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Commentary
Death Cluster In El Paso Texas Raises H1N1 Pandemic Concerns
Recombinomics
Commentary 19:10
April 24, 2011
The recent spike in pneumonia and influenza (P&I) deaths in El Paso, Texas has raised pandemic concerns. The 19 deaths in week 14 was one shy of the highest week for El Paso in the past 15 years, and the 24 deaths in week 15 set a new weekly record. Moreover, the 43 deaths in the two weeks were well above the record of 17 deaths for weeks 14 and 15. The recently confirmed H1N1 death in El Paso provides additional support for the linkage of this cluster to the H1N1 deaths across the border in Juarez in Chihuahua, Mexico, as do reports that one of the first cases in Juarez was an El Pasoan, as noted above.
The historic spike in fatal cases comes at a time when the flu season is winding down in Texas and Chihuahua and raises pandemic concerns that a more lethal variant will become dominant. Two of the eight Chihuahua sequences, from upper respiratory tract (pharyngeal) samples had D225N, which was rarely detected previously. Moreover anecdotal reports indicate that at least five of the Chihuahua sequences that have yet to be released also have D225N, which might explain other anecdotal reports of patients presenting with nose bleeds and breathing difficulties at emergency rooms in northern Mexico (Chihuahua and Nuevo Leon).
The spike in deaths has not been addressed by the El Paso Department of Health or the CDC. Recently released sequences indicate the Chihuahua sub-clade is widespread in the United States and recent travel to Chihuahua will likely increase the spread as Easter travelers return home.
More detail on the deaths in El Paso and release of the sequences from these patients, as well as the Chihuahua sequences with D225N, would be useful.
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