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H
1N1 Spreads to Puebla Near Mexico City
Recombinomics Commentary 18:50
April 1, 2011

The Mexican state of Puebla, east of the capital, three cases of influenza A H1N1, officials said.

Chedraui Jorge Aguilar, head of the state Health Department confirmed the cases as part of a resurgence of the disease.

The above translation describes the confirmation of the cases of H1N1 in Puebla, just east of Mexico City, raising concerns that the H1N1 will rapidly spread in the capital. 

The emergence of h1n1 at this time of the year is unusual because the flu season in Mexico was ending.  H3N2 dominated but peaked in late 2010 and the level of influenza was low and declining prior to the recent upsurge, first reported in Juarez in Chihuahua.  Similarly, influenza levels in the United States were also declining and the H1N1 in the US did not produce high levels of H1N1 in northern Mexico.

The surge in cases at this time of year matches events in 2009 when the H1N1 pandemic emerged between mid-March and early April.  Like 2011, the initial cases were difficult to characterize and cases were diagnosed as atypical pneumonia.

Although lab confirmations are still problematic, the atypical pneumonia cases generate a high hospitalization and death rate raising concerns that the H1N1 has significantly evolved and is now harder to detect and is producing more severe illness.

The CDC has withheld 2011 H1N1 sequence from the US, and Mexico has not released sequences from recent severe and fatal cases.

The time for release of these sequences is long overdue.

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