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July 31st, 2008 posted by Paul Rega, MD, FACEP July 31, 2008 @ 8:05 am

WNV Update

ProMEDmail, 7/31/08 

Date: 22-29 Jul 2008
States newly reporting WNV detected: Idaho, Minnesota
States newly reporting new human cases:  Idaho, Minnesota,
Pennsylvania, West Virginia, and Wyoming;
62 cases to date in 2008 with no fatalities.



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July 31st, 2008 posted by Paul Rega, MD, FACEP @ 7:16 am

62 million Americans with disabilities

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MedPage Today (http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/tb/10268)

 reported that almost “30 percent of the noninstitutionalized adult U.S. population — about 62 million people — have some disability that affects daily activity,” according to findings published in the National Center for Health Statistics 2008.

Barbara M. Altman, Ph.D., formerly of the Centers for Disease Control and Prevention, and colleagues, analyzed “data collected by the National Health Interview Survey (NHIS), which canvassed 157,976 adults from 2001-2005 via the Sample Adult Core Questionnaire.” The researchers found that over “20 percent of the population reported difficulties walking, bending, reaching overhead, or using their fingers to grasp something.” The data also showed that “[o]ther significant disabilities involved vision and hearing, with more than 13 percent of those surveyed reporting difficulties. Emotional or cognitive difficulties were less prevalent, with only three percent of the population reporting each difficulty.” Moreover, about 14 percent of respondents reported “more complex activities like working, participating in social activities, or being able to manage self-care.”



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July 31st, 2008 posted by Kelly Burkholder-Allen, RN, MSEd @ 5:15 am

MMRS Funding….

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http://hstoday.us/index.php?option=com_content&task=view&id=4455&Itemid=149
 

Program to be expanded throughout the greater Washington, DC region

Under the new $1.69 billion Homeland Security Grant Program, almost $40 million has been allotted for the Metropolitan Medical Response System, or MMRS, the longest running federal program supporting first responders.

Created in 1996, “the purpose of [MMRS] is to support regionally integrated all-hazards mass casualty preparedness, emphasizing the WMD threat,” former MMRS National Program Manager Dennis Atwood told HSToday.us.

The MMRS program “requires the participation of first responders, first receivers, public health, emergency management, law enforcement, and volunteer organizations,” Atwood explained.

Historically, Atwood said, “ while small in funding [$30 million to $50 million annually in recent years], and lacking the visibility and public relations clout of related DHHS/CDC programs, it’s concept, structure, and partnerships are an essential element of overall mass casualty preparedness.”

Indeed. as HSToday.us readers are aware, preparedness for mass casualty events – especially emergency medical preparedness – remains troubled. As important as the MMRS program is, authorities tell HSToday.us it’s terribly underfunded given its mission when compared to the funding levels of other programs.

In 2005, while still National Program Manager, Atwood stressed that the need for MMRS is as great, or greater, then ever.

As a grant program to 124 metro areas, DHS Secretary Michael Chertoff said this week that it wasn’t until “this year [that the Washington, DC] region is going to use its funds to expand the Metropolitan Medical Response System to Northern Virginia and the rest of the region.”

The greater Washington metro area has been criticized as not being adequately prepared for a mass casualty or catastrophic event.

Today, several MMRS jurisdictions have a decade of experience in developing their response capabilities for a mass care event, exemplifying the MMRS program’s goal of integrating infrastructure, communication, intelligence, and critical care with best practices in emergency preparedness and emergency management.

Initially managed by HHS, the MMRS program now operates under the aegis of DHS at the Office of Health Affairs’ Medical Readiness Office.

The MMRS program undertakes the following:

  • Integrates and enhances existing response systems to respond to a mass casualty or “surge” event;
  • Incorporates customized incident planning and specialized training exercises;
  • Provides specialized pharmaceutical and equipment acquisitions including, but not limited to, protective equipment, communications equipment, and medical supplies;
  • Uses and “all-hazards” planning approach;
  • Prioritizes the response activities and allocation of resources until significant external resources arrive and are operational (typically between 24 and 72 hours)


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July 31st, 2008 posted by Kelly Burkholder-Allen, RN, MSEd @ 5:09 am

Is the FDA too overwhelmed to ensure patient safety? Would drug companies really step up to the plate and “self regulate”?

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http://abcnews.go.com/Health/story?id=5441082&page=1

‘Pharmaceutical Companies Must Take Responsibility’

Drug Company Executive Says FDA Too Overwhelmed to Ensure Safety

By JUJU CHANG and MARY CLAUDE FOSTER

July 30, 2008—

 

The blood thinner heparin is one of the most used drugs in America, employed daily in hospital surgeries and for kidney dialysis patients.

But a safe supply of this critical drug fell into jeopardy last winter in a catastrophe that illuminated severe problems caused by the fact that most ingredients for American drugs now come from foreign sources. These sources are not being adequately monitored by either the pharmaceutical industry or the Food and Drug Administration.

The FDA told “Nightline” that as many as 55, or perhaps considerably more, people may have died from the contaminated heparin. So far it’s only been able to definitively link three deaths to specific lots of the tainted drug.

Although so far it’s only been able to definitively link three deaths to specific lots of the tainted drug. Heparin used to be primarily produced by the pharmaceutical giant Baxter, but Baxter recalled its entire stock, nearly half the nation’s supply, after the deaths from contaminated heparin. A number of smaller companies also recalled supplies. To date, Baxter says they have received 955 reports about contaminated heparin in 2008.

That’s when billionaire pharmaceutical executive Dr. Patrick Soon-Shiong and his company American Pharmaceutical Partners (APP) stepped in with a large, safe supply of the drug. Without it, countless more Americans would have died.

“How would all these thousands of dialysis patients have dialysis? What would happen to all these surgeries?” Soon-Shiong said. “I have no idea; it’s very scary to have thought.”

Soon-Shiong has called for the reform of how the pharmaceutical industry polices its products. The companies must take a greater role, he argues, because the FDA is simply overwhelmed.

 

Heparin Horror

No one knows that better than Leroy Hubley. He says his wife of 48 years, Bonnie, died from a severe allergic reaction after taking contaminated heparin at a Toledo dialysis clinic.

“The doctors recommended we remove her breathing tube to end her suffering,” Leroy recalled in congressional testimony. “Our entire family — our son, daughter, in-laws and grandchildren — were all there. Christmas music played in the background, and each one of us said our goodbyes. Then my wife of 48 years drifted away.”

Hubley’s nightmare didn’t end there. Within weeks, he says his only son, Randy, also a dialysis patient, died after taking heparin from the same batch of the drug.

“He too developed nausea, low blood pressure, fatigue, abdominal pain and diarrhea,” Hubley testified. “A week later, my 47-year-old son was dead, leaving behind three children and a grandchild.”

Investigations into the deaths pointed to China, where the raw ingredient for heparin originates.  According to the FDA, someone there spiked the crude heparin with a counterfeit look-alike drug to increase profit.

“I see these foreign drugs as essentially a string of time bombs,” said former FDA commissioner William Hubbard. “Heparin has gone off, and there will be more until we fix the problem.”

 

‘Process Controls’

Heparin isn’t the only drug that’s manufactured overseas. Roughly 80 percent of all the raw ingredients for America’s drugs now come from foreign countries. Soon-Shiong, who has made billions as a pharmaceutical executive, is calling for reform.

“It became very clear to me that, unfortunately, the future is that China and India will be the breadbasket of raw materials, creating the raw materials for the rest of the world,” he said. “I think heparin is a prime example of where pharmaceutical companies must take responsibility”

He said the FDA must also take responsibility, “but the FDA is overwhelmed,” he said.   Heparin may be used in high-tech medicine, but the raw material is literally hand-wrung from pigs’ intestines in crude agricultural workshops. And the process is virtually unregulated.

“There is no process controls at the farmer level,” Soon-Shiong said. “One has no idea what crude comes in, the source of the crude, are the pigs ill, do these pigs have any viruses. Frankly, are these pigs, even?”

Soon-Shiong says at his plant in China they track the entire supply chain, from “the live pig, the health and welfare of the pig, all the way to the slaughterhouse, all the way to the intestine, all the way into the crude heparin, all the way into the final heparin.”

 

Prioritizing Patients

It’s not the first time he has bucked his own industry. Back in 1985, when Soon-Shiong was working as a surgeon, he was poised to perform a pioneering transplant of cells from pigs to humans when he made a chilling discovery.

“We discovered a virus in pigs, and I refused to do that transplant,” he said. “My investors said, You will do the transplants.”  

His investors later sued him for fraud, and he won in arbitration.

“I recall vividly, they said, ‘You know, heroes and pioneers take risks, and all that you will suffer is a slap on the hand from the FDA.’ And I said, ‘No, that’s not all I’ll suffer. We’ll put patients’ lives at risk and I will not do it,’” he recalled.

Soon-Shiong’s unwavering stance in the face of opposition may come from his personal biography. He grew up in South Africa under apartheid, and he had to fight to become the first nonwhite doctor in a whites-only hospital.

He later emigrated to the U.S. with his wife Michele, whose career as a television actress paid the bills while he labored in a university lab.

“I wanted to follow my dreams with regard to my science and my research,” he said. 

The gamble paid off. Soon-Shiong’s medical prowess and business skills have made him one of the richest men in the pharmaceutical industry.

 

Self-Regulation

FDA Commissioner Janet Woodcock says the FDA is taking a “much closer look” at the safety of drugs that come from overseas, but the administration is woefully underfunded to safeguard America’s drug supply.

Hubbard said the FDA “can only inspect less than 1 percent of imported foods and drugs. For example, [the FDA] can go to virtually none of these foreign drug manufacturers because it simply does not have the staff to do so.”

“We don’t have the resources to do that, nor should it be our primary responsibility,” Woodcock said. She said the FDA keeps Americans safe “by holding the people accountable who are on the ground. Our inspectors can’t be in every plant all the time.”

In fact, the FDA couldn’t even find Baxter’s subsidiary plant “SPL” in China for an inspection.

“The plant wasn’t inspected because there was a mix-up between that plant and another one,” Woodcock said.

That leaves the pharmaceutical companies to police themselves.  Baxter did conduct its own inspection last September and gave itself a passing grade, just months before Americans began dying from contaminated heparin.

“It is clearly our job to make sure that our therapies are safe, for which we have our own inspections and our own audits,” said Baxter’s chief scientist, Norbert Riedel. “But it is also the responsibility of the FDA to provide the necessary oversight and checks and balances than that is indeed occurring.”

Riedel says that Baxter has formed a task force to examine the oversight process.

“We have put a team of scientists in place, and I’m chartering them with the task of asking where else could any one of our products be tampered with in this fashion,” he said.

But Riedel points out that additional inspectors may not have saved any lives from the spiked heparin.

“I think the contaminant was made to be so similar to heparin that no test that we had in place and no facility inspection could have found it,” he said.



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July 31st, 2008 posted by Kelly Burkholder-Allen, RN, MSEd @ 5:02 am

Where did all the passports go?

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Source: Reuters, UK 

 



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July 31st, 2008 posted by Kelly Burkholder-Allen, RN, MSEd @ 4:54 am

A year after the worst bridge collapse in U.S. history, little has been done to repair other bridges!

http://ap.google.com/article/ALeqM5jUG0EOP6unZQXXXaHPVv9mXjQvfwD928NQAG0

Little progress made in bridge repairs across US

MINNEAPOLIS (AP) — A year after the worst U.S. bridge collapse in a generation brought calls for immediate repairs to other spans, two of every three of the busiest problem bridges in each state — carrying nearly 40 million vehicles a day — have had no work beyond regular maintenance.

An Associated Press review of repairs on each state’s 20 most-traveled bridges with structural deficiencies found just 12 percent have been fixed. In most states, the most common approach was to plan for repairs later rather than fix problems now.

The bridges reviewed by the AP — 1,020 in all — are not in imminent danger of collapse, state engineers and highway officials say. But the officials acknowledge the structures need improvement, many sooner rather than later.

The collapse of the eight-lane Interstate 35W bridge into the Mississippi River on Aug. 1, 2007, killed 13 people and brought immediate calls for repairs to bridges across the nation.

The failure to follow through was not because of lack of effort, officials said. Soaring construction costs, budget shortages, election-year politics, a backlog of bridge projects, competing highway repairs and bureaucracy often held bridge work to only incremental progress.

The AP gathered information on repair status from 48 states and Washington, D.C. In six states, data could not be obtained for some locally owned bridges. Louisiana and Nevada failed to respond.

The AP findings:

_Sixty-four percent of the bridges received no work beyond regular maintenance, though most were targeted for some kind of future work.

_Twelve percent had their structural defects fixed — usually through a major rehabilitation or outright replacement.

_An additional 24 percent have seen a partial improvement, either through a short-term repair to temporarily address the defect or an ongoing project that is not yet complete.

The worst were Indiana, Oklahoma, New Hampshire and South Carolina, where work was conducted on only one of each state’s 20 most heavily traveled structurally deficient bridges.

“At some point, relying on miracles is not going to be the best way to manage our system,” said Pete Rahn, the transportation commissioner of Missouri. “I would pray we don’t have to have another disaster to bring about the right attention to this. I see very little political will there.”



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July 31st, 2008 posted by Kelly Burkholder-Allen, RN, MSEd @ 4:45 am

The day….the kitty died…

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http://threatswatch.org/rapidrecon/2008/07/the-cat-died/

The possible spread of pandemic bird flu (or H5N1 and its variants) has been discussed in the past. There are many questions, with probably the most important one being whether or not (and possibly when) the H5N1 would make a jump to the broad human population. Now, in the South Korean city of Gimje, about 250 km south of Seoul, there is a reported incident in which a cat has died after being infected with a virulent form of the H5N1 virus.

According to health officials, this is the first mammal in the South Korea to have contracted the H5N1 virus, and the first report of a cat having the disease since one occurred in Thailand in 1996. The reassurances are not so reassuring, however.

”…there was little risk to humans as there has never been a known transmission of the virus from a cat to other mammals. “It is quite rare for a cat to be infected by the avian flu virus,” said Cho Hyun-Ho, a deputy director of the National Veterinary Research and Quarantine Service.

This is by no means intended to sound an alarm. According to some estimates, “only” 240 people have actually died worldwide from the H5N1 virus.

Scientists fear the virus will eventually mutate into a form that is much more easily transmissible between humans, triggering a global pandemic.

Referencing the article, BioResearch: The Risk/Reward Ratio, you can begin to understand the importance of careful diligence in studying diseases in animals and the possible vectoring of an animal-borne disease to the human population. As objectively as possible, it is important that animal diseases that could pass to humans be studied. No one knows just how H5N1 will (or even leaving some doubt, “if”) run to the human population and create the havoc of a pandemic. Staying ahead of the curve is the only logical way.

Here is something to be remembered. During the 2003 outbreak of SARS (Severe Acute Respiratory Syndrome) is China, civet cats, mammals related to the mongoose and a distant relative of feline cats, were suspected as one of the paths of the jump to humans. In Southwestern U.S., however, there is a continuing fear of plague carrying rats (see Yersinia Pestis. There, the feral cat population is credited in some ways with controlling the spread of that disease by killing the rats. Mother Nature does influence an awful lot of what happens. In fact, in some ways, Mother Nature, through natural events like hurricanes or earthquakes, or through the spread of diseases, represents a significant threat to us.



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July 31st, 2008 posted by Kelly Burkholder-Allen, RN, MSEd @ 4:41 am

Brother Mike bestows the virtues of “Team Diarrhea”….Allelujiah!

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http://www.startribune.com/nation/26124594.html?location_refer=Homepage:8

Outbreak example of nation’s ‘largely broken’ system, Osterholm says

By EMILY KAISER, Star Tribune

July 30, 2008

WASHINGTON – Mike Osterholm, former Minnesota state epidemiologist, said Wednesday that a recent salmonella outbreak exemplifies the country’s “largely broken” state and local food illness investigation system. He said the system needs major updates to prevent future outbreaks.

Osterholm spoke at a House subcommittee meeting that reviewed the country’s capacity to trace fresh produce. The recent salmonella outbreak sickened more than 1,300 people in 43 states and Canada, and still poses unanswered questions.

Although solving nationwide food-borne illnesses relies heavily on federal efforts, Osterholm said local and state public health departments play a vital role in detection. Uneven response, due to varying expertise and resources, played a serious role in the slow and often-muddled salmonella investigation, he said.

Osterholm, director of the University of Minnesota Center for Infectious Disease Research and Policy, proposed modeling the national system after Minnesota’s, which traced the salmonella strain to jalapeno peppers in less than two weeks.

“Insufficient product traceability, inadequate food protection planning and inadequate inspection and trace-back capacity” at the federal level led to illness and public confusion and halted many fresh produce industries, Osterholm said.

Investigators originally focused on tomatoes as the possible culprit, but as the outbreak continued to baffle federal officials, Minnesota Department of Health investigators traced the strain to jalapeno peppers.

The Food and Drug Administration (FDA) has confirmed contaminated Mexican jalapeno and serrano peppers, but officials said there still could be more unconfirmed sources.

David Acheson, FDA associate commissioner, said this outbreak shows the complexities of tracing illness in fresh produce. Much of the perishable produce is grown on farms around the world, passes through many packing and processing chains and is already discarded when illness is detected, he said.

Data on food-borne illness outbreaks can’t always be easily centralized because of varying state resources. It takes about three days in Minnesota, but in many states it can take more than five weeks, Osterholm said.

To help prevent and solve future outbreaks quickly, he recommended federal agencies model their system after a group dubbed “Team Diarrhea,” which includes Minnesota public health students who interview patients and worked on the current case.



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July 31st, 2008 posted by Kelly Burkholder-Allen, RN, MSEd @ 4:36 am

Blame it on the jalapenos….the Mexican ones….of course…..

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http://www.ajc.com/news/content/health/stories/2008/07/30/salmonella_mexican_peppers.html

Mexican farm pegged as source of U.S. salmonella cases


The Atlanta Journal-Constitution
Published on: 07/31/08

Washington — The outbreak of salmonella poisoning that sickened more than 1,300 people across the country and cost American tomato growers more than $300 million has been traced to irrigation water and peppers grown on a farm in Mexico, federal officials said Wednesday. But they refused to completely clear tomatoes as carriers of the bacteria.

“Now we have a smoking gun, it appears,” said Lonnie King, who directs investigations of food-borne illnesses at the Centers for Disease Control and Prevention in Atlanta.

David Acheson, the head of food safety at the Food and Drug Administration, said the strain of salmonella Saintpaul that caused the nationwide outbreak has been found in irrigation water and serrano peppers on a Mexican farm. Earlier, a single contaminated jalapeno pepper had been traced to the Mexican grower.

Consumers should not eat jalapeno and serrano peppers imported from Mexico, Acheson told the Horticulture and Organic Agriculture Subcommittee of the House Agriculture Committee.

Members questioned Acheson and King sharply about why it has taken since May to track down the source of the food poisoning and whether they were mistaken all along in associating the illness with tomatoes.

The warning from the federal agencies led to a mass removal of tomatoes from grocery market bins and restaurant menus and cost the industry more than $300 million, said subcommittee chairman Dennis Cardoza (D-Calif.). He asked Acheson if a single contaminated tomato was ever found.

“No,” Acheson said.

But he would not clear tomatoes, saying the fruit, as well as jalapeno and serrano peppers, were grown on the Mexican farm in the state of Tamaulipas with contaminated irrigation water. In addition, he said, tomatoes were processed through the same packing center in Nuevo Leon, Mexico, so it is “plausible” that some of the illnesses were caused by contaminated tomatoes.

King said the CDC’s first series of interviews “indicated raw tomatoes were the most commonly consumed food item — reported by 84 percent of ill persons — leading to the hypothesis that they were a possible source of the illnesses.”

On July 21, however, a genetic match with the salmonella Saintpaul was found in a jalapeno pepper. And now another type of pepper has been implicated. But the officials still wouldn’t admit that their agencies had been wrong on tomatoes.

“It appears likely that more than one food vehicle is involved,” said King. “The outbreak appears to be ongoing, but with fewer new illnesses each day.”

Rep. Tim Mahoney (D-Fla.) told the officials that tomato growers in Florida had lost $47 million because of the federal warning.

“You understand that crop insurance doesn’t cover this,” he said pointedly.

The CDC and FDA were criticized by members from both political parties.

“This incident demonstrated that our governing food safety authorities are outdated and must be reformed,” said Rep. Adam Putnam (R-Fla.). He said the agencies are not protecting consumers and hurting growers with their blanket warnings and slow “tracebacks.”

“Despite the fact that nearly all spinach was harmless in 2006, and the vast majority of jalapenos are probably safe now, and the distinct possibility that not a single tomato was ever contaminated, growers and distributors suffered catastrophic losses,” said Rep. Diana DeGette (D-Colo.).

The fact that it took more than two months and more than 1,300 illnesses to trace the cause of the outbreak “is extremely troubling,” especially considering the attention and funds focused on the process under the Bioterrorism Act, said Cardoza, the subcommittee chairman.

“Clearly serious flaws continue to exist in the methodology used by some states to collect primary epidemiological data,” he said. “Furthermore, the process used by the CDC to verify and refine the collected data calls into serious question the effectiveness of communications between the states, CDC and FDA.”

King said some states do get data to the CDC faster than others. In half these cases, he said, it took more than 16 days from the time the person fell ill to the time the DNA footprint of their salmonella was added to the PulseNet database used by the CDC and states.



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July 30th, 2008 posted by Kelly Burkholder-Allen, RN, MSEd July 30, 2008 @ 5:18 am

California Earthquake: A whole lot of shakin’ but not much breakin’!

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http://www.latimes.com/news/printedition/california/la-me-la-quake30-2008jul30,0,6546841.story

Minor damage from 5.4 quake shows California has learned its lessons

The quake struck hardest in an area of San Bernardino County that has seen massive growth in population and housing in the last decade. That meant that the buildings shaken the hardest were mostly built under California’s strictest building codes, updated in 1997 in response to the 6.7 Northridge quake of 1994. That kept damage to a minimum.

Only minor injuries were reported, three at an outpatient medical clinic in Brea and five at a building in the Wilshire district of Los Angeles.

“The most interesting thing to us is that this is the first one we’ve had in a populated area for a long time,” seismologist Kate Hutton of Caltech said. “People have forgotten what an earthquake feels like. We should look at this as an earthquake drill for the Big One that will come one day.”

Although moderate in intensity, the quake rumbled up from a relatively shallow depth, making it feel sharper, stronger and scarier than its magnitude suggested, especially in areas close to the epicenter.

“It’s the first time in my life I actually got under my desk,” said Anaheim Police Sgt. Ken Seymour, a native Southern Californian.

Robert Heded, 32, a Time Warner technician who lives in Culver City, was about 30 feet up a telephone pole at La Cienega and Pico boulevards in Los Angeles when the quake hit.

“I just sat there and waited, kinda rode it out,” he said a while later as he bought an energy drink at a 7-Eleven, still dressed in his reflective safety vest.

The lines were “swaying a lot more than usual, about four feet from side to side,” he said. “I wasn’t sure what was happening, if it was an earthquake or if it was me.” Heded said he finished up his work, still strapped to the pole in his safety gear. Then made his way down.

“It was bad,” said Nirmala Dawson, the director of the Montessori School of Chino. She said the school performs frequent earthquake drills. “But at that moment, to be honest, we forgot them. We just evacuated.”

No one was injured, she said, but a few children were frightened by the shaking. Then, after the quake, phones began ringing off the hook with calls from parents.

That nearly universal instinct to call loved ones — or someone — strained the capacity of the regional phone network, perhaps instructive for officials planning emergency responses to the next massive earthquake.

Verizon lost some phone service Tuesday in several quake-affected areas. “We have some outages on our land-line side,” said Jonathan Davies, Verizon spokesman. “We’re not sure yet if it’s physical damage or just due to high call volumes.”

AT&T’s cellphone service was spotty in some areas. Sitting in a Starbucks in Pasadena, Paul Roberts was able to get calls on his cellphone. “But I am sitting here with my buddy, who has AT&T, too, and he can’t make outgoing calls,” said Roberts, a student at Art Center College of Design.

The Los Angeles Times’ website, latimes.com, was briefly unavailable to many users when heavy traffic swamped its servers immediately after the earthquake. Full access returned in about 10 minutes, according to Meredith Artley, the executive editor of the site. It had about 630,000 page views in the hour after the temblor, roughly double the usual amount.

The earthquake slowed, but for the most part didn’t stop, the region’s transportation network.

A section of the southbound Interstate 5 near Bake Parkwayin Mission Viejo was briefly closed to traffic so that Caltrans workers could inspect it, according to Tom Marshall, spokesman for the California Highway Patrol. No problems were found.

No disruptions were reported on Los Angeles County highways. Raja Mitwasi, chief deputy director of the Caltrans office in Los Angeles, said Caltrans was inspecting highway bridges and pavement, but had not found any signs of damage.

The biggest delays were on passenger trains, which were slowed to allow inspectors access to tracks.

Denise Tyrrell, a Metrolink representative, said there were delays of up to an hour or more on Metrolink trains serving Orange, Riverside, San Bernardino and Los Angeles counties. Metrolink use is at an all-time high because of rising gas prices. Similar delays were reported on Amtrak’s Surfliner trains, with shorter ones on Los Angeles County’s Metro Rail lines.

On Tuesday afternoon at Union Station in Los Angeles, some passengers affected by the delays said they understood the need to check tracks for damage.

“They had to do what they had to do to make sure it was safe,” said Pete Paladino, 64, a special needs teacher who was delayed about 30 minutes on the Red Line to downtown and was headed home to Upland.

The quake briefly knocked out the ground radar system at Los Angeles International Airport, but did not affect any flights, LAX officials said. The radar is linked to a safety system that warns air traffic controllers of potential collisions. Nancy Castles, a representative for the airport, said no damage has been found at LAX except for a broken water heater that caused some flooding in the checked baggage area of Terminal 7.

One terminal at Ontario International Airport sustained cosmetic damage, but flights were not affected, according to spokesman Harold Johnson. Staffers at John Wayne Airport in Santa Ana closed one runway for five minutes after the quake to inspect it, airport spokeswoman Jenny Wedge said. They found no damage.

The quake did cause its share of damage, mostly in the form of shattered glass and dislodged bricks. In the city of Los Angeles, problems included flooding at a Macy’s in Topanga Canyon, some people stuck in an elevator at Pershing Square, some cracking and other minor damage to some downtown buildings, and five minor injuries to people in the 3600 block of Wilshire Boulevard “who were rushing and trampling each other out the building,” according to City Councilwoman Wendy Greuel, who was serving as acting mayor in the absence of Mayor Antonio Villaraigosa, who was on vacation in London.

The quake gives new urgency to a drill, the Great Southern California Shakeout, being planned for November by a consortium of public and private organizations. It will simulate the response to a magnitude 7.8 quake on the San Andreas fault.

Seismologists consider such a quake to be inevitable, although they cannot predict when it might hit. To put the latest temblor in perspective: A 7.8 quake would be 3,981 times more powerful than one of magnitude 5.4, according to Anthony Guarino, a seismic analyst at Caltech.

The recent devastating earthquake in China’s Sichuan Province was calibrated at magnitude 7.9. As powerful as that quake was, it also demonstrated what can happen when buildings are not built to the highest earthquake standards. Hutton, the Caltech seismologist, said even a 5.4 quake could cause widespread damage “anyplace where there’s no earthquake regulation, where no reinforcement is required.”

The Chino Hills quake hit hardest in an area of relatively new development. Valerie McClung, community relations manager for the city of Chino Hills, said almost all of the residential and commercial development in the city began no earlier than 1991, the year the city was incorporated. Most development, she said, occurred after the Northridge quake.

“It’s the best possible location,” said Lucy Jones, chief scientist for the Multi-Hazards Initiative of the U.S. Geological Survey. “If this had happened in San Bernardino [city], where there are over 200 unreinforced masonry buildings, we would have had a lot of downed buildings.”

Jones said big earthquakes often lead to an upgrade in building codes. For instance, she said, unreinforced masonry was outlawed in California in a 1935 code, adopted in the aftermath of the 1933 Long Beach earthquake. The 1997 code, adopted after Northridge, banned brittle steel and mandated that builders use a stronger welding material to join steel parts.



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