Apr 29, 2009Dr. Margaret Chan, head of the World Health Organization, today raised the agency’s pandemic alert level to phase 5, one notch below a full-scale influenza pandemic, signaling that it’s time for all countries to prepare. [Margaret Chan’s statement]The US Centers for Disease Control and Prevention (CDC) today reported a total of 91 confirmed cases of swine flu in 10 states, with 51 cases in New York City. Besides New York, affected states and case numbers are Arizona, 1; California, 14; Indiana, 1; Kansas, 2; Massachusetts, 2; Michigan, 2; Nevada, 1; Ohio, 1, and Texas, 16. [CDC swine flu page]Fukuda said the WHO knew of 114 confirmed swine flu cases in seven countries as of 5 p.m. Geneva time today. These included 13 in Canada, 64 (with 1 death) in the United States, 26 (with 7 deaths) in Mexico, 2 in Israel, 4 in Spain, 2 in the United Kingdom, and 3 in New Zealand.A 22-month-old boy from Mexico City died in a Houston, Tex., hospital earlier this week, marking the first swine flu death in the United States and the first outside Mexico, the Texas Department of Health Services reported today. The boy’s close contacts have remained healthy, officials said. [TDHS news release]Germany reported three swine flu cases and Austria reported one, according to a Reuters report today. The patients included a Bavarian couple in their 30s, a 22-year-old woman from Hamburg, and a 28-year-old Austrian.New York and Indiana have received their full allotments of influenza antivirals from the Strategic National Stockpile, and all other states will receive theirs by May 3, Dr. Richard Besser, acting CDC director, said in a press briefing held by the US Department of Health and Human Services.A “reference strain” of the swine flu H1N1 virus has been isolated by the CDC and sent to vaccine manufacturers, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said at the HHS briefing, adding that limited pilot lots of vaccine could be available for human trials in “early fall.”The US Food and Drug Administration has organized its swine-flu response into an “incident management” structure of seven teams—vaccine, antivirals, personal protective equipment, blood needs, diagnostic research, shortages, and consumer protection—acting FDA Commissioner Dr. Joshua Sharfstein said at the HHS briefing.Viral geneticist Andrew Rambaut, from the University of Edinburgh, told Wired magazine yesterday that the H1N1 virus detected in the global swine flu outbreak doesn’t have human or avian components, but is instead a reassortment of two pig viruses, North American and Eurasian, which have never been detected in pigs or humans before. Two other experts, and reportedly a document from the Centers for Disease Control and Prevention (CDC), confirmed the findings.Only 3 of 14 US swine flu patients with known travel histories had been in Mexico, the CDC said in an MMWR Dispatch last night. Forty of the 64 confirmed cases were not linked to travel or to another confirmed case. [Apr 28 MMWR Dispatch]Between Apr 19 and 27, federal officials checked 15 sick travelers entering the United States from Mexico and confirmed that 2 of them had swine flu, the CDC said in the MMWR Dispatch. Nine travelers remained in isolation pending further evaluation, and four travelers were released.