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Pigs sniff for food at a farm on the outskirts of Mexico City, April 25, 2009. The swine flu is usually contracted through direct contact with pigs.

Swine flu confirmed in Canada

Unlike deadly outbreak in Mexico, the cases in Nova Scotia and B.C. were mild and didn't require hospitalization

April 26, 2009

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Richard J. Brennan


OTTAWA—Canada’s six confirmed cases of swine flu likely won’t be the last, federal Health Minister Leona Aglukkaq and Canada’s chief public health officer Dr. David Butler-Jones predicted on Sunday.

Aglukkaq said two confirmed cases of human swine flu have been reported in British Columbia and four in Nova Scotia, all directly or indirectly related to the Mexican outbreak, which has claimed 103 lives.

“The swine flu symptoms seen in Canada have thankfully been relatively mild and the patients are recovering. These are Canada’s first confirmed cases but … these cases are likely not the last we’ll see in Canada,” she told a press conference.

A spokesperson from Prime Minister Stephen Harper acknowledged he “has been briefed on the situation by his officials, his staff and Minister Aglukkaq, and is kept apprised of developments on an ongoing basis."

In the meantime, the United States declared a public health emergency after 20 confirmed cases were discovered in Texas, California, Kansas and New York, where again symptoms were reported to be mild.

The latest strain of swine flu originated in Mexico where 103 are believed dead, during the deadly outbreak, which some experts fear could turn into an influenza pandemic.

“Simply because we are having milder cases nobody should take this for granted in any way. That’s why we are paying very close attention,” Butler-Jones said.

“It’s too soon to say where this will lead us,” he told reporters. “It doesn’t mean we won’t see more severe illness or potentially deaths.”

Butler-Jones said Canadians should protect themselves by washing hands thoroughly and often or using a hand sanitizer, coughing or sneezing into arm or sleeve, not hands, staying home if experiencing flu-like symptoms and getting a flu vaccine, which he says may offer some limited protection.

“And talk to a health professional if you experience severe flu-like symptoms,” said Butler-Jones, who noted that about 4,000 Canadians died prematurely every year from the flu generally.

Dr. Frank Plummer, scientific director general for the federal public health agency, said Canada is at the beginning of this outbreak “and there is a lot more unknown than is known.”

Plummer noted that Canada has done much of the testing of the virus for Mexico simply because the relationship that has developed between the two countries with respect to infectious disease matters.

With the discovery of the Canadian cases, federal health and security agencies are expected to step up efforts at airports to quarantine, if necessary, travellers arriving in Canada showing signs of the flu, especially those from Mexico.

Expected to begin this week, information sheets describing the swine flu symptoms will be distributed to passengers going to or coming from Mexico.

“We are not in a full pandemic situation but I guess you could say everybody is poised,” Brian Ward, an infectious disease expert at McGill University, told CBC.

Ward said what is most concerning is that the Mexican virus has killed otherwise healthy young people, which he says was indicative of the 1918-19 flu pandemic that killed millions of people around the world.

Butler-Jones said Canada is much better prepared to deal with disease outbreak after the 2003 SARS outbreak that claimed 44 lives in the Toronto area.

The WHO announced on Sunday it is doing preliminary work on a finding swine flu vaccine, which was confirmed by Canadian officials.

Nova Scotia’s public health officer Dr. Robert Strang said the four infected students, ages 12 to 15, from a private school near Windsor area, were recovering from mild cases of the illness.

Health authorities in Nova Scotia said the students reported fatigue, muscle aches and coughing, but nothing out of the ordinary for people who suffer from the flu.

Butler-Jones emphasized the swine flu is being spread human to human and has nothing to do with the consumption of pork products.

Oakville’s Dr. Neil Rau, an infectious disease expert, told CTV’s Question Period political affairs program he did not believe the swine flu outbreak would turn into a pandemic.

"One of the key issues to have a pandemic is to have a virus that is very virulent, a virus that kills a high percentage of people it infects, or severely sickens a high percentage of people that it infects. And that hasn’t actually happened here,” he said.

Around the world, countries from New Zealand to Spain also reported suspected cases, and some warned citizens against travel to North America while others planned quarantines, tightened rules on pork imports and tested airline passengers for fevers.

The news follows the World Health Organization’s decision Saturday to declare the outbreak first detected in Mexico and the United States a “public health emergency of international concern.’’

A senior World Health Organization official said the agency’s emergency committee will meet for a second time Tuesday to examine the spread of the virus before deciding whether to increase the alert for a possible pandemic, or global epidemic.

The same strain of the A/H1N1 swine flu virus has been detected in several locations in Mexico and the United States, and it appears to be spreading directly from human to human, said Keiji Fukuda, WHO’s assistant director-general in charge of health security.

Governments including China, Russia and Taiwan began planning to put anyone with symptoms of the deadly virus under quarantine.

Others were increasing their screening of pigs and pork imports from the Americas or banning them outright despite health officials’ reassurances that it was safe to eat thoroughly cooked pork.

Some nations issued travel warnings for Mexico and the United States.

WHO’s emergency committee is still trying to determine exactly how the virus has spread, Fukuda said

“Right now we have cases occurring in a couple of different countries and in multiple locations,” he said. “But we also know that in the modern world that cases can simply move around from single locations and not really become established."

Raising the pandemic alert phase could entail issuing specific recommendations to countries on how to halt the disease. So far, WHO has only urged governments to step up their surveillance of suspicious outbreaks.

WHO Director-General Margaret Chan called the outbreak a public health emergency of “pandemic potential” because the virus can pass from human to human.

Her agency was considering whether to issue nonbinding recommendations on travel and trade restrictions, and even border closures. It is up to governments to decide whether to follow the advice.

“Countries are encouraged to do anything that they feel would be a precautionary measure,” WHO spokesperson Aphaluck Bhatiasevi said. “All countries need to enhance their monitoring."

New Zealand said 10 students who took a school trip to Mexico "likely” had swine flu, and on Monday it said three students in a second group just back from Mexico likely have it as well. Israel said a man who had recently visited Mexico had been hospitalized while authorities try to determine whether he had the disease. French Health Ministry officials investigated four possible cases of swine flu, but three were found to be negative. In Brazil, a hospital said a patient who arrived from Mexico was hospitalized with some swine flu symptoms.

Spanish authorities said seven suspected cases were under observation.

Hong Kong and Taiwan said visitors who came back from flu-affected areas with fevers would be quarantined. China said anyone experiencing flu-like symptoms within two weeks of arrival from an affected area had to report to authorities. A Russian health agency said any passenger from North America running a fever would be quarantined until the cause of the fever is determined.

Tokyo’s Narita airport installed a device to test the temperatures of passengers arriving from Mexico.

Indonesia increased surveillance at all entry points for travellers with flu-like symptoms — using devices at airports that were put in place years ago to monitor for severe acute respiratory syndrome, or SARS, and bird flu.

Hong Kong and South Korea warned against travel to the Mexican capital and three affected provinces. Italy, Poland and Venezuela also advised their citizens to postpone travel to affected areas of Mexico and the United States.

Symptoms of the flu-like illness include a fever of more than 100F (37.8C), body aches, coughing, a sore throat, respiratory congestion and, in some cases, vomiting and diarrhea.

The virus is usually contracted through direct contact with pigs, but Joseph Domenech, chief of animal health service at U.N. Food and Agriculture Agency in Rome, said all indications were that the virus is being spread through human-to-human transmission.

No vaccine specifically protects against swine flu, and it is unclear how much protection current human flu vaccines might offer.

Russia banned the import of meat products from Mexico, California, Texas and Kansas. South Korea said it would increase the number of its influenza virus checks on pork products from Mexico and the U.S.

With files from the Star's wire services

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