Sunday, April 26, 2009

Swine Flu and Travel

The swine flu outbreak has evidently spread from Mexico, where more than 80 deaths have now been attributed to a severe respiratory illness, to the United States, where at least 20 people are known to have contacted swine flu. The United States declared a public health emergency today.

As if Mexico hasn't had enough problems with travel.

[UPDATE: This is now starting to sound potentially dire for world travel. Look at this link to an AP story, via Yahoo, which mentions (alas, without any elaboration) that some countries are considering issuing travel warnings for the United States and Mexico. If this gains any traction, it will be disastrous news for airlines already staggering under the sharp drop-off in international travel that clobbered them during the first quarter.)

(By the way, don't go to the Aeromexico Web site for any unpleasant news. Not a word about this as of late afternoon Sunday. Nada.) U.S. airlines, on the other hand, are prominently advising Mexico bound passengers that they can change plans without penalty. Here's the American Airline advisory, for example.

The American Airlines policy, by the way, allows someone who cancels a Mexico trip to reuse the ticket without penalty to anywhere for the length of the validity of the ticket (a year after purchase for most nonrefundable seats.)

But have a look at the cheesy US Airways policy:

It reads: "US Airways has relaxed ticketing policies for travel to Mexico City due to an influenza outbreak. US Airways will waive the standard change fee, advance reservation and ticketing requirements for customers with travel to, from or through Mexico City on the dates above ..." [note: through April 30]

" * You can move your entire itinerary up to seven days before or after the scheduled origination date.
* You can apply the full value of your wholly unused tickets toward the purchase of a ticket to an alternate destination, although travel must originate within seven days of the scheduled origination date.

What sports, huh? Even assuming you don't want to go to Mexico during a swine flu epidemic, you have to use the ticket within SEVEN DAYS!

Here's the latest report on the situation from the Huffington Post, which appears to have lifted the story entirely from the AP.

Here's a link to the much more comprehensive New York Times story.

And here is an advisory from earlier today from the global crisis-response company International SOS. Note that the ISOS numbers of those affected are now out of date.

" ... public health authorities are investigating two unusual occurrences - the appearance of a new swine flu that has infected at least 7 people in the U.S., and 20 deaths in Mexico from a severe respiratory illness that appears to be spreading. At this stage there is no [known] evidence to link the two, and the illnesses do not appear to have extended beyond the regions discussed below.

Over one hundred and thirty cases of a severe respiratory illness have been detected in south and central Mexico, of which at least some are due to influenza. It is unclear at this stage the cause of the other cases, and whether all are in fact due to the same infection.

Public health officials in Mexico began actively looking for cases of respiratory illness upon noticing that the seasonal peak of influenza extended into April, when cases usually decline in number.

They found two outbreaks of illness - one centered around Distrito Federal (Mexico City), involving about 120 cases with 13 deaths. The other is in San Luis Potosi, with 14 cases and 4 deaths. A death in Oaxaca, in the south, and 2 in Baja California Norte, were also detected.

The majority of cases are occurring in adults, between 25 and 44 years of age. Some have occurred in health care workers. Symptoms are initially like flu, with fever, cough, headache and muscle pains. Severe cases progressed rapidly within 5 days.

In response, health officials have temporarily suspended classes for schools and universities in Mexico City and nearby locations.

Investigations are ongoing, and samples have been sent to Canada for further testing. Influenza virus was detected in at least four of the fatal cases.

Swine flu in California and Texas

The U.S. Centers for Disease Prevention and Control initially reported two confirmed cases of a swine influenza in two children in California. Since then, three others in California and two others in Texas have been found with the same illness. All have fully recovered, and one case required management in hospital. All other cases were mild. None had contact with pigs, and it is likely that there is spread from human to human.

The first two cases detected were a 10-year-old boy and a 9-year-old girl, who did not have contact with each other. They live in two adjacent counties in California, and both have recovered. Neither child had exceptional symptoms or severe illness. Authorities discovered that they had swine flu as part of routine testing performed on people with flu-like symptoms - they were not singled out for testing based on their symptoms.

The boy, from San Diego county, fell ill with a fever, cough and vomiting on March 30. He recovered completely within a week. His mother and brother had flu-like illnesses before he became ill, but they weren't tested at the time.

The 9-year-old girl is from Imperial County and had visited a fair where pigs were on display a few weeks before getting sick. She developed a cough and fever on March 28, and has recovered fully. Both her brother and cousin suffered similar symptoms but were not tested for flu.

Authorities are tracking people with whom the children had contact. This effort is ongoing and extends into Texas, as the boy traveled to that state on April 3. Two teenagers who attended the same school in San Antonio have been detected with the unusual flu strain, as well as a father and daughter in California.

Public health officials are investigating whether the illness is more widespread, and how it may have arisen. They have advised residents of Texas and California to take everyday precautions to prevent illness, and if they have flu-like symptoms to contact their health care providers.

The virus found is a new strain of swine flu H1N1 which is resistant to the older antiviral medications amantadine and rimantidine. The virus is sensitive to the newer antiviral medications oseltamivir and zanamivir. It is unknown if the seasonal influenza vaccination provides any protection against this swine flu.


In both situations there is currently limited information, and no definite link between the two. The illnesses do not appear to have extended beyond the areas mentioned above.

Health authorities have not determined whether or not the swine flu has "pandemic potential" and a definitive cause for the respiratory illnesses in Mexico has not yet been found. Investigations are ongoing. For the latest information see the medical alerts on International SOS Country Guides:

USA Swine Flu
Mexico Severe Respiratory Illness

Travel to the United States and Mexico can proceed. People who have not had an annual flu vaccination should consider having one to prevent regular seasonal flu.

In addition, to prevent respiratory infections, including flu and prevent spreading illness:

* Maintain good personal hygiene. Wash your hands frequently and avoid touching your face.
* Cover coughs and sneezes with a mask or a tissue.
* Avoid obviously sick people
* Stay at home if you are unwell, and seek medical attention if you develop flu-like symptoms
* Parents should take their young children with fever or influenza-like symptoms for prompt medical attention."


By the way:

Here's a useful Q&A from the World Health Organization on swine flu.


And remember Texas Governor Rick Perry, making all that silly noise recently about Texas maybe seceding from the United States because some people were upset about taxes or something?

Comes trouble, and Perry is first in line to demand extra federal assistance.

On Saturday, Perry asked the U.S. Centers for Disease Control and Prevention for 37,430 doses of antiviral medicine from the Strategic National Stockpile after the three cases of swine flu turned up in high school students in Guadalupe County.


Meanwhile, the Air Transport Association says that U.S. airlines are monitoring the situation in Mexico. "We are in communication with the U.S. Centers for Disease Control and Prevention (CDC) and look to their public health experts for recommendations on whether any additional measures are needed to prevent spread of the disease by air travel. In the meantime, ATA member airlines will continue to comply with long-standing requirements to report any case of communicable disease on board aircraft flying to or within the United States.

“At this time CDC is not advising U.S. citizens postpone or forgo travel to Mexico, although we understand that they will be issuing an 'outbreak notice' to inform travelers and provide reminders about standard and enhanced recommendations for the region.”


Incidentally, the U.S. Centers for Disease Control advisory on the situation hasn't been updated since yesterday (what, nobody working there on a Sunday?)


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