Symptoms of Swine Flu

Calling in sick could mean losing a paycheck — or losing your job entirely!

2009-05-01T15:02:00.000-07:00

(CNBC) NEW YORK - You wake up one morning and you're feeling achy and feverish. The directions from health officials battling swine flu are clear: Stay home from work. Don't risk infecting others. And certainly don't send a sick kid to school.

But what if you're one of the estimated 57 million working Americans with no paid sick days?
Staying home could mean losing a paycheck, or worse, losing your job entirely.
The prospect of workers showing up with swine flu — or sick kids infecting their schoolmates — is bringing added urgency to efforts to pass a federal law guaranteeing paid sick leave.

"The problem has really come into sharp relief the past few days," said Debra Ness, president of the National Partnership for Women and Families, which has long pushed for paid sick leave. "Many people don't even realize that almost half the private sector — 48 percent — has no sick days, not even a single one."

"We have officials telling people to stay home when they're sick," she added. "Well, guess what? That can be the beginning of economic disaster for many, especially in this economy."
Making matters even worse: Those least likely to have sick leave are low-income workers, particularly in fields like food services, child care and the hotel industry — in other words, the people you most want to be staying home if they're sick. "The public health implications of this are huge," Ness said.

The Associated Press interviewed a number of workers in the food industry. Not surprisingly, most didn't want their names used for fear they would be fired. They told stories of coming to work with a fever or flu in order to keep their jobs, and of seeing sick co-workers sneezing and coughing near food.

"As a student I'm working to help pay my education, so I have to keep this job," said one who agreed to be identified, Grace Fuhr, a bartender and waitress at the Bucca di Peppo restaurant in Milwaukee.

"I've had to work sick — when I was pressured to work after a car accident, and when I've had a cold," said Fuhr, 21. "Swine flu could create an epidemic in restaurants. I have co-workers who are single parents and have impossible decisions when their kids are sick."

A study on sick leave found that 68 percent of those without paid sick days had gone to work with a contagious illness like the flu or a viral infection. And one of six workers reported that they or a family member had been fired, suspended, punished or threatened with firing after taking time off to care for themselves or a family member, according to the 2008 study by the University of Chicago's National Opinion Research Center.

Making the problem even thornier: Kids. Children get sick all the time and infect each other. Yet even among those workers lucky enough to have paid sick leave, few have flexible sick days that can be used to care for a family member.

"I can't tell you how many parents face this dilemma: Do I send my kid to school with a fever or face economic ruin?" Ness said. She calculated that 100 million workers lack flexible sick days.
Advocates for family-friendly policies point out that the U.S. is the only country out of the top 20 world economic powers with no federally mandated sick days. Put another way, some 140 other countries have them.

No U.S. states have them either, though three cities have passed such measures: San Francisco, Washington and Milwaukee, where implementation has been held up by a lawsuit.
Advocates for paid sick leave are hoping the swine flu scare will give them momentum.

W.H.O. Warns Swine Flu Threatening to Become Pandemic

2009-05-01T01:21:00.000-07:00

By MICHAEL WARREN and PAUL HAVEN, Associated Press Writers – Wed Apr 29, 7:59 pm ET

MEXICO CITY – Global health authorities warned Wednesday that swine flu was threatening to bloom into a pandemic, and the virus spread farther in Europe even as the outbreak appeared to stabilize at its epicenter. A toddler who succumbed in Texas became the first death outside Mexico. New cases and deaths finally seemed to be leveling off in Mexico, where 160 people have been killed, after an aggressive public health campaign.

But the World Health Organization said the global threat is nevertheless serious enough to ramp up efforts to produce a vaccine against the virus.

"It really is all of humanity that is under threat during a pandemic," WHO Director General Margaret Chan said in Geneva. "We do not have all the answers right now, but we will get them."

It was the first time the WHO had declared a Phase 5 outbreak, the second-highest on its threat scale, indicating a pandemic could be imminent.

The first U.S. death from the outbreak was a Mexico City toddler who traveled to Texas with family and died Monday night at a Houston hospital. U.S. Health and Human Services Secretary Kathleen Sebelius predicted the child would not be the last U.S. death from swine flu.

The virus, a mix of pig, bird and human genes to which people have limited natural immunity, had spread to at least nine countries. In the United States, nearly 100 have been sickened in 11 states.

Eight states closed schools Wednesday, affecting 53,000 students in Texas alone, and President Barack Obama said wider school closings might be necessary to keep crowds from spreading the flu. Mexico has already closed schools nationwide until at least May 6.

"Every American should know that the federal government is prepared to do whatever is necessary to control the impact of this virus," Obama said, highlighting his request for $1.5 billion in emergency funding for vaccines.

Just north of the Mexican border, 39 Marines were being confined to their California base after one contracted what may be swine flu. Senators questioned Homeland Security Secretary Janet Napolitano about her decision not to close the border, action she said "has not been merited by the facts."

Ecuador joined Cuba and Argentina in banning travel either to or from Mexico, and other nations considered similar bans. In France, President Nicolas Sarkozy met with cabinet ministers to discuss swine flu, and the health minister said France would ask the European Union to suspend flights to Mexico.

The U.S., the European Union and other countries have discouraged nonessential travel to Mexico. Some countries have urged their citizens to avoid the United States and Canada as well. Health officials said such bans would do little to stop the virus.

Germany and Austria became the latest countries to report swine flu infections Wednesday, with cases already confirmed in Canada, Britain, Israel, New Zealand and Spain.

In addition to the 160 deaths, the virus is believed to have sickened 2,498 people across Mexico. But only 1,311 suspected swine flu patients remained hospitalized, and a closer look at daily admissions and deaths at Mexico's public hospitals suggests the outbreak may have peaked during three grim days last week when thousands of people complained of flu symptoms.

Scientists believe that somewhere in the world, months or even a year ago, a pig virus jumped to a human and mutated, and has been spreading between humans ever since. Unlike with bird flu, doctors have no evidence suggesting a direct pig-to-human infection from this strain, which is why they haven't recommended killing pigs.

Medical detectives have not zeroed in on where the outbreak began. One of the seven deaths in Mexico directly attributed to swine flu was that of a Bangladeshi immigrant, said Mexico's chief epidemiologist, who suggested that someone could have brought the virus from Pakistan or Bangladesh.

Miguel Angel Lezana, the epidemiologist, said the unnamed Bangladeshi had lived in Mexico for six months and was recently visited by a brother who arrived from Bangladesh or Pakistan and was reportedly ill. The brother has left Mexico and his whereabouts are unknown, Lezana said.
By March 9, the first symptoms were showing up in the Mexican state of Veracruz, where pig farming is a key industry in mountain hamlets and where small clinics provide the only health care.

The earliest confirmed case was there: a 5-year-old boy who was one of hundreds of people in the town of La Gloria whose flu symptoms left them struggling to breathe.

Days later, a door-to-door tax inspector was hospitalized with acute respiratory problems in the neighboring state of Oaxaca, infecting 16 hospital workers before she became Mexico's first confirmed death.

Neighbors of the inspector, Maria Adela Gutierrez, said Wednesday that she fell ill after pairing up with a temporary worker from Veracruz who seemed to have a very bad cold. Other people from La Gloria kept going to jobs in Mexico City despite their illnesses, and could have infected people in the capital.

The deaths were already leveling off by the time Mexico announced the epidemic April 23. At hospitals Wednesday, lines of anxious citizens seeking care for flu symptoms dwindled markedly.
The Mexican health secretary, Jose Angel Cordova, said getting proper treatment within 48 hours of falling ill "is fundamental for getting the best results" and said the country's supply of medicine was sufficient.

Cordova has suggested the virus can be beaten if caught quickly and treated properly. But it was neither caught quickly nor treated properly in the early days in Mexico, which lacked the capacity to identify the virus, and whose health care system has become the target of widespread anger and distrust.

In case after case, patients have complained of being misdiagnosed, turned away by doctors and denied access to drugs. Monica Gonzalez said her husband, Alejandro, already had a bad cough when he returned to Mexico City from Veracruz two weeks ago and soon developed a fever and swollen tonsils.

As the 32-year-old truck driver's symptoms worsened, she took him to a series of doctors and finally a large hospital. By then, he had a temperature of 102 and could barely stand.
"They sent him away because they said it was just tonsillitis," she said. "That hospital is garbage."

That was April 22, a day before Mexico's health secretary announced the swine flu outbreak. But the medical community was already aware of a disturbing trend in respiratory infections, and Veracruz had been identified as a place of concern.

Gonzalez finally took her husband to Mexico City's main respiratory hospital, "dying in the taxi." Doctors diagnosed pneumonia, but it may have been too late: He has suffered a collapsed lung and is unconscious. Doctors doubt he will survive.

Swine flu has symptoms nearly identical to regular flu — fever, cough and sore throat — and spreads like regular flu, through tiny particles in the air, when people cough or sneeze. People with flu symptoms are advised to stay at home, wash their hands and cover their sneezes.
While epidemiologists stress it is humans, not pigs, who are spreading the disease, sales have plunged for pork producers around the world. Egypt began slaughtering its roughly 300,000 pigs on Wednesday, even though no cases have been reported there. WHO says eating pork is safe, but Mexicans have even cut back on their beloved greasy pork tacos.

Pork producers are trying to get people to stop calling the disease swine flu, and Obama notably referred to it Wednesday only by its scientific name, H1N1. U.N. animal health expert Juan Lubroth noted some scientists say "Mexican flu" would be more accurate, a suggestion already inflaming passions in Mexico.

Authorities have sought to keep the crisis in context. In the U.S. alone, health officials say about 36,000 people die every year from flu-related causes.

Mexico's government said it remains too early to ease restrictions that have shut down public life in the overcrowded capital and much of the country. Pyramids, museums and restaurants were closed to keep crowds from spreading contagion.

"None of these measures are popular. We're not looking for that — we're looking for effectiveness," Mexico City Mayor Marcelo Ebrard said. "The most important thing to protect is human life."
___

Associated Press writers Olga Rodriguez in Oaxaca, Mexico, E. Eduardo Castillo in Mexico City, Lauran Neergaard and Tom Raum in Washington, Juan A. Lozano in Houston, Mike Stobbe in Atlanta, Patrick McGroarty in Berlin and Maamoun Youssef in Cairo contributed to this report.

Development of Swine Flu Worldwide

2009-04-29T02:23:00.000-07:00

Key developments on swine flu outbreaks, according to Centers for Disease Control and Prevention, World Health Organization, and government officials:

Deaths: 159, all in Mexico, seven confirmed as swine flu and rest suspected.
Sickened: 2,498 suspected and 19 confirmed in Mexico; 66 confirmed in U.S.; 13 confirmed in Canada; two confirmed in Scotland; 14 confirmed in New Zealand; three confirmed in Germany; two confirmed in Spain; and two confirmed in Israel.
Confirmed U.S. cases, by state: 45 in New York, 11 in California, six in Texas, two in Kansas and one each in Indiana and Ohio, according to CDC and states.
U.S. Food and Drug Administration issues emergency guidance allowing certain antiviral drugs to be used in broader range of population if needed. Public health emergency declared and roughly 12 million doses of Tamiflu from federal stockpile to be delivered to states.
Cuba bans flights to and from Mexico; Argentina suspends flights from Mexico; U.S., European Union, other countries discourage nonessential travel there. Arriving travelers questioned at Mexico's U.S. border and world airports. Cruise lines avoid Mexico ports.
Mexico suspends all schools until May 6. In U.S., some schools closed in New York City, Texas, California, South Carolina, Connecticut and Ohio.
In Mexico City, surgical masks given to the public, venues closed and public events canceled. President assumed new powers to isolate infected people. World Bank loaning Mexico more than $200 million.
Worldwide: WHO alert at Phase 4 of 6, meaning disease spreads easily but isn't pandemic

Symptoms of Swine Flu

2009-04-28T23:25:00.001-07:00

Dr. Joe Bresee with the CDC's Influenza Division.

Since March 2009, persons with infection caused by a new strain of swine flu virus have been identified in the U.S. and other countries. It's important that people recognize the symptoms of swine flu and seek medical care if necessary.

For many years, we've known that swine flu occasionally infects humans, so we know the typical symptoms of swine flu. The symptoms are similar to the symptoms of regular human flu and can include fever, cough, sore throat, body aches, headache, chills, or fatigue. Some people with swine flu have also reported diarrhea or vomiting. In the past, severe illness, such as pneumonia or respiratory failure, as well as death has been reported with swine flu infections in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.

If you live in an area where swine flu infections have been reported, and if you become ill with flu-like symptoms you may want to contact your health care provider, particularly if you're worried about your symptoms. Your health care provider will determine whether swine flu testing or treatment is needed.

If you become ill and experience any of the following warning signs, get emergency medical care. In children, emergency warning signs that need urgent medical attention include: fast breathing or trouble breathing, bluish skin color, not drinking enough fluids, not waking up or not interacting, being so irritable that the child does not want to be held, fever with a rash, or flu-like symptoms that improve but then return with fever or worse cough. In adults, emergency warning signs that need urgent medical attention include: difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, or severe or persistent vomiting.

People with swine flu can infect others and could be contagious as long as they are symptomatic, and possibly for up to seven days following the onset of illness. Children, especially younger children, might potentially be contagious for longer periods.

Fortunately, there are medicines that can be used to treat swine flu. Antiviral drugs are prescription medicines, such as pills, liquids, or an inhaler that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and can make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started within two days of symptoms. CDC recommends the use of oseltamivir, which is also called Tamiflu®, or zanamivir, which is also called Relenza®, for the treatment or prevention of infection with these swine flu viruses.

If you get sick with swine flu, CDC recommends that you stay home from work or school and limit contact with others to reduce the chance of transmitting the infection. Avoid touching your eyes, nose, or mouth because germs can spread that way. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
For more information about swine flu, visit www.cdc.gov/swineflu.

For the most accurate health information, visit http://www.cdc.gov/

You can also call 1-800-CDC-INFO, 24/7.

Swine Influenza - CDC Travel Warning

2009-04-28T23:19:00.000-07:00

CDC has activated its emergency operations center to coordinate the agency’s emergency response. CDC ’s goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by this swine influenza virus. Yesterday, CDC issued a travel warning recommending that people avoid non-essential travel to Mexico. CDC continues to issue interim guidance daily on the website and through health alert network notices. CDC’s Division of the Strategic National Stockpile (SNS) is releasing one-quarter of its antiviral drugs, personal protective equipment, and respiratory protection devices to help states respond to the outbreak. The swine influenza A (H1N1) virus is susceptible to the prescription antiviral drugs oseltamivir and zanamivir. This is a rapidly evolving situation and CDC will provide updated guidance and new information as it becomes available.