American, Already Ailing, Dies of Swine Flu

American, Already Ailing, Dies of Swine Flu

The first American has died after contracting the swine flu virus, Texas health officials said Tuesday. Officials did not identify the 33-year-old Texas woman but added that she suffered from an unnamed pre-existing medical condition.
The health of the woman, a schoolteacher who lived in Harlingen, near the border with Mexico, was worsened by the H1N1 flu virus, said Leonel Lopez, the Cameron County Department of Health and Human Services epidemiologist. Mr. Lopez said that the woman had recently given birth, and added that the baby was in good health.
“I don’t want people to panic,” Mr. Lopez said. “Her death was a combination of a pre-existing health condition and the flu. The flu just made things worse.”
The woman had been hospitalized with complications from the flu since April 14, and died earlier this week, said Doug McBride, a spokesman for the state health department. He said that other members of her family had undergone testing and none were known to have contracted the flu.
The woman’s death came roughly a week after the first known swine-flu fatality in the United States, a Mexican toddler who died in a Houston hospital on April 27. Earlier on Tuesday, federal health officials said they expected that more cases of the disease, including some deaths, would come to light.
But while the virus, officially called influenza A(H1N1), has continued to spread across the United States and around the world, it is far less deadly than initially feared. In Mexico, where the outbreak apparently had its origins, new cases have begun to ebb, and President Felipe Calderón lowered the national alert level on Monday.

Still, Mexico called off Cinco de Mayo celebrations on Tuesday, including the biggest — a re-enactment of the May 5, 1862, victory over French troops in the central state of Puebla. The number of confirmed cases in Mexico now stands at 942 and 29 deaths, according to the Mexican authorities.
The authorities have been seeking to strike a balance between the health risk of widespread shutdowns and the economic cost of keeping parts of the economy shuttered. In Mexico, the nationwide impact on industries, including tourism, has cost about $2.3 billion, or between 0.3 percent and 0.5 percent of gross domestic product, Finance Minister Agustin Carstens said Tuesday.
“We know that there could be a light or small increase in the number of cases, but we are also conscious of the importance of reactivating the economy and the return to normality of ordinary life for all Mexicans,” Health Minister José Ángel Córdova said Monday afternoon.
Instead of closing schools, he said, officials said parents should keep children showing any symptoms home, and teachers will keep a close eye on the health of students. But bars, nightclubs, cinemas and theaters, however, will remain closed until further notice.
Worldwide, health authorities are taking a variety of measures to try to limit the outbreak, as confirmed cases continue to rise.
In Geneva on Tuesday, the World Health Organization said 1,490 cases had been confirmed in 21 countries, compared with 1,085 cases in the same number of countries a day earlier. The only confirmed deaths have been in Mexico and the United States, which is now reporting 403 confirmed cases in 38 states. Officials at the Centers for Disease Control and Prevention said they believed the disease was not nearly as lethal or severe as they had initially thought it could be, and they recommended on Tuesday that schools with confirmed cases no longer shut their doors.
“Closing schools is not effective” in halting the spread of the virus, said Dr. Richard E. Besser, acting director of the Centers for Disease Control and Prevention.
In Illinois, the number of confirmed infections rose more than tenfold in the space of 24 hours, climbing from eight cases on Monday to 82. New York continues to lead the tally, with 90 confirmed cases of H1N1 flu. There can be up to a week delay in confirming infections due to laboratory backlogs, experts say.
Vigilance remains important because this is a new disease to which people have limited immunity and whose course remains uncertain, Dr. Keiji Fukuda, W.H.O.’s deputy director general, said in a Tuesday news conference. Pandemics, he said, can start out mild, and over the course of several months become a severe illness, as was the case during the devastating flu pandemic of 1918.
“This is a situation that can evolve,” Dr. Fukuda said. “If it stays mild and people stay healthy, that’s great. But if it does turn severe, this is something that we have to jump on.”
To date, the majority of laboratory-confirmed infections, Dr. Fukuda said, have been occurring in people younger than 60, with the average age around the mid-20s, for still uncertain reasons. Males and females are getting infected at the same rate, he said.
The incubation period for the disease appears to be one to five days, nearly that of a seasonal flu virus. The new strain appears to be the same in confirmed cases around the world, and it remains responsive to two antiviral drugs, Tamilflu and Relenza, Dr. Fukuda said. It is still not clear in what percentage of cases the disease results in serious respiratory disease, he said.
In China, a Mexican airliner hop-scotched the country on Tuesday picking up 70 Mexican nationals who had have been quarantined by health authorities since the weekend, when a Mexican traveler arrived in Hong Kong and promptly tested positive for the virus.
In Shanghai, a squadron of police stood by as masked personnel in protective clothing directed passengers from their hotel into 27 ambulances, according to Xinhua, the state news agency. The plane was scheduled to pick up people in Beijing, Guangzhou and Hong Kong, although health officials said they would not allow the 25-year-old infected patient to leave the hospital, where he is in stabile condition.
About 240 other guests will remain quarantined for three more days at the Metropark Hotel, where the man briefly stayed.
The Chinese government agreed to release those sequestered after Mexican officials criticized the measures as unreasonable and discriminatory, given that many of those who sent into isolation showed no signs of illness. Although many of those put in quarantine shared a flight with the sick patient, others were rounded up simply because they held Mexican passports.
Also Tuesday, the U.S. Embassy said that four America citizens had been quarantined in China, although two of them had been released by the afternoon. Susan Stevenson, an embassy spokeswoman, said she could not provide more information about the others, one of whom was being quarantined in Beijing and the other in Shanghai. “We would hope all the decisions were made on the basis of sound science,” she said.
In Britain, the authorities began distributing leaflets to households on Tuesday regarding basic hygiene to ward off infection. Some 27 cases have been confirmed in Britain and five schools have been closed. Throughout Europe, 107 infections have been confirmed, the European Center for Disease Prevention and Control said. Most patients had recently traveled to Mexico, but 17 cases were transmitted person-to-person within Europe. Still, transmission between people in Europe remains limited, authorities said.
VALHALLA, N.Y. — As soon as Doris Bucher learned that a new strain of swine flu had turned up in the United States, she e-mailed the Centers for Disease Control and Prevention offering to send materials that might be useful in making a vaccine
Research assistants at New York Medical College on Tuesday prepared to harvest swine flu .Her colleagues at the C.D.C. had a better idea. Less than a week later, they sent a sample of the new type of virus, influenza A(H1N1), to Dr. Bucher, an associate professor of microbiology and immunology at New York Medical College.
Dr. Bucher, a cheerful, fast-talking scientist who has been involved in flu research for 40 years, runs a laboratory here in Westchester County that is highly regarded for its skill at turning flu viruses into “seed stock” — a form of the virus that will grow rapidly in eggs so that drug companies can use it to make hundreds of millions of doses of vaccine.
Federal health officials have not yet decided whether to call for a swine flu vaccine, but they say it is important to be ready for quick production of millions of doses. Because the virus is new, some people may need two shots to build immunity. The vaccine would probably be separate from seasonal flu vaccine, meaning a total of three shots might be recommended for certain people.
Creating the seed stock is an essential first step for any vaccine. So the C.D.C. has sent samples of the new strain to about 10 other government and academic laboratories in this country, Australia, Britain, Hungary and Russia. For the past five years, Dr. Bucher’s laboratory has provided seed stock for one of the virus strains included in the seasonal flu vaccine used all over the world.
“Our job is to make it grow really well,” she said. “We’re good at this.”
One of the group’s strengths has been in developing a “high-yield donor,” meaning an influenza virus that grows well in eggs and that, when injected into eggs along with a new strain like H1N1, will swap some of its genes with the new strain. An array of new viruses results, and the researchers can sort through it to pick ones that have donor genes inside the ball-shaped viral particles, so they will grow well in eggs, but that will retain the new strain’s traits on the outside — enabling the vaccine to spark immunity when injected into people.
The unlikely headquarters of this major player in the world’s supply of flu vaccine is a modest cluster of small to midsize laboratories with a half-dozen freezers, a walk-in incubator at 95 degrees Fahrenheit and a walk-in cold room. In the midst of it all is Dr. Bucher’s cluttered office, her desk awash in documents like “virus certificates” from the C.D.C. and handwritten bills for 84 dozen eggs.
A vial containing millions of swine flu viruses in a milliliter of fluid (about a fifth of a teaspoon) arrived at her lab on April 28, packed with dry ice in a plastic foam box inside a cardboard carton stamped, “infectious substance affecting humans.”
The viruses had been grown from a cotton swab rubbed in the nose and throat of a child in California who received one of the first diagnoses of the flu in this country.
Dr. Bucher’s team opened the box in a laboratory hood, a specially ventilated compartment that prevents any samples from escaping, and set to work. Wearing specially fitted masks, double gloves, surgical caps and other protective gear, their first task was to make more of the virus, by injecting it into fertilized eggs from leghorn hens. Creating seed stock is a quirky business that melds high-tech science and simple tools from 100 years ago. In one lab, members of the team amplify virus genes, cut them up with enzymes and analyze their origins. In others, their colleagues candle eggs, mark the shells with a pencil, pierce them with a drill bought at Sears and shoot them full of swine flu viruses.
Basically, the process involves repeated rounds of injecting the two types of virus into eggs, and sorting and purifying what grows. Each round of virus growth takes about 42 hours. The ultimate goal is to create a uniform seed stock from a single virus, and to produce 80 vials of it, each containing millions of viruses, that will be sent to drug companies, the C.D.C. and the Food and Drug Administration. Dr. Bucher said she expected to ship out those 80 vials by May 25.
Members of the research team said they were used to working with flu viruses, and this one did not alarm them. Rene Devis, a research associate, admitted that he did feel a bit concerned at first.
“But you do what you have to do, especially if you can help save a life,” Mr. Devis said. “You don’t think of yourself.”
The swine flu came along just about a week after Dr. Bucher’s team had finished a seed stock for the next seasonal flu vaccine and started work on other projects.
Now they are back to flu viruses, and working so hard that Dr. Bucher fears they will burn out.
What if they make a seed stock, and then health authorities decide there is no need to make a vaccine after all?
“We’ll put it in the freezer,” Dr. Bucher said.