By Thomas H. Maugh II
11:32 AM PDT, April 29, 2009
As the swine flu outbreak spread to four more states overnight, bringing the total to at least 91 cases, the United States reported its first death from the new virus, a 23-month old child who died in a Houston hospital.
The boy was a Mexican national from Mexico City who had traveled to Matamoros on a commercial flight with his family to visit relatives in Brownsville, Texas. After his symptoms grew more severe, he was taken to Houston to seek medical treatment.
Arizona, Massachusetts, Michigan and Nevada joined the list of states with new cases. Texas said its total has now climbed to 16 cases, New York has 51, and California has 14.
The Centers for Disease Control and Prevention said there have been more hospitalizations as well and reported on its website that “a pattern of more severe illness associated with the virus may be emerging in the United States.”
“We expect to see more cases, more hospitalizations, and, unfortunately, we are likely to see more deaths from the outbreak,” Health and Human Services Secretary Kathleen Sebelius told reporters on her first day at work following Senate confirmation Tuesday.
As with all flu strains, experts said, the more people who are infected, the greater the likelihood that some will develop more severe illnesses. At this time, however, there is little to suggest this strain will be more virulent than other strains already in the population.
Worldwide, new cases have been reported in Canada, the United Kingdom, Austria and New Zealand, among other countries.
“It’s clear that the virus is spreading, and we don’t see any evidence of it slowing down at this point,” Dr. Keiji Fukuda, assistant director-general of the World Health Organization, said at a morning news conference in Geneva.
“The illness we are seeing is generally consistent with seasonal influenza infection,” he added, but there is “a suggestion that cases are developing diarrhea more often.”
He also added that “the epidemiologic information to date more strongly suggests that we are dealing with a virus that is being transmitted form person to person. It is this transmission and travel that are accounting for the cases.”
Mexican health officials said today that the number of confirmed cases of swine flu had risen to 49, a jump from the previous official tally of 26. Mexican authorities say seven of those people have died.
The revised count results from new testing of samples from flu patients and doesn’t necessarily mean more people are getting sick. The number of people believed infected by the swine flu virus in Mexico remained at 2,498, according to the government tally. The virus is suspected in 159 deaths in Mexico.
Mexico City Mayor Marcelo Ebrard told reporters that the number of new flu cases in his city appeared to be leveling off, though he did not cite figures. The city’s health secretary, Armando Ahued Ortega, said one person died of swine flu during the previous 24 hours in Mexico City, the country’s hardest-hit spot.
Ebrard said confirmation that the crisis was stabilizing would allow him to consider loosening restrictions on public gatherings, including new rules that allowed restaurants to serve take-out food only. Cinemas, museums, gyms, concert halls and a host of other public places have closed their doors as part of the effort to prevent further infection.
In light of the outbreak, France today called on the European Union to ban flights to and from Mexico. Cuba and Argentina already have done so. A representative of the union’s executive commission said, however, that although individual countries in Europe have the power to take such an action, the union itself does not.
President Obama issued a statement today, saying, “We are closely and continuously monitoring the emerging cases of the virus throughout the United States” and noting that his “thoughts and prayers go out” to the family of the child who died in Houston.
Public health officials recommended that schools where a case of the virus has been confirmed “should strongly consider temporarily closing.” Several school systems in Texas and New York have done so.
Fukuda said that genetic analysis of the new virus indicated that it was originally a swine influenza virus “but is now behaving more or less like a human influenza virus.” Reflecting that change — as well as pressure from the pork industry — many officials have begun referring to the virus as the H1N1 virus. European officials prefer to call it “novel flu.”
“There is no evidence that people are getting infected from pigs or that it is dangerous to eat pork,” Fukuda said.
Nonetheless, the Egyptian government today ordered the slaughter of 300,000 pigs in the country as a protective measure. Muslims in the country do not eat pork, but the animals are raised for the Christian minority.
Dr. Richard E. Besser, the acting head of the Centers for Disease Control, said New York and Indiana had already received their complete allotments of antiviral drugs and all states would have their doses by Sunday.
Public health officials have stressed that the two leading antiviral drugs — Tamiflu, known generically as oseltamivir, and Relenza, or zanamivir — are effective against the swine flu virus, and the drugs are given to those who have been in close contact with a flu victim in an effort to halt the spread of the illness.
But he acknowledged today that the drugs have thus far been tested primarily in laboratories and may not work in every case.
“The anti-influenza drugs, they are effective. They can reduce the severity of the illness and its complications,” but it is crucial that they be taken within 48 hours of the onset of symptoms, said Dr. Jesse Goodman, the acting chief scientist at the Food and Drug Administration.
Besser also said that seed stocks of the virus are being distributed to vaccine manufacturers. “I’d love to say, ‘Here’s a timetable.’ . . . But it’s a process that has land mines,” added Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
thomas.maugh@latimes.com
Noam Levey and Mark Silva in Washington and Ken Ellingwood in Mexico City contributed to this report.
