April 27, 2009 — Though no case has been reported yet in the Virgin Islands, the territory is gearing up for a potential Swine Flu epidemic, coordinating with federal officials and taking a tack of watchful preparation.
"As you know, the U.S. Department of Health and Human Services has declared a public-health emergency as a result of the 20 confirmed cases of Swine Influenza H1N1 virus that has spread across five states," acting Health Commissioner Julia Sheen said Monday at a press conference on St. Croix. "Thus far, there are no cases reported in the Virgin Islands, but the V.I. Department of Health is working with health-care providers to identify any potential cases of influenza, and we have increased surveillance at our hospitals, health centers and our borders."
Monday evening the World Health Organization issued an update saying the U.S. government has reported 40 laboratory-confirmed human cases with no deaths; Mexico has reported 26 confirmed human cases of infection with the same virus, including seven deaths; Canada has reported six cases, with no deaths; while Spain has reported one case, with no deaths.
Swine Flu is a respiratory disease caused by type A influenza virus that breaks out fairly regularly in pigs. People occasionally get it from pigs, but most strains don't transmit from person to person. When a strain begins transmitting from person to person, type A influenza has the potential for spreading rapidly and being deadly. A major outbreak or pandemic may still be unlikely, but sustained human-to-human transmission makes it a far less remote possibility than if there were only isolated cases of animal-to-human transmission. On Sunday, the U.S. Department of Health declared a nationwide public-health emergency, and Monday the World Health Organization declared the flu outbreak to be in phase 4, indicating there is strong evidence of sustained human-to-human transmission of the virus.
Mexico, the epicenter of the outbreak, has closed its public schools in an attempt to stem expansion of the disease. U.S. schools remain open for now.
In the Virgin Islands, business will continue more or less as normal for now.
"There are no plans to close down the schools at present," said Dr. Eugene Tull, an epidemiologist with the V.I. Department of Health.
While there is no reason to think schools will close, he said, the Centers for Disease Control and Prevention and the U.S. Department of Education are in the process of coordinating with local school districts, and V.I. officials were scheduled to get more information Monday afternoon during a conference call.
Planes will continue to come and go with visitors for St. Thomas' Carnival, but passengers will be screened for flu symptoms.
"We are doing passive surveillance," said Mark Walters, director of the V.I. Territorial Emergency Management Agency. "If anyone displays the symptoms of the flu at any of the points of entry, we will pull them aside and screen them."
Being certain a person has swine flu influenza A virus requires sending the specimen to CDC for laboratory testing, so on a practical, immediate basis, diagnosis is based on symptoms, while testing serves to track the spread of the outbreak.
Because swine both carry and are susceptible to the Swine Flu, the Department of Agriculture will screen locally raised swine for signs of flu, too.
Mass inoculations for flu carry risks, too, which is one reason the United States and the Virgin Islands are taking a posture of watchful waiting rather than immediately beginning mass flu vaccinations, said Dr. Richard Olans, an infectious-disease specialist at Health. When there was a swine flu outbreak in 1976, the federal government spent hundreds of millions of dollars to inoculate about a quarter of the U.S. population. There was no pandemic, but 25 people died and around 500 people suffered long-term debilitating lung problems from Guillain-Barré Syndrome as a result of taking the vaccine, he said.
Though no mass inoculations are planned for now, local officials are coordinating with federal officials to be able to move quickly if there is a change.
"One of the discussions we've had is on logistics of getting anti-viral medication from the U.S. Department of Health and Human Services' Division of Strategic National Stockpile if the situation necessitated it," Sheen said.
By announcing a public-health emergency, the federal government sets into motion streamlined procedures to enable the swift release of medications and resources if needed, she said.
Meanwhile, the best approach is the tried and true.
"Wash your hands and cover your mouth if you cough," Olans said.
Use an alcohol-based hand sanitizer if you can. Avoiding close personal contact with people is helpful, too. There is no risk from eating pork, though it is possible to catch the disease from working with live swine.
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