Here’s what the swine flu outbreak looks like today:
An Everett school is closed for the day.
Ten people in the state, and perhaps three others, may eventually be diagnosed with the new hybrid virus.
And health officials believe they have a drug that can weaken the contagious new bug.
So what’s the big deal?
Why is this bug, which has caused a single death in the U.S., suddenly receiving international attention? After all, known flu strains kill about 35,000 Americans every year.
And why is the response from people who are working to protect the lives of men, women and children causing increasing backlash from some who believe the outbreak is being overblown, if not an outright conspiracy?
“We want to be safe,” said Tim Church, of the state Department of Health. “We’d rather be cautious with this because, literally, we’re talking about the potential for people’s lives to be at stake.”
And being cautious means activating regional plans that try to control the spread of the virus, treat those who are ill, and reduce fear by providing as many facts as possible, as fast as possible, he said.
“We’re trying to put the information out,” Church said. “How big the headlines are and how many cut-ins (television) newspeople do, we don’t decide that.”
So, simply put, what is the message public health agencies want to put out?
“We know we have a new virus that no one has seen before. That’s pretty darned concerning.”
The Mill Creek clinic
Thursday started with news that a pediatrician from the Mill Creek branch of The Everett Clinic was one of the people believed to have the swine flu — and that she had treated nearly two dozen kids the day her symptoms hit.
Children are good spreaders of viruses. So this news caused The Everett Clinic to act quickly, as the medical profession demands.
They started calling patients who had been seen by the doctor, and found one who had flu symptoms.
They also put out word that certain people should come in for a checkup. The emphasis was on those most at risk: pregnant women and children under 6 years old.
Anyone else with flu symptoms was also asked to come in.
Extra staff were sent to the Mill Creek clinic, where a separate triage area screened people who had flu-like respiratory symptoms. Those people were asked to wear surgical masks and wait in their cars in the Town Center parking lot until they were called for their appointment.
The 37-year-old doctor, who lives in Seattle, had not traveled to Mexico, where the swine flu outbreak began. The doctor’s own two children also became ill, and all three were reportedly doing well and recovering.
“It’s unclear where she contracted this,” said Dr. Yuan-Po Tu, a clinic physician, during the news conference Thursday.
It can take up to a week for a person exposed to flu to become ill. So it will be several days before The Everett Clinic knows whether other patients treated by the physician have become ill, too.
The clinic wasn’t alone in stepping up health screenings.
Valley General Hospital in Monroe Thursday “locked down” so that all visitors and patients entered through one of two doors. Staff were at both doors monitoring for flu-like symptoms, and temporarily removed its cafeteria salad bar, because the nature of salad bars can contribute to the spread of illnesses.
Other hospitals are following similar protocols.
These include physicians actively watching for patients who exhibit flu-like symptoms: including fevers greater than 100 degrees, coughs, sore throats, body ache, runny nose or chills, said Bobbi Ragland, manager of infection control and employee health at Stevens Hospital in Edmonds.
Local cases
“I’m not going to be surprised if we have more additional cases here in Snohomish County,” said Dr. Gary Goldbaum, health officer with the Snohomish Health District.
Any new cases will take days or weeks to show themselves, he told reporters at a media briefing at the county health agency’s Everett headquarters Thursday afternoon.
He shared more details about Snohomish County’s two probable cases.
One is a 3-year-old Snohomish boy who traveled with his family to Mexico last week. The child began feeling ill during the trip. His 6-year-old brother was also tested but the results were negative. He’s now being retested, Goldbaum said.
The other is a 34-year-old woman from Lynnwood who has no apparent connection to Mexico. Her husband and two children have felt sick but testing them for the virus would not be very successful because they’re too far along in their illnesses, Goldbaum said.
A probable case is one that a state lab has identified as having a 95 percent probability of being swine influenza A but haven’t yet been confirmed by the Centers for Disease Control, Goldbaum said.
Only the CDC can give a definitive result on whether someone has been infected with swine flu, although the state will soon receive lab materials that will allow it to make those determinations itself.
So far the cases in Washington state appear to be about as severe as the common flu, he said.
“We don’t understand why the cases in Mexico look different,” Goldbaum said.
It may be that there have been far more cases of swine flu in Mexico that weren’t deadly and that Mexican authorities have only seen the most severe cases, he said. If swine flu hadn’t caused any deaths in Mexico, officials here wouldn’t be as concerned as they are now.
“The initial cases in Mexico had a high fatality rate and that’s what alarmed everyone,” he said.
Viruses demand respect
“People can’t seem to accept how complicated these viruses are,” said Michael Katze, a professor in microbiology at the University of Washington. “They feel if we can send a man to the moon, why do we have to worry about these lousy viruses?”
This one is different from other flu strains.
“It’s a very, very unique virus that contains genes from birds, people and pigs,” he said “If you look at the distribution around the world already, it’s clear it’s spreading pretty dramatically.”
History shows that flu periodically changes from a typical seasonal bug into a killer virus that triggers worldwide epidemics, called pandemics.
“We’re a little bit overdue for a major outbreak,” Katze said. The last was the 1918 worldwide Spanish flu outbreak, which killed an estimated 40 million people.
Flu viruses are “nasty, highly evolved little beasts,” he said. Their eight genes have the capacity to invade cells and change their metabolic processes, the way they release energy.
The 1918 Spanish flu started out as a pretty mild flu virus, Katze said, but rebounded in the fall to become “the most lethal infectious disease in the history of mankind.”
He figures this new type of swine flu outbreak will not be anything like that one.
It’s also too early to know how virulent, or serious, this virus will be, he said.
“It might peter out tomorrow and never come back,” he said.
On the other hand, it seems to be spread person-to-person “and people don’t have immunity to it,” Katze said.
Medicine and information
The county and the public health district have been preparing for a pandemic flu since 2003.
“We all recognize more people may indeed get sick,” County Executive Aaron Reardon said at the press briefing. “We want them to know we have the resources at our fingertips to get the information they may need to keep themselves and their families healthy.”
The Snohomish Health District expects a call center to be up and running this morning to help people get information they need. That number is 425-388-5060. County emergency management personnel will be helping to field calls.
The health agency is also keeping people up to date with a page on the social networking site Facebook and alerts through Twitter.
Unlike avian flu, anti-viral drugs appear to be effective in combating the swine flu, Goldbaum said.
“That’s great news,” he said. “That means we’ve got treatment available.”
The state has enough of the medicine on hand to treat up to 85,000 people. By Monday, a shipment of enough of the medication to treat another 230,000 people is expected to arrive.
The health district has asked health care providers to only prescribe the anti-viral drugs to people who likely have swine flu, rather than as a preventive measure.
At the Washington state Public Health Laboratories in Shoreline, lead microbiologist Denny Russell is among those putting in 12-hour days this week to process flu specimens from around the state.
His job involves separating out influenza A samples through DNA tests. Russell put his rubber-gloved hands into a glassed-in biosafety cabinet to perform genetic tests on virus specimens. He can prepare about 20 samples in an hour, though the test takes about 4 to 6 hours to run.
So far, the lab has processed more than 100 flu samples, most of which have been ruled out.
Church, with the state health department, said his agency and others must continue answering questions about whether the virus will become a pandemic.
“We’re saying it’s important to know what is happening” with the swine flu, he said. “That’s why we’re tracking it. If it is in our state, we want local communities to know that information, and do what fits those communities to protect themselves.”
Herald reporters Noah Haglund, Chris Fyall, Eric Stevick and David Chircop and Enterprise reporter Amy Daybert contributed to this story.
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