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40 Swine Flu Cases Confirmed in the U.S.
(Posted on 04/27/09)
The U.S. has declared a public health emergency after 40 cases of swine influenza are confirmed in California, Kansas, New York, Ohio and Texas, and in other countries. The virus, for which there is no known vaccine, is described as a strain of influena A (H1N1) not previously found in pigs or humans. The American Academy of Pediatrics is closely monitoring communications from the Centers for Disease Control and Prevention and the World Health Organization.
Background and Guidance for Clinicians on Swine Flu (Influenza A H1N1 Triple Reassortant Virus)
Cases of a new H1N1 influenza virus strain have been documented in 5 states (California, Kansas, New York, Ohio and Texas) and Mexico during the past week. In addition, swine influenza cases also have been reported in Canada, New Zealand, Spain, France and Israel. This new virus is a hybrid, with genetic elements of swine influenza (both American and Eurasian components), avian influenza, and human influenza.
While detailed information on the U.S. and Mexican cases is being collected and thoroughly analyzed by the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), Mexican health authorities, and local health departments, important facts are already available that may help pediatric health care practitioners now. Up-to-date information and/or recommendations will continue to be available on the CDC Web site.
Forty cases have been identified so far in the United States; all of the U.S. cases have had mild clinical courses with no mortality. Only 1 patient, already known to be immunocompromised, was hospitalized. None of the U.S. cases had any recognized exposure to pigs, suggesting that this swine influenza virus has uniquely developed the capacity to spread from human to human.
Concurrently, in Mexico City, a large outbreak of respiratory tract infection has been reported (as many as 900 people may be affected), associated with significant mortality (perhaps as high as 5%). By April 27, only 26 of the cases in Mexico have been confirmed by the CDC to be caused by the same swine influenza strain identified in the U.S. However, fears that the outbreak may be caused primarily by a hypervirulent swine influenza strain, for which we have no vaccine, have prompted aggressive public health investigations, raising public anxiety about a potential new pandemic.
Enhanced surveillance has now been instituted in the U.S. Respiratory tract samples are being collected from people who present with an “influenza-like illness” -- fever and sore throat and/or cough. These samples are being rapidly analyzed by county, state and federal public health agencies.
The possibility of swine influenza should be considered in patients presenting to you with a febrile respiratory illness who have traveled to San Diego County or Imperial County, California; San Antonio, Texas, other areas in the U.S. where cases have occurred, or some areas in Mexico (i.e., Mexico City, Mexicali and San Luis Potosi), or have been in contact with sick persons with flu-like illnesses from these areas in the 7 days prior to their illness onset.
As always, encourage the consistent use of respiratory hygiene and cough etiquette measures to prevent the spread of any type of influenza:
The most pressing question at this time is whether or not this new swine flu strain is able to cause disease that is more severe than recently circulating seasonal strains of human influenza.
The Department of Health and Human Services (HHS) issued a nationwide public health emergency declaration on April 26 in response to these recent human infections with a newly discovered swine flu virus. This declaration facilitates HHS preparation and mobilization for disasters and emergencies.
For current, frequently updated information, visit the CDC Swine Influenza Web site. This site will be updated at 3:00 p.m. ET daily.
Additional Resources:
For Parents: For Travelers: For Schools:
(Posted on 04/27/09)
The U.S. has declared a public health emergency after 40 cases of swine influenza are confirmed in California, Kansas, New York, Ohio and Texas, and in other countries. The virus, for which there is no known vaccine, is described as a strain of influena A (H1N1) not previously found in pigs or humans. The American Academy of Pediatrics is closely monitoring communications from the Centers for Disease Control and Prevention and the World Health Organization.
Background and Guidance for Clinicians on Swine Flu (Influenza A H1N1 Triple Reassortant Virus)
Cases of a new H1N1 influenza virus strain have been documented in 5 states (California, Kansas, New York, Ohio and Texas) and Mexico during the past week. In addition, swine influenza cases also have been reported in Canada, New Zealand, Spain, France and Israel. This new virus is a hybrid, with genetic elements of swine influenza (both American and Eurasian components), avian influenza, and human influenza.
While detailed information on the U.S. and Mexican cases is being collected and thoroughly analyzed by the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), Mexican health authorities, and local health departments, important facts are already available that may help pediatric health care practitioners now. Up-to-date information and/or recommendations will continue to be available on the CDC Web site.
Forty cases have been identified so far in the United States; all of the U.S. cases have had mild clinical courses with no mortality. Only 1 patient, already known to be immunocompromised, was hospitalized. None of the U.S. cases had any recognized exposure to pigs, suggesting that this swine influenza virus has uniquely developed the capacity to spread from human to human.
Concurrently, in Mexico City, a large outbreak of respiratory tract infection has been reported (as many as 900 people may be affected), associated with significant mortality (perhaps as high as 5%). By April 27, only 26 of the cases in Mexico have been confirmed by the CDC to be caused by the same swine influenza strain identified in the U.S. However, fears that the outbreak may be caused primarily by a hypervirulent swine influenza strain, for which we have no vaccine, have prompted aggressive public health investigations, raising public anxiety about a potential new pandemic.
Enhanced surveillance has now been instituted in the U.S. Respiratory tract samples are being collected from people who present with an “influenza-like illness” -- fever and sore throat and/or cough. These samples are being rapidly analyzed by county, state and federal public health agencies.
The possibility of swine influenza should be considered in patients presenting to you with a febrile respiratory illness who have traveled to San Diego County or Imperial County, California; San Antonio, Texas, other areas in the U.S. where cases have occurred, or some areas in Mexico (i.e., Mexico City, Mexicali and San Luis Potosi), or have been in contact with sick persons with flu-like illnesses from these areas in the 7 days prior to their illness onset.
As always, encourage the consistent use of respiratory hygiene and cough etiquette measures to prevent the spread of any type of influenza:
- frequent hand washing;
- covering coughs and sneezes; and
- staying home when sick to keep from spreading illness.
The most pressing question at this time is whether or not this new swine flu strain is able to cause disease that is more severe than recently circulating seasonal strains of human influenza.
- If disease severity is similar, then we probably will not treat this strain much differently than any other antigenically distinct new strain.
- If this strain is highly virulent, enhanced infection control practices, including isolation of hospitalized cases in negative-pressure isolation rooms, the use of N95 respirator masks, and antiviral prophylaxis to those exposed to a person with disease, will be instituted.
The Department of Health and Human Services (HHS) issued a nationwide public health emergency declaration on April 26 in response to these recent human infections with a newly discovered swine flu virus. This declaration facilitates HHS preparation and mobilization for disasters and emergencies.
For current, frequently updated information, visit the CDC Swine Influenza Web site. This site will be updated at 3:00 p.m. ET daily.
Additional Resources:
For Parents: For Travelers: For Schools:
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