Swine Flu Cases Suspected in North Carolina

[dundare]

State health officials say there are suspected cases of swine flu in North Carolina, but investigators declined to say how many cases or where they were located.
Dr. Jeffrey Engel, the state health director, said Monday evening that officials are involuntarily isolating patients who may have the virus. But he said the handful of cases are sporadic and in different parts of the state. Earlier in the day, Engel had told reporters that there had been no cases reported in the state.

Investigators are gathering specimens and hope to know whether the cases are "probable" some time Tuesday and will seek confirmations by Wednesday.

Engel said the suspected cases are related to travel, mostly to Mexico. He said nobody has been hospitalized and that the suspected cases have been ordered to in-home isolation.

http://www.newsobserver.com/news/health_science/v-print/story/1503196.html

 

[Niko]

Re: Swine Flu Cases Suspected in North Carolina

Too close to home

Thank you and welcome to FT, dundare.

 

[Farmer]

Re: Swine Flu Cases Suspected in North Carolina

These illnesses seem to be 'probable' case based upon travel history.

N.C. official: Swine flu cases suspected

Raleigh, N.C. ? The state's health director said Monday afternoon that there are suspected cases of swine flu in North Carolina, but declined to say how many cases or where they were located.

Dr. Jeffrey Engel said Monday evening that officials are involuntarily isolating patients who may have the virus. He declined to specifically say how many suspected cases were in the state, noting that the number is always changing, and he declined to say where they were located.

"We're working very closely with providers, and they are investigating cases on a daily basis," Engel said. "It's a very fluid situation and there will be suspect cases. People travel all the time."

Investigators were gathering specimens and hope to know whether the cases are "probable" some time Tuesday and will seek confirmations by Wednesday.

Federal health officials have confirmed 40 cases in the United States ? in New York, Ohio, Kansas, Texas and California. Of those, only one person has been hospitalized and all have recovered. That's in contrast to Mexico, where the suspected death toll was at 149, with more than 1,600 cases reported.

Track swine flu cases across the globe.

Engel said the suspected cases are related to travel, mostly to Mexico. He said nobody has been hospitalized and that the suspected cases have been ordered to in-home isolation.

Along with the travel history, Engel said the suspected cases involve patients with severe flu symptoms. The state is encouraging providers to only report more severe cases ? people with higher fevers or more prominent respiratory problems.

Engel said he expects the number of suspected cases to increase. "This is dynamic," he said.

At a news briefing Monday morning, Engel said the state is "better prepared" than ever to handle any potential outbreak of the virus in North Carolina. The state has a stockpile of 660,000 doses of treatment for the flu, if necessary.

He urged residents to take precautions by staying at home if they present with flu-like symptoms, wash their hands frequently with soap and water for at least 15 seconds, and see a doctor if flu symptoms become serious.

"To ward off any potential, just be prudent as you would during normal flu season," he said.

But, Engel said, there's one thing people don't have to stop doing in order to avoid the swine flu: eating pork.

"You can't catch the flu through eating any food item," he said.

That announcement was welcome news for those who profit from pork such as restaurants and grocery stores. "That would affect our business" if people were afraid to eat pork, said Worth Westbrook, co-owner of McCall's Bar-B-Que & Seafood in Clayton.

"I am not too concerned, because I love barbecue," said McCall's customer Glenn Hines, who filled up his plate at the buffet while updates on the swine flu played on television screens.

Gov. Bev Perdue, in a statement Monday morning, also advised people to be careful and take proper preventative measures and that she is confident in the state's readiness to handle a potential pandemic.

"North Carolina is equipped with a full supply of antiviral medications and personal protective supplies such as face masks," Perdue said. "We have public health teams ready to deploy to any community in our state that needs assistance."

Local hospitals, meanwhile reviewed emergency plans, many of which were put in place after the SARS epidemic in 2003 that infected more than 8.000 people and caused 74 deaths worldwide.

"We all have plans on how to deal with that," Dr. David Weber, an infectious diseases expert at UNC Hospitals. "The hospital has detailed 20-page plan."

Weber said it includes how to protect staff treating patients. He also said the hospital has enough protective gear to last up to six months.

"We have ability for rapid communications and to expand the number of both beds within the hospital and clinic availability, if wee need, too,' he added.

On the higher-education level, UNC System President Erskine Bowles asked universities to review their emergency plans and distribute basic information on flu prevention.

At the University of North Carolina at Chapel Hill, students preparing for final exams said they were concerned about the swine flu because of the number of people in the college environment who travel.

"I guess there are a lot of people coming in and out, so it could be more likely to happen here," sophomore Jill Zartman said.

http://www.wral.com/news/local/story/5034385/

 

[Thornton]

Re: Swine Flu Cases Suspected in North Carolina

from post #3 above

Dr. Jeffrey Engel said Monday evening that officials are involuntarily isolating patients who may have the virus.

Maybe someone can help them elaborate on that quote. The first instance I have seen in the USA for involuntary isolation of a suspect swine flu. Exactly how and where do they do this? How many suspect patients are they involuntarily isolating? How does the local community feel about that and how will others respond? I did go back to the source article and the quote in the post is the same as in the article. Amazing.

 

[dundare]

Re: Swine Flu Cases Suspected in North Carolina

I cannot comment authoritatively on the specifics of that statement, but I would imagine it requires some designation from government in order to do this.

Being a resident of NC, I have checked some of local newspapers online and watched the coverage on two newscasts at 10 and 11 and my guess is that it might be a mistake in the writing. There was no comment on that, all the reports were really light. My guess is there will be a lot more in the morning.

I did a quick search on legal authority to quarantine and came up with this from the CDC. I then added in North Carolina to the search and it came back with this, although limited to acts of nuclear, biological, or chemical terrorism (though the language in the law says suspected not proven).

A search of the general laws of NC shows most of the stuff on isolation authority and quarantine is found in chapter 130A-475. You can find the chapter to search through here.

Some of the relevant stuff from this non-lawyer's eyes:

"Isolation authority" means the authority to issue an order to limit the freedom of movement or action of persons or animals that are infected or reasonably suspected to be infected with a communicable disease or communicable condition for the period of communicability to prevent the direct or indirect conveyance of the infectious agent from the person or animal to other persons or animals who are susceptible or who may spread the agent to others.

"Quarantine authority" means the authority to issue an order to limit the freedom of movement or action of persons or animals which have been exposed to or are reasonably suspected of having been exposed to a communicable disease or communicable condition for a period of time as may be necessary to prevent the spread of that disease. Quarantine authority also means the authority to issue an order to limit access by any person or animal to an area or facility that may be contaminated with an infectious agent. The term also means the authority to issue an order to limit the freedom of movement or action of persons who have not received immunizations against a communicable disease when the State Health Director or a local health director determines that the immunizations are required to control an outbreak of that disease.

and

(a) The State Health Director and a local health director are empowered to exercise quarantine and isolation authority. Quarantine and isolation authority shall be exercised only when and so long as the public health is endangered, all other reasonable means for correcting the problem have been exhausted, and no less restrictive alternative exists.
(b) No person other than a person authorized by the State Health Director or local health director shall enter quarantine or isolation premises. Nothing in this subsection shall be construed to restrict the access of authorized health care, law enforcement, or emergency medical services personnel to quarantine or isolation premises as necessary in conducting their duties.
(c) Before applying quarantine or isolation authority to livestock or poultry for the purpose of preventing the direct or indirect conveyance of an infectious agent to persons, the State Health Director or a local health director shall consult with the State Veterinarian in the Department of Agriculture and Consumer Services.
(d) When quarantine or isolation limits the freedom of movement of a person or animal or of access to a person or animal whose freedom of movement is limited, the period of limited freedom of movement or access shall not exceed 30 calendar days. Any person substantially affected by that limitation may institute in superior court in Wake County or in the county in which the limitation is imposed an action to review that limitation. The official who exercises the quarantine or isolation authority shall give the persons known by the official to be substantially affected by the limitation reasonable notice under the circumstances of the right to institute an action to review the limitation. If a person or a person's representative requests a hearing, the hearing shall be held within 72 hours of the filing of that request, excluding Saturdays and Sundays. The person substantially affected by that limitation is entitled to be represented by counsel of the person's own choice or if the person is indigent, the person shall be represented by counsel appointed in accordance with Article 36 of Chapter 7A of the General Statutes and the rules adopted by the Office of Indigent Defense Services. The court shall reduce or terminate the limitation unless it determines, by the preponderance of the evidence, that the limitation is reasonably necessary to prevent or limit the conveyance of a communicable disease or condition to others.
If the State Health Director or the local health director determines that a 30‑calendar‑day limitation on freedom of movement or access is not adequate to protect the public health, the State Health Director or local health director must institute in superior court in the county in which the limitation is imposed an action to obtain an order extending the period of limitation of freedom of movement or access. If the person substantially affected by the limitation has already instituted an action in superior court in Wake County, the State Health Director must institute the action in superior court in Wake County or as a counterclaim in the pending case. Except as provided below for persons with tuberculosis, the court shall continue the limitation for a period not to exceed 30 days if it determines, by the preponderance of the evidence, that the limitation is reasonably necessary to prevent or limit the conveyance of a communicable disease or condition to others. The court order shall specify the period of time the limitation is to be continued and shall provide for automatic termination of the order upon written determination by the State Health Director or local health director that the quarantine or isolation is no longer necessary to protect the public health. In addition, where the petitioner can prove by a preponderance of the evidence that quarantine or isolation was not or is no longer needed for protection of the public health, the person quarantined or isolated may move the trial court to reconsider its order extending quarantine or isolation before the time for the order otherwise expires and may seek immediate or expedited termination of the order. Before the expiration of an order issued under this section, the State Health Director or local health director may move to continue the order for additional periods not to exceed 30 days each. If the person whose freedom of movement has been limited has tuberculosis, the court shall continue the limitation for a period not to exceed one calendar year if it determines, by a preponderance of the evidence, that the limitation is reasonably necessary to prevent or limit the conveyance of tuberculosis to others. The court order shall specify the period of time the limitation is to be continued and shall provide for automatic termination of the order upon written determination by the State Health Director or local health director that the quarantine or isolation is no longer necessary to protect the public health. In addition, where the petitioner can prove by a preponderance of the evidence that quarantine or isolation was not or is no longer needed for protection of the public health, the person quarantined or isolated may move the trial court to reconsider its order extending quarantine or isolation before the time for the order otherwise expires and may seek immediate or expedited termination of the order. Before the expiration of an order limiting the freedom of movement of a person with tuberculosis, the State Health Director or local health director may move to continue the order for additional periods not to exceed one calendar year each. (1957, c. 1357, s. 1; 1983, c. 891, s. 2; 1987, c. 782, s. 15; 2002‑179, s. 5; 2004‑80, s. 2.)

FWIW, I havent seen a thing saying this has been implemented in NC.

 

[dundare]

Re: Swine Flu Cases Suspected in North Carolina

The Greensboro News-Record now has an AP story on there website that reiterates the involuntary part. Since it rehashes the other story, I have just included the link and the relevant paragraphs.

There are a handful of suspected swine flu cases in North Carolina, and investigators were gathering specimens in Raleigh to determine whether the outbreak had spread to the South, state health officials said Monday.

Dr. Jeffrey Engel, the state health director, said officials are involuntarily isolating patients who may have the virus. But he said the handful of suspected cases are sporadically located in various parts of the state.

"We're working very closely with providers, and they are investigating cases on a daily basis," Engel said. "It's a very fluid situation and there will be suspect cases. People travel all the time."

Investigators were gathering specimens and hope to know whether the cases are "probable" some time Tuesday and Engel said they will seek confirmations by Wednesday...

Engel said the suspected cases are related to travel, mostly to Mexico. He said nobody has been hospitalized and that the people who may be sickened by swine flu have been ordered to in-home isolation.

He declined to say specifically how many suspected cases were in the state, noting that the number is always changing, and he declined to say where they were located.

Along with the travel history, Engel said the suspected cases involve patients with severe flu symptoms. The state is encouraging medical providers to only report more severe cases ? people with higher fevers or more prominent respiratory problems.

Engel said he expects the number of suspected cases to increase.

"This is dynamic," he said.

 

[sharon sanders]

Re: Swine Flu Cases Suspected in North Carolina

Welcome Dundare!

 

[Laidback Al]

Re: Swine Flu Cases Suspected in North Carolina

The Greensboro News-Record now has an AP story on there website that reiterates the involuntary part. Since it rehashes the other story, I have just included the link and the relevant paragraphs.

Welcome dundare. The two stories are very similar with the same quotes, although I could not find a a wire service notice. I would not consider the second report a corroboration of the involuntary patient isolation. It just seems that one reporter copied the other's story and changed a few words in the introductory paragraphs.

 

[Niko]

Re: Swine Flu Cases Suspected in North Carolina

Welcome dundare. The two stories are very similar with the same quotes, although I could not find a a wire service notice. I would not consider the second report a corroboration of the involuntary patient isolation. It just seems that one reporter copied the other's story and changed a few words in the introductory paragraphs.

or 2 reporters at the same press briefing.

 

[dundare]

Re: Swine Flu Cases Suspected in North Carolina

FWIW, the Charlotte Observer pieceis taken from the N&O. The Greensboro one is from the AP and they often rehash stuff from the locals. I checked the Durham Herald Sun and they dont have anything yet, same with the Burlington Times-News.

I just checked the Fayetteville Observer and their story seems to substantiate the involuntary part and the stuff I cited from the general laws.

State health officials have identified a handful of people in the state who may have swine flu, but the cases can?t be confirmed until Wednesday, said Dr. Jeffrey Engel, the state health director, at a news conference Monday.

Those suspected of having the illness have been isolated in their homes under orders from directors of local health departments, Engel said. He would not say which counties were affected.

and

Scientists also found Monday that it may take up to seven days for someone to show symptoms of the disease after exposure. Initially, they believed it took about two to five days, Engel said.

This could mean that those suspected of having the disease could be quarantined in their homes for a longer period of time than originally thought, Engel said.

The state has the authority to quarantine individuals in the instance of an epidemic, Engel said.

 

[Mimi_NC]

Re: Swine Flu Cases Suspected in North Carolina

Just read that five students from Appalachian State University, in Boone, N.C., are being tested for swine flu after returning from Mexico and were experiencing flu-like symptoms.

Has me a bit on edge since my daughter is a student on that same campus as well :|

http://www.wsoctv.com/news/19302192/detail.html

 

[dundare]

Re: Swine Flu Cases Suspected in North Carolina

Well, fwiw, I know the UNC system has been preparing for this type of event for a good while. As far as I know, all the schools have conducted multiple rounds of planning including a pandemic flu tabletop exercise. I participated in one of them and found it to be interesting, but also came away impressed with the level of knowledge and preparedness that can only come from multiple iterations of a plan for a future scenario.

http://www.ncpanflu.gov/cdcExercise.htm

That is the link to the powerpoint of the exercise for UNC Chapel Hill (the only one I could find on the net). It will try to download the file rather than open the page, so dont be alarmed when it happens.

 

[dundare]

Re: Swine Flu Cases Suspected in North Carolina

A small number of people in North Carolina have suspected cases of the new strain of swine flu that has killed more than 100 in Mexico, but the cases have not been confirmed with laboratory tests.
State health leaders said the number of suspected cases was fewer than 10. They would not give an exact number because several are likely to be ruled out, while others may come to light. Only confirmed cases will be announced, they said.

"We had a suspected case this weekend that turned out to be regular seasonal flu, so that's why we aren't announcing numbers yet," said Dr. Jeffrey Engel, state health director.

Confirmation of the virus will likely not occur until Wednesday at the earliest, after additional laboratory analysis in Atlanta. The virus is so new that only scientists at the Centers for Disease Control and Prevention have the material to detect it. Engel said that testing agent will be shipped to the state's lab and others across the nation Wednesday, but until then the labs will need to rely on federal authorities for confirmation.

All the North Carolina patients suspected of having swine flu are recovering with fairly mild symptoms at home, and no one has been sick enough to go to the hospital. Engel said most had recently returned from Mexico.

http://www.newsobserver.com/news/health_science/v-print/story/1504010.html

 

[Mimi_NC]

Re: Swine Flu Cases Suspected in North Carolina

Thank you for the additional information, Dundare.

 

[dundare]

Re: Swine Flu Cases Suspected in North Carolina

The handful of people in North Carolina who are suspected of having swine flu are under mandatory orders to stay at home, state health officials said today.
And one traveler, who was aboard a plane that landed yesterday in Charlotte, was hospitalized late yesterday after appearing sick. The plane arrived from Mexico, and the other travelers were allowed to continue their journeys. The hospitalized person is being required to remain in Charlotte until tests either confirm or rule out swine flu.
"The disease is likely here in North Carolina," said Dr. Jeffrey Engel, state health director. "That's the way we're treating it in public health."

None of the suspected illnesses in North Carolina have been confirmed as the new swine flu, which has killed more than 100 people in Mexico and caused an international public health alert.
Confirmation of the disease is contingent on testing that currently can only be performed at the Centers for Disease Control and Prevention in Atlanta. State health leaders hope to conduct their own confirmation tests later this week, using material shipped from the CDC.
Until cases are confirmed, Engel said, he would not release where the patients live, or how many people have the disease.

Except for the Charlotte airplane traveler and one other visitor to the state, the North Carolina patients with suspected swine flu have experienced mild symptoms and have not been hospitalized.
But under an order from the state public health department, they are required to stay home until they no longer have symptoms.
"From a public health standpoint, we are treated the suspect (patients) as if they have confirmed disease," Engel said. "They are under isolation orders."
He said public health officials routinely order mandatory isolation for people afflicted with certain highly contagious illnesses, including tuberculosis.

http://www.newsobserver.com/news/story/1504674.html

Ties into a lot of what we were talking about last night.

 

[dundare]

Re: Swine Flu Cases Suspected in North Carolina

A Lee County resident is suspected of having swine flu, according to the director of the county?s Health Department.

The case has not been confirmed, however, said Director Howard M. Surface.

The unidentified patient will be isolated for seven days beginning at 2 p.m. today, Surface said.

Details such as the patient?s condition and whether he or she was exposed through travel couldn?t be released publicly, Surface said. He said he didn?t know whether the patient had been hospitalized.

The Health Department is monitoring the situation closely, but there are no immediate plans to close schools or public buildings, Surface said.

http://www.fayobserver.com/article?id=324910

Two people suspected of having swine flu are being held in isolation in Mecklenburg County, state health director Dr. Jeffrey Engel said Tuesday. Neither is a North Carolina resident.

One was a traveler who became ill on a flight to Mexico, ?got off a plane and wasn't feeling well.? The person was sent to a local hospital, where laboratory tests are being done ?to tell us what's going on,? Engel said during a news conference in Raleigh.

The second person is from Texas and was planning to return home by plane but was not allowed to board because of flu-like symptoms.

The second person also went to a hospital, but Engel did not know if they remain in the hospital.

There are others in North Carolina suspected of having the swine flu, but Engel said he will not give numbers until they are confirmed. If tests show the suspected cases actually have seasonal flu, their orders to stay isolated in their homes will be cancelled.

http://www.charlotteobserver.com/living/story/692140.html

 

[Farmer]

Re: Swine Flu Cases Suspected in North Carolina

Initial tests negative- more suspect cases with tests pending.

Initial tests reveal no swine flu in N.C.
Posted: Today at 10:34 a.m.
Updated: 14 minutes ago

Tests on 15 people in North Carolina suspected of having swine flu were negative, the state's public health director said Tuesday.

"I was very pleasantly surprised," Dr. Jeffrey Engel said, noting none of the 15 even tested positive for a seasonal flu. "The situation appears to be stable."

A few dozen samples still need to be tested in the coming days, Engel said, and more suspect cases continue to turn up around the state.

"These things change on an hour-to-hour basis," he said. "My guess is this is going to be ongoing for weeks to months. We're in for a long haul."


One of the negative tests was for a traveler who got off a plane from Mexico in Charlotte and went to a hospital because of flu-like symptoms.

One other traveler also went to a Charlotte hospital this week with flu-like symptoms, Engel said. Tests are not complete on that person, who was about to return home to Texas but decided to see an emergency room physician.

Engel urged calm Tuesday as officials continue trying to determine if there are any "probable" cases of swine flu in North Carolina. People suspected of having the disease have been ordered to remain in isolation at home.

"We're treating suspects as if they have the disease," he said. "That's the best way to control it."

The state has resisted issuing any quarantine orders for healthy people who have been in contact with suspect cases, he said, noting that educating households about hygiene and how to maintain a proper distance from an ill person is enough at this point to keep the disease in check.

"We want science to be driving all of the policy," he said during a news conference. "We're not going to be running this issue with fear, but with scientific facts."

Where the cases of swine flu are
Across the country, health officials had identified 64 cases of swine flu ? most in New York City ? as of Tuesday afternoon. Of those, five have been hospitalized and none has died.

A handful of schools around the country have closed over swine flu fears and some people were wearing masks. Many people also canceled trips to Mexico after the government advised against unnecessary travel to the country.

The World Health Organization said Tuesday that swine flu may be spreading beyond recent travelers to others in the United States.

The global health agency says, so far, most people confirmed with swine flu were in Mexico. In that country, the swine flu strain is suspected in more than 150 deaths, and more than 1,000 others may be suffering symptoms.

WHO spokesman Gregory Hartl says the source of some infections in the United States, Canada and Britain is unclear.

The Centers for Disease Control and Prevention reported that 85 percent of the confirmed U.S. cases weren't associated with travel, according to Engel.

Yet, Cuba on Tuesday banned travel to Mexico. Several European countries also issued travel advisories.

Scotland and Spain reported confirmed cases of swine flu on Tuesday.

On Monday, Engel said the state is "better prepared" than ever to handle any potential outbreak of the virus in North Carolina. The state has a stockpile of 660,000 doses of treatment for the flu, if necessary.

North Carolina also will receive next week a quarter of its allotment from a national strategic stockpile of medications and masks, he said. But the commercial marketplace had more than enough supply of anti-viral drugs to meet state demand, he said.

Engel urged residents to take precautions by staying at home if they have flu-like symptoms, washing their hands frequently with soap and water for at least 15 seconds and seeing a doctor if flu symptoms become serious.

"To ward off any potential, just be prudent as you would during normal flu season," he said.

President Barack Obama on Tuesday asked Congress to approve $1.5 billion to fight the outbreak. Money would go toward improved monitoring to identify and isolate suspected cases and upgrades in testing both to confirm cases and to develop vaccines.

http://www.wral.com/news/local/story/5037708/