What is Arizona doing to get ready for the swine flu and is the problem as bad as it is being portrayed? Arizona Acting State Health Director Will Humble discusses the swine flu.
Ted Simons:
Concerns continue to grow about the new strain of swine flu, 64 confirmed cases in the United States, no fatalities as yet. Mexico 150 deaths are being blamed on the disease. Arizona has no reported cases, although four samples are being sent to the Centers for Disease Control to see if they test positive for swine flu. First, here is some reaction from city and county officials.
Phil Gordon:
The fact of the matter is there isn't -- there is not an emergency here in Arizona, but that Arizona, because of its training, participation as a state throughout the state, the state to the counties to the cities, and particularly our involvement with the state and the federal and the county of Maricopa, are prepared and well trained to handle an emergency if it should arise. Let me acknowledge secondly right off the bat as of a few minutes ago, there are still no reported cases of the swine influenza in the state of Arizona.
Claude Mattox:
Centers for disease control has actually put out -- every flu season they put out a list of things that you should be doing to stay healthy. The first is to avoid close contact. If you know someone who is ill, you know, just stay away from them. Don't shake hands. You know, this -- this particular influenza is airborne, so keep distance from folks like that. If you are sick, to avoid infecting other folks stay at home. Simple way to avoid getting other people sick. Cover your mouth and your nose if you are going to be coughing or if you are around someone that is ill, make sure that you use a mask. Make sure that you're not breathing directly from them. Clean your hands wash your hands. That is very simple, but this virus obviously is something that can be left behind. So, just wash your hands more frequently. Avoid touching your eyes, nose, or mouth. Again, washing your hands will help in that regard. And also as we learned to practice no longer do you want to cough into your hands. You want to cough into the crook of your arm or something to that effect. And then finally just practicing good health habits. Get plenty of sleep. Get exercise. Eat nutritious food. Drink water. These are common-sense ways to keep yourself healthy and avoid becoming a victim of this influenza.
Deborah Ostreicher:
We have been working with the local, state, and federal officials throughout the last several days, as well as into today to figure out what it is that we can do at the airport to help mitigate the transmission of this disease through air travel. For now, if a passenger does arrive at Sky Harbor with symptoms of the flu, the customs and border protection will isolate that person, give them a mask, work with them and contact the centers for disease control and figure out how to proceed. I'm sure they will have updated information for you of exactly how that is going to work. We have 18 daily nonstops between Phoenix and Mexico. I can give you more information on where those go and the times. We are cleaning carefully as we always are throughout the airport to make sure that disease that could be passed through touch is mitigated as much as possible, but we at the airport encourage you to heed the advice about taking your own precautions as responsible members of the public to do whatever you can to help mitigate the issue. We will keep you posted as to anything that changes at Sky Harbor in the coming days. Thank you.
Ted Simons:
Here to talk about Arizona's reaction to the swine flu, Will Humble. Good to have you on the show. Thank you for joining us.
Will Humble:
Good evening, thanks.
Ted Simons:
No reported cases in Arizona as yet. Little surprised by that?
Will Humble:
We don't have any cases yet. We may get some in the next few days. We don't really quite know. We have stepped up our surveillance in the last few days, especially since Friday. Previous to Friday we were in our routine public health surveillance phase. After Friday, we kicked up to what we called enhanced surveillance, which means we're doing more specific outreach with emergency departments, community health centers, and individual clinicians out there in the field so that as they do test the folks, what is called a rapid test out there in the field, out there in the doctor's office, we're encouraging them to send in samples to the public health laboratory when folks test positive to influenza A that we can really look at that individual sample and determine if it is the swine flu variant, or like we have been finding all week long, just the regular seasonal flu.
Ted Simons:
What happens if you do find it is swine flu? What changes here in Arizona?
Will Humble:
Okay. The first thing we would do is get back with the county health department and that individual clinician to make decisions about what kinds of public health interventions to conducts. So, for example, if we were to find a case in, say, an eight-year-old child in the second grade, all right, we talk to the county health department. The county health department would talk to that school and sort of make decisions about where to go from there. It could mean that the county health department would work with that school to dismiss school for say one week in that individual school, not the whole district, not the state, just that individual school so that we can get through a couple of incubation periods without spreading the disease, thereby limiting the spread to the community.
Ted Simons:
From where you sit, how serious is this outbreak?
Will Humble:
Well, I mean, it is a really good question, because it depends. We know that the same -- it is the exact same virus in Mexico as it is in the U.S. This is -- we test the D.N.A., we know it is the exact same strain. In the U.S., we've got over 60 cases now, and we see a very relatively mild virus, a lot like the regular seasonal flu. It is not mild if you have a 101 fever, but relative to what we normally see, the swine flu cases we see across the country are really similar to normal flu season viruses, yet in Mexico, we see this extraordinary difference where it is far more lethal and the symptoms are more severe. It is puzzling for us public health officials because really the outcomes for the patients ought to be the same. We haven't really gotten an answer yet. But what is striking to me is that each day that goes by in the U.S., we see the same kind of symptoms relatively mild, very few hospitalizations, and no deaths, and as we build our end, what we call in the business, as we get our sample size larger, the body of evidence points to this maybe not being as extreme as an epidemic as it appeared to be with the initial Mexican national reports.
Ted Simons:
That being said, do we know enough about this disease to get a vaccine ordered, get a vaccine considered or do we have to wait and find out more?
Will Humble:
That process is actually already starting. The C.D.C. has gotten samples from some of the states that have had cases and they put that in what they call their seed stock. The C.D.C. has actually got this new swine flu variant in their seed stock and they're going to use that to start that process towards developing a vaccine. Now, whether they actually proceed and include the swine flu variant in the next seasonal flu vaccine, or whether it is a separate vaccine or whether they don't do it at all, depends on what happens between now and the next couple of months.
Ted Simons:
The vaccine everyone got last year, is that making any difference at all with this?
Will Humble:
No, the vaccine that people got last fall, and, by the way, still vaccine out there for the regular seasonal flu, that vaccine does not cover this new swine flu H1N1, variant. That will not provide protection from this flu. There is regular seasonal flu out there in Arizona. All of the samples that we tested today all of them were seasonal flu, except for a few which we sent to CDC.
Ted Simons:
We hear about the threat of a pandemic. What makes a pandemic?
Will Humble:
Well, a pandemic means it is a brand new virus, which we know this is. It is a virus easily transmitted from person to person, right? We know we have that. It needs to be easily transmitted within communities, right? And then it needs to become global. When you have all four of those components, you've got a pandemic. But, and here is an important thing, not all pandemics are created equal. Everyone has heard about the 1918 pandemic. There are books written about it. Grandparents tell stories about it. There was two others pandemics in the 20th century, in 1968 and '59. No one hears about those pandemics because they were almost like regular seasonal flu years. What we could very well see is this turning into a pandemic, but a pandemic that looks an awful lot like the regular flu season.
Ted Simons:
Interesting. I have been reading about the Spanish flu, the 1918 epidemic, and it sounds like young people were hit especially hard there, because their immune systems were so strong. Is this similar at all?
Will Humble:
Well, in the U.S., we're seeing that people recover. In the Mexican cases, in the cases from Mexico, the cases seem to be -- seem to look like that, where the folks who are in their 20s were hardest hit. The people who have the most vigorous immune system. We're not seeing the same thing here.
Ted Simons:
Can what's happening in Mexico wind up evolving into something in America that more resembles what is going on in Mexico?
Will Humble:
Well, we know it is the same virus. The virus in Mexico is the virus that we have in the U.S. It is the same virus. That is what is so puzzling. The disease manifests itself in the Mexico City population in such an aggressive way and yet we see something different here in the U.S. Time may well -- It may get more severe as we get a larger sample size in terms of the number of cases here. So far, the last couple of days, I would say, have been in the U.S. encouraging despite the increased number of cases.
Ted Simons:
The President says it is a reason for concern, not alarm. You would agree?
Will Humble:
Sure, I would agree with that. It is reason to take action in terms of implementing solid public health measures that we know work.
Ted Simons:
Okay.
Will Humble:
So, that's where we are today. There is enough, I think, concern in the public health community to implement those things that we know work in terms of public health interventions, and that's what we're doing, because that's our job.
Ted Simons:
And the state has a good stockpile at the ready or increasing as we speak.
Will Humble:
Well, we've got -- there are two antiviral medications that we have a stockpile of that we bought three years ago with federal money. And so we have that in place already, and over the next couple of days, we are going to be receiving a portion of the strategic national stockpile, which will include additional antiviral medications plus masks, gowns for use in emergency departments and so forth.
Ted Simons:
Last question here. It is always wise to remind folks to wash your hands for goodness sakes and not cough on other people. But it is nice to hear these techniques again. Overall, is there a chance that we are overreacting to this?
Will Humble:
Well, you know, when we had those initial reports from what was going on in Mexico that was compelling evidence that something needed to happen because of the severity of what we were at least hearing about in Mexico. As we progress and see what is happening here in the U.S., we need to take that into consideration as we continue to progress through this outbreak. I mean, one of the things that we always talk about, I always talk about with my staff is look at the data. Look at the information that we see today, because that needs to drive our decision making. I don't want to make decisions based upon perception or liability or anything else. Just let's look at the science and let's do what works.
Ted Simons:
All right. Very good. Thank you so much for joining us. We appreciate it.
Will Humble:
Take care.
Will Humble:Arizona Acting State Health Director;
