Health officials say flu vaccine could come soon

Published 9:50 am Wednesday, May 6, 2009

WASHINGTON — Health officials told lawmakers today it took only two weeks to identify the genetic characteristics of swine flu, and they are in good position to quickly produce a vaccine if the flu takes a turn for the worse.

At the same time, the officials cautioned members of a House Foreign Affairs subcommittee that there are still elements of what they called the novel 2009 H1N1 influenza virus that they don’t understand, and it was not time for complacency.

Dr. Dennis Carroll, special adviser on pandemic flu to the U.S. Agency for International Development, noted that the 1918-1919 flu pandemic also began in the spring and was initially mild, but a much more lethal version hit six months later and the virus eventually killed 50 million worldwide.

Dr. Anne Schuchat, acting deputy director for science and program at the Centers for Disease Control and Prevention, also urged caution, saying they expected to see more people get sick and more serious cases. One factor, she said, is that the Southern Hemisphere is now moving into its flu season.

But she also stressed that “at no time in our history have we been more prepared to face this challenge.”

She said the CDC moved rapidly to determine that the virus circulating in the U.S. and around the world contains genetic pieces from four different virus sources and that within two weeks it was able to understand its complete genetic characteristics.

“We have isolated and identified the virus and discussions are under way so that, should we need to manufacture a vaccine, we can work towards that goal very quickly,” she said.

Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, said the CDC is currently at the stage of processing vaccine seed virus. If the need arises, they can coordinate with manufacturers on clinical trials, verifying the safety, efficacy and right dosages of the vaccine, and then move to mass production.

Schuchat said that as of today there had been 1,516 confirmed H1NI cases in 22 countries — Guatemala being the latest. Confirmed cases in the United States have reached 403, with another 702 probable cases.

CDC and World Health Organization figures show 42 deaths in Mexico and two in the United States, both in Texas.

The WHO has stopped short of declaring the outbreak a pandemic. There were three pandemics in the 20th century, the Spanish flu of 1918 that killed 50 million worldwide, the Asian flu of 1957 that killed 1-2 million and the Hong Kong flu of 1968 that killed 700,000.

Schuchat said the swine flu appears to differ from seasonal flu in that most U.S. cases, including those needing hospitalization, involve those aged five to 50 instead of the very young and the elderly. One possibility is that people older than 50 might have protection because of exposure to a similar virus when they were young, she said.

Rep. Donald Payne, D-N.J., chairman of the Africa and global health subcommittee, also expressed concern that not one case had been found in Africa. That “may actually represent the absence of the ability to detect the virus and may mean the true impact of the strain is yet to be seen,” he said.

AID’s Carroll said his group is working with more than 30 countries in the developing world on pandemic responses. He said some of the groundwork was laid with the U.S. investment of $543 million since 2005 to help countries monitor the spread of avian influenza virus.

Meanwhile, dozens of Mexican nationals quarantined in China despite having no swine flu symptoms arrived home today on a government-chartered jet, some complaining of “humiliation and discrimination” by the Chinese. But as Mexicans emerged from their own five-day swine flu shutdown, the death toll rose and many remained fearful.

Mexico City showed more of its usual ebullience during a raucous morning rush hour. Thousands of newspaper vendors, salesmen hawking trinkets and panhandlers dropped their protective masks and added to the familiar din of truck horns and street music. Cafes accepted sitting customers, and many corporate offices reopened.

Construction worker Roberto Reyes, 36, walked through the capital’s Chapultepec subway station without a protective mask.

“The news says all of this is over, so I got rid of my mask, and a lot of people are doing the same in the streets,” he said.

Many others worried about Mexico letting its guard down too quickly, especially with high schools and universities reopening Thursday, and primary schools reopening next week.

Mexico’s shutdown was designed to reduce the spread of the virus at its epicenter, and deaths did slow as the country mobilized an aggressive public health response to the epidemic that has gone on to sicken nearly 1,900 people in 21 countries.

But the virus keeps setting off more health alarms. A pregnant 33-year-old teacher in Texas who fell into a coma and had her baby delivered by Cesarean section became the first U.S. resident to die of swine flu. And Mexico announced a jump in the confirmed death toll today to 42 after testing backlogged cases.

Two of those deaths were from Tuesday. While the rate of new cases and hospitalizations has declined, epidemiologists said the virus has spread throughout Mexico. “We have seen a tendency (of the outbreak) to diminish, but not disappear,” Health Secretary Jose Angel Cordova said.

The Texas woman had chronic medical conditions, as did a Mexico City toddler who died of swine flu last week during a visit to Houston, health officials said. Her district said it would close schools until Monday as a precaution.

Mexico criticized China’s quarantine of its citizens as discriminatory, and first lady Margarita Zavala was up before dawn to greet the 136 passengers at Mexico City’s international airport. Authorities said 72 had been in Shanghai, 18 in Beijing, 34 in Guangzhou and 12 in Hong Kong. None had flu symptoms, Mexican diplomats said.

“It was discrimination and humiliation in my case,” said Myrna Berlanga, who said she was taken off a flight from the United States by Chinese officials and put in a mobile laboratory for five hours without food, water or a bathroom. “They took me out because of my passport,” she said.

Maria Lourdes Castaneda traveled to Hong Kong for a trade show. “Nobody wanted to give us a hotel room,” she said. “The manager of the Ramada kicked us out and told us there weren’t any rooms.”

Several other Mexican passengers said they were treated well despite being quarantined for four days.

China has defended its measures to block the virus from entering the world’s most populous nation and says it will continue strident checks on travelers from regions hit by swine flu. Its foreign ministry denied singling out Mexicans and said it hoped Mexico would “address the issue in an objective and calm manner.”

China had earlier canceled the only direct flights between China and Mexico, a twice weekly service by Aeromexico.

“This is purely a question of health inspection and quarantine,” ministry spokesman Ma Zhaoxu said Monday.

Lin Ji, a health official with China’s health department in Jilin province, said the government had decided to lift a quarantine for a group of Canadian students two days early, following pressure from Canada.

In Hong Kong, 34 passengers who arrived on a flight from Shanghai with a Mexican swine flu patient April 30 will be released from quarantine Thursday, Secretary for Food and Health York Chow said. Their nationalities weren’t immediately clear.

Doctors were still running tests on the Mexican patient. Chow said he was in stable condition.

Dr. David Nabarro, senior U.N. coordinator for influenza, said countries must explain to WHO their rationale for quarantines and trade restrictions, saying their effectiveness is minimal at best.

“We want to be very clear that the World Health Organization is not recommending travel restrictions related to the outbreak of this novel influenza,” Nabarro said.

Elsewhere today, Swedish authorities confirmed the Scandinavian country’s first swine flu case — a woman who recently visited the United States. The Swedish Institute for Infectious Disease Control said the woman, in her 50s, has recovered.

Before the Mexican nationals came home, about 20 Chinese businessmen and students, each wearing surgical masks, left the border city of Tijuana on a Chinese government flight. They had been stranded when China canceled all direct flights to Mexico.

Mexico’s government had imposed the five-day shutdown to curb the flu’s spread, particularly in this metropolis of 20 million where the outbreak sickened the most people. Capital residents overwhelmingly complied — other towns less — and government officials hailed the drastic experiment as a success.

Some, however, again urged caution. “We can’t make a prediction of what’s going to happen,” said Dr. Ethel Palacios, deputy director of the swine flu monitoring effort in Mexico City.

Mexican Finance Secretary Agustin Carstens unveiled plans Tuesday to stimulate key industries and fight foreign bans on Mexican pork products. He said persuading tourists to come back is a top priority.

Carstens said the outbreak cost Mexico’s economy at least $2.2 billion, and he announced a $1.3 billion stimulus package, mostly for tourism and small businesses, the sectors hardest hit by the epidemic.

The World Health Organization said it was shipping 2.4 million treatments of anti-flu drugs to 72 countries “most in need,” and France sent 100,000 doses worth $1.7 million to Mexico.