Mexico’s
Fast Diagnosis By Julio Frenk
Mexico City, May 1, 2009
Op-Ed Contributor
EVERY year approximately 10,000 Mexicans die from the effects of
seasonal flu. Usually they are the elderly and the very young, people whose
immune systems are not robust enough to fight off the virus. But this year has
been different. The Mexican disease surveillance system, a network of more than
11,000 hospitals, clinics and doctors’ offices, picked up a minor but
troubling trend in April. Across this nation of 110 million people, a handful
of young adults had apparently died from influenza. An immediate investigation
led, within a few hectic weeks, to the isolation and full genetic sequencing of
the microbe causing the illness. The experts’ worst fear was confirmed:
it was a new kind of influenza virus.
Some have complained that the Mexican government did not act fast enough
to identify this new bug and sound the alarm. But such criticism fails to take
into account the real-life complexity of recognizing and responding to an
unexpected public health emergency.
As a former minister of health for Mexico, I met with Mexican officials
this week to consult with them on their response to the influenza, and I was
impressed by how medical scientists in the country quickly perceived the
unusual trend of illness against a background of standard flu and then analyzed
the virus and alerted global health authorities. Their fast action gave other countries the warning they needed to screen for the
new virus, which is why cases of swine flu have already been discovered in a
dozen other countries — cases that might otherwise have long gone
unnoticed.
The number of confirmed deaths in Mexico from this new virus is still
uncertain and may be only several score. Further epidemiologic detective work
will tell us whether the virus had been circulating throughout the seasonal flu
period in Mexico, beginning as early as last fall, making thousands only mildly
ill, and alerting us to its presence only with the unexpected deaths of young
adults.
From the moment this so-called swine flu was identified, the Mexican
government worked vigorously to contain the contagion — closing all
schools across the country, limiting public gatherings and instructing people
to wear masks and refrain from greetings involving physical contact. President
Felipe Calderón himself led the response, underlining
the seriousness of the situation, and that may explain why so many Mexicans
have complied. Already, the number of deaths seems to be stabilizing, perhaps
indicating that the first wave of this influenza has peaked.
It’s still not known why this flu seems to have been deadly only
in Mexico. It stands to reason that for the entire winter flu season, Mexican
doctors, not knowing that a new virus was afoot, saw any instances of it as
ordinary seasonal flu, and thus did not give patients the antiviral drugs that
could have saved their lives. These medicines are effective only if given
within 48 hours of the onset of symptoms.
