Swine Flu Update - Pandemic Worries 4/29/09

It started off like any other springtime flu in one of the largest cities in the world.
Concerned residents line up outside a pharmacy Monday in Mexico City, Mexico.

But a week later, Mexico City is a metropolis under siege. Armed police officers guard hospitals. Roads and schools in the city of 20 million are deserted. Blue masks shield the faces of mothers and babies from a virus that doctors are still trying to understand, let alone bring under control.

"I'm pretty nervous of this whole virus thing," Berta Hernandez said as she touched up her eyeliner inside a packed and humid subway car. She did not dare lift her surgical mask to put on lip gloss.

"I'm nervous of the people who aren't wearing masks. Maybe they will suddenly sneeze or cough."

By early Tuesday, the swine flu outbreak in Mexico was suspected in 152 deaths and more than 1,600 illnesses, its health minister said.

While authorities wait to verify whether the virus is responsible for all the deaths, the number of confirmed cases is sobering: 19 infected, seven others dead and thousands flooding hospitals. iReport.com: Are you worried about swine flu?

Mexico seems to be the epicenter of the outbreak, but it is by no means the only country affected.

At least 90 cases have been confirmed worldwide, including 50 in the United States, six in Canada, three in New Zealand, two each in Spain and the United Kingdom, and one in Israel.

With at least 11 other countries suspecting infections, the World Health Organization on Monday raised its alert level from three to four on its six-level scale.

The move means the agency has determined that the virus is capable of significant human-to-human transmission -- a major step toward a pandemic but not necessarily inevitable, said Dr. Keiji Fukuda, assistant director-general of WHO.

"In this age of global travel, where people move around in airplanes so quickly, there is no region to which this virus could not spread."

Some countries, such as China and Russia, banned pork imports from the United States and Mexico. Several others, such as Japan and Indonesia, used thermographic devices to test the temperature of passengers arriving from Mexico.

The Philippines health department urged people to avoid kissing and hugging in public.

The U.S. Food and Drug Administration issued emergency authorization for the use of two of the most common anti-viral drugs, Tamiflu and Relenza. The authorization allows the distribution of the drugs by a broader range of health care workers and loosens age limits for their use.

The median age of all the U.S. cases is 16 years.

Arianna Anastos is a student at a Queens, New York, preparatory school where 28 of the 40 U.S. cases were confirmed after students returned from a trip to Cancun, Mexico.

Anastos was not among the group but said she thinks she may have caught the flu from someone else.

"I mean, people touch the railing on the school, and then I touch them," she said.

By Saturday, Anastos felt dizzy, had difficulty breathing, and her fever shot up to 103.

"She looked like she was run over by a truck really," said her father, Chris. "She was on the couch lying down with her eyes closed. Could not move. Could not even open her eyes. I had a wet towel over her eyes to keep her temperature down."

A trip to the hospital and a prescription for anti-viral medication helped Anastos recover. She said she felt better after two doses.

In Mexico City, however, there is a shortage of such medication. And the government ran out of surgical masks after handing them out to one of every five residents.

Panicked citizens continue to flood hospitals night and day, only to be turned around by armed guards.

"I was looking for a mask at my local pharmacy, but they sold out," supermarket worker Rafael Martinez said as he rode the subway. "I know it's a risk, but I can't find one."

To minimize spread of the virus, the Mexican government closed universities, postponed sporting events and canceled church services in the country's most populous city. Video Watch Mexican officials discuss flu plan »

Officials also have talked about shutting down the bus and subway systems, which shuttle thousands to and from work every day.

"I don't think it's feasible or advisable to shut down the city," said newspaper vendor Jose Luis Suarez. "People would try and get out somehow, and that would make a bad situation worse."

Swine influenza, or flu, is a contagious respiratory disease that affects pigs.

When the flu spreads person to person, instead of from animals to humans, it can continue to mutate, making it harder to treat or fight, because people have no natural immunity. Symptoms include fever, runny nose, sore throat, nausea, vomiting and diarrhea.

For perspective, the common seasonal flu kills 250,000 to 500,000 people every year.

"I think the reason to be concerned is ... we had a vaccine for regular flu," said Dr. Carlos del Rio of the Emory University School of Medicine in Atlanta, Georgia. "This is a totally new virus. ... You have a virus to which there's no pre-vaccination, there's no prior immunity. And, therefore, the mortality rate may be higher than other influenza viruses."

Researchers do not know how the virus is jumping relatively easily from person to person, or why it's affecting society's healthiest demographic.

"When you think about the flu, the seasonal flu, the flu that we're accustomed to, it typically tends to have the worst ramifications in people that don't have developed immune systems -- the elderly and the very young. They can't fight it off," said Dr. Sanjay Gupta, CNN's chief medical correspondent. Video Watch Gupta on the outbreak in Mexico »
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"What's counterintuitive with this particular virus, it's in the people who have robust immune systems. As their body starts to respond, to try and fight off that virus, they produce tons of inflammatory cells. Those inflammatory cells can sort of flood the lungs.

"So, in essence, it's not the virus itself that's so problematic, but the body's reaction to it."