(ChinaPost.com.tw) – Taiwan’s travel agencies, who still have not recovered from the global financial storm, have been left reeling even further with the World Health Organization’s declaration of a global pandemic of the A(H1N1) influenza virus, which has frightened many local people into avoiding foreign travel.

According to the latest Tourism Bureau statistics, only a few first-stop overseas destinations such as South Korea, Britain, Palau and Australia, enjoyed growth in the number of travelers from Taiwan in May thanks to the incentives that included favorable exchange rates, visa-free privileges and convenient flight services.

The number of Taiwanese travelers to Japan, which attracts over 1 million Taiwanese visitors each year, had only 80,382 visits by this group in May, marking a drop of 35.41 percent from the same month of the previous year, the statistics show.

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Nothing was going to stop this wedding. Not a messed-up wedding cake, missing wedding rings, the bride running off with the best man, nothing. Of course, none of those happened. Swine flu, however, did.

In an unlikely set of events, both the bride and the groom in this Chicago wedding had swine flu. Realistically, it probably wasn’t all that unlikely, since they were going to be married, and likely shared some intimate time. Ilana Jackson and Jeremy Feirstein, both 26, received the news just 48 hours before their nuptials, from their doctor:

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(ChinaPost.com.tw) – The Central Epidemics Command Center reported yesterday two more cases of imported swine flu, officially known as influenza A(H1N1), raising the total number of confirmed cases to 60.

The center said the patients are two female students, 14 and 21 years old, who returned home from California. One of them developed swine flu symptoms after her return to Taiwan, while the other was found to have a fever upon arrival at the Taiwan airport.

There were no signs of swine flu symptoms among members of the students’ families, the center said.

Meanwhile, one of the two indigenous cases of swine flu in Taiwan has not yet fully recovered, the center added.

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(ChinaPost.com.tw) – The new strain of H1N1 flu is causing “something different” to happen in the United States this year — perhaps an extended year-round flu season that disproportionately hits young people, health officials said on Thursday.

An unusually cool late spring may be helping keep the infection going in the U.S. Northeast, especially densely populated areas in New York and Massachusetts, the officials at the U.S. Centers for Disease Control and Prevention said.

And infections among healthcare workers suggest that people are showing up at work sick — meaning that workplace policies may be contributing to its spread, the CDC officials said.

The new strain of swine flu is officially a pandemic now, according to the World Health Organization.

So far the virus is causing mild to moderate disease, but it has killed at least 167 people and been confirmed in nearly 40,000 globally.

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- 3 confirmed cases in Wales. – 0 probable cases in Wales. – 136 people have been under investigation in Wales. Of these, swine flu has been confirmed in three cases (see above) and ruled out in 123 cases, leaving 10 still under investigation. All of these are displaying, or have displayed, mild symptoms. – Of the 10 people under investigation, seven were well when first identified, but reported recent flu-like symptoms following travel to affected areas. Blood tests are being undertaken on these individuals to see if they had the flu and to help the NPHS understand the pattern of the disease from the past. Their symptoms may or may not have been due to swine flu. Testing will be conducted in a number of weeks to check whether these people did have swine flu – scientifically it won’t work before that. Investigations have shown that people they had close contact with did not catch flu from them when they were ill.

- No further details will be confirmed or denied about cases in order to protect their right to confidentiality.

- There are now 1,472 laboratory confirmed cases in the UK – three cases in Wales, 508 cases in Scotland, 952 cases in England and nine in Northern Ireland.

- One person with swine flu in the UK – a case in Scotland – has died. The patient had underlying health conditions. – Swine flu cases have been confirmed in 76 countries. For the latest international figures for the spread of swine flu, visit the website of the World Health Organization at www.who.int

Comment from Welsh Assembly Government and National Public Health Service for Wales

- Chief Medical Officer for Wales, Dr Tony Jewell, said:

“So far the virus is generally mild in most people, but proving more severe in a small number of cases, and tragically one person has died in Scotland.

“We have warned that we need to expect that, with large numbers of people contracting swine flu, there will be deaths, particularly in patients with underlying health conditions. Even with the seasonal flu, we do see excess deaths occuring.

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The Centers for Disease Control and Prevention (CDC), USA, in its latest update, dated Friday evening, 19th June, 2009, reports a total of 21,449 confirmed human cases of swine flu A(H1N1) infection, including 87 deaths. Authorities say the novel A(H1N1) influenza virus has not mutated and is not more virulent (aggressive) than most normal seasonal human flu viruses. However, health services are bracing themselves for a busy flu season this winter as the swine flu virus will have been circulating for several months, but will still be a relatively novel one.

U.S. Human Cases of H1N1 Flu Infection (CDC)

Alabama – 172 cases – 0 deaths
Alaska – 23cases – 0 deaths
Arkansas – 18cases – 0 deaths
Arizona – 645 cases – 7 deaths
California – 1245 cases – 8 deaths
Colorado – 103 cases – 0 deaths
Connecticut – 767 cases – 3 death
Delaware – 223 cases – 0 deaths
Florida – 562 cases – 1 death
Georgia – 51 cases – 0 deaths
Hawaii – 279 cases – 0 deaths
Idaho – 47 cases – 0 deaths
Illinois – 2526 cases – 8 deaths
Indiana – 223 cases – 0 deaths
Iowa – 92 cases – 0 deaths
Kansas – 97 – 0 deaths
Kentucky – 108 – 0 deaths
Louisiana – 134 cases – 0 deaths
Maine – 42 – 0 deaths
Maryland – 263 – 0 deaths
Massachusetts – 1270 – 1 death
Michigan – 442 cases – 2 deaths
Minnesota – 365 – 1 death
Mississippi – 81 cases – 0 deaths
Missouri – 46 cases – 1 death
Montana – 44 cases – 0 deaths
Nebraska – 81 cases – 0 deaths
Nevada – 198 cases – 0 deaths
New Hampshire – 187 cases – 0 deaths
New Jersey – 603 cases – 2 deaths
New Mexico – 155 cases – 0 deaths
New York – 1300 – 24 deaths
North Carolina – 125 cases – 0 deaths
North Dakota – 41 cases – 0 deaths
Ohio – 63 cases – 0 deaths
Oklahoma – 112 cases – 1 death
Oregon – 219 cases – 1 death
Pennsylvania – 942 cases – 3 deaths
Rhode Island – 94 cases – 1 death
South Carolina – 83 – 0 deaths
South Dakota – 17 cases – 0 deaths
Tennessee – 121 cases – 0 deaths
Texas – 2519 cases – 10deaths
Utah – 755 cases – 8 deaths
Vermont – 43 cases – 0 deaths
Virginia – 135 cases – 1 death
Washington – 588 cases – 3 deaths
Washington, D.C. – 33 cases – 0 deaths
West Virginia – 77 cases – 0 deaths
Wisconsin – 3008 cases – 1 death
Wyoming – 63 cases – 0 deaths
Territories
Puerto Rico – 18 case – 0 deaths
Virgin Islands – 1 case – 0 deaths

TOTAL – 21,449 cases – 87 deaths
(Total includes District of Columbia, Puerto Rico, and US Virgin Islands)

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Travelers to China who display flu-like symptoms may be randomly quarantined over concerns of the swine flu virus, the U.S. State Department warned.

There have been cases of children being separated from parents after either tested positive for the virus, also known as H1N1, a travel alert said Friday.

Chinese officials may give medications to minors in such cases without consulting their parents, according to the alert.

“Although the proportion of arriving Americans being quarantined remains low, the random nature of the selection process increases the uncertainty surrounding travel to China,” the alert said.

Swine flu is a respiratory disease of pigs transmitted to humans and caused by type A influenza virus. Symptoms include fever, lethargy, lack of appetite and coughing.

There have been about 48,000 confirmed cases worldwide, including 519 in China, according to the World Health Organization.

The Chinese government has taken measures to stop the spread of the virus. They include placing passengers who have fever or flu-like symptoms on a seven-day quarantine, the alert said.

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Swine flu infection of health care workers (or as CDC refers to them, health care personnel or HCP) was of interest early in the pre-pandemic phase for at last two reasons. One was the obvious goal of estimating the risk to front line workers and devising best practices for their protection. Another was the belief, reinforced by the SARS outbreak in 2003, that spread to HCP was an early warning that the virus was easily transmissible from person to person. SARS is a disease where patients are most infectious in the later stages when they are extremely ill, and HCP were among the hardest hit groups. Most flu is transmitted in the community, but the SARS model still seems appropriate for flu viruses like H5N1 (“bird flu”) where transmission is rare. Any report that a health care worker has been infected from a bird flu patient is viewed with alarm, possibly suggesting that the probability of transmission has increased. And bird flu was the template upon which pandemic planning was based. So within a few weeks of the outbreak (the first case of novel H1N1 was diagnosed in mid-April), CDC asked state health departments to report any cases of novel H1N1 among HCP. Yesterday they reported the first results in CDC’s Morbidity and Mortality Weekly Reports (MMWR):

As of May 13, CDC had received 48 reports of confirmed or probable infections with novel influenza A (H1N1) virus; of these, 26 reports included detailed case reports with information regarding risk factors that might have led to infection. Of the 26 cases, 13 (50%) HCP were deemed to have acquired infection in a health-care setting, including one instance of probable HCP to HCP transmission and 12 instances of probable or possible patient to HCP transmission. Eleven HCP had probable or possible acquisition in the community, and two had no reported exposures in either health-care or community settings. Among 11 HCP with probable or possible patient to HCP acquisition and available information on PPE [Personal Protective Equipment] use, only three reported always using either a surgical mask or an N95 respirator. (CDC, MMWR [cites omitted])

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Health officials said on Thursday that it looks like the novel H1N1 swine flu virus will continue to spread in the US through the summer months, and then resurge in the autumn. This is different to the previous expectation that the swine flu virus would follow a seasonal flu pattern: abate in the northern hemisphere as it approached the summer, spend a few months in southern hemisphere countries that are now approaching winter, and then return to the northern hemisphere in the fall.

Two senior officials from the US Centers for Disease Control and Prevention in Atlanta held a telebriefing with journalists yesterday and spoke about the pattern of swine flu transmission in the US and also about infections among health workers and the need for more rigour in H1N1 infection control in health care settings.

Dr Daniel Jernigan, Deputy Director of the Influenza Division at the CDC said 89 per cent of flu cases the CDC are seeing now are the novel H1N1 strain, but the pattern varies widely across the US.

The latest figures from the CDC show that the number of lab-confirmed novel H1N1 cases in the US now exceeds 17,800, including about 1,600 that have been hospitalized and 44 deaths, but Jernigan said surveys suggest the actual number of novel H1N1 infections is probably much greater, and around 7 per cent of the population is currently reporting flu-like symptoms.

Although the overall proportion of outpatients being treated for flu-like illness is now below the national baseline (more or less as expected with seasonal flu), 17 states were still reporting flu activity, with patterns of infection vary significantly from region to region: Northeastern states continue to have the highest number of cases, especially New York and Massachusetts.

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The Daily Journal

VINELAND — Three more school children here have swine flu, city health officials confirmed this afternoon, bringing the county total to five confirmed cases.

An 8-year-old Durand Elementary School student, who is the sister of the first two cases — both students at Landis Middle School — was confirmed as were another Landis student and a Mennies Elementary student — neither of which are related to the first three students — Vineland Health Officer George Sartorio said.

Those are the first five cases in Cumberland County so far.

The 8-year-old was tested for the novel flu strain known as H1N1 on June 9. The results were confirmed Wednesday, Sartorio said, and the girl is recovering at home.

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