Q And if I could just follow with one other question. Relenza and Tamiflu, how effective are they in treating this particular strain, if at all?
DR. BESSER: At this point, it’s premature to talk about how effective they are. Those are some of the studies that we would want to undertake and assist Mexico in undertaking. We do know from seasonal flu that early treatment with antivirals can shorten the course of illness. But in terms of this situation, we know that the strain is susceptible, it’s not resistant to those drugs. It is resistant to other drugs, amantadine and rimantadine. But it’s not resistant to oseltamivir and zanamavir, which are the drugs that we’ve been stockpiling.
SECRETARY NAPOLITANO: I just wanted to clarify — on the declaration of emergency, I wish we could call it declaration of emergency preparedness, because that’s really what it is in this context. It’s similar to what we do, for example, when we know — when a hurricane may be approaching a site, we will go ahead and issue an emergency declaration that allows us to preposition — frees up money, resources to get pre-positioned, to get ready. A hurricane may not actually hit a particular landfall, but it allows you to undertake a number of preparatory steps. And really that’s what we’re doing right now, the government. We’re leaning forward, we’re preparing in an environment where we really don’t know ultimately what the size or seriousness of this outbreak is going to be.
Q Dr. Besser, you said we were likely to see more cases and the CDC’s Dr. Ann Schuchat said yesterday, “We do not think we can contain the spread of this virus.” What exactly does that mean?
DR. BESSER: In strategies for outbreak control there’s a concept of containment where if you can detect it very quickly in one community, that you could swoop in and try and quench it and knock it out so it doesn’t go further. We don’t think that that’s a possibility, but we do think that it’s very possible to mitigate or reduce the impact of this infection around the country.
In terms of detection, what we’re seeing in this country is mild disease — things that would never have been detected if we weren’t ramping up our surveillance. And so my comment there is that by our efforts of asking doctors to culture — we are asking doctors when they see someone who has flu-like illness who has traveled to an affected region to do a culture — take a swab in their nose and send it to the lab so we can see, is it influenza, is it this type. And I expect that as we do that we’re going to find cases all — in many different parts.
When I mentioned the states we’re seeing cases in right now, they’re not all contiguous. The travel patterns of people now are such that we would expect that we’re going to see cases in more states.