On March 3rd, Veratect got a report of a Canadian man returning from Mexico who was hospitalized with severe respiratory distress. It ended up that this case tested negative.
However, the timing was providential because it drew Veratect's attention to a high incidence of unusual and severe respiratory diseases in the area and so they began monitoring.
By April 6th, they were alerted to the LaGloria outbreak, (which involved some 1,800 cases) which a local health official had been seeking assistance for since FEBRUARY! Local officials finally attempted to contain the spread from LaGloria.
By April 10 or 11, the CDC, PAHO, and WHO had accessed Veratect's report.
By April 16, cases in Oaxaca were also reported to these agencies who basically sat on the information for 3 weeks. Veratect's most recent press release states: "Since April 16, Veratect analysts have issued more than 100 alerts of suspect respiratory and influenza illnesses arising from this event.”
Who got these reports? Emergency Operations Center and Global Disease Detection Center at the Centers for Disease Control and Prevention as well as to WHO, the International Federation of Red Cross (IFRC), and several other state and foreign governments as well as NGO and other non‐governmental public health entities.
Basically it's either tale of some people under-estimating the potential severity of this influenza or/and some actively covering it up.
Tasha Tchin made a very astute connection about the timing of this outbreak and Mexico's lack of reportage in her comments on Biosurveillance, [scroll to the bottom for the comments],
"Considering the bad economy and scarce tourist dollars, could it be the case that the Mexican gov't didn't want to know about an epidemic BEFORE the Spring Break vacationers had a chance to spend their tourist dollars? If the Mexican gov't had taken steps to contain the problem much earlier, the traveling public would have been alerted long before spring break and most wouldn't have allowed their kids travel to Mexico."
Tasha, these are chilling thoughts.
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Stephanie,
ReplyDeleteSome clarifications are needed here:
1. We ourselves did not actually think there may have been a problem in Mexico on March 30th. We reported the traveler, but that was it.
2. We sent email notifications to CDC (only, not WHO because the group in CDC we were talking to already talk frequently with their WHO counterparts) on April 16th and again on April 17th- there were 2 emails, not 100 emails.
3. On April 20th, I called CDC's Emergency Operations Center to notify them of the problem in Mexico. They reacted immediately and without hesitation to better understand the situation there. WHO, I'm sure, was notified almost immediately or were already aware at that point.
4. I see no evidence whatsoever of a cover-up but rather an event that caught everyone- the world's experts- by surprise.
Hope this helps us better understand the detection and alerting timeline of swine flu.
Cheers,
James Wilson, MD