By William Branigin and William Booth
Washington Post Staff Writers
Monday, May 4, 2009 4:57 PM
The swine flu virus has spread to 36 states and infected at least 286 people, but the outbreak at this point appears to be milder than initially feared, U.S. officials said Monday, and Mexico declared that the epidemic is "slowing."
In its latest tally, the Centers for Disease Control and Prevention in Atlanta said the virus it calls "novel H1N1 flu" has been confirmed in six more states since yesterday and has infected 60 more people. The confirmed U.S. death toll still stands at one: a Mexican toddler who died a week ago in a Houston hospital. Most of the U.S. cases, however, have been relatively mild.
"While we're not out of the woods, we're seeing a lot of encouraging signs," CDC Acting Director Richard E. Besser said in a news briefing this afternoon. He said scientists are encouraged that the illness so far seems to be no more severe than seasonal flu and that not many variations are showing up.
Nevertheless, he told reporters, the virus is still spreading. In addition to the confirmed cases, there are more than 700 "probable cases" of swine flu in 44 states, Besser said, adding that this "likely represents an underestimation of the total cases across the country."
In the near future, he said, "we expect all states will have confirmed cases."
Asked about variations in the virus that could make it more dangerous, Nancy Cox, director of the CDC's influenza division, said: "So far, we have very good news. We haven't seen any changes that would cause alarm."
As for Mexico, where the swine flu outbreak originated last month, "it appears that things are leveling off," Besser said.
In Geneva, the World Health Organization said that although travel-related infections have spread to different parts of the globe, there is still no evidence that the disease is spreading within communities outside Mexico, the United States and Canada.
"We do not have any evidence that the virus has taken hold and has led to community-level transmissions in any other country right now" outside North America, said Keiji Fukuda, the WHO's acting assistant director general. He said cases have been seen in 20 countries and that there are indications the virus is moving into the southern hemisphere. There, winter is approaching, raising the prospect that swine flu could spread during the cold season while it wanes during the summer months in the north.
Colombia has reported a swine flu case, the first in South America.
WHO Director General Margaret Chan said the organization has no immediate plans to raise its pandemic alert to "phase 6," its highest level, after having raised it to "phase 5" last week. The highest alert level would mean that a global pandemic of swine flu was underway.
Homeland Security Secretary Janet Napolitano said, however, that a WHO decision ultimately to raise the alert level "would not be a surprise" and would not affect U.S. efforts, which she said are predicated on an eventual pandemic.
A declaration of phase 6 would "not mean that the virus has become any more severe," but that it has spread to a number of countries around the world, she said. "The level is about geography, not severity," she said.
Despite the relative mildness of the swine flu strain, Napolitano said, "this is not the time to rest." She said the virus could die down soon and reemerge in the fall when the new school year is in full swing.
In Mexico, meanwhile, authorities today lowered their flu alert level in the capital, Mexico City, and prepared to reopen many businesses and tourist sites this week.
Although the confirmed swine flu death toll rose slightly, officials said the epidemic appears to be ebbing.
"The trend is slowing," Health Minister Jose Angel Cordova told a news conference this morning. But he warned that "a resurgence is possible, and this could occur in the coming days or even much later."
Mexican officials said the confirmed death toll in the country stands at 26 and that at least 701 other people have been sickened by the virus. Officials had earlier reported about 160 "probable" swine flu deaths.
Of the 26 dead, Cordova said, 16 were women. The 26 ranged in age from 21 to 40, a relatively young set of victims. By comparison, seasonal flu, which kills as many as 36,000 people a year in the United States, mostly strikes the frail and elderly.
Mexico's previous confirmed swine flu toll, released on Sunday, was 22 dead and 568 infected.
With the epidemic apparently waning, Mexico City Mayor Marcelo Ebrard announced that restaurants will be able to reopen on Wednesday, ending a five-day period during which all nonessential businesses and government offices were shuttered to help contain the virus.
Ebrard said churches and museums would reopen Thursday. Cantinas, nightclubs, cinemas and theaters are to remain closed until further notice.
The government later said most schools, which have been closed for a week, would not reopen until May 11. Younger students will stay out until then, but those over 15 will return Thursday, officials said.
"Mexico is trying to return to normalcy as soon as possible," Mexican President Felipe Calderón said in a televised interview Sunday night.
Booth reported from Mexico City.