This preliminary negative stained transmission electron micrograph

depicts some of the ultrastructural morphology of the A/CA/4/09

swine flu virus. Courtesy of CDC/ C. S. Goldsmith and A. Balish.

Medscape.com, April 29, 2009, by Robert Lowes In her first day on the job, Health and Human Services Secretary Kathleen Sebelius announced during a news conference that development of a vaccine for the new swine influenza virus is in “full gear.”

“The process is more speedy than it’s ever been before,” said Ms. Sebelius, whose appointment was confirmed by the US Senate yesterday.

However, she also sought to allay fears of a repeat of the 1976 swine flu scare, when a vaccine led to higher rates of Guillain-Barré syndrome. “We’ll work quickly, but safety will be our top priority,” Ms. Sebelius said.

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said at today’s news conference that the federal government, working with pharmaceutical manufacturers, is on track to produce a pilot vaccine “in a few months.” Clinical trials in humans will determine “whether or not we have the right dose, whether or not we have the immune response we want, and whether or not it is safe,” said Dr. Fauci, adding that these trials will last several months.

The urgency in their statements reflected the worsening of the swine flu outbreak, which has resulted in 91 confirmed cases in 10 states and the death of a 23-month-old child in Texas, according to the US Centers for Disease Control and Prevention (CDC). Confirmed cases have emerged in a total of 8 countries, including Mexico, where the number of deaths likely caused by the virus has reached 159, according to the New York Times.

Despite the grim statistics, Ms. Sebelius and other public health officials at the news conference cautioned against taking draconian but unproductive measures against the swine influenza A (H1N1) virus. Ms. Sebelius, for example, said that the CDC continues to recommend that schools be closed only if they experience a laboratory-confirmed case of swine flu. Closing schools when there are no confirmed cases, she said, creates a “ripple effect” of complications. “What happens to their parents? Where do their children go?” she said, referring to the logistical problems of ad hoc childcare.

Likewise, CDC acting director Richard Besser, MD, also said it was a bad idea to close the border with Mexico, as some have suggested. “We’ve learned a lot from previous [infectious disease] outbreaks,” said Dr. Besser. “Intensive efforts at border screening and entry aren’t effective in preventing the introduction of an infectious disease. Closure would tie up resources. We want to do things that have the greatest impact.”

However, public officials are not ignoring what happens at the Mexican border, he said. Customs and border guards are on the look-out for visitors who appear sick and are distributing leaflets that describe swine influenza symptoms and recommend steps to take if someone seems to be infected.

While the CDC and other agencies take short-term measures, such as investigating the exact nature of the swine flu deaths in Mexico and distributing the antiviral drugs zanamivir (Relenza) and oseltamivir (Tamiflu) to state governments, work proceeds on a swine flu vaccine.


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