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Published on April 24, 2009 AAP News 2009, doi:aapnews.20090424-1 © 2009 American Academy of Pediatrics
CDC confirms 7 cases of swine influenza; more expectedFive new human cases of swine influenza have been confirmed by the Centers for Disease Control and Prevention (CDC), bringing the total to 7 patients, all from Southern California or the San Antonio, Texas, area, according to an April 23 briefing.The seven cases of swine influenza A (H1N1) virus infection occurred in individuals from 9 to 54 years old. The illnesses were not considered severe, and all patients have recovered. The newest cases involved 5 in California and 2 in Texas, near San Antonio. Two individuals (16-year-old boys) attend the same Texas school, and the cases in California involved a father-daughter pair in San Diego County and another individual in neighboring Imperial Country. On April 17, the CDC confirmed the cases of a 10- year-old boy in San Diego County, Calif., and a 9- year-old girl in Imperial County. None of the patients reported contact with pigs. "We don’t really know how they got the virus, but we believe human-to-human spread is occurring," said Anne Schuchat, M.D., director of the CDC’s National Center for Immunization and Respiratory Diseases. She said while the CDC is stepping up surveillance efforts, especially in California and Texas, "it’s not a time for major concern around the country." In addition, CDC officials fully expect they could find more cases, especially in the coming days in those same geographic regions. The particular genetic combination of swine influenza virus segments has not been recognized previously. "But we haven’t been looking as intensively either," cautioned Dr. Schuchat. The virus is sensitive to oseltamivir and zanamivir but resistant to amantadine and rimantadine. While the CDC has not determined how easily the virus spreads, general precautionary measures should be taken by residents of the Southern California and San Antonio,Texas, areas: People should cover their nose and mouth with a tissue after coughing or sneezing, and then discard the tissue. In addition, wash hands frequently with soap and water, especially after coughing or sneezing. Alcohol-based cleaners also are effective. Avoid close contact with sick people. Those who become ill should stay home, limit contact with others, and try to avoid touching their eyes, nose or mouth. People who live in these areas of California and Texas who do develop illness with fever and respiratory symptoms, such as cough and runny nose and possibly, body aches, nausea, or vomiting and diarrhea, should see their health care provider, who can determine if influenza testing is needed. Clinicians are urged to consider swine influenza virus infections in patients with febrile respiratory illness who • live in San Diego County or Imperial County, Calif., or San Antonio, Texas, • have traveled to these areas, or • have been in contact with ill persons in these areas in the seven days prior to onset of their illness. The CDC is working with state health departments, the U.S. Department of Agriculture and international partners, including Mexico, where the influenza season has been more virulent and has extended longer than usual. For interim guidance and updates, plus links to reports in Morbidity and Mortality Weekly Report, visit www.cdc.gov/flu/swine/index.htm. State and local health departments should contact the CDC Influenza Division, Epidemiology and Prevention Branch, at 404-639-3747 (Monday-Friday, 8:30 a.m..- 5 p.m.) or the on-call epidemiologist at 770-488-7100 (other times).
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