Monday, May 4, 2009

Penna. confirms first case of H1N1

Gov. Rendell announced yesterday Pennsylvania's first confirmed case of swine flu after receiving the test results of a 31-year-old Mexican man who had recently arrived in Montgomery County to work as a landscaper.

The man, who has a work visa, was met on Wednesday by his American sponsor, who recognized his symptoms and took steps to get him immediate treatment, Rendell and health officials said at a late-afternoon news briefing in Norristown.

The case proved to be mild, and the man recovered without hospitalization.

Although the case in Upper Merion Township is the first H1N1 influenza confirmed by testing from the Centers for Disease Control and Prevention in Atlanta, the Pennsylvania Department of Health lists seven more probable cases: two in Philadelphia; two in Montgomery County, one of which was new yesterday; and one each announced yesterday in Bucks, Lycoming and Luzerne Counties. None of the cases have required hospitalization.

New Jersey has one probable case and seven confirmed cases, including four in Burlington County. Three of those are members of a family who had recently been to Mexico; a fourth case in the county involved a woman who had contact with the family but who had not traveled.

Rendell urged the public to remain calm and follow basic health practices such as routine hand washing, that have been shown to slow the spread of flu.

Across the region health officials are moving quickly to coordinate efforts to combat the spread of the flu, which has killed 22 people in Mexico and one toddler in Texas. The child had traveled from Mexico with relatives seeking treatment in the United States.

Rendell said the state had stockpiled 1.8 million courses of antiviral medication, which consists of five days worth of Tamiflu and Relenza. Both drugs have been shown to be effective against H1N1.

Pennsylvania is one of 34 states to report a confirmed case of the flu. yesterday, CDC officials said the tally of confirmed cases in the United States jumped to 241, but that's largely from catching up on a backlog of lab tests rather than a sudden spurt in new infections.

Those numbers are sure to rise, said the CDC's Anne Schuchat, because states are now contributing their results and many cases remain to be analyzed.

"Virtually all of the United States probably has this virus circulating now. That doesn't mean that everybody's infected, but within the communities, the virus has arrived," she said yesterday.

Federal health officials added that the virus was not behaving like a severe flu, but cautioned that that did not mean the threat had passed.

A big concern is whether the virus will return, perhaps harder, when regular influenza season returns. Production of regular winter flu vaccine is going full-tilt "to make sure we kind of clear the decks," Health and Human Services Secretary Kathleen Sebelius said.

Scientists are still gathering information on how severe the nation's 30 hospitalized cases are, she said. They are mostly older children and young adults, in contrast to ordinary flu, which tends to send the elderly and very young to the hospital, said Schuchat, the CDC official.

So far none of the cases in New Jersey, Delaware, or Pennsylvania have been severe enough to require hospital treatment, which was in part attributable to people's seeking prompt treatment for the illness, Rendell said.

Experts say that the first confirmed cases in any community, though a milestone for a disease that was previously unknown, do not by themselves say much about risk to others. People should continue taking precautions - washing hands thoroughly with soap and water or using alcohol-based hand cleaners, coughing into sleeves or handkerchiefs rather than their hands, staying home when sick - that were already recommended.

Multiple person-to-person transmissions, such as when one vacationer returns from Mexico with H1N1 and passes it to a nontraveler who then infects a friend, indicate that it is spreading locally and may suggest actions to try to slow its movement. But even that says nothing about severity.

The University of Delaware stopped testing its students over the weekend, after a 10th confirmed case and more than a dozen probable cases made clear that the disease was already widespread on campus and that more testing would not contain it. Because the symptoms and treatment for seasonal flu and swine flu are nearly identical, all students with flulike illness will be treated for the flu, as more than 500 already have been.

In New Jersey two of the seven infected, a 14-year-old boy and a 10-year-old girl, are students in the Mount Laurel School District, which decided Thursday, when the cases were announced, to continue holding classes as usual. Officials said that neither student had exhibited symptoms while attending school.

In nearby Hainesport, by contrast, school officials decided last night to close the Hainesport School today and tomorrow as a precaution after two students displayed flulike symptoms. Samples had not yet gone to the state lab to determine whether it was H1N1.

Schools are known to be reservoirs of influenza infection generally, and children tend to be contagious longer than adults. But in deciding whether to close a school or keep it open, the CDC advises local officials to consider a number of factors, including how many students have been sick and how far along the illness is.

"It's a balance," said Schuchat, an infectious-disease expert.

"There are lots of benefits to the students and the community for students being in school. And certainly if you dismiss students and then they go congregate somewhere else, they're really not getting the benefit of the school or school lunches but all the risk of being around a lot of other kids."


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