U.S. readies in case swine flu explodes

WASHINGTON —- As Mexico’s suspected death toll in the swine flu epidemic rose to 149 Monday, the Obama administration monitored 42 less serious cases in the United States and prepared to respond as if the outbreak would spread into a full pandemic.

President Barack Obama said there was reason for concern but not yet “a cause for alarm.”

The State Department on Monday evening warned U.S. citizens to avoid nonessential travel to Mexico, where the virus has spread to half the country, and advised those who live in Mexico to avoid hospitals or clinics there unless they have a medical emergency.

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

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.

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.

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

Dr. Richard Besser, acting director of the U.S. Centers for Disease Control and Prevention in Atlanta, 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. No deaths had been reported in the United States, and only one hospitalization.

“I wouldn’t be overly reassured by that,” Besser told reporters at CDC’s headquarters. 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 United States 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 confirmed cases in the United State announced on Monday were double the 20 earlier reported by the CDC. Besser said this was because of further testing —- not further spreading of the virus —- in New York at a school in Queens, bringing the New York total to 28.

Besser said that, of the 42 cases, only one person has been hospitalized and all have recovered.

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

Mexico suspended schools nationwide until May 6 and the Mexico City government was considering shutting down all public transportation if the death toll keeps rising. China, Taiwan and Russia considered quarantines, and several Asian countries scrutinized visitors arriving at their airports.

At the White House, a swine flu update was added to the president’s daily intelligence briefing, delivered by homeland security adviser John Brennan.

The White House defended the administration’s ability to respond to a crisis that is coming so early in its tenure and while it still lacks a health and human services secretary, a surgeon general and a CDC director. White House press secretary Robert Gibbs took pains to note that a long-standing presidential directive gives the homeland security secretary —- not the health chief —- the authority to coordinate federal action in such situations.

“Our response is in no way hindered or hampered,” Gibbs said.

On Capitol Hill, several panels scheduled emergency hearings beginning today.

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.

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.

There were signs of growing unease among the public, even in places where there was no immediate known cause for alarm.

Pharmacies in Manhattan reported that paper face masks were selling by the box. Students at a Chicago school were instructed not to shake hands with anyone. And in New Mexico, health officials were so besieged by calls that they set up a swine flu hot line.

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.