Mon Apr 27, 4:53 PM ET

WASHINGTON – Confirming at least 40 cases of swine flu in the U.S., the Obama administration said Monday it was responding aggressively as if the outbreak would spread into a full pandemic. Officials urged Americans against most travel to Mexico as the virus that began there spread to the United States and beyond. President Barack Obama urged calm, saying there was reason for concern but not yet "a cause for alarm."

Yet just in case, administration officials said that they were already waging a vigorous campaign of prevention, unsure of the outbreak's severity or where it would show up next.

U.S. customs officials began checking people entering U.S. territory. Millions of doses of flu-fighting medications from a federal stockpile were on their way to states, with priority given to the five already affected and to border states. Federal agencies were conferring with state and international governments.

"We want to make sure that we have equipment where it needs to be, people where they need to be and, most important, information shared at all levels," Janet Napolitano, head of the Homeland Security Department, told reporters.

Her briefing came shortly before the World Health Organization raised the severity of its pandemic alert level to four from three on a six-point scale. Level four means there is sustained human-to-human spread in at least one country. Level six is a full-fledged pandemic, an epidemic that has spread to a wide geographic area.

"We are proceeding as if we are preparatory to a full pandemic," Napolitano said.

She said travel warnings for trips to Mexico would remain in place as long as swine flu is detected.

Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention, said that so far the disease in the United States seemed less severe than the outbreak in Mexico, where more than 1,600 cases had been reported and where the suspected death toll had climbed to 149. No deaths had been reported in the U.S, and only one hospitalization.

"I wouldn't be overly reassured by that," Besser told reporters at CDC's headquarters in Atlanta. He raised the possibility of more severe cases — and deaths — in the United States.

A European Union official warned against travel to parts of the U.S. as well as Mexico, but Besser said that seemed unwarranted.

State Department spokesman Robert A. Wood said the EU commissioner's remarks were his "personal opinion," not an official position, and thus the department had no comment. "We don't want people to panic at this point," Wood said.

Still Besser said of the situation, "We are taking it seriously and acting aggressively. ... Until the outbreak has progressed, you really don't know what it's going to do."

The U.S. stepped up checks of people entering the country by air, land and sea and issued a new U.S. travel advisory suggesting "nonessential travel to Mexico be avoided."

The confirmed cases announced on Monday were double the 20 earlier reported by the CDC. Besser said this was due to further testing — not further spreading of the virus — in New York at a school in Queens, bringing the New York total to 28.

The CDC reported 40 cases: 28 in New York, seven in California, two in Texas, two in Kansas and one in Ohio. Other information suggested three cases in Texas and eight in California, bringing the total to 42.

Besser said other cases have been reported in Ohio, Kansas, Texas and California. He said that, of the 40 cases, only one person has been hospitalized and all have recovered.

Countries across the globe increased their vigilance amid increasing worries about a worldwide pandemic. Obama told a gathering of scientists that his administration's Department of Health and Human Services had declared a public health emergency "as a precautionary tool to ensure that we have the resources we need at our disposal to respond quickly and effectively."

"This is obviously a cause for concern and requires a heightened state of alert, but it's not a cause for alarm," Obama said. He said he was getting regular updates.

The Senate has yet to confirm a secretary of human services, a surgeon general or a director of CDC. The absence of those officials left Besser and Napolitano to brief reporters on the swine flu outbreak.

The quickening pace of developments in the United States in response to the spreading new flu strain was accompanied by a host of varying responses around the world.

Mexico, at the center of the outbreak, suspended schools nationwide. China, Taiwan and Russia considered quarantines, and several Asian countries scrutinized visitors arriving at their airports.

U.S. customs officials began checking people entering U.S. territory. Officers at airports, seaports and border crossings were watching for signs of illness, said Customs and Border Protection spokesman Lloyd Easterling.

While "the borders are open," Easterling said officials were "taking a second look at folks who may be displaying a symptom of illness."

If a traveler reports not feeling well, the person will be questioned about symptoms and, if necessary, referred to a CDC official for additional screening, Easterling said. The customs officials were wearing personal protective gear, such as gloves and masks, he said.

The CDC can send someone to the hospital if they suspect a case, but no one is being refused entry. Also, the CDC is readying "yellow cards" with disease information for travelers, in case they later experience symptoms.The border monitoring resembles that done during the SARS epidemic earlier in the decade.

Multiple airlines, including American, United, Continental, US Airways, Mexicana and Air Canada, said they were waiving usual penalties for changing reservations for anyone traveling to, from, or through Mexico, but had not canceled flights.

Napolitano urged Americans to take "common sense" precautions.

"Common sense means washing hands, staying home from work or school if you feel sick, covering your mouth if you cough or sneeze. These are straightforward and simple measures, but they can materially improve our chances of avoiding a full-fledged pandemic," she said.

Administration officials said about 11 million doses of flu-fighting medications from a federal stockpile have been sent to states in case they are needed — roughly one quarter of the doses in the stockpile.

While there presently is no vaccine available to prevent the specific strain now being seen, there are antiflu drugs that do work once someone is sick. If a new vaccine eventually is ordered, the CDC already has taken a key preliminary step — creating what's called seed stock of the virus that manufacturers would use.

A private school in South Carolina was closed Monday because of fears that young people who recently returned from Mexico might have been infected. Officials of Newberry Academy in Newberry, S.C., said some seniors on the trip had flu-like symptoms when they returned.

State Department of Health and Environmental Control spokesman Jim Beasley said test results on the students could come back as early as Monday afternoon. To date, there have been no confirmed swine flu cases in the state.

Stock markets fell overseas and in the United States out of concern that the outbreak could derail economic recovery. Airline and other travel-related stocks suffered the sharpest losses.

The New York City school where 28 cases have now been confirmed was closed Monday and Tuesday.

Also, 14 schools in Texas, including a high school where two cases were confirmed, will be closed for at least the next week. Some schools in California and Ohio also were closing after students were found or suspected to have the flu.

In Mexico, the outbreak's center, soldiers handed out 6 million face masks to help stop the spread of the virus.

Spain reported its first confirmed swine flu case on Monday and said another 17 people were suspected of having the disease. Also, three New Zealanders recently returned from Mexico are suspected of having it.

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Associated Press writers Mark Stevenson and Olga R. Rodriguez in Mexico City; Frank Jordans in Geneva; Mike Stobbe in Atlanta; Maria Cheng in London and Eileen Sullivan and Robert Burns in Washington contributed to this report.




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What you need to know about swine flu

WASHINGTON – A never-before-seen strain of swine flu has turned killer in Mexico and is causing milder illness in the United States and elsewhere. While authorities say it's not time to panic, they are taking steps to stem the spread and also urging people to pay close attention to the latest health warnings and take their own precautions.

"Individuals have a key role to play," Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention, said Monday.

Here's what you need to know:

Q: How do I protect myself and my family?

A: For now, take commonsense precautions. Cover your coughs and sneezes, with a tissue that you throw away or by sneezing into your elbow rather than your hand. Wash hands frequently; if soap and water aren't available, hand gels can substitute. Stay home if you're sick and keep children home from school if they are.

Q: How easy is it to catch this virus?

A: Scientists don't yet know if it takes fairly close or prolonged contact with someone who's sick, or if it's more easily spread. But in general, flu viruses spread through uncovered coughs and sneezes or — and this is important — by touching your mouth or nose with unwashed hands. Flu viruses can live on surfaces for several hours, like a doorknob just touched by someone who sneezed into his hand.

Q: In Mexico, officials are handing out face masks. Do I need one?

A: The CDC says there's not good evidence that masks really help outside of health care settings. It's safer just to avoid close contact with someone who's sick and avoid crowded gatherings in places where swine flu is known to be spreading. But if you can't do that, CDC guidelines say it's OK to consider a mask — just don't let it substitute for good precautions.

Q: Is swine flu treatable?

A: Yes, with the flu drugs Tamiflu or Relenza, but not with two older flu medications.

Q: Is there enough?

A: Yes. The federal government has stockpiled enough of the drugs to treat 50 million people, and many states have additional stocks. As a precaution, the CDC has shipped a quarter of that supply to the states to keep on hand just in case the virus starts spreading more than it has so far.

Q: Should I take Tamiflu as a precaution if I'm not sick yet?

A: No. "What are you going to do with it, use it when you get a sniffle?" asks Dr. Marc Siegel of New York University Langone Medical Center and author of "Bird Flu: Everything you Need To Know About The Next Pandemic." Overusing antiviral drugs can help germs become resistant to them.

Q: How big is my risk?

A: For most people, very low. Outside of Mexico, so far clusters of illnesses seem related to Mexican travel. New York City's cluster, for instance, consists of students and family members at one school where some students came back ill from spring break in Mexico.

Q: Why are people dying in Mexico and not here?

A: That's a mystery. First, understand that no one really knows just how many people in Mexico are dying of this flu strain, or how many have it. Only a fraction of the suspected deaths have been tested and confirmed as swine flu, and some initially suspected cases were caused by something else.

Q: Should I cancel my planned trip to Mexico?

A: The U.S. did issue a travel advisory Monday discouraging nonessential travel there.

Q: What else is the U.S., or anyone else, doing to try to stop this virus?

A: The U.S. is beginning limited screening of travelers from Mexico, so that the obviously sick can be sent for treatment. Other governments have issued their own travel warnings and restrictions. Mexico is taking the biggest steps, closings that limit most crowded gatherings. In the U.S., communities with clusters of illness also may limit contact — New York closed the affected school for a few days, for example — so stay tuned to hear if your area eventually is affected.

Q: What are the symptoms?

A: They're similar to regular human flu — a fever, cough, sore throat, body aches, headache, chills and fatigue. Some people also have diarrhea and vomiting.

Q: How do I know if I should see a doctor? Maybe my symptoms are from something else — like pollen?

A: Health authorities say if you live in places where swine flu cases have been confirmed, or you recently traveled to Mexico, and you have flulike symptoms, ask your doctor if you need treatment or to be tested. Allergies won't cause a fever. And run-of-the-mill stomach bugs won't be accompanied by respiratory symptoms, notes Dr. Wayne Reynolds of Newport News, Va., spokesman for the American Academy of Family Physicians.

Q: Is there a vaccine to prevent this new infection?

A: No. And CDC's initial testing suggests that last winter's flu shot didn't offer any cross-protection.

Q: How long would it take to produce a vaccine?

A: A few months. The CDC has created what's called "seed stock" of the new virus that manufacturers would need to start production. But the government hasn't yet decided if the outbreak is bad enough to order that.

Q: What is swine flu?

A: Pigs spread their own strains of influenza and every so often people catch one, usually after contact with the animals. This new strain is a mix of pig viruses with some human and bird viruses. Unlike more typical swine flu, it is spreading person-to-person. A 1976 outbreak of another unusual swine flu at Fort Dix, N.J., prompted a problematic mass vaccination campaign, but that time the flu fizzled out.

Q: So is it safe to eat pork?

A: Yes. Swine influenza viruses don't spread through food.

Q: And whatever happened to bird flu? Wasn't that supposed to be the next pandemic?

A: Specialists have long warned that the issue is a never-before-seen strain that people have little if any natural immunity to, regardless of whether it seems to originate from a bird or a pig. Bird flu hasn't gone away; scientists are tracking it, too.

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EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

On the Net:

U.S. government flu info: http://www.hhs.gov/web/library/index.html

Article: HERE