was confirmed to have the H1N1 virus, making him the person in Britain to get the flu without having visited Mexico, Reuters reported.
The Scottish Health Secretary Nicola Sturgeon told reporters that, while Mr. Pacitti’s symptoms were not severe, the idea that the virus could be spreading within the country “give us cause for concern.”
The same concerns emerged in Germany. The Health Ministry in Berlin said Friday that swine flu had spread within the country after a Bavarian woman who had not been to Mexico fell ill. She had been in contact with one of three people previously diagnosed with the illness after returning from Mexico. The woman, who was not identified by name, had now recovered, the ministry said.
In Canada, the confirmation of 15 additional cases on Thursday brought the total number of cases there to 34.
On Friday, Mexico implemented its plan to shut down non-essential federal government offices and businesses for five days. The closing of stores and other businesses is meant, in part, to keep people home during a long holiday weekend there when people would normally head out to the beach and to restaurants.
On Thursday evening, Health Secretary José Ángel Córdova said there had been a drop in the number of suspected cases handled by the hospital system of the Mexican Social Security Institute.
“Social Security received 212 probable cases April 20. Today there were only 46. There has been a progressive decline in these cases,” he said.
In the United States, the government continued to roll out the plans it had made to deal with a nationwide outbreak. Until now, states have had to send samples to the C.D.C. in Atlanta to be tested for the new flu strain. But this week, the C.D.C. began sending materials to the states so that they could do their own tests and get results more quickly.
California was among the first to receive the materials, and a spokesman for the state health department said that by the end of the week, the state should be able to do its own testing.
But as health officials kept working in emergency mode, a few infectious disease experts quietly suggested that fears related to the outbreak were overblown.
Dr. Paul Offit, chief of infectious diseases at the Children’s Hospital of Philadelphia, said the death of a 23-month-old Mexican child in Texas did not mean that the outbreak was extraordinarily dangerous.
“Every year we see between 75 and 150 children die of flu, most of whom were previously healthy,” Dr. Offit said.
Recent improvements to the nation’s flu surveillance system led officials to notice the swine flu outbreak, he said, when just a few years ago it would have been lost among the sea of routine sicknesses.
“We’re very quick now to identify new strains of the flu,” Dr. Offit said. “The question is what we should do with that.”
Dr. John Treanor, a professor of medicine at the University of Rochester Medical Center and an infectious-disease expert, said swine flu would probably be only slightly more dangerous than the usual seasonal flu.
“It won’t be severe, although there will be some deaths,” Dr. Treanor said. Because seasonal flu causes about 36,000 deaths a year in the United States, some deaths should not be surprising, he said. |
