Swine flu saga

WASHINGTON — The most pivotal moments in the swine flu saga are yet to come, experts say.

Will it sweep through impoverished Southern Hemisphere countries? Will it roar back in the rest of the world in the fall? And who will be vaccinated if it does?

In the weeks since swine flu grabbed world attention, and even years before that, some important actions have helped shape the course of this outbreak and the ways the world will handle future epidemics.

It’s not clear if this new swine flu strain is a brush fire, sparking up around the globe only to fizzle, or if it will worsen when the influenza season hits.

No matter how this story ends, at the very least it has offered a real-world drill to find gaps in the playbook.

First turning point
A different virus was the world’s wake-up call. SARS (severe acute respiratory syndrome) started in China, and once it broke out of the mainland in early 2003, it took just weeks to infect more than 8,000 people from 37 countries. The virus killed more than 770 people.
Governments started scrambling to put together plans to handle the next global disease threat. Soon after, bird flu hit Asia, reinforcing the need.

Had the new swine flu hit sooner, it almost certainly would have spread faster. Even if it proves no more dangerous than garden-variety flu, that’s deadly enough. The World Health Organization says between 250,000 and 500,000 people worldwide die each year because of regular winter flu.

Uncovering threat
As early as February, people in the Mexican hamlet of La Gloria were suffering unusually strong flu symptoms. When officials arrived to investigate in mid-March, nearly half the 3,000 villagers sought medical help. About 450 were diagnosed with acute respiratory infections, but it was not until April 12 would the world start getting official word of the unexplained illness.
By then Centers for Disease Control and Prevention already was on the trail of swine flu in California. Studies found two children in San Diego with a strain of Type A influenza that turned out to be a never-before-seen type of swine flu.

On April 23, CDC confirmed five more illnesses in California and Texas and put all states on alert. That same day, CDC delivered the bad news: The new flu was in Mexico, too.

Aggressive action
With the diagnosis, Mexico’s government ordered the closure of all schools, museums, libraries and theaters in Mexico City. Schools nationwide and other businesses shut down in the following days, and soldiers handed out millions of face masks.
The U.S. raced antiflu drugs from a government stockpile to every state. After a large outbreak at a New York City school, U.S. schools started closing. Ultimately about 468,000 students were affected before the CDC decided that schools should reopen because the virus was mild.


What’s still to come?
What happens to all those antiflu medicines that were shipped to U.S. states but not used? They’re waiting in case they’re needed come fall. Experts say that’s the next weakness. Flying in drugs is easy; getting them to the sick is hard.
Then there’s the vaccine dilemma.

Makers could be told to start brewing doses in a few weeks. But that will take months and require testing to see if they induce immunity and seem safe. And if vaccine is ordered, would developing countries get a fair share?

The big worry is that the virus will mutate, becoming more severe.

"The thing that’s keeping me up at night ... is that feeling of dodging the bullet, in the sense that people are taking a sigh of relief too soon,” said Dr. Richard Besser, acting chief of the CDC.


by the associated press