A concise summary of some additional developments, courtesy Bloomberg:
Three teachers and 22 students from Auckland?s Rangitoto high school are being tested for swine flu after returning to New Zealand?s most populous city from Los Angeles following a three week trip to Mexico, Stuff.co.nz reported on its Web site. Some of the travelers had symptoms of flu-like illness and were being isolated as a precaution pending test results, it said, citing the Auckland?s public health service.
In the U.K., a British Airways Plc crewmember with flu-like symptoms was taken to Northwick Park Hospital, in north London, for tests after arriving yesterday on a flight from Mexico City, British Broadcasting Corp. reported on its Web site. [NB: Bloomberg now reporting the crew member does not have swine flu.] (John Lauerman, Jason Gale, Bloomberg)
Add to this two additional cases in California, bringing the US total of lab confirmed cases to 11.
Now for the zombie idea (promoted to some extent by WHO) that we could ever bottle up an incipient flu pandemic by containing it at the source. As we have pointed out here too many times to count, that never was in the cards for a disease that hides itself in the background noise of prevalent respiratory disease, is difficult to diagnose, and for which there is little good surveillance in most countries. But because it was held out as a possibility, there is a faint whiff of recrimination in current news accounts. First, the premise as seen in a piece from Bloomberg:
The virus has already evaded the first line of defense that health officials had hoped to use against a pandemic. International flu experts preparing for a pandemic had planned to contain the initial outbreak of a new, lethal strain of flu. The swine flu virus has already spread so far in Mexico and the U.S. that the containment strategy is out of the question, said Anne Schuchat, interim deputy director for science and public health programs at the Centers for Disease Control and Prevention, the Atlanta-based U.S. agency.
?We don?t think we can contain the spread of this virus,? she said yesterday in a conference call with reporters. (John Lauerman, Jason Gale, Bloomberg)
Now, the consequence, as seen in today’s Washington Post under the headline, “U.S. Slow to Learn of Mexico Flu”:
In the wake of the 2001 terrorist attacks, the outbreak of severe acute respiratory syndrome (SARS) in 2003 and the more recent emergence of H5N1 bird flu in Asia, national and local health authorities have done extensive planning for disease outbreaks that could lead to global epidemics, or pandemics. Open and frequent communication between countries and agencies has been a hallmark of that work.
Whether delayed communication among the countries has had a practical consequence is unknown. However, it seems that U.S. public health officials are still largely in the dark about what’s happening in Mexico two weeks after the outbreak was recognized.
Asked at a news conference yesterday whether the number of swine flu cases found daily in Mexico is increasing — a key determinant in understanding whether an epidemic is spreading — Anne Schuchat, an interim deputy director of the Centers for Disease Control and Prevention, said, “I do not know the answer to those questions.”
In recent years, Mexico has done extensive pandemic planning with Canada and developed a close relationship with the National Microbiology Laboratory in Winnipeg. Tests on virus samples from the Mexican patients suggested the strain was different from this year’s flu. So on Monday, Mexican officials sent lung and throat swabs to Canada to be characterized.
The CDC, in Atlanta, is one of WHO’s four “reference laboratories” for flu. It routinely gets samples from Mexico and many other countries, and processes them with great urgency, Nancy J. Cox, the head of the flu lab, said last night. It, too, eventually received the Mexican samples.
“The only reason the samples went first to Winnipeg is because the paperwork is easier. We were in a rush,” Hernández said.(David Brown, WaPo)
Canada got the clinical specimens on Wednesday and within 6 hours told the Mexican authorities it was the same swine flu virus that CDC had isolated in California. The next day (Thursday), Mexico alerted CDC and the Department of Health and Human Services (DHHS) that they were having an outbreak with the same virus as in the US. The Mexicans then sent specimens to CDC in Atlanta.
The idea that flu could be contained at the source was always a WHO pipe dream. Their flu people knew it couldn’t be done but WHO suggested it might just be possible anyway. Now they see the bitter fruit of this. There is another relevant fact that should be mentioned here. CDC is an agency on organizational hold, with an Acting Director. As public health professionals they are doing a heroic job, but they depend on DHHS, of which they are a part, for building government-to-government relationships. Those relationships suffered badly during the Bush years, with the result that Mexico had a better and more comfortable connection with Canada than the US. So why hasn’t the Obama administration righted the problem? Because, among other things, there is still no Secretary of DHHS. Obama’s nominee, the highly capable administrator Kansas Governor Kathleen Sebelius, has had her confirmation held up by Republican ideologues playing abortion politics.
If ever there was a time when we needed strong leadership at DHHS, this is it. Playing politics has consequences.