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Much ado about new flu

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By Roger Snodgrass

A flurry of activity erupted Monday in response to reports of an emerging flu epidemic traced to southeastern Mexico late last week.

By this morning, the disease had reached the Middle East and Asia-Pacific. Travel advisories, but not bans, are in effect for Mexico, according to the Associated Press.

Mexico has reported more than 150 fatalities blamed on influenza A (H1N1), a respiratory ailment found in pigs, which does not normally infect humans.

Los Alamos County emergency coordinator Philmont Taylor said no cases have been identified in New Mexico.

As of this morning, the Centers for Disease Control and Prevention reported 45 cases in New York City, 10 in California, six in Texas, two in Kansas and one in Ohio.

No fatalities have yet been reported in the United States, while the toll in Mexico has grown above 150, but with a slight down tick in new cases in recent days.

“All the states are monitoring fairly carefully, especially New Mexico, since we share a border with Mexico,” Taylor said.

A statement from the laboratory’s Medical Director Michael Eaton said this morning, “LANL Occupational Medicine is taking this situation very seriously. As the clinical picture is dynamic and rapidly evolving, OM is maintaining communications with the NM Dept of Health, DOE, local medical providers and the CDC to keep our workforce apprised of the latest developments and recommendations.”

Also this morning, a statement from Los Alamos Medical Center said the local hospital “is not aware of any confirmed cases of swine flu in Los Alamos,” adding that they were following a formal regimen of “universal precautions” and staying up-to-date with the Centers for Disease Control.

Chris Minnick, public information officer for the state Department of Health said a Border Influenza Sentinel Surveillance Network was set up two years ago along the Mexican-American frontier and could be relied on to report to the state on a regular basis.

“The Department of Health in the state has been planning for years for any kind of pandemic,” he said. “We’re in the first stage of that right now.”

Media saturation has focused public attention on the sudden international viral outbreak, but no one knows how bad it’s going to get.

Catherine Macken, who studies viral genetics and epidemiology at Los Alamos National Laboratory, said one of the most remarkable things about the current outbreak is that it happened where nobody was looking.

“It’s very hard to predict,” she said. “For all the years we’ve been studying it, there is still no way of predicting what type is going to be dominate in what area or how virulent it is going to be.”

Because attention has been focused on Asia lately as the source of avian flu, she said, “Who would have thought that Mexico would be the focus point?”

Macken, along with Tim Germann and Kai Kadau, helped develop EpiCast, a computer model for understanding how avian flu might spread across the United States.

That virus, known as H5N1, continues to cause infections, mostly in Asia, but reached a peak in 2006. The lab’s funding for pandemic modeling came to an end in 2007.

“The main thing right now are the basics,” Macken said. “CDC has tremendous capacity to run a virus through a test to see its reaction to human antibodies and human T-cells, to see what kind of immune reaction there will be.”

On Sunday, Secretary of the Department of Homeland Security, Janet Napolitano, declared a public health emergency related to the swine flu outbreak

On Monday, the Director General of the World Health Organization raised the level of alert  from what was a phase 3 to a phase 4. WHO said the higher phase meant that the likelihood of a pandemic has increased, but is not yet inevitable.

WHO’s Phase 4 is “characterized by verified human-to-human transmission” of a virus able to cause “community-level outbreaks.”

Beverly Allen, director of public information for the Department of Homeland Security Emergency Management said she remembered the Hong Kong flu in 1968-69, which infected 500,000 people worldwide.

“I’m getting on a plane tomorrow and I’m going to wear a mask,” she said.

At the present stage, “It’s a wait and prepare game.” Taylor said. “When the school system called, I told them to take the plan for avian flu and do a find and replace ‘swine’ for ‘avian,’ and they’ll be safe with that plan.”

The basic advice at this point, is for strict hygiene and hand washing, visiting the doctor in response to any flu symptoms and staying away from sick people and staying at home, if sick.