Swine flu has not yet arrived in Maine, but the state’s top public health official says it is just a matter of time.
“We won’t be able to prevent it from coming here,” said Dr. Dora Anne Mills, director of the Maine Center for Disease Control and Prevention, speaking to health care providers on Monday. “The genie is out of the bottle.”
The swine flu virus is of special concern for anyone who recently has traveled to Mexico and border regions of Texas and California. Mills pointed out that some Maine students and their families may have been exposed during last week’s statewide public school vacation. Individuals who have recently returned from these areas should be alert to flulike symptoms for the next seven days and report them promptly to their health care providers, she said.
The seasonal flu vaccine is not effective against the swine flu strain. Neither is a vaccine that was widely distributed in the mid-1970s after a swine flu scare. Anti-viral medications such as Tamiflu and Relenza may be effective at easing symptoms and shortening the illness.
Mills stressed that personal behavior such as washing hands frequently, covering sneezes and coughs, and staying home from school or work if symptoms strike can effectively limit the spread of the illness.
As of Monday afternoon, about 150 deaths in Mexico, where cases first were reported late last week, had been linked to the swine flu outbreak. In the United States, at least 40 cases have been confirmed in California, Kansas, Ohio, Texas and New York, with 28 of those cases in New York City alone. Six cases of swine flu in the Canadian provinces of British Columbia and Nova Scotia were reported on Monday, and a handful of suspected cases have been identified in Great Britain and Spain. No deaths outside of Mexico have been linked to the illness.
On Saturday, the World Health Organization said the outbreak constitutes “a public health emergency of international concern.” On Sunday, the U.S. government declared its own public health emergency, freeing up funding, supplies and other resources to respond to the epidemic.
So far, the handful of specimens sent to the Maine public health lab have not contained the swine flu virus, but Mills said public health experts expect the outbreak to spread to every state in the nation in the next few days and to increase in severity.
This influenza epidemic is of special concern, Mills said, because the identified strain of the virus includes elements of swine, bird and human influenza viruses, can cause serious illness and is easily transmitted among humans.
Dr. Erik Steele, an emergency room physician and chief medical officer for Eastern Maine Healthcare Systems in Brewer, said Maine health care providers are on high alert for individuals whose symptoms and recent history could point to swine flu.
But even “really sick” individuals — with a fever, cough, runny nose, aches and other flulike symptoms — are unlikely to have contracted the swine flu virus unless they have recently traveled in affected areas or have been in close contact with someone who has, he said.
“These are not your garden-variety cold symptoms, … but if you don’t have the [travel] exposure we probably won’t even test for swine flu,” Steele said Monday.
Over the past five years, Maine has developed a comprehensive plan for responding to a global outbreak of deadly influenza, an event that international public health officials have predicted for many years. Although the swine flu outbreak may not become a full-blown global pandemic, Mills said, the Maine CDC already has implemented an incident command system to help manage the event, is expanding the ability to test respiratory specimens, and is offering day-to-day updates on the outbreak to hospitals, doctors and other health care providers.
“The goal of the Maine CDC is to minimize the impact of swine flu in Maine,” she said. In addition to providing support and information to health care providers, Mills said the Maine CDC is working closely with the Maine Emergency Management Agency and county-level emergency planners to ensure effective communication and a coordinated distribution of supplies and other resources.
The federal emergency designation will release to states supplies from a national stockpile, including anti-viral medicines, gloves and surgical masks, Mills said. Maine’s share of supplies, including enough anti-viral medicine to treat an estimated 35,000 to 40,000 people, is expected to arrive this week and will be distributed to Maine’s 39 community hospitals.
Mills said any decisions to close schools or cancel public gatherings, if necessary in the future to limit transmission, will be made at the local level. No official travel advisories have been issued, but Mills said Monday she would encourage people to “think twice” before heading for Mexico.