Second Suspected Case of Swine Flu Reported in Israel

Health Ministry issues directives to medical institutions in order to combat a potential outbreak.

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A second case of suspected swine flu has been reported in Israel, after a man who returned recently from Mexico checked himself into a Kfar Sava hospital complaining of a sore throat.

The 47-year-old patient will remain in quarantine until his test results are released in the coming days. Hospital officials say, nevertheless, that chances are low that he has actually contracted the disease.

The first suspected case of swine flu in Israel was reported on Sunday, when a Netanya man Mexico was hospitalized under quarantine with flu-like symptoms upon his return from Mexico.

After that hospitalization, Israel began to take measures to combat a potential outbreak of the disease, which has already struck across two continents.

Magen David Adom representatives said on Sunday they would not take blood donations from individuals who had visited Mexico, California or Texas in the past week.

The Israel Embassy in Mexico has also decided to cancel Memorial Day events honoring fallen Israel Defense Forces soldiers, to avoid "taking any unnecessary risks" posed by public gathering, Israeli media quoted an embassy spokesman as saying.

Health Ministry Director-General Professor Avi Israeli on Sunday issued directives to health care institutions, which he described as "temporary instructions intended to be on the side of caution until we learn more details."

According to the ministry's instructions, a patient may be considered a potential carrier of the swine flu virus if his or her breathing system becomes compromised without apparent reason and the patient shows symptoms such as respiratory malfunction, high fever, congestion, throat pain, coughing or shortness of breath.

In addition, the patient, in order to be considered a potential carrier, must have visited Mexico in the week before falling ill or have been in close contact with someone who had visited the country, or been in contact with an individual who had treated somebody with the virus. The instructions also require anyone meeting these criteria to report for medical treatment immediately.

The dangerous viral strain has killed up to 103 people and infected 1,614 in Mexico. 20 cases have also been discovered in the United States.

New York official said Monday the city has 20 more cases of swine flu, and an additional 17 probable cases.

Tomer Vajim, a 26-year-old Israeli, checked himself into Netanya's Laniado Hospital on Sunday after returning Friday from Mexico with minor flu-like symptoms. Vajim, of Moshav Geulim, is currently being treated in quarantine, and the Health Ministry said laboratory results pointing to whether he was carrying swine flu would be ready in three days.

The Health Ministry said it had not issued special instructions to the public on the matter, nor adopted extraordinary measures for monitoring those returning from Mexico. Ministry officials said the disease had potential to snowball into a global pandemic, but the chances of that happening remain unclear at this point. The World Health Organization has yet to issue instructions on preparing for such an eventuality, and has yet to change the global alert level for the disease, currently at 3, meaning predominantly animal infections; few human infections.

Sharon Sa'ar, the partner of the Israeli patient hospitalized after returning from Mexico, said Vajim had returned Friday from a one-week trip to Mexico City for work purposes complaining of flu-like symptoms. After friends told him they had read about swine flu on the Internet, he sought medical care.

Sa'ar said her partner "feels slightly better, and his temperature dropped a little. We're hoping this will end up just being regular flu, and that everything will be okay."

"Tomer has agreed to expose this so that others won't be harmed. That's why he's calling on everyone who was with him on the flight or in contact with him during the trip or after and has flu-like symptoms to be examined," she said.

Defense Ministry may be put in charge if alert level raised

The World Health Organization convened an emergency meeting on Saturday, but the panel adjourned without raising the pandemic alert level, stating it was still waiting for more information. Some experts believe the Mexico outbreak meets the definition of a Level 4 alert sustained human-to-human transmission.

Raising the alert level to 4, one below that of "pandemic," would likely obligate the government to transfer responsibility for containing the disease from the Health Ministry to the Defense Ministry, the only state body with the necessary logistical resources to handle a public health emergency on such a massive scale. Defense sources said at this point the ministry is making due with "updating procedures" and continuously briefing Defense Minister Ehud Barak and other senior ministry officials.

Should a global pandemic be declared, the Health Ministry would likely receive authorization to close both air and sea ports. The discovery of the virus in Israel would also likely lead to certain regions of the country being closed to visitors.

Still, senior medical officials believe even if the flu strain develops into a global epidemic, there will be no need for mass immunization in Israel, as the treatment Tamiflu is highly effective when administered in the disease's earliest stages.

The Israel Airports Authority told Haaretz Sunday, "We're preparing for all possibilities of an epidemic, but we are waiting to receive the Health Ministry's instructions. It is those instructions which will determine how we will deal with travelers returning from abroad."

The Foreign Ministry has urged Israelis living or traveling in Mexico to maintain high standards of personal hygiene and avoid crowded places. It urged travelers to keep abreast of instructions issued by global medical organizations, and to check the ministry's Web site regularly.