Swine Flu Outbreak Spreads, Spurring Asia to Screen Travelers

By Hans Nichols and Shannon Pettypiece

April 27 (Bloomberg) -- The swine-flu outbreak extended beyond Mexico and the U.S., prompting concern of a pandemic and forcing Asian countries to screen travelers.

Six people in Canada contracted swine flu and more cases are likely, government officials said yesterday. Ten New Zealand students who recently visited Mexico are “highly likely” to have swine flu, and three more are suspected, Health Minister Tony Ryall said in Wellington.

Japan, Malaysia and Singapore said they are screening passengers at checkpoints for fever, while Hong Kong raised its swine-flu response level to “serious” from “alert.” The Obama administration has declared swine flu, normally spread among pigs, a public health emergency after 20 people contracted the disease in five U.S. states. More than 80 people have died in Mexico, where the first cases were discovered.

Swine flu is a respiratory disease of pigs caused by type- A influenza that regularly causes outbreaks among the animals, according to the U.S. Centers for Disease Control and Prevention. Three main human flu strains -- H3N2, H1N1 and type B -- circulate and cause 250,000 to 500,000 deaths a year in seasonal epidemics, according to the World Health Organization. Pandemics occur when a novel influenza A-type virus, to which almost no one has natural immunity, emerges and begins spreading.

The 10 New Zealand students who recently visited Mexico already tested positive for influenza A. More tests are being done to confirm if they have swine flu, with the outcome likely in a “couple of days,” Mark Jacobs, director of public health, said at a conference today. The other three students from a second school are ill and being tested for influenza A, with result known today, Ryall said.

More U.S. Cases Likely

The number of U.S. swine flu cases is likely to expand, said Richard Besser, acting chief of the Centers for Disease Control and Prevention, at a White House briefing yesterday. While those instances were mild and no one died, the disease may become “more severe,” he said. The cases were confirmed in California, Kansas, New York, Ohio and Texas.

In Mexico, the government requested that bars, movie theaters and churches be closed in the capital, Mexico City. In New York, where eight cases were confirmed at a private school, Mayor Michael Bloomberg is keeping city schools open and urging residents to wash their hands frequently, stay home if ill and avoid the hospital unless very sick.

“We do think that this will continue to spread, but we are taking aggressive actions to minimize the impact on people’s health,” Besser said at the White House briefing. “We expect that we’re going to be changing our recommendations over time based on what we learn.”

Mutation Fears

Fears of a lethal pandemic lie in the nature of flu germs, which mutate readily and can become virulent by exchanging genes with related influenza viruses. While the H5N1 bird virus that spread across Asia in the last few years, killing millions of fowl and several hundred people, never gained genes to spread easily among humans, the Mexican swine flu already has, said Malik Peiris, a microbiologist from the University of Hong Kong.

“The concern is that this virus has the ability to transmit from humans to humans because a number of the cases who got infection have had no direct exposure to swine,” said Peiris, who has studied the SARS and avian flu viruses. “That is certainly a cause for concern.”

Asia on Guard

Singapore tightened checks at Changi airport to screen arriving passengers, and those with higher-than-normal temperatures will undergo a more thorough medical assessment, the Health Ministry said in a statement. As of yesterday, there were no known cases of human swine flu in Singapore, it said.

Malaysia placed health officials at airports to screen travelers for the virus, and told hospitals and clinics to check for patients with unusual fevers. The government is checking whether the seasonal flu vaccine will protect the country’s pig farmers, doctors and nurses, Health Minister Liow Tiong Lai said in a phone interview today.

Japan, where no cases have been reported, will heighten its monitoring for any signs of swine flu and authorities will examine flights from Mexico, Chief Cabinet Secretary Takeo Kawamura said in Tokyo today. The country is considering producing a swine-flu vaccine, the government said in a statement.

The Philippines, which doesn’t get pig and pork supplies from Mexico, has banned such imports from that country and the U.S., Bureau of Animal Industry Director Davino Catbagan said by phone. The government also lifted import restrictions on swine flu vaccines to make them freely available, he said.

Russia suspended imports of all meat from Mexico and the U.S. states of Texas, California and Kansas shipped after April 21, the country’s veterinary watchdog said.

Same Level of Alert

WHO, an agency of the United Nations, declared the outbreak a “public health emergency of international concern” on April 25. The organization also concluded that more evidence is needed to determine whether the level of pandemic alert should be increased.

An emergency committee will meet again April 28 to consider raising the alert, said Keiji Fukuda, the Geneva-based agency’s assistant director-general for health security and environment, in a call with reporters.

The WHO’s pandemic threat level, a six-stage measure, is currently at 3. Evidence of increased human-to-human spread of a new virus would move it to level 4, according to the WHO Web site.

Scientists are trying to determine why the virus has been more severe in Mexico. In the U.S. only one person has required hospitalization, Besser said.

More Drug Orders

There is no vaccine for the virus, he said. Homeland Security Secretary Janet Napolitano said 25 percent of “courses of treatments” of drugs, known as antivirals, were being released from U.S. stockpiles. In all, there are 50 million courses, she said. Among those are Tamiflu, sold by Roche Holding AG, of Basel, Switzerland, and Relenza, from GlaxoSmithKline Plc of London.

“This significantly increases the chances the U.S. government, and perhaps other governments, will restock Tamiflu supplies,” said Mark Schoenebaum, an analyst with Deutsche Bank Securities in New York, in a note to clients. “In addition, we believe retail prescriptions could increase.”

If the U.S. government bought 13 million doses of Tamiflu to replenish stockpiles, and the public bought an additional 1 million, Foster City, California-based Gilead Sciences Inc. could see its 2009 earnings rise 4 percent, or about 10 cents, Schoenebaum said. Gilead invented the drug and gets royalties.

The Defense Department “has procured and strategically positioned 7 million treatment courses of Tamiflu,” Napolitano said.

Like a Hurricane, Flood

The U.S. government is issuing a health emergency declaration to devote more resources to blocking the virus. Napolitano compared their preparation to what the department does when it knows a hurricane is approaching. The move “frees up money” to buy medicines, and allows the use of “medication and diagnostic tests that we might not otherwise be able to use.”

For now, she said, the monitoring of travelers will remain “passive” and no restrictions on travel with Mexico have been issued. People entering the U.S. will be asked if they’re sick or have been, and those with apparent symptoms will be “isolated per established rules,” Napolitano said.

White House press secretary Robert Gibbs said it was “far too early to determine” whether there will be an economic impact from the outbreak. Fukuda, of the World Health Organization, said there’s no evidence the disease is spread by exposure to “pork or pigs.”

Obama’s Mexico Visit

The World Bank promised Mexico $205 million in loans to help fight the disease, said Mexico’s finance minister, Agustin Carstens.

President Barack Obama was in Mexico City April 16 for meetings with Mexican President Felipe Calderon. Gibbs said the incubation period for an infection is long past and “the president’s health was never in danger.”

John Brennan, a special assistant to the president for homeland security, said the government is putting in place systems to allow “rapid identification” of any new cases and efforts to “mitigate a broader outbreak” in the U.S.

He said there is “no evidence whatsoever” of a connection to bioterrorism. Besser said all investigations so far point to a naturally occurring virus.

France, Brazil

France is investigating four possible cases of swine flu, including three in one family in the north of the country and one woman in the Paris region, officials said. Test results should be available within 24 hours, Francoise Weber, director general of the Sanitary Surveillance Institute, said at a news conference in Paris.

In Brazil, the Sao Paulo state hospital Emilio Ribas has isolated a potential case, said Doctor Edenilson Eduardo Calore, head of weekend duty. The patient had been in Mexico, Calore said.

The latest U.S. tally includes eight students at the St. Francis Preparatory School in Queens.

“There is an outbreak at St. Francis school and we are monitoring that outbreak very carefully,” New York Mayor Bloomberg said at a news conference. “We’re also looking for outbreaks elsewhere in the city. So far there does not seem to be any.”

Bloomberg is the founder and majority owner of Bloomberg LP, the parent company of Bloomberg News.

To contact the reporters on this story: Hans Nichols in Washington at Hnichols2@bloomberg.net; Shannon Pettypiece in New York spettypiece@bloomberg.net;