More H1N1 Flu Deaths Confirmed Outside Mexico, Virus Reaches China

Over the weekend, health officials confirmed two more H1N1 (swine) influenza deaths – the third U.S. death and the first known H1N1 flu death in Costa Rica – the New York Times reports (Brustein, New York Times, 5/11). The confirmations fall on the heels of Friday's announcement by Canadian officials that the death of a 39-year-old woman late last month was also caused by swine flu, the Globe and Mail reports (O'Neill/Walton, Globe and Mail, 5/8).

Health officials said that each of the patients reportedly had underlying health conditions. "Underlying health conditions appear to put swine flu victims at greater risk of hospitalization or death," the WHO and the CDC said on Friday. "Officials stressed that their observations were preliminary," the New York Times writes (New York Times, 5/11).

Even as the confirmation of the deaths to swine flu came in, scientists expressed optimism that "[S]o far the virulence markers for the 1918 and H5N1 (bird) influenza viruses do not appear in the H1N1 strain," said Anne Schuchat, interim deputy director for science and public health at the CDC. Still, she cautioned, "What we don't know is whether there may be other virulence markers. Remember the first wave of the 1918 virus was mild and the next wave was devastating."

Also over the weekend, the health ministry of China announced its first confirmed case of swine flu, after a University of Missouri student became ill on a flight from Beijing to Chengdu city, Bloomberg reports. The man's father, girlfriend and those he came into contact with since his arrival in Chendgu city have been quarantined. Taiwan issued a travel alert for passengers traveling to China (Chase/Lauerman, Bloomberg, 5/11).

The WHO on Monday reported that 30 countries have officially reported 4,694 cases of H1N1, including 1,626 confirmed cases in Mexico, including 48 deaths; 2,532 cases in the U.S., including three deaths; 284 cases in Canada, resulting in one death; and eight cases in Costa Rica, resulting in one death. The WHO writes, "The following countries have reported laboratory confirmed cases with no deaths - Argentina (1), Australia (1), Austria (1), Brazil (8), China (2, comprising 1 in China, Hong Kong Special Administrative Region, and 1 in mainland China), Colombia (3), Denmark (1), El Salvador (4), France (13), Germany (11), Guatemala (1), Ireland (1), Israel (7), Italy (9), Japan (4), Netherlands (3), New Zealand (7), Norway (2), Panama (15), Poland (1), Portugal (1), Republic of Korea (3), Spain (95), Sweden (2), Switzerland (1) and the United Kingdom (47). (WHO Influenza A(H1N1) - update 25, 5/11).

Bloomberg reports, "The WHO hasn't seen sustained, person-to-person spread of the disease outside North America, so the agency's pandemic alert will remain at phase 5, the second-highest level, Sylvie Briand, acting director of the WHO's global influenza program, said on May 8. The alert won't be raised unless there's evidence of community spread in another part of the world, she said" (Bloomberg, 5/11).

Health ministers and senior officials from the Association of Southeast Asian Nations (ASEAN), China, South Korea and Japan on Friday announced plans to ramp up national and regional swine flu monitoring and prevention strategies, the AP/Taiwan News reports. The health officials called for the region to begin conducting exit screens of passengers to prevent the spread of swine flu and for an increase in the stockpiles of medical supplies (Peck, AP/Tawain News, 5/8).

The AP/Google.com examines how international preparedness plans have helped shape the global response to the H1N1 flu outbreak thus far and looks at key decisions that have yet to be made about protecting people and controlling a word wide outbreak.

"It's not clear if this new swine flu strain is a brush fire, sparking up around the globe only to fizzle, or if it will worsen when the regular influenza season hits," the AP/Google.com writes. "No matter how this story ends, at the very least it has offered a real-world drill to find gaps in the playbook" (Neergaard, AP/Google.com, 5/10).