MEXICO CITY Mexican officials lowered their flu alert level in the capital on Monday and said they will allow cafes, museums and libraries to reopen this week. World health officials weighed raising their pandemic alert to the highest level.
Mexican officials declared the epidemic to be waning, announcing that Wednesday will conclude a five-day closure of nonessential businesses that was called to stop the spread of the new virus. Health officials need to finish inspecting schools before students can return to class.
Global health experts however said it was too early for countries to lower their guard, but there were no imminent plans to raise the pandemic alert level.
In New York on Monday, U.N. Secretary-General Ban Ki-moon said the World Health Organization "has no plan to raise the alert level to 6 at this moment." WHO chief Margaret Chan also told the U.N. General Assembly by videolink from Geneva that "we are not there yet."
In an interview with the Spanish newspaper El Pais published Monday, Chan implied the agency might raise its alert. She played down the impact of going to level 6, saying she was concerned about causing unnecessary panic.
WHO spokesman Thomas Abraham said the comments appeared to be consistent with what the global body has said all along.
"We have consistently said a pandemic is imminent. It's only a matter of time before we move to phase 6 unless the virus suddenly becomes weaker and dies off," he said.
According to the WHO's pandemic phase definitions, being in level 5 means the agency believes a global outbreak is "imminent." Though Mexican authorities believe the outbreak may have peaked, WHO maintains it is still too early to tell if the outbreak is slowing down.
WHO also emphasized that a pandemic did not necessarily mean the disease was particularly deadly. The past two pandemics in 1957 and 1968 have been relatively mild. WHO said that the term pandemic refers to a disease's geographic spread in all countries worldwide rather than its severity.
While Mexico began its first steps toward normalcy, the virus spread to Colombia in the first confirmed case in South America, where flu season is about to begin. More cases were confirmed in North America and Europe including Portugal's first with the total number sickened worldwide rising to more than a 1,000 people, according to health and government officials.
With the scope of the disease unknown, several countries have taken urgent measures against arriving Mexicans or those who have recently traveled to Mexico.
In China, 71 Mexicans have been quarantined in hospitals and hotels, Foreign Secretary Patricia Espinoza said. Arriving Mexicans were taken into isolation, said Mexico's ambassador, Jorge Guajardo. Even the Mexican consul in Guangzhou was briefly held after returning from a vacation in Cambodia.
And in Hong Kong, 350 people remained isolated Monday in a hotel after a Mexican traveler there was determined to have swine flu.
Mexican President Felipe Calderon complained of the backlash against Mexicans abroad, and his government said a chartered plane left Monday morning for China and will make stops in several cities to pick up any Mexican citizen wanting to return home.
"I think it's unfair that because we have been honest and transparent with the world some countries and places are taking repressive and discriminatory measures because of ignorance and disinformation," Calderon said.
"There are always people who are seizing on this pretext to assault Mexicans, even just verbally," he said, though he did not point to any country.
Espinoza planned to talk to Chinese officials about their policy toward Mexicans.
China's Foreign Ministry denied it was discriminating against Mexicans.
But the Mexican Embassy in Beijing sent a circular out to all its citizens saying China had imposed "measures of unjustified isolation" in response to swine flu and urging trips there to be canceled or postponed.
Espinoza also criticized Argentina, Peru and Cuba for banning flights to Mexico, and said Argentina was sending a plane to Mexico on Monday to pick up Argentines who want to leave Mexico.
A group of 25 Canadian university students and a professor have been quarantined at a hotel in China since the weekend over swine flu fears. Canada has 103 confirmed cases of swine flu. The group does not have any flu symptoms, University of Montreal spokeswoman Sophie Langlois said Monday.
Health Secretary Jose Angel Cordova said at a news conference Monday that Mexico had 727 cases of swine flu and 26 deaths from the virus.
Health officials raised the number of confirmed U.S. swine flu cases to 245 in 35 states late Sunday. The new number reflects streamlining in federal procedures and the results of tests by states, which have only recently begun confirming cases, said Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention.
The CDC's acting chief, Dr. Richard Besser, said swine flu is spreading just as easily as regular winter flu.
"The good news is when we look at this virus right now, we're not seeing some of the things in the virus that have been associated in the past with more severe flu," Besser said. "That's encouraging, but it doesn't mean we're out of the woods yet."
In Alberta, Canada, officials quarantined about 220 pigs infected by a worker who recently returned from Mexico. It was the first documented case of the H1N1 virus being passed from a human to another species. Canada stressed that pigs often get the flu and there is no danger in eating pork.
Cordova presented the most comprehensive description yet of the dead in Mexico.
He said 15 were female and seven were men. One possible explanation could be that women get poorer health care in Mexico because of its male-dominated culture, he said. Cordova also said only 4 percent were unemployed; the rest either had jobs or were housewives and students. More than 50 percent had not graduated from high school and only 11 percent had university education.
Pablo Kuri, an epidemiologist advising Cordova, told The Associated Press that tests have confirmed a swine flu death in Mexico City on April 11, two days earlier than what had been believed to be the first death.
Kuri also said there were no deaths among health care workers treating swine flu patients in Mexico, an indication that the virus may not be as contagious or virulent as initially feared.
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Associated Press writers Christopher Bodeen in Beijing, Bradley S. Klapper in Zurich and Alexandra Olson, Paul Haven and E. Eduardo Castillo in Mexico City, John Heilprin at the United Nations, Rob Gillies in Toronto and Min Lee in Hong Kong contributed to this report.
Developments on swine flu worldwide
Key developments on swine flu outbreaks, according to Centers for Disease Control and Prevention, World Health Organization, and government officials:
- Deaths: 26 confirmed in Mexico and one confirmed in U.S., a toddler from Mexico who died in Texas.
- Confirmed sickened worldwide, 1,223: 727 in Mexico; 286 in U.S.; 101 in Canada; 44 in Spain; 27 in Britain; eight in Germany; six in New Zealand; four in Israel, Italy and France; two in El Salvador; one each in Austria, Costa Rica, Colombia, Denmark, Hong Kong, Ireland, the Netherlands, Portugal, South Korea and Switzerland.
- U.S. confirmed cases from CDC or states: New York, 74; Texas, 43; California, 29; Delaware, 20; Arizona, 18; South Carolina, 15; Illinois, nine; Colorado, Louisiana, Massachusetts and New Jersey, seven; Florida, five; Alabama and Maryland, four; Indiana, Nebraska, Ohio, Oregon, Virginia and Wisconsin, three; Connecticut, Kansas and Michigan, two; and one each in Iowa, Kentucky, Minnesota, Missouri, Nevada, New Hampshire, New Mexico, North Carolina, Pennsylvania, Rhode Island, Tennessee, Idaho and Utah.
- More U.S. school closings announced, including all 24 schools in a district west of Detroit after a high school student came down with an apparent case of the illness. New York City high school that had 45 students with confirmed swine flu cases reopens.
- Centers for Disease Control and Prevention says about a third of confirmed U.S. cases are people who had been to Mexico and likely picked up the infection there.
- Hong Kong, where severe acute respiratory syndrome killed 299 in 2003, ordered weeklong quarantine of downtown hotel where a Mexican tourist was confirmed to have the illness, trapping 274 guests and employees inside.
- Mexico to allow most businesses to reopen Wednesday. Mexico City cafes, museums and libraries to reopen this week; schools to reopen after inspections are completed.
- Mexican government charters a plane to bring its citizens home from China after 70 Mexican nationals traveling in China were quarantined there.
- World Health Organization says slaughtering pigs unnecessary because virus is being spread through humans; says swine herd in Canada likely infected by farmworker who returned from Mexico.
- U.S. Meat Export Federation, which represents pork and beef interests abroad, estimates that U.S. pork exports have dropped about 10 percent since the swine flu scare started.
- Visitation at all California prisons is suspended after an ill inmate at Centinela State Prison in Imperial County is tested for swine flu.
On the Net:
CDC:http://www.cdc.gov/swineflu
Leading US health expert urging cautious approach
WASHINGTON A leading U.S. health expert said Monday that while "there are encouraging signs" of a leveling off in the severity of the swine flu threat, it's still too early to declare the problem under control.
"I'm not ready to say that yet," Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention, said when asked about indications by Mexican health authorities that the disease has peaked there.
Besser did tell network television interviewers that "what we're seeing is an illness that looks very much like seasonal flu. But we're not seeing the type of severe disease that we were worrying about." He noted that roughly 36,000 people die each year in this country from the winter flu, so it's still a serious matter.
At least 274 cases of swine flu virus have been confirmed in 35 states so far in the United States, a count by The Associated Press shows. The most recent CDC count was 226 cases in 30 states. The discrepancy can be attributed at least in part to a time lag in state reporting to the federal agency. And in some instances, states have identified "probable" cases that were not confirmed subsequently.
Besser said "we are by no means out of the woods."
"In previous pandemics," he said, "there have been waves and you don't know what this virus is going to do."
U.S. confirmed cases from the CDC or the states: New York, 63; Texas, 43; California, 29; Arizona, 18; South Carolina, 15; Delaware, 10; Louisiana, New Jersey and Massachusetts, seven; Colorado, four; Florida, Indiana, Illinois, Nebraska, Ohio, Oregon, Virginia and Wisconsin, three; Connecticut, Kansas and Michigan, two; and one each in Alabama, Iowa, Kentucky, Minnesota, Missouri, Nevada, New Hampshire, New Mexico, North Carolina, Pennsylvania, Rhode Island, Tennessee, Idaho and Utah.
There has been one death in the United States, a toddler who succumbed to the disease after he was brought to this country from Mexico.
Besser said health authorities also are concerned about indications that the flu had so far struck the young more heavily than older people, and that there still may be deaths from it.
He also said he didn't think it was necessarily time to ease off on school closings and other steps that have been taken to contain the spread of the infection.
"We're seeing infections in almost every state," Besser said, "and as that occurs, those who have underlying problems (such as the elderly and people with compromised immune systems) may be affected more …. It may be that this disease is starting first in children, and then moving to the elderly, so there's still much that we do not know."
Besser said that as a parent and a pediatrician, he thinks it's best for kids to be in school, whenever possible, and that adjustments in school shutdowns might be possible "as we learn and see that this virus is not more serious than ordinary flu."
Asked whether the food supply has been compromised, he said, "It may be that pigs have more to fear from people than people have to fear from pigs."
"With each day some of the uncertainty goes away, we learn more, and we're seeing encouraging signs," Besser said. "The encouraging signs have to do with severity." He summed up the situation by saying he was "precautiously optimistic" about trends now surfacing.
But he hastened to add that people still need to take everyday precautions, like vigorous and frequent hand washing, covering their noses and mouths when they sneeze and staying home when they're sick.
Besser said that what now ensues in the Southern Hemisphere, which is just entering flu season, will be "critically important for us to understand as we think about the decisions around vaccination."
The CDC chief was interviewed on CBS's "The Early Show" and NBC's "Today" show.
US flu tally jumps to 245 as labs catch up
Malcolm Ritter
AP Science Writer
NEW YORK The tally of confirmed swine flu cases in the United States jumped Sunday to 245 in 35 states, but officials said that's largely from catching up on a backlog of lab tests rather than a sudden spurt in new infections.
The new count reflects streamlining in federal procedures and the results of tests by states, which have only recently begun confirming cases, said Dr. Anne Schuchat of the Centers for Disease Control and Prevention in Atlanta.
Because states are now contributing their results, and because there are many cases to analyze, "I expect the numbers to jump quite a bit in the next couple days," she told reporters Sunday.
Beyond eating into the backlog, the new number also reflects that "we do think this virus is fairly widespread," she said.
"Virtually all of the United States probably has this virus circulating now. That doesn't mean that everybody's infected, but within the communities, the virus has arrived."
Early Sunday, the CDC updated its number to 226 cases in 30 states, up from 160 in 21 states. Later, five more states reported confirmed cases, and new illnesses elsewhere were added to the tally.
Mexico's health secretary said Sunday that his country's outbreak is "now in its declining phase," but Schuchat noted that the United States got off to a later start. "We believe we are just in the upswing here," she said.
Scientists are still gathering information on how severe the nation's 30 hospitalized cases are, she said. They are mostly older children and young adults, in contrast to ordinary flu, which tends to send the elderly and very young to the hospital, Schuchat said.
The only swine flu death in the U.S. is that of a Mexican toddler who was visiting Texas.
Local authorities announced more school closings Sunday, including all 24 schools in a district west of Detroit after a high school student came down with an apparent case of the illness.
On Sunday's talk shows, U.S. health officials said they were cautiously optimistic that the swine flu isn't as dangerous as first feared, but urged people to keep taking commonsense precautions. They said they can't predict if the virus will roar back in the fall.
"The good news is when we look at this virus right now, we're not seeing some of the things in the virus that have been associated in the past with more severe flu. That's encouraging, but it doesn't mean we're out of the woods yet," said Dr. Richard Besser, acting CDC chief.
With swine flu, or the H1N1 flu as the government prefers to call it, now in more than 30 states and counting, authorities say it's spreading just as easily as regular winter flu. But, as Besser appeared on talk shows with the president's health and homeland security chiefs, they said that it doesn't seem to cause as severe a disease as it did in Mexico.
A big concern is whether the virus will return, perhaps harder, when regular influenza begins its march here. Flu season in the Southern Hemisphere is about to begin, and U.S. authorities will watch how the swine flu circulates there over the coming months as they prepare the first vaccine and then decide whether to order that large amounts of it be produced in the fall.
Production of regular winter flu vaccine is going full-tilt, "to make sure we kind of clear the decks," Health and Human Services Secretary Kathleen Sebelius said.
"We are testing the virus strain for H1N1 virus so that we're ready to go into production later, in a month or two, when we make sure that we have the right dosage and the right tests. So we'll be ready for both," she said.
Even if the swine virus doesn't prove as potent as authorities first feared, Besser said that doesn't mean the U.S. and World Health Organization overreacted in racing to prevent a pandemic, or worldwide spread, of a virus never before seen.
With a new infectious disease, "you basically get one shot, you get one chance to try to reduce the impact," Besser said. "You take a very aggressive approach and as you learn more information you can tailor your response."
It was just over a week ago that authorities learned the new flu CDC had detected in a few people in California and Texas was causing a large outbreak and deaths in Mexico, triggering global alarm.
"We didn't know what its lethality was going to be. We had to move. Once you get behind flu, you can't catch up," Homeland Security Secretary Janet Napolitano said.
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AP Medical Writer Lauran Neergaard in Washington contributed to this report.