Since this morning there have been several more articles and lots of questions. Here is more out of Mexico.

Canadians returning from Mexico urged to be on alert for flu-like symptoms
20 die from severe respiratory illness in Mexico

Last Updated: Thursday, April 23, 2009 | 9:30 AM ET

Canadians who have recently returned from Mexico should be on alert for flu-like symptoms that could be connected to a severe respiratory illness, according to an advisory sent to health services across Canada.

The Public Health Agency of Canada contacted health and quarantine services on April 17 to inform them that Mexican health authorities had advised Canada to be on alert for possible infections.

A severe respiratory illness appears to have infected hundreds in south and central areas of Mexico, according to Mexican health officials.

The illness has killed at least 20 people in Mexico, mostly men between the ages of 25 and 44, according to a public advisory sent out by Canadian health authorities.

Hundreds of people have also reportedly been hospitalized and health-care workers have also been infected.

Officials said there are not yet any reports of the illness outside of Mexico.

The cause of the illness has not been confirmed. Mexican health officials said samples so far have tested positive for influenza A and B.

People infected with the virus initially suffer flu-like symptoms that include fever, cough, sore throat, muscle and joint pain and shortness of breath. The illness then elevates to a severe respiratory illness within about five days.

Anyone who has returned from Mexico within the last two weeks and is suffering similar symptoms is being asked to contact a physician.

Mexican health authorities said that many of those diagnosed with the illness have had to be put on ventilators.




MEXICO CITY .- The Ministry of Health yesterday began a siege of health hospitals in the Federal District before the alert for cases of influenza.

The outbreak of respiratory disease, which claimed 13 lives in the capital, changed part of the routine of the hospital, the staff began to be vaccinated, was suspended access to pregnant women, were canceled the medical students for 15 days, restricted visits and a few family members who entered were given masks.

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influenza kills 10 in one day
23/Apr/09Yesterday, only in the Instituto Mexicano del Seguro Social (IMSS) ten people died from SARS presumably caused by seasonal influenza virus, and six deaths were recorded in the Federal District.

Meanwhile, the Ministry of Health reported that in the present season (October to March) increased three times the number of probable and confirmed cases of influenza, compared with the two previous periods.

The report of the IMSS, in power Excélsior, reveals that on Friday, April 17 until 17:30 pm yesterday, only in units of the institute in the country, 28 people lost their lives for this cause.

The focus of the deaths in the capital of the Republic, where there are 17 deaths.

However, there is confusion among the authorities on the exact number of deaths. The Health Ministry has recorded 20 deaths since March 18 until yesterday morning.

Of these, 13 occurred as the SSA in the Federal District, four in San Luis Potosi, Baja California in two, and one in Oaxaca. Five of the deaths in Mexico City were between Saturday and Sunday.

Therefore, the federal agency has launched a national alert for a close surveillance of hospitalizations and deaths that could be associated with this disease. This is a “negative reporting”, which means that even hospitals that have had no cases to report.

Undersecretary for Prevention and Health Promotion, Mauricio Hernandez Avila, acknowledged that “unfortunately, the suffering will grow because there are serious patients who are tube and mortality in them is high.”

The official admitted that it is still uncertain what course to take the virus, or if already reached its maximum level of involvement.

“We still do not know what course you are taking this revival peak. We know more or less in one or two weeks, and we have to report to the entire network of hospitals that miss to walk, “he said.

However, the Ministry of Health as the IMSS insisted that people should not worry because there is no epidemic, and there is only a warning by the unprecedented phenomenon of cases of influenza are being presented during the off season. And both institutions ensured that health staff, we will have a high risk of infection, be fully protected.

-We do not want to cause panic, but we can not hide reality. Is there no epidemic or epidemic? he inquired.

– No, no epidemic! There is no epidemic of influenza! replied the undersecretary.

Health Secretary Jose Angel Cordova Villalobos, acknowledged that the federal government does not currently has enough vaccine in an emergency, but said that if necessary the purchase to prevent the evil from spreading.

He asked the Mexicans do not be alarmed by the outbreaks of influenza that have emerged in the country. “The call to people is that there is no panic, one must be careful if you have a respiratory problem, stay home and see your doctor so they can be cared for,” asked the Secretary of Health.

Faced with the possibility that this seasonal outbreak spreads faster in the country and killed more people, he clarified that this is not an epidemic, for it would affect more than five million inhabitants of the national population.

“A pandemic is when it extends to most of the population, we are talking about a five to ten by the way of the population,” he said.

However, he acknowledged that it is necessary to be in an epidemiological alert, so this unit will seek to obtain about 400 thousand vaccinations for health care, to prevent an outbreak among doctors and nurses to meet patients without any problem. It also specified that it applied throughout the winter 19 million vaccines, it denied that it is a failure in the vaccination campaign.

“It is an extension of the period of seasonal influenza, which normally ends in February, but we are seeing cases in March and April and most likely is related to an epidemic of United States and also generated some deaths and is the tail of the epidemic which is affecting us, “he said.

In an interview, Dr. James Zuno Echeverria, director of the IMSS medical benefits, said the outbreak of influenza “is not something that leads to a significant widespread alarm.”

“We simply need some more of that normally should take these times of year, but no alarm,” he said.

The official reported that the epidemiological surveillance system that implemented the special weekend in the IMSS to record probable influenza cases yielded more than 500 throughout the country over the past five days.

At a press conference, Deputy Secretary Mauricio Hernandez said that unlike previous years, the peaks where winter is in November and December, is now having an excess of cases during this April.

“Some cases are severe, that have caused deaths and hospitalizations. These are young adults, mainly because it is the group that did not vaccinate, “he explained.

This is because the people most vulnerable to contracting this disease are children under 36 months and older than 60 years.

On the origin of the outbreak, Hernandez said that the epidemic comes from United States, where it is already out. “This virus that comes down the stock, and the climate of why now we have this peak in April, we do not have clear, we do not know what the explanation, if the characteristics of moisture, dryness of the characteristics that are in the environment, “he said.

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Alert national influenza: Cordova

Mexico City .- The Ministry of Health launched a national epidemiological alert, even though the country is experiencing an epidemic or pandemic of influenza, despite the 20 deaths recorded in the national territory of the March 18 date, said the head of the agency, José Ángel Córdova Villalobos.

“It must be clear and it is important that everybody understands, this is no pandemic influenza, a pandemic is because when several thousand cases, stressed in an interview at the end of the First International Congress Towards Universal Coverage, in the Faculty of Medicine, UNAM.

What we are seeing, he said, are cases that were filed in March and April, which most likely are related to an epidemic that occurred in the United States also led to some deaths and “say it is the tail of the epidemic we are affecting us. ”

Therefore, the Secretary of Health, did the epidemiological alert to take into account this possibility and will pay close attention to people and went to the hospital availability of antiviral to be most affected is the ‘oseltamivir’ what if he had saved by the pandemic, well, although this is not a pandemic, the virus itself is sensitive to this drug but in some cases like United States, are taking more resistance. ”

Furthermore, it was made available to health care medicines, “cephalosporins” high generation because this is complicated with more severe respiratory problems like pneumonia. “And we are seeing the existence of any vaccine that has to begin to distribute mainly for health personnel.”

In this sense, Córdova Villalobos reported that influenza vaccine was used in practically the National Campaign, which used 19 million vaccines, however, because the number of probable cases of seasonal influenza have increased, others will be obtained 400 thousand to apply “for now”, which will cost 25 million pesos.

Meanwhile, he said, are increased measures of care between the medical staff to prevent transmission through the use of cubrebocas of gowns, hand washing, in fact “in the INER (Institute of Respiratory Diseases) is directing a flag for these special cases. ”

When questioned about if they have cases of influenza in the Federal District, the head of the country’s health policy said, “No, there has been a case in Oaxaca, San Luis Potosí we diagnosed eight cases.

In Mexico City, he added, are about 120 cases diagnosed so far, 9 of which were deaths.

Before, Mauricio Hernandez, Undersecretary for Prevention and Health Promotion, said that since March 18 began to observe an unusual increase of the disease and expressed concern about the increase in the number of deaths, which has been presented in a population group that usually “did not see, what we’re looking to see what is going on.”

He also reported Wednesday that until yesterday had been 13 deaths reported in Mexico City, 4 in San Luis Potosi, Baja California on 2 and one in Oaxaca.

Did not rule out raising the deaths because there are several patients hospitalized in serious situation which could not specify number.

“We know that deaths will increase because there are tube-severe patients, there is high mortality,” he said.

On this point, Hugo López-Gatell, director of epidemiology, said that one third of those who died were between 5 and 45 years old, an age group where it is not unusual presents daily deaths.

He indicated that from October 1, 2008, to March 1 this year 237 thousand were detected 7 cases of influenza in the country.

Questioned about the number of cases recorded so far in 2009, stated that the January 1 2009 to last April 17 were 4 thousand 157 cases.

Then, the undersecretary of Health, Mauritius Hernandez announced that 500 thousand to vaccinate workers in this sector, who have contact with patients.

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Alert national influenza; detected 22 cases in the city
23 April 2009

While the Ministry of Health issued a national alert to the 20 deaths recorded by seasonal influenza in the country in the first three weeks of April, which is considered unusual or atypical, local health authorities detected 22 cases in the city, mostly in children one to four years, so they decided to extend surveillance to May.

Roberto Suárez Pérez, an epidemiologist from the Sanitary Jurisdiction No. 2, reported yesterday that in total there were 72 suspected cases in the locality, some of which are still awaiting their results.

“This is talking about the flu, the influenza virus has circulated in our area and thus measures should be performed frequently,” he said.

In Mexico City the SS announced that more deaths occurred in the Federal District to 13 and soon found four San Luis Potosi, Baja California and Oaxaca, two on one.

Of the 20 deaths, 12 were men and 8 women, the third was between five and 45 years, a group regarded as somewhat vulnerable to influenza, and therefore was not vaccinated by the health sector during the winter season.

In contrast, in six months, from October 2008 to March 2009, only 30 people died from influenza, according to the agency.

Mauricio Hernandez Avila, assistant secretary for Prevention and Health Promotion, said that there is no cause for alarm, but the real extent of this problem is to know within two weeks, when it reaches the peak of the transmission.

SS indicated that in 2009 have been reported nationally just over 100 thousand probable cases and 313 of those were confirmed. Also there were 14 outbreaks of influenza in Veracruz, Baja California, Chihuahua and the Federal District.

In this city, Suárez Pérez noted that total 22 positive cases, thus warned to wash their hands frequently, avoid sudden temperature changes and not go to crowded places, measures should be applied because the disease is transmitted by a virus .

Consistent with the data made public by the Sanitary Jurisdiction No. 2, there were two cases of children under one year, 10 people in one to four years, seven from five to 14 years, as well as a group of 15 to 19 years, and two from 20 to 44 years.

Influenza is a respiratory tract disease caused by virus type A or B, and is different from that caused by common colds. However, both diseases have similar symptoms, but more severe when it comes to influenza.

One measure is to prevent coughing or sneezing with the mouth covered to prevent infection.

Seasonal influenza usually occurs in the winter, but with the ups and downs in temperature also began to occur in the spring time.

“We are doing surveillance in relation to seasonal influenza, particularly the approach we are awaiting the identification of persons having fever, headache, sore throat, runny nose or that somehow these people, given the developments in the clinical picture, develop a fever over 38 degrees Celsius, “explained epidemiologist interviewed yesterday.

He commented that in these cases the cough is usually dry and sometimes the patient has discomfort in the throat, difficulty breathing, intense headache, joint pain, muscle and chest.

“So this is the situation which is intensified surveillance on an annual basis and especially this season,” he said.

He said that in September 2008 was carried out mock influenza pandemic, which led to prepare and train health personnel in various institutions by providing something to prepare for and respond to such cases.

Explained that although the seasonality could be regarded as the prelude to the pandemic that has not been submitted.

Suárez Pérez said the communique issued after throughout the country for seasonal influenza, here is carried out to prevent and identify when a probable, sent samples to the laboratory for diagnostic confirmation or their discards.

He emphasized that in Juárez since October last year began monitoring because it is the cold season when they can develop the condition.

It was in April when the observation, but this will continue until next month because the weather conditions and new cases appeared.

He added that with the low temperatures, the conditions are conducive to beating the virus in circulation.

“The overcrowding contributes to the task is transmitted by coughing and sneezing and is where the particles are quite likely that if we are not wash hands before consuming any food or touching someone else, can be carry the virus, “he said.

At this border, three units of special attention are given to the task of identifying persons with acute respiratory illness, which is the main cause of demand for care in the community since last year alone, based on preliminary data, there were 189 thousand 250 IRAS.

Buildings where rapid testing for influenza is the Health Center B (located in Vicente Guerrero and Juarez) and the Centers for Advanced Primary Health Care (CAAPS) Anapra of Saragossa and eagles.

This, he pointed out, is a measure to know that the virus is circulating in the community and not just stay with the idea that there is a process of viral type.

A surveillance of seasonal influenza joined other medical institutions.

In this regard, which spoke of the 72 cases were identified from October to date, 22 were positive, those who underwent medical treatment and thus isolated.

“This is talking about the influenza virus has been circulating in our area and therefore there are steps to do so frequently,” he said.

Epidemiologist asked to avoid going to sites with high concentration and maintaining hygiene. “If a person comes to have respiratory problems should avoid the kiss of greeting because many times someone brings their runny nose, cough and brings close to someone else, he shares the virus.

One of the measures to prevent evil, is the vaccination of all children under 5 years and to complement your scheme.

But they must also be immunized older adults, with children who are an extreme age population that requires more care.

“We know the complications of influenza virus infection can sometimes be pneumonia or bronchopneumonia and have other associated disease such as diabetes or smoking, is likely to be complicated,” he said.

Suarez stressed that depends on the immunological condition of the person, while stressing that the period of contagion is between two and five days.

To identify opportunities for someone with seasonal influenza, there is if they have complications of breath, runny nose, chest pain, abdominal muscles and the headache, and mood very decayed.

In this regard, said that children under five years are often irritable because they have a headache, but do not know how to express that discomfort and that is why they share that.

“If the child walks with tears, unbearable, then it may be one of the data to guide us,” he said.

Epidemiologist from the Sanitary Jurisdiction # 2 explained that there are three types of influenza: the seasonal, which is the cooling time, the avian is identified in birds and the other is the pandemic, which has not been submitted.

With regard to the influenza pandemic that is affecting your property several countries and continents.

Explained that there are several viruses, each of which has certain features that make the same change and mute when it leads to become more resistant, have greater capacity to be easily identified and therefore can not be reached to have a specific drug to its attention.

He commented that in Asia and has been the mutation of the virus from birds to humans, has been able to disease transmission.

“This has not been seen here, has been in Asia, has not been given the status of a virus of birds is in the best position to get to the human virus to replicate and is easily transmitted from human a human, “he said.

The seasonal, said that once the virus reaches the person, the foreign agent generates an immune response.

“The answer may be that the patient begins to cough and the virus was doing to his body, he found time for replication, as we understand their growth and development,” he said.

Therefore the activated cough, secretions are removed, which are viruses, which are microparticles.

Epidemiologist asked to avoid self-medication and seek medical advice as soon as a situation with the above characteristics.

Mauricio Hernandez Avila, assistant secretary for Prevention and Health Promotion of the SS, said that the number of deaths due to influenza will grow in the coming days in the country because there are serious patients who are tube and mortality in them is high.

Even the federal government dip into the reserve of antiviral protection and materials purchased years ago to be prepared should be presented in Mexico bird flu.

Miguel Angel Lezana, director of the National Epidemiological Surveillance Center, reported that it provides the health staff of the lens or N95 masks, gloves, gowns and alcohol gel, as well as antiviral.

“We have more than one million treatments and believe that we will actually use less than one percent,” he said.

(Miguel ángel Lezana, director del Centro Nacional de Vigilancia Epidemiológica, informó que se dotará al personal de salud de los lentes o máscaras N95; guantes, batas y alcohol gel; así como de antivirales.)

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