State and federal officials intensified their response to the swine flu outbreak on Tuesday, with President Obama asking Congress for $1.5 billion in supplemental funding and New York reporting two new potential clusters at local schools.
The global response included more restrictions on travel to and from Mexico, the origin of the outbreak and the only country to have reported deaths from swine flu. Officials there shut down schools across the country and limited restaurant service in Mexico City in an effort to curb transmission of the virus, which has killed at least 152.
Israel confirmed its first two cases of swine flu, which is now in at least seven countries. Ten others including China and Russia, which were set to quarantine passengers suspected of having the flu, are investigating possible cases.
Dr. Richard Besser, the acting director of the Centers for Disease Control and Prevention, termed the early days of swine flu in the United States as a “pre-pandemic period” and was blunt about the potential impact of this influenza.
“As this moves forward,” Dr. Besser said, “I fully expect that we will see deaths from this infection.”
He said that five people confirmed to have swine flu had been hospitalized in the United States — two in Texas and three in California, where Governor Arnold Schwarzenegger declared a state of emergency. Still, the nation’s highest number of cases continued to be in New York City, where 44 people were confirmed to have swine flu.
All of those cases are from same high school in Queens, St. Francis Preparatory Academy, where the outbreak was first discovered last Thursday, Mayor Michael R. Bloomberg said at a news conference. But he said that two new potential outbreaks at schools were being investigated. At P.S. 177, near St. Francis Prep, 12 students had fevers, and at Ascension School, in Manhattan’s Upper West Side, six students showed flu-like symptoms. Students from both schools were still being tested.
In addition, Mayor Bloomberg said that there were five other cases being investigated: three more from Saint Francis and two others who had contact with people recently in Mexico: a 2-year-old Bronx boy who remains hospitalized but is recovering and a Brooklyn woman who has been released from a hospital.
“It is here and it is spreading,” Dr. Thomas R. Frieden, the New York City Health Commissioner, said at the news conference at City Hall.
Dr. Frieden, however, said that the New York cases were mild and that the city had enough courses of Tamiflu stockpiled for one million people. He added that it was still “early” to determine the course of the virus.
In Washington, Congressional hearings addressed the seriousness of the outbreak.
“I really think we need to be prepared for the worsening of the situation,” Rear Adm. Anne Schuchat, the C.D.C.’s interim science and public health deputy director, told a Senate Appropriations health subcommittee. “It’s more of a marathon than a sprint,” she said, echoing what Dr. Besser had said on Sunday, when the country first declared swine flu a public health emergency.
Senator Tom Harkin, the Iowa Democrat who heads the subcommittee, noted that “there’s a lot of anxiety right now across the country.”
Still, that anxiety is not on the same scale as in Mexico, where the number of people believed to have been sickened in the country surpassed 1,600 on Tuesday.
The economic response to the health crisis rippled from Mexico throughout the globe: Cuba canceled all flights to Mexico. Carnival Cruise Lines said it had canceled Mexico stops for three of its cruise ships because of the swine flu alert, according to Reuters. So far, nine countries have some kind of ban on pork imports: China, Croatia, Indonesia, Lebanon, Russia, South Korea, Thailand, Ukraine and Ecuador.
Mexico City, meanwhile, was looking increasingly like a ghost town. On Tuesday morning, the city government ordered all restaurants, except those that serve take-out food, be closed until May 6. About 30,000 restaurants will be affected.
In some neighborhoods, restaurants had begun shutting down as early as last weekend. Cinemas, bars and discoteques have also been shut.
But the city has yet to make the decision to shut down public transportation, a move that would freeze most economic activity in the capital. Schools all over the country were closed Tuesday, affecting some 33 million students.
Citigroup’s Mexican subsidiary, Banamex, ran a newspaper ad asking customers to wear their masks and wash their hands. At bank branches, where employees have been told to wash their hands every hour, antiseptic gel dispensers were being installed. Banamex also asked customers to do as much banking by phone and Internet as possible.
Wal-Mart de Mexico, the country’s largest private employer with some 170,000 employees, told workers who felt ill to stay home. It also directed employees who are pregnant or nursing to stay home until May 6, said a spokesman, Antonio Ocaranza. Wal-Mart customers, though, were not necessarily following public health officials’ recommendations. At one crowded supermarket on Tuesday, most customers were not wearing masks.
Google said it had closed its Mexican City on Monday, although employees were working at home. “No decisions have been made for the rest of the week,” Google said in a released statement.
Spanish police officers at Madrid’s airport wore masks on Monday while checking passengers arriving from Mexico. Spain has had one confirmed swine flu case. More Photos >
Swine FluIn New York, both St. Francis Prep and P.S. 177 were closed, and St. Francis Prep will remain closed through the end of the week, Mayor Bloomberg said. City health officials arrived at P.S. 177 at noon to conduct investigations. A school nurse wearing a mask was examining sick students.
By 1:15 on Tuesday afternoon, parents were arriving early to pick up their children, who had been given a letter from the principal about the school closing because of students with flu-like symptoms.
“I freaked out,” said Karina Kelloggs, of Forest Hills, who was picking up her 7-year-old daughter.
Mary Ellen Do, who was picking up her niece, Holly Hagerty, said the school had stressed that there were no confirmed cases of swine flu. She added that Holly’s brother is a student at St. Francis, and suffered from flu-like symptoms but had tested negative for swine flu.
“But we’ve living with this flu,” Ms. Do said.
In Mexico, state health authorities looking for the initial source of the outbreak toured a million-pig hog farm in Perote, in Veracruz State. The plant is half-owned by Smithfield Foods, an American company and the world’s largest pork producer.
Mexico’s first known swine flu case, which was later confirmed, was from Perote, according to Health Minister José Ángel Córdova. The case involved a 5-year-old boy who recovered.
But a spokesman for the plant said the boy was not related to a plant worker and that none of its workers were sick.
On Tuesday, company officials allowed a reporter to tour their facilities after showering and donning a mask and sanitized clothing.
About 15,000 pigs could be seen in various enclosures, and officials said that at least three pig carcasses were on the farm. But they said the pigs had not died of influenza and insisted there had been no spike in deaths.
“We’re just as worried about this as everyone else,” said Mike Hawn, a Smithfield spokesman.
In Europe, Spanish Health Minister Trinidad Jiménez on Tuesday said Spain had confirmed a second case of swine flu, in the eastern province of Valencia, but that the patient was recovering..
Israel’s Ministry of Health on Tuesday reported the first case in the country. Smadar Shazo, a Health Ministry spokeswoman, said the man who contracted the illness, a 26-year-old, had recently returned from Mexico. Ms. Shazo said he is in good health now and is likely to be released from hospital on Wednesday. The Health Ministry later reported that a second man had contracted the flu as well, but his condition was unclear.
Hospital authorities in Scotland said two people — the first known cases of the virus in Britain — were recovering after contracting the flu while on honeymoon in Cancún, Mexico.
Canada now has 13 confirmed cases, all of which have been linked to Mexico.
David Williams, the chief medical officer of health for Ontario, said on Tuesday that the province, Canada’s most populous, has four confirmed cases. He said that another 20 people are undergoing tests.Dr. Williams offered few details about the patients beyond saying their cases were mild and that they live in the Toronto area.Ontario was the centre of a SARS outbreak that killed 43 Canadians in 2003.
Earlier in the day, the British Columbia Center for Disease Control confirmed a third case in that province. Alberta also confirmed two cases, with one in Calgary, the other in a northern region of the province.
Given extensive human-to-human transmission, the World Health Organization raised its global pandemic flu alert level on Monday, but it recommended that borders not be closed nor travel bans imposed, noting that that the virus had already spread and that infected travelers might not show any symptoms.
However, many countries are tightening border and immigration controls, and on Tuesday Britain advised against any nonessential travel to Mexico. Japan announced that it would no longer allow Mexican travelers to obtain visas upon arrival. The United States, France and Germany have also warned against nonessential travel to Mexico.
Canada had done the same, a decision that appeared to contradict the country’s campaign for international coordination of health-related travel advisories.
During the SARS outbreak in 2003, recommendations against visiting Canada severely impaired the country’s tourism industry. Canada said then that that warnings were unnecessary and has since promoted the idea that the W.H.O. should be the body which issues them.
At least nine countries in Asia were checking air passengers arriving from North America, and China was tightening land border checks as well. Hong Kong, Taiwan and Russia were set to quarantine passengers suspected of having the flu
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