04.29.09
Posted in Uncategorized at 1:01 am by Luis
NEW YORK (AP) -- The global swine flu outbreak worsened Tuesday as authorities said hundreds of students at a New York school have fallen ill and federal officials said they expected to see U.S. deaths from the virus. Cuba suspended flights to and from Mexico, becoming the first country to impose a travel ban to the epicenter of the epidemic.
The mayor of the capital cracked down further on public life, closing gyms and swimming pools and ordering restaurants to limit service to takeout.
Confirmed cases were reported for the first time as far away as New Zealand and Israel, joining the United States, Canada, Britain and Spain.
Swine flu is believed to have killed more than 150 people in Mexico, and the Centers for Disease Control and Prevention said the U.S. has 68 confirmed cases in five states, with 45 in New York, one in Ohio, one in Indiana, two in Kansas, six in Texas and 13 in California.
"I fully expect we will see deaths from this infection," said Richard Besser, acting director of the CDC.
That was echoed by Homeland Security Secretary Janet Napolitano.
"It is very likely that we will see more serious presentations of illness and some deaths as we go through this flu cycle," she said.
President Barack Obama asked Congress for $1.5 billion in emergency funds to fight the illness.
In New York, there were growing signs that the virus was moving beyond St. Francis Preparatory school, where sick students started lining up last week at the nurse's office. The outbreak came just days after a group of students returned from spring break in Cancun.
At the 2,700-student school, the largest Roman Catholic high school in the nation, "many hundreds of students were ill with symptoms that are most likely swine flu," said Health Commissioner Thomas Frieden. The cases haven't been confirmed.
Twelve teachers reported flu-like symptoms as well, said the principal, Brother Leonard Conway.
A nearby public school for special education students was shut down after more than 80 students called in sick. Frieden said that some of the students have siblings at St. Francis.
"It is here and it is spreading," Frieden said.
Some of the New York students who tested positive for swine flu after a trip to Mexico passed it on to others who had not traveled - a significant fact because it suggests the strain suspected in dozens of deaths in Mexico can also spread through communities in other countries, said Keiji Fukuda, assistant director-general of the World Health Organization.
"There is definitely the possibility that this virus can establish that kind of community wide outbreak capacity in multiple countries, and it's something we're looking for very closely," Fukuda said. So-called "community" transmissions are a key test for gauging whether the spread of the virus has reached pandemic proportions.
Fukuda warned, however, against jumping to the conclusion that the virus has become firmly established in the United States.
Still, U.S. officials stressed there was no need for panic and noted that flu outbreaks are quite common every year. The CDC estimates about 36,000 people in the U.S. died of flu-related causes each year, on average, in the 1990s.
The increase in cases was not surprising. For days, CDC officials said they expected to see more confirmed cases - and more severe illnesses. Health officials nationwide stepped up efforts to look for symptoms, especially among people who had traveled to Mexico.
Scientists hope to have a key ingredient for a vaccine ready in early May, but it still will take a few months before any shots are available for the first required safety testing. Using samples of the flu taken from people who fell ill in Mexico and the U.S., scientists are engineering a strain that could trigger the immune system without causing illness.
"We're about a third of the way" to that goal, said Dr. Ruben Donis of the CDC.
In Mexico City, authorities opened the national naval hospital to civilians to deal with the still-mounting wave of suspected swine flu cases, and prospective patients crowded the waiting rooms and reception areas for a chance to get in.
With at least 152 suspected swine flu deaths in Mexico, complaints were heard throughout the capital of 20 million that the supply of surgical masks was running out.
The economic toll also spread. Officials said Mexico City is losing $57 million a day amid a shutdown that includes schools, state-run theaters and other public places. The government said it was closing all of Mexico's famed archaeological sites until further notice.
Cuba announced a 48-hour ban on flights to and from Mexico, except in "exceptional cases." The last flight from Mexico touched down in Havana around 4 p.m., then returned to Mexico City with passengers before the two-day suspension officially began.
The U.S. stepped up checks of people entering the country and warned Americans to avoid nonessential travel to Mexico. Canada, Israel and France issued similar travel advisories.
For all the government intervention, health officials suggested that efforts to contain the flu strain might prove ineffective. Around the world, officials hoped the outbreak would not turn into a full-fledged pandemic, an epidemic that spreads across a wide geographical area.
"Border controls do not work. Travel restrictions do not work," said WHO spokesman Gregory Hartl, recalling the SARS epidemic earlier in the decade that killed 774 people, mostly in Asia, and slowed the global economy.
The pork industry was dealing with a public relations nightmare over the virus, which is a never-before-seen hybrid of human, swine and bird influenza that is widely called swine flu.
Public health officials have said people cannot get sick from eating pork, but some countries, such as China, Russia and Ukraine, have banned imports from Mexico and parts of the U.S.
U.S. officials said they may abandon the term "swine flu" for fear of confusing people into thinking they could catch it from eating pork.
"It's killing our markets," said Francis Gilmore, 72, who runs a 600-hog operation in Perry, Iowa, outside Des Moines, and worries his small business could be ruined by the crisis. "Where they got the name, I just don't know."
Gov. Arnold Schwarzenegger declared a state of emergency to help California agencies coordinate efforts in response to the outbreak. He cautioned, however, that "there is no need for alarm."
In New York, the city called on the CDC for additional resources to investigate the outbreak at St. Francis Prep.
About 1,500 students replied to surveys sent out by the health department about the outbreak, helping the city get a better sense of how the virus is spreading. Some students have complained of sudden nausea; others dealt with high fever, sore throats, coughs and aches.
Rachel Mele and her mother, Linda, were relieved when the 16-year-old's fever broke Tuesday for the first time in five days. It had been hovering around 101.
The family could finally breathe easy - a relief after a terrifying night Thursday in which Mele's parents bundled her into the car and rushed her to the hospital when they realized she was having trouble breathing.
"I could barely even catch my breath. I've never felt a pain like that before," Mele said. "My throat, it was burning, like, it was the worst burning sensation I ever got before. I couldn't even swallow. I couldn't even let up air. I could barely breathe through my mouth."
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Associated Press Writers Marcus Franklin and Samantha Gross in New York; Peter Orsi, Julie Watson and E. Eduardo Castillo, in Mexico City; Mike Stobbe in Atlanta; Mary Clare Jalonick, David Espo, Philip Elliott and Matthew Lee in Washington; Alexander G. Higgins in Geneva, Maria Cheng in London and Pan Pylas in London contributed to this report.
© 2009 The Associated Press.
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Posted in Uncategorized at 1:01 am by Luis
WASHINGTON (AP) -- U.S. scientists hope to have a key ingredient for a swine flu vaccine ready in early May, but are finding that the novel virus grows slowly in eggs - the chief way flu vaccines are made.
Even if all goes well, it still will take a few months before any shots are available for the first required safety testing, in volunteers.
"We're working together at 100 miles an hour to get material that will be useful," Dr. Jesse Goodman, who oversees the Food and Drug Administration's swine flu work, told The Associated Press.
Using samples of the new swine flu, taken from people who fell ill in Mexico and the U.S., scientists are engineering a strain that could trigger the immune system without causing illness.
"We're about a third of the way" to that goal, Dr. Ruben Donis of the Centers for Disease Control and Prevention said in an interview Tuesday.
The hope is to have that ingredient - called a "reference strain" in vaccine jargon - to manufacturers around the second week of May, so that they can begin their own laborious production work, Donis said.
But, "this is biology, not mathematics," he cautioned.
To further speed the vaccine hunt, the CDC has shipped a raw sample of the new virus to one manufacturer - Gaithersburg, Md.-based MedImmune LLC, which sells the only flu vaccine given via a nasal spray instead of a shot. MedImmune thus uses a slightly different approach to creating influenza strains suitable for that spray, Donis explained.
Health authorities are struggling to rein in the swine flu epidemic that has sparked a global crisis since discovery of the never-before-seen strain just last week - and the world learned that travelers to Mexico, where dozens may have died, were carrying the bug home.
Standard anti-flu drugs can treat the illness. But the world has no vaccine that prevents this new strain, a mix of pig, human and bird viruses that people presumably have little natural immunity to. And if the virus ultimately spreads enough to spark a pandemic - which hasn't happened yet and may not - a vaccine would be key to mitigating the disaster.
Vaccine manufacturers are just beginning production for next winter's regular influenza vaccine, which protects against three human flu strains. Monday, the World Health Organization said factories should stay with that course for now - it won't call for mass production of a swine flu vaccine unless the outbreak worsens globally.
Think of flu viruses as wearing coats, changeable proteins on their surface that trigger the immune system to mount an attack. Those proteins give flu strains their main identity: This new swine flu is part of the Type A/H1N1 family - the "H" being a version of the protein hemagglutinin and the "N" is the protein neuraminidase. Matching those H and N components forms the basis of a vaccine.
First researchers had to grow enough virus samples, culled from a handful of patients, to work with. Influenza virus traditionally is grown by injecting it into fertilized chicken eggs, but this novel virus didn't grow easily there. There's an alternative, growing it in vats of cells instead, but most flu vaccine manufacturers today still rely on eggs.
"There is a little bit of concern there," said CDC's Donis, whose laboratory eventually created three samples that did grow in eggs, just slowly. More work is under way to try to improve that.
Next, using a technique called reverse genetics, scientists are selecting genes for the swine flu's H and N antigens to create a customized strain and look for signs that it will prompt a good immune response. Then manufacturers would get the strain to start their own production supply, which could take another two months.
"It's worth taking that time at the very beginning to really make sure you've got exactly what you want," said MedImmune senior director Dr. Kathleen Coelingh. "We've got to get this right."
But those initial pilot lots will go straight into human safety tests already being planned, Goodman said. Flu vaccine in general is very safe. But in 1976, thousands claimed side effects from a swine flu vaccine administered after an outbreak at Fort Dix, N.J., that never spread.
For now, manufacturers are studying production options. Sanofi Pasteur, the world's largest flu vaccine maker, just opened a new U.S. factory but if necessary could keep its older one open as well just for swine flu vaccine production, said spokesman Len Lavenda. It also produces vaccine at a factory in France.
At Novartis AG, spokesman Eric Althoff said the company is studying which of its two technologies for vaccine-making would be better. The Swiss drugmaker can make vaccines both in eggs and in cell culture.
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AP Business Writer Linda A. Johnson in Trenton, N.J., contributed to this report.
© 2009 The Associated Press.
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Posted in Uncategorized at 1:01 am by Luis
MEXICO CITY (AP) -- The cloth patches in green, blue and white are everywhere, clamped tight over the mouth and nose of teachers, toddlers, policemen and drunks. Even the statue at the church of St. Jude, patron of lost causes, has been fitted with a light-blue surgical mask to ward off swine flu.
But do they work?
While Mexico has handed out millions of facial coverings, U.S. officials have held off, saying there is little evidence of their effectiveness. Some doctors warn they might even be harmful, causing people to take risks - like venturing into crowds or neglecting to wash hands - in the mistaken belief that the mask protects them.
The ubiquitous masks give an eerie, unsettling air to this overcrowded city, as if 20 million people have entered a scene from some kind of apocalyptic future. They're also a reminder of an equally frightening episode: Technicolor versions of those dotting scratchy black and white photographs from the 1918 Spanish Influenza epidemic, which claimed up to 50 million lives worldwide.
Soldiers hand them out at subway stations. Pharmacies and hardware stores can't keep them in stock. Newspapers have begun running front page instructions on making do-it-yourself mouth coverings. President Felipe Calderon proudly boasted over the weekend that more than 6 million masks have been distributed.
"They must be worn when one is out in public or in a closed, crowded space," Health Secretary Jose Angel Cordova insisted Monday, while acknowledging in the same breath that the government-distributed masks are too porous to eliminate all risk.
"They still offer enough protection as a public health measure," he offered.
U.S. health officials give very different guidance. The Centers for Disease Control and Prevention said there is not a lot of evidence that masks do much good, and have pointedly not recommended their use by the general public. Swine flu is thought to be transmitted in much the same way as seasonal flu, by touching something with the virus and then passing it to the nose or mouth or through coughing or sneezing.
Experts say people who come in close contact with known swine flu patients should wear high filtration masks like those used by health professionals, which are more effective but also more expensive (about 12 pesos or a dollar) and generally unavailable in Mexico City. But even these masks, which filter out fine particles carried in the air, must be used properly to give real protection.
"The evidence that masks work is relatively weak," said Peter Sandman, a New Jersey-based consultant in crisis communication. Still, he was loath to criticize the Mexican government, because mask-wearing also can have psychological benefits.
"It's not dumb to give people things to do, even if those things are only slightly effective, because it will make those who are anxious feel calmer, and those who are too nonchalant take the threat more seriously," he said.
In the streets of Mexico's capital, almost everybody was taking the threat seriously.
Drivers wore the masks while alone in their cars. Young couples strolled down the street talking to each other through the gauzy coverings, and parents fitted small masks over the faces of toddlers and infants.
Some wore the masks like talismans wrapped around their necks rather than over their mouth and nose, more as a point of faith than for physical protection. Others took a comical approach, painting Pancho Villa mustaches or wide, toothy smiles on the mask - but still keeping them firmly in place.
Inside the church of San Hipolito, someone fitted a surgical mask over a statue of St. Jude. Whether as a precaution or to highlight the hopelessness of the effort, the gesture was not enough to stop church officials from canceling a special service held on the 28th of each month to have their statues blessed.
Several hundred people - many carrying statues of the saint - lingered outside the church anyway in the midday heat, undeterred by the warnings blared from a patrol car's loudspeaker: "Disperse! It is dangerous to gather in groups. Disperse!"
Antonio Guzman, a 44-year-old laborer who clutched a blue mask to his face as he pushed through the crowd, said he had come to the church to ask St. Jude for protection against the virus, and for help with work.
"He needs to help us. It isn't fair, all that we have been suffering," said Guzman, wearing a black T-Shirt that read: "FEED THE FEVER."
Remedios Ramirez sold religious trinkets to the faithful, her mask dangling loosely around her neck. Asked why she didn't have it over her mouth, she gestured to a lollypop she was sucking.
"I'll put it back on when I finish," she said. "But I don't have a lot of faith in these masks. It is all in God's hands."
© 2009 The Associated Press.
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Posted in Uncategorized at 1:01 am by Luis
CHICAGO (AP) -- An experimental treatment added four months to the lives of men with advanced prostate cancer in a study that tested an entirely new approach to fighting the disease, doctors reported Tuesday.
Dendreon Corp.'s Provenge vaccine trains the immune system to fight tumors. It's called a "vaccine" even though it treats disease rather than prevents it.
Doctors have been trying to develop such a therapy for decades, and this is the first to meet a preset goal for improving survival in late-stage testing.
"There have been a lot of false starts, but this is a real start," said Dr. Paul Schellhammer, a urologist at Eastern Virginia Medical School in Norfolk, Va., who led the study. Results were reported Tuesday at an American Urological Association conference in Chicago.
Seattle-based Dendreon paid for the study, and Schellhammer owns stock in the company. Dendreon shares fell sharply, and then trading was halted leading up to the release of the data. Shares fell $9.74, or 45.2 percent, to $11.81. The reason was not immediately clear.
Four months may not sound like a lot, but it is longer than the three months afforded by Taxotere, the only chemotherapy approved for men in this situation. Doctors hope for even greater benefit if they give the drug earlier in the course of the disease. Dendreon would give no cost estimate for Provenge, but other such biotech drugs cost several thousand dollars a month.
It remains to be seen if side effects will keep Provenge from winning federal Food and Drug Administration approval. Two years ago, the FDA went against its advisers and delayed a decision, asking for more proof of safety and effectiveness.
The new study involved 521 men whose cancer had spread and wasn't responding to standard hormone treatments. Two-thirds were given Provenge, a treatment that is customized for each patient.
Doctors collect special blood cells from each patient that help the immune system recognize cancer as a threat. They are mixed with a protein found on most prostate cancer cells and another substance to rev up the immune system. The resulting "vaccine" is given back to the patient as three infusions two weeks apart.
The other one-third of men in the study had a dummy infusion.
Median survival was 26 months in men given Provenge and 22 months in the others. Three-year survival rates were 32 percent for the Provenge group and 23 percent for the others - a 38 percent improvement.
Strokes and other brain-related problems were no more common with Provenge - a worry raised by earlier studies. However, four men given Provenge suffered lung clots, though none were fatal. High blood pressure was twice as common with Provenge. Overall, the rate of serious side effects was the same in each group.
Improving survival "is the gold standard" for any treatment, and Provenge appears to do that, said Dr. Ira Sharlip, a urologist from the University of California in San Francisco and a spokesman for the urological association.
Dr. Otis Brawley, the American Cancer Society's chief medical officer, said the FDA had been right to ask for more study. But even if the drug had only extended survival by 10 days, "I would vote for approval," he said.
One patient said it did not hurt his. Thomas Robbins, 74, of Forest City, N.C., was diagnosed in 2002 with prostate cancer that was growing despite hormone treatment.
"They wanted to give me chemo," but he feared its side effects and enrolled in the Provenge study instead. He learned afterward that he had been one of those given the vaccine.
"Did it help me? I can't 100 percent guarantee, but I think it did," he said.
Advocacy groups cheered the results. Scott Riccio, founder of Accelerate Progress, called them "compelling."
"For the first time, we have real clinical validation that cancer can be fought by stimulating the body's immune system," he said in a statement. "Hundreds of thousands of men fighting prostate cancer will now have real hope that a safe and effective new option will be available to them in their fight for life."
Thomas Farrington, a prostate cancer survivor and founder of the Prostate Health Education Network, said: "Prostate cancer patients finally have hope for a better life. We are in desperate need of groundbreaking new treatments like Provenge."
Prostate cancer is the most common non-skin cancer in American men. An estimated 186,000 new cases and 28,660 deaths from it occurred last year.
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On the Net:
Urology group: http://www.AUAnet.org
(This version CORRECTS reference to results regarding Dr. Otis Brawley, who did not see the final numbers.))
© 2009 The Associated Press.
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Posted in Uncategorized at 1:01 am by Luis
ATLANTA (AP) -- The number of confirmed swine flu cases in the United States has jumped to 64, federal officials said Tuesday, and states reported at least four more.
The U.S. Centers for Disease Control and Prevention said the new count includes "a number of hospitalizations." CDC officials had previously said just one person had been hospitalized.
The CDC said there were 17 new cases in New York City, four more in Texas and three additional cases in California. That brings the total numbers of cases confirmed by federal officials to 45 in New York City, 10 in California, six in Texas, two in Kansas and one in Ohio.
State health officials in California have confirmed three other cases, and Indiana authorities have confirmed one.
The increase is not surprising. For days, CDC officials have said they expected to see more confirmed cases - and more severe illnesses. Health officials across the country have stepped up efforts to look for cases, especially among people with flu-like illness who had traveled to Mexico.
CDC officials also warned that updates in the number of confirmed cases would at time be disjointed, as different states announce new information before the CDC's national count is updated.
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On the Net:
CDC swine flu Web page: http://www.cdc.gov/swineflu/
© 2009 The Associated Press.
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