This year is set to be a tough one for the flu virus, and
recent events in Mexico are cause for some concern for residents throughout the
Americas.
The Health Sector in Tlaxcala,
Mexico, north of Puebla
to the east of Mexico
City, has reported the death of one
person from the A/H1N1 influenza virus. The death occurred in December in a
state hospital.
The A/H1N1 virus is a subtype of influenza A virus; it was
the most common flu strain in 2009, when the World
Health Organization (WHO) declared a pandemic that originated in Mexico.
Often called “swine flu” by the public media, it is spread by pigs, as opposed
to the “bird” or “avian” flu, which is spread by fowl, mostly domestic chickens.
In 2009 the A/H1N1 pandemic caused widespread concern in
Mexico, where an estimated 159 people died. Worldwide, it was estimated to have
caused about 17,000 deaths by the start of 2010. By August 10, 2010, the World
Health Organization declared the pandemic over. Now, this most recent death in
Mexico has raised concerns that 2012 could be a tough year.
In fact, the WHO has been on top of this since earlier in
2011. On April 26th, 2011, an H1N1 pandemic preparedness alert was
issued by the WHO for the Americas, with affected areas including the Chihuahua
region of Mexico, where its severity and “work load” (i.e. viral activity in
the body) have been high.
Concern remains elevated because the current vaccine targets
this virus, yet may have been losing effectiveness in 2011.
In the case of the recently confirmed death in Mexico, the
head of the Ministry of Health (Secretaría
de Salud), Jesus Fragoso Bernal, confirmed that the Instituto
Nacional de Referencia Epidemiológica (InDRE), Mexico’s equivalent of the
US’s Centers for Disease Control and Prevention,
had confirmed that the submitted sample tested positive for A/H1N1.
The
death was recorded in mid-December, but it was only yesterday (Thursday,
January 5), that the state Health Department received official notification
from the laboratory. In explaining the delay in confirmation, Fragoso Bernal said that the case
had been “kept in reserve” at InDRE in order to verify that the
death was indeed from influenza.
Fragoso Bernal also noted that
the individual had complicating risk factors that increased the
likelihood he would succumb to the disease, most notably a high body mass index
which resulted in morbid obesity.
Mexican states intensify campaigns against
A/H1N1
Surveillance to
combat the H1N1 influenza has been upped in many areas in Mexico due to the
presence of positive cases in Michoacan, Mexico State and Guanajuato.
Meanwhile in Hidalgo, officials
from the state Health Department and the Directorate General of Civil
Protection said that so far there have been two deaths associated with high
fevers. They denied that these deaths were due to A/H1N1, though it appears
that InDRE has not
conducted any tests specific to these deaths.
In 2009 Mexico was in the grip of an A/H1N1 pandemic
Officials in Hidalgo
further reported that in 2011 the state saw 19 cases of seasonal flu, but none
of these were A/H1N1. As a precaution, they reminded citizens to avoid igniting
wood or charcoal indoors, to wear warm clothing, to be careful with children
and the elderly, and to consume vegetables and fruits with vitamin C.
The state of Querétaro has responded
with a mass vaccination campaign against A/H1N1 – it has ordered 450,000 doses
of the vaccine. Officials also said that
they planned to send 30% more samples to InDRE for verification.
To
date, the state government in Querétaro has
administered 158,000 doses of the vaccine. It has 5,000 doses of medication in
reserve for treatment.
Officials
are concerned because of the significant flow of people between neighbouring Michoacán
and Guanajuato,
which have already had people testing positive for A/H1N1. At present, however,
there have been no positive test cases in Querétaro.
Mexico’s Ministry of Health has said that there were 747
cases of influenza in 2011, with some increases over the winter
season, particularly in the past three weeks. Of these, 200 were A/H1N1, but
there was no imminent threat of a pandemic.
Overall, 2011 saw
38 deaths due to influenza, with half of these deaths being attributed A/H1N1. Officials
noted that since the pandemic of 2009 the A/H1N1 strain had become part of the
seasonal influenza reality throughout the world and not only in Mexico.
Back in 2009, Mexican authorities were forced to close all
schools in Mexico City and central Mexico in response to the A/H1N1 pandemic.
The country reported many hundreds of human cases of swine flu. Though in the
end "only" 159 people died of A/H1N1 – far more than the estimated 19 who have
succumbed to A/H1N1 so far this season – the country was gripped in panic.
At the time it was determined that approximately 80% of the
virus was highly related to a North American body of swine flu that had been
known of for a number of years. However, about 20% was determined to come from
a Eurasian variety of swine flu first seen in Thailand. It was this
recombination that was completely new.
Canadian and US
authorities on alert
On January 1st 2012 the Canadian
Food Inspection Agency officially urged pig farmers, farm workers – and even
people planning to visit a swine farm – to get a flu shot in order to reduce the risk
of transmission between livestock and humans.
As well, the Canadian
Swine Health Board, which has no legal authority to require vaccinations, has
urged producers and farm workers to get the vaccine.
Canada has reason to be concerned: during the 2009 pandemic,
the A/H1N1 virus killed 56 people in the western province of British Columbia. And
Canadian authorities believe that a farm worker who came to Canada from Mexico
likely infected a swine herd in Alberta in 2009.
Several similar incidents have been reported in the US. Worryingly,
at the end of 2011 the US state of Indiana confirmed 19 H1N1 flu cases, and
expressed concern that some could be a variant of the A/H1N1 swine flu.
According to the CDC, so far this season in the United
States eleven children and one adult in five states have been infected by the new
variant, with three hospitalized. All of the individuals have recovered.
The strain has been detected in Indiana, Iowa, Maine,
Pennsylvania and West Virginia. Of these, at least six reported no recent
exposure to pigs, suggesting "limited human-to-human transmission."
The new virus, named H3N2v, contains a gene from the 2009
variant of A/H1N1.
During the A/H1N1 pandemic in 2009, China and Russia closed
their markets to U.S. pork. Industry revenue was estimated to have fallen by
nearly $2.2 billion in the last eight months of 2009.
Twitter: @TimothyEWilson
Email: lapoliticaeslapolitica [at] gmail [dot] com
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