Mexico News and Analysis: April 27-May 3, 2009

1.  Inter-American Court hears femicide case
2.  Influenza Update

1.  Inter-American Court hears femicide case
2.  Influenza Update



1. Inter-American Court hears femicide case
The Inter-American Human Rights Court (CIDH), part of the Organization of American States (OEA), heard evidence this week accusing Mexican authorities of failing to prevent femicides in Ciudad Juarez.  This is the first international tribunal to hear a case addressing any of the almost 500 young women murdered in Ciudad Juarez over the past 15 years.  Mothers of three victims found in an abandoned cotton field across the street from the Ciudad Juarez Maquiladora Association presented compelling testimony before the court, held in Santiago, Chile.  State and federal authorities denied all charges the following day, claiming that the three cases in question would be solved shortly.  The three victims were discovered along with the bodies of five unidentified women in 2001, and to date there has been no progress in the cases.  The past twelve months has seen the worst rash of femicides in Ciudad Juarez since NGOs began to track the murder of women in 1993. 


2. Influenza Update
This evening, Mexico’s Secretary of Health reported 590 confirmed cases of A/H1N1 influenza in Mexico, an increase from previous days largely because of increased testing capabilities.  Mexican laboratories can now test about 500 samples per day, and more than ¾ of the suspected cases test negative.  Hospitalizations for suspected influenza have decreased during the past two days in Mexico City and there have been no reported deaths in the past four days, apparently because suspected cases are receiving early treatment with common influenza medications.  The number of confirmed deaths attributable to A/H1N1 stands at 22, largely from untreated cases that developed into pneumonia or other complications.  Doctors visited the homes of 87 patients who died in recent weeks of possible influenza and interviewed 287 family members, of which four required medical treatment.  Most patients hospitalized because of A/H1N1 have been recovered, likely due to the fact that this strain of influenza is similar to other known strains.  Dr. Peter Palese, a leading flu researcher at New York’s Mount Sinai Medical School, said the new virus appeared to be similar enough to other common flu strains that “we probably all have some type of immunity.” 

On Thursday, Secretary of Health Jose Angel Cordova said, “I think, given the evolution this is having, given the full recovery we are seeing with treatment, there is reason to be calmer, there’s reason to think that this can be solved quickly and well,” he said. “We simply have a new virus with what is fortunately a low mortality rate ... so I think this problem will be resolved favorably.” And on Sunday morning, Cordova reported that the outbreak appears to have peaked between April 23 and 28.  "The evolution of the epidemic is now in its phase of descent," he told a morning news conference, citing decreasing numbers of new cases and fewer hospital visits for influenza symptoms. 

US authorities agreed, expressing increasing confidence that the virus is not as virulent as originally thought.  "What I can say is that we're seeing encouraging signs," said Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention. "That makes us all very happy . . . When we get a virus we look to see: Does it relate to any other viruses?" Besser said. "And then we look for things that are called virulence factors, those things that in the past have been linked to more severe disease. And what we've found is that we're not seeing the factors that were associated with the 1918 pandemic" that claimed millions of lives.  In the US there are currently 226 confirmed cases in 21 states, and at least 903 confirmed cases worldwide.  Dr. Anne Schuchat, the interim Deputy Director for Science and Public Health at the Centers for Disease Control and Prevention, said the virus was “circulating all over” the United States.  “The virus has arrived, I would say, in most of the country now,” she added.  Most cases have been mild, but 30 people have been hospitalized.  Only one US death has been attributed to the A/H1N1 virus, in Texas. 

Despite the optimistic statements from health officials, the emergency is not over.  The virus may still flare up in other areas and there is always a concern that the virus could mutate into a more virulent form. 

Influenza is a common ailment (though the current strain is new) that affects much of the world’s population, particularly during winter months.  250,000-500,000 worldwide die each year from the seasonal flu.  On average, there are 36,000 deaths and more than 200,000 hospitalizations each year in the US.  People infected with influenza are contagious from the day before they develop symptoms until seven days afterwards.  Influenza typically strikes in the Northern hemisphere from November to May, and this strain may disappear with Summer climate changes, as do most influenza strains. 

Despite some unfortunate and unfounded claims by Vice President Joseph Biden, health authorities are not discouraging travel unless the traveler is sick. 

Mexico Solidarity Network Study Abroad students

Fifteen students from our Spring study abroad program left Mexico between Aril 29 and May 1.  None of the students were ill upon departure and none have reported influenza symptoms since returning to the US.  There may have been one case of influenza among the students in early April, before health authorities became aware of the A/H1N1 virus.  Symptoms were typical of influenza and included fever, body aches and a sore throat.  The symptoms were mild and the student recovered within 48 hours.  We have no way of confirming whether or not this case involved A/H1N1, or another more common strain of influenza, or some other illness.  Most cases of suspected A/H1N1 virus have turned out to be seasonal influenza. 

This Summer, the Mexico Solidarity Network has programs scheduled from June 7 to August 1 in Chiapas, Tlaxcala and Mexico City, and from June 14 to July 4 in Ciudad Juarez.  Unless we receive new information concerning increased risk for students, we will maintain these scheduled programs.  We ask that students who present influenza symptoms before leaving the US delay their departure for Mexico until three days after the symptoms clear up.  We will carry sufficient Tamiflu and/or Relenza to treat all of our students, if need be, and always under the guidance of local physicians.  We will take a daily health survey with all students as a preventative measure.  Early detection of symptoms is important if influenza medicines are to be effective.   

The health and safety of our students is of the highest priority, and we continue to monitor the health situation in Mexico on a daily basis.  If the health situation changes for the worse and we cancel the summer programs, we will provide a full refund to all students.   

Treatment

There are currently no vaccines available to protect from infection.  Health officials expect vaccines to be available within three to six months.  However, according to the World Health Organization: 

The viruses obtained from the recent human cases with swine influenza in the United States are sensitive to oselatmivir and zanamivir but resistant to amantadine and remantadine.  

Health officials in Mexico report successful treatment of A/H1N1 influenza with oselatmivir (Tamiflu or Relenza). 

World Health Organization

Last Wednesday, the World Health Organization (WHO) raised the level of influenza pandemic alert from phase 4 to 5.  The most recent WHO update states: 

3 May 2009 -- As of 1600 GMT, 3 May 2009, 18 countries have officially reported 898 cases of influenza A(H1N1) infection. 

Mexico has reported 506 confirmed human cases of infection, including 19 deaths. The higher number of cases from Mexico in the past 48 hours reflects ongoing testing of previously collected specimens. The United States Government has reported 226 laboratory confirmed human cases, including one death. 

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (85), China, Hong Kong Special Administrative Region (1), Costa Rica (1), Denmark (1), France (2), Germany (8), Ireland (1), Israel (3), Italy (1), Netherlands (1), New Zealand (4), Republic of Korea (1), Spain (40), Switzerland (1) and the United Kingdom (15).  

Further information on the situation will be available on the WHO website on a regular basis.  

WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities. 

History of the virus

The new strain of influenza, H1N1, contains genetic material from swine, birds and humans.  While the much of the media is dubbing this the “Mexican swine flu,” there is strong evidence the H1N1 virus began in the US, while Mexico, a third world country with an inadequate health care system, is bearing the brunt of the influenza spread.  “A preliminary analysis of the virus isolated from cases in California and Texas reveals that six of the eight viral gene segments arose from North American swine flu strains circulating since 1998, when a new strain was first identified on a factory farm in North Carolina” (Dr. Michael Greger, Director of public health for the US Humane Society).  In an article published on April 29, 2009, Dr. Greger explains the development of the current swine flu in detail: 

In August 1998, a barking cough resounded throughout a North Carolina pig factory in which all the thousands of breeding sows fell ill. A new swine flu virus was discovered on that factory farm, a human-pig hybrid virus that had picked up three human flu genes. By the end of that year, the virus acquired two gene segments from bird flu viruses as well, becoming a never-before-described triple reassortment virus—a hybrid of a human virus, a pig virus, and a bird virus—that triggered outbreaks in Texas, Minnesota, and Iowa. 

Within months, the virus had spread throughout the United States. Blood samples taken from 4,382 pigs across 23 states found that 20.5% tested positive for exposure to this triple hybrid swine flu virus by early 1999, including 100% of herds tested in Illinois and Iowa, and 90% in Kansas and Oklahoma. According to the current analysis, performed at the Columbia University's Center for Computational Biology and Bioinformatics, it is from this pool of viruses that the current swine flu threat derives three-quarters of its genetic material.

Tracing the Origins of Today's Virus

Since the progenitor of the swine flu virus currently threatening to trigger a human pandemic has now been identified, it is critical to explore what led to its original emergence and spread. Scientists postulate that a human flu virus may have starting circulating in U.S. pig farms as early as 1995, but "by mutation or simply by obtaining a critical density, caused disease in pigs and began to spread rapidly through swine herds in North America. [emphasis added]" It is therefore likely no coincidence that the virus emerged in North Carolina, the home of the nation’s largest pig production operation. North Carolina has the densest pig population in North America and reportedly boasts more than twice as many corporate pig mega-factories as any other state. 

The year of emergence, 1998, was the year North Carolina's pig population hit ten million, up from two million just six years earlier. Concurrently, the number of pig farms was decreasing, from 15,000 in 1986 to 3,600 in 2000. How can five times more animals be raised on almost five times fewer farms? By crowding about 25 times more pigs into each operation. In the 1980s, more than 85% of all North Carolina pig farms had fewer than 100 animals. 

By the end of the 1990s, operations confining more than 1,000 animals controlled about 99% of the state's pig population. Given that the primary route of swine flu transmission is thought to be the same as human flu—via droplets or aerosols of infected nasal secretions[13]—it's no wonder experts blame overcrowding for the emergence of new flu virus mutants. 

Intensive Crowding and Long-Distance Transport

Starting in the early 1990s, the U.S. pig industry restructured itself after Tyson's profitable chicken model of massive industrial-sized units. As a headline in the trade journal National Hog Farmer announced, "Overcrowding Pigs Pays—If It's Managed Properly." The majority of U.S. pig farms now confine more than 5,000 animals each. A veterinary pathologist from the University of Minnesota stated the obvious in Science: "With a group of 5,000 animals, if a novel virus shows up it will have more opportunity to replicate and potentially spread than in a group of 100 pigs on a small farm." 

Dr. Robert Webster, one of the world's leading experts of flu virus evolution, blames the emergence of the 1998 virus on the "recently evolving intensive farming practice in the USA, of raising pigs and poultry in adjacent sheds with the same staff," a practice he calls "unsound." North Carolina is also one of the nation's largest poultry producers, slaughtering nearly three-quarters of a billion chickens and confining enough hens to produce nearly 3 billion eggs. 

Once the new viral mutant appeared in 1998, the rapid dissemination across the country has been blamed on long-distance live animal transport. In the United States, pigs travel coast to coast. They can be bred in North Carolina, fattened in the corn belt of Iowa, and slaughtered in California. While this may reduce short-term costs for the pork industry, the highly contagious nature of diseases like influenza (perhaps made further infectious by the stresses of transport) needs to be considered when calculating the true cost of long-distance live animal transport. 

"A Recipe for Disaster"

The remaining two gene segments of the H1N1 swine flu virus now spreading in human populations around the world appear to come from a swine flu viral lineage circulating in Eurasia, where similar conditions may be to blame. "Influenza [in pigs] is closely correlated with pig density," said a European Commission-funded researcher studying the situation in Europe. As such, Europe's rapidly intensifying pig industry has been described in Science as "a recipe for disaster." Some researchers have speculated that the next pandemic could arise out of "Europe's crowded pig barns." In Europe in 1993, a bird flu virus had adapted to pigs, acquiring a few human flu virus genes and infected two young Dutch children, displaying evidence of limited human-to-human transmission. 

The European Commission's agricultural directorate warns that the "concentration of production is giving rise to an increasing risk of disease epidemics." Concern over epidemic disease is so great that Danish laws have capped the number of pigs per farm and put a ceiling on the total number of pigs allowed to be raised in the country. No such limit exists in the United States. 

Warnings Unheeded

The public health community has been warning about the risks posed by factory farms for years. More than five years ago, in 2003, the American Public Health Association, the largest and oldest association of public health professionals in the world, called for a moratorium on factory farming. In 2005, the United Nations urged that "[g]overnments, local authorities and international agencies need to take a greatly increased role in combating the role of factory-farming," which, they said, combined with live animal markets, "provide ideal conditions for the [influenza] virus to spread and mutate into a more dangerous form." 

Last April, the Pew Commission on Industrial Farm Animal Production released its final report. The prestigious, independent panel chaired by a former Kansas Governor and including a former U.S. Secretary of Agriculture, former Assistant Surgeon General, and the Dean of the University of Iowa College of Public Health, concluded that industrialized animal agriculture posed "unacceptable" public health risks: "Due to the large numbers of animals housed in close quarters in typical [industrial farm animal production] facilities there are many opportunities for animals to be infected by several strains of pathogens, leading to increased chance for a strain to emerge that can infect and spread in humans." 

Specific to the veal crate-like metal stalls that confine breeding pigs like those on the North Carolina factory from which the first hybrid swine flu virus was discovered in North America, the Pew Commission asserted that "[p]ractices that restrict natural motion, such as sow gestation crates, induce high levels of stress in the animals and threaten their health, which in turn may threaten human health." Unfortunately we don't tend to "shore up the levees" until after the disaster, but now that we know swine flu viruses can evolve to efficiently transmit human-to-human we need to follow the Pew Commission's recommendations to abolish extreme confinement practices like gestation crates as they're already doing in Europe, and to follow the advice of the American Public Health Association to declare a moratorium on factory farms. 

A "Reservoir of Viruses" in the U.S.

With massive concentrations of farm animals within whom to mutate, these new swine flu viruses in North America seem to be on an evolutionary fast track, jumping and reassorting between species at an unprecedented rate. This reassorting, Webster's team concludes, makes the 65 million strong U.S. pig population an "increasingly important reservoir of viruses with human pandemic potential. We used to think that the only important source of genetic change in swine influenza was in Southeast Asia," said Christopher Olsen, a molecular virologist at the University of Wisconsin, Madison. Now, "we need to look in our own backyard for where the next pandemic may appear."