The Discovery of the 2009 A/H1N1 Pandemic - Mexico: April 17 New Respiratory Illnesses - Including Mexico City & Oaxaca

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Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

This illness is not confined to Mexico. We likely have international spread. This article is from Canada (again - why no US sources?)

http://www.newsdurhamregion.com/news/life/article/124690

Local hospitals watching for Mexican flu-type illness
Local hospitals watching for Mexican flu-type illness

Local hospitals are keeping a lookout for a flu-type illness which has led to deaths in Mexico and the hospitalization of one Rouge Valley patient in Scarborough.Map data ©2009 Tele Atlas - Terms of UseMapSatelliteHybridTools
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One patient being monitored at Rouge Valley Centenary hospital in Scarborough
Apr 23, 2009 - 03:22 PM

By Reka Szekely

DURHAM -- Local hospitals are keeping a lookout for a flu-type illness which has led to deaths in Mexico and the hospitalization of one Rouge Valley patient in Scarborough.

Ministry of Health officials are asking hospitals to watch for severe respiratory illnesses in patients recently returned from Mexico and report incidences to the local medical officer of health. Patients who fit a list of criteria released by the MOH are to be isolated.

Dave Brazeau, a spokesman for Rouge Valley Health Systems, said a bulletin regarding the illness has gone out.

"We shared that with all of our staff at both of our campuses," he said.

There have been no cases at the Ajax site, though a patient is under watch at the Scarborough Centenary Hospital.

"At this point, this patient is being closely monitored related to that alert," said Mr. Brazeau.

Since SARS, hospitals have been screening patients with flu-type illnesses; they've now added Mexico to the list of places to look out for, said Helen Gibson, director of infection prevention and control for Lakeridge Health. There are no cases at the Lakeridge hospital.

Ms. Gibson said all staff were notified on Tuesday about the situation and signs have gone up around the hospital as well. All patients admitted are asked if they've recently been to Mexico, since the country's south and central areas are a hot pocket for the illness.

"Which is hugely problematic because it's a tourist area and we know lots of people from Durham Region travel down to Mexico for vacation."

The ministry said the Mexican cases involved flu-like symptoms which rapidly became severe respiratory distress in about five days with many patients requiring ventilation. Some have died and most cases have occurred in previously healthy young adults aged 25 to 44.

Some samples have tested positive for A and B flu viruses, but it's unknown whether they're linked or the cases represent isolated incidents. The ministry said there is no evidence to suggest infection with an unusual pathogen including a novel strain of flu.

Ms. Gibson stressed that since the illness reportedly acts very quickly, people shouldn't ignore symptoms.

"What we'd really want to encourage people to do, if they have the fever, the chills, the coughs, they really need to plan on getting health care as quickly as possible," she said.

 

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Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Another Canadian source. At least the PAHO is getting involved.

http://www.google.com/hostednews/canadianpress/article/ALeqM5hKrwlM2yh12pNDe6_7gtuplU31Fw

TORONTO ? Public health units, quarantine officers and medical practitioners across the country have been warned to be on guard for cases of a mystery illness in Canadians returning from Mexico.

The warning follows reports from that country of cases of severe respiratory illness, which in some cases has led to death.

Mexican authorities have insisted the outbreak is not an epidemic and that preventive measures are being taken to reduce the risk of transmission of disease.

Mexican authorities informed Canadian counterparts about the situation on April 17, asking for help with their investigation. Scientists at the National Microbiology Laboratory in Winnipeg are assisting in efforts to determine the cause or causes of the illnesses.

"We are aware of the reports and are looking into them," said Andrew McDermott, a spokesperson for the Public Health Agency of Canada.

It's not clear if there is any link between these illnesses and the recent discovery of several human cases of swine flu infection in California.

Dr. Arlene King, who is the Public Health Agency of Canada's point person for pandemic influenza preparedness, said samples from Mexico will need to be studied to see if there is any link.

King, who was named Ontario's new chief public health officer on Thursday and takes on the job in mid-June, said it is important to be on the lookout for new infectious disease outbreaks.

"We absolutely have to remain vigilant in the country around the situation in Mexico and globally," said King, who is director general of the public health agency's centre for immunization and respiratory infectious diseases.

"We need to be prepared for any emerging infectious disease threat that may occur outside of our borders. It's absolutely fundamental."

A spokesperson for the Pan American Health Organization - the World Health Organization's Americas branch - said PAHO is also working with Mexican authorities to look into the reports.

"We're co-operating with (Mexican) authorities on it," Donna Eberwine-Villagran said from Washington.

"We have people in our field office in Mexico City and also in our border office working with Mexican authorities looking at the cases."

The illnesses are said to have been occurring in south and central Mexico and involve mainly young, previously healthy adults. Some reports have suggested health-care workers have become ill.

To date, two clusters of severe respiratory infections with death have been reported in April, one in Mexico City and one in San Luis Potosi. Mexico City has reported 120 cases including 13 deaths while San Luis Potosi, in central Mexico, has reported 14 cases including four deaths.

In addition there has been a death reported in Oaxaca, in southern Mexico and two deaths reported in Baja California Norte, which borders California.

Health authorities have been told some of the cases have tested positive for influenza, but some cases are influenza A and others are influenza B.

A leading infectious diseases expert said a number of pathogens could be the culprit or culprits.

"It could be anything," said Dr. Allison McGeer of Toronto's Mount Sinai Hospital. "Full range from new and unidentified virus to stuff that goes on every day and somebody just did a test."

She added, though that it was "improbable" that the illness was being caused by anything exotic and was most likely the work of influenza or an adenovirus.

An advisory from Toronto Public Health to health professionals said that given the severity of the illness, health care workers should be actively looking for cases of severe respiratory infection in people who have been in Mexico in the previous two weeks.

But the advisory stressed that there is no evidence the infections are caused by an unusual pathogen or a novel flu strain.

Mexican health officials held a news conference Wednesday to discuss the situation, putting the surge in illnesses down to end-of-season flu activity.

Mauricio Hernandez Avila, the undersecretary for health prevention and promotion, said the health department had initiated an active search for cases of serious pneumonia associated with the illness in the country, especially in the federal district that encompasses Mexico City.

 

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Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

http://toronto.ctv.ca/servlet/an/lo...o_illness_090423/20090423/?hub=TorontoNewHome

Canadians told to be on alert for Mexico illness
Updated: Thu Apr. 23 2009 4:02:06 PM

CTV.ca News Staff

A mysterious and "severe" respiratory illness has surfaced in parts of Mexico and may be affecting some Canadians who recently vacationed there.

Canadians who have recently returned from Mexico are being warned they should be on alert for severe flu-like symptoms that could be connected to the illness, says an advisory sent by the Public Health Agency of Canada to health services across Canada.

While the chances that this is a new pandemic are "pretty low," health officials are still treating the outbreak seriously, said Alison McGeer, an infectious disease specialist at Toronto's Mount Sinai hospital.

"At the other end, is the possibility that this is a new virus that we haven't before described," she told CTV Newsnet Thursday.

"But one of the things we've committed to around the world is enhanced surveillance and being really sure that we don't miss these new viruses," she said.

Since respiratory illnesses have short incubation periods, travellers who get sick two weeks after returning from Mexico shouldn't worry, said McGeer.

However, if you've recently returned from Mexico and have a severe fever, cough and respiratory problems, you should let a doctor know of your travels so experts can map out different flu strains, added McGeer.

PHAC contacted health and quarantine services on April 17 to inform them that Mexican health authorities had advised Canada of possible infections. PHAC has told Canadian quarantine services to be on alert for travellers returning from Mexico showing signs of illness.

The mystery illness has infected hundreds in south and central areas of Mexico, according to Mexican health officials, killing some and leaving others on ventilators. The Mexican health secretary has issued a national alert, following reports of numerous influenza deaths in the first three weeks of April.

The flu-like condition has so far affected healthy young adults between the ages 25 and 44. The victims showed influenza-like symptoms that progressed to "severe respiratory distress" within five days. Some health care workers have been affected.

Health officials say some specimens collected from the patients have tested positive for influenzas A and B.

The illness appears to have infected hundreds in south and central areas of Mexico, but not the tourist areas on the coast. According to a report in a Spanish-language newspaper in Mexico, the regions affected include: the capital region; San Luis Potos?; Oaxaca; and Baja, California.

At this point, no cases have been confirmed outside of Mexico. The Pan American Health Organization, the Americas branch of the World Health Organization, says it is working with Mexican authorities to monitor the situation.

Anyone who has returned from Mexico within the last two weeks and is suffering the following symptoms should contact a physician:

fever
cough
sore throat
shortness of breath
muscle and joint pain
McGeer said that health officials have become increasingly vigilant over the past decade in tracking down new illnesses.

"SARS taught us that it can take a very little time to move a virus all around the globe," she said.

Infectious disease specialist Dr. Neil Rau told CTV Newsnet that it appears that the illnesses in Mexico are simply seasonal flu illnesses, though virological and epidemiological studies are being conducted.

"In a few days, we will have more information after more lab tests are done," he said.

"The outstanding question is whether this is a more severe form of the garden-variety flu. The word pandemic certainly isn't being used yet. And a 'new virus' is not coming into the vernacular yet either."

At a press conference Wednesday, the Mexican undersecretary for Health Prevention and Promotion, Mauricio Hern?ndez ?vila said that while this year's flu season is stretching into April, the flu cases do not appear to indicate an epidemic.

He noted that the cases appearing in young people may be a consequence of the fact that many of these people did not get the flu shot, which is typically given to children and the elderly, the highest risk groups.

Rau said he doesn't think this illness report should deter any Canadians from travelling to Mexico, but they should consult a travel health clinic at least six weeks before they travel.

"At this point, people going to Mexico should think about getting the flu shot, if they haven't had one already. But I don't think there is any preventative measure they can take unless Canada issues a travel alert saying not to go."

 

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Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

And now a Mexican source. This article says 30% of those with this illness are in intensive care. This isn't seasonal flu. If you're feeling ambitious, read the comments at this link. The mexican people aren't buying the cover story.

http://www.eluniversal.com.mx/notas/593119.html

There are 70 DF cases with symptoms of influenza
Armando Ahued, secretario de Salud capitalino, recomend? a la ciudadan?a que ante casos de gripa intensa acudan al m?dico para descartar o confirmar los cuadros cl?nicos Armando Ahued, secretary of health capital, advised the public that in cases of intense cold go to a doctor to rule out or confirm the clinical






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Digg Digg Del.icio.us Del.icio.us Men?ame Men?ame Yahoo Yahoo Technorati Technorati Facebook Facebook ?Qu? es esto? What is this?








Sindicato garantiza vacunas para personal de Salud 13:25 Union reaction to personal health 13:25

Ssa llama a la calma ante brote de influenza 11:47 Ssa called for calm before the outbreak of influenza 11:47

Hay pocas vacunas y ser?n para m?dicos 11:47 There are a few shots and will be for doctors 11:47

?Pega? al pa?s brote at?pico de influenza 11:47 "Paste" to the country outbreak of atypical influenza 11:47

Vacunas contra influenza, s?lo para personal m?dico 2009-04-22 Influenza vaccine, only to medical staff 2009-04-22







Gr?fico Influenza Figure Influenza

Ent?rate ?Qu? es la influenza y c?mo prevenirla? Find out What is influenza and how to prevent it?

La influenza : tipos de virus Influenza: virus types

La influenza : vacuna y contraindicaciones Influenza: vaccination and contraindications

La influenza : del estornudo a la muerte Influenza: the sneeze to death






Comenta la nota The note says Comentarios (4) Comments (4)


Edith Mart?nez Edith Martinez
El Universal El Universal
Ciudad de M?xico Jueves 23 de abril de 2009 Mexico City Thursday April 23 2009
12:52 El secretario de Salud del Distrito Federal, inform? que se tienen identificados 70 casos compatibles con los s?ntomas de la influenza, de los cuales 30% se encuentran en terapia intensiva de los hospitales de la ciudad de M?xico. 12:52 The Health Secretary of the Federal District, reported that it had identified 70 cases with symptoms of influenza, of which 30% are in intensive care in hospitals in Mexico City.

Armando Ahued se?al? que se realizan los estudios necesarios para determinar el n?mero exacto de las personas enfermas con este virus. Armando Ahued noted that surveys are conducted to determine the exact number of people sick with the virus.

Sin embargo, descart? que la influenza sea una epidemia en el pa?s e insisti? en que se trata de un alargamiento "at?pico" de la enfermedad. However, denied that an influenza epidemic in the country and stressed that this is a stretch "atypical" of the disease.

Recomend? a la poblaci?n que ante casos de gripa intensa acudan al m?dico para descartar o confirmar los cuadros cl?nicos de influenza. Recommended to people in cases of intense cold go to a doctor to rule out or confirm the clinical influenza.

Reiter? que las vacunas se aplicar?n s?lo al personal m?dico y pidi? a la ciudadan?a extremar precauciones cobre todo en ni?os y adultos mayores, grupos con mayor vulnerabilidad ante esta enfermedad. He reiterated that vaccines will apply only to medical personnel and requested the public to exercise extreme precaution copper in children and the elderly groups most vulnerable to this disease.

 

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Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Another Mexican source. This one attributes this outbreak to many different illnesses. That's a bad lie, as we have almost no known illness (excpet maybe SARS) that is clinically compatible with these illnesses.

http://sdpnoticias.com/sdp/contenido/2009/04/23/382215

City has 79 cases and 13 deaths related to influenza
Hoy 15:10 ? Today 15:10 --
M?xico, 23 Abr (Notimex).- El secretario de Salud del Distrito Federal, Armando Ahued, inform? que en la ciudad de M?xico existen 79 casos cl?nicamente compatibles con la influenza en 23 hospitales y se han registrado 13 decesos relacionados con esa enfermedad. Mexico, Apr 23 (EFE) .- The Secretary of Health of Mexico, Armando Ahued, reported that in Mexico City there are 79 cases clinically compatible with influenza in 23 hospitals and 13 deaths have been associated with the disease.


Entrevistado luego del acto en el que se celebr? el segundo a?o de que entr? en vigor la Ley de Interrupci?n del Embarazo, llam? a los capitalinos a acudir al m?dico en caso de tener alguna infecci?n de v?as respiratorias y alert? que la influenza es altamente contagiosa. Interviewed after the event which was held in the second year of the entry into force of the Interruption of Pregnancy Act, called the capital city to see a doctor if you have any respiratory tract infection and warned that the flu is highly contagious.


"Que vaya a nuestros centros de salud, los 28 hospitales del gobierno de la ciudad, o acuda al ISSSTE, el IMSS oa donde acostumbre ir, pero que de ninguna forma se automedique", puntualiz? Ahued Ortega. "To go to our health centers, 28 hospitals of the city government or go to the ISSSTE, IMSS, or usually where to go, but in no way automedique," said Ortega Ahued.


Pidi? tambi?n tomar medidas higi?nico-diet?ticas, como lavarse las manos y abstenerse de salir de sus casas o de asistir a la escuela si presenta s?ntomas del mal. Also requested to take action on diet and hygiene, including washing hands and refrain from leaving their homes or to attend school if you have symptoms of evil. "La influenza es altamente contagiosa, por lo que estornudar o toser puede ser el medio de contacto. "The flu is highly contagious, so they sneeze or cough can be the means of contact.


"Quien est? enfermo que no comparta alimentos, cucharas o bebidas con otras personas, no acuda a lugares p?blicos, ni salude de beso o de mano a nadie, que se cubra la boca y que, si se limpia con un papel, lo deposite en una bolsa de pl?stico. Tratamos de minimizar el riesgo de contagio", puntualiz?. "Anyone who is sick who does not share food, drinks or spoons with other people, not go to public places, or health of a hand or kiss anyone, who is covering his mouth and, if cleaned with a paper, placed in a plastic bag. We try to minimize the risk of contagion, "he said.


Tras indicar que la Secretar?a de Salud (SSA) coordina los esfuerzos en este tema, dio a conocer que ese organismo federal efect?a un monitoreo diario de todas instituciones p?blicas y privadas para llevar el seguimiento respectivo. Noting that the Health Secretariat (SSA) is coordinating efforts in this matter, announced that a federal agency conducts daily monitoring of all public and private institutions for follow-up.


El funcionario capitalino coment? que la Secretar?a de Educaci?n P?blica, en coordinaci?n con la SSA, tom? la decisi?n de mandar una alerta a los maestros, padres de familia y ni?os para que, quien se enferme, de inmediato asista al m?dico y evite sitios concurridos. The official said that the City Department of Education, in coordination with the SSA's decision to send a warning to teachers, parents and children to who gets sick, the doctor immediately and avoid attending crowded places.


Aclar? que no todas los casos son provocadas por la influenza. He clarified that not all cases are caused by influenza. Hay bacterias de otro tipo, "por eso es importante que no se automediquen ni tomen antibi?ticos hasta que el m?dico sea quien lo prescriba". There are other bacteria, so it is important not to take antibiotics automediquen or until the doctor who is prescribing. "


Se?al? que no se trata de una epidemia. He noted that this is not an epidemic. "No es una epidemia, de ninguna manera; es un caso at?pico y un alargamiento del periodo estacional de la influenza". "There is an epidemic in any way that is unusual and a lengthening of the period of seasonal influenza."

 

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Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Another Mexican source. If there have supposedly been on 20 deaths in the whole country (and only 13 in Mexico City), explain the red lines below. Again, the reference to SARS should read atypical pneumonia - the translator makes that error.

http://www.exonline.com.mx/diario/n.../influenza_atipica_mata_a_10_en_un_dia/578187

Atypical influenza kills 10 in one day
Laura Toribio, Lilian Hern?ndez y Jaime Contreras Laura Toribio, Jaime Hernandez and Lilian Contreras
Los decesos ocurrieron ayer en hospitales del IMSS; el gobierno admite que las defunciones aumentar?n The deaths occurred yesterday in hospitals of the IMSS, the government admits that deaths will increase Ayer, s?lo en el Instituto Mexicano del Seguro Social (IMSS) diez personas murieron por neumon?a at?pica presumiblemente causada por el virus de la influenza estacional; seis fallecimientos se registraron en el Distrito Federal. Yesterday, 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.

En tanto, la Secretar?a de Salud inform? que en la presente temporada (de octubre a marzo) creci? tres veces el n?mero de casos probables y confirmados de influenza, comparado con los dos periodos anteriores. 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.

El reporte del IMSS, en poder de Exc?lsior, revela que del viernes 17 de abril hasta las 17:30 horas de ayer, ?nicamente en las unidades del pa?s del instituto 28 personas perdieron la vida por esta causa. The report of the IMSS, in power Exc?lsior, 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.

El foco de las defunciones est? en la capital de la Rep?blica, donde se concentran 17 decesos. The focus of the deaths in the capital of the Republic, where there are 17 deaths.

No obstante, hay desconcierto entre las autoridades sobre la cifra exacta de defunciones. However, there is confusion among the authorities on the exact number of deaths. La Secretar?a de Salud tiene registradas 20 muertes desde el 18 de marzo hasta ayer por la ma?ana. The Health Ministry has recorded 20 deaths since March 18 until yesterday morning.

De ellas, seg?n la Ssa 13 ocurrieron en el Distrito Federal, cuatro en San Luis Potos?, dos en Baja California, y una en Oaxaca. Of these, 13 occurred as the SSA in the Federal District, four in San Luis Potosi, Baja California in two, and one in Oaxaca. Cinco de las muertes en la Ciudad de M?xico se presentaron entre s?bado y domingo. Five of the deaths in Mexico City were between Saturday and Sunday.

Por ello, la dependencia federal puso en marcha una alerta nacional para tener una vigilancia estrecha de las hospitalizaciones y de las defunciones que se pudieran asociar a este padecimiento. Therefore, the federal agency has launched a national alert for a close surveillance of hospitalizations and deaths that could be associated with this disease. Se trata de una ?red de notificaci?n negativa?, que significa que inclusive los hospitales que tienen cero casos tienen que notificarlo. This is a "negative reporting", which means that even hospitals that have had no cases to report.

El subsecretario de Prevenci?n y Promoci?n de la Salud, Mauricio Hern?ndez ?vila, reconoci? que ?desafortunadamente los padecimientos van a crecer porque hay pacientes graves que est?n entubados y la mortalidad en ellos es alta?. 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."

El funcionario admiti? que todav?a no se sabe cu?l es el curso que tomar? el virus, ni si lleg? ya a su m?ximo nivel de afectaci?n. The official admitted that it is still uncertain what course to take the virus, or if already reached its maximum level of involvement.

?A?n no sabemos qu? curso va a tomar este pico de reactivaci?n. "We still do not know what course you are taking this revival peak. Lo sabremos m?s o menos en una o dos semanas, ya que tengamos reportando a toda la red de hospitales que echamos a andar?, refiri?. 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.

Sin embargo, tanto la Secretar?a de Salud como el IMSS insistieron en que la poblaci?n no debe de preocuparse, porque no existe epidemia, y s?lo hay una alerta por el fen?meno in?dito de que casos de influenza se est?n presentando fuera de temporada. 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. Y ambas instituciones garantizaron que el personal de salud, que es el que tiene un alto riesgo de contagio, estar? completamente protegido. And both institutions ensured that health staff, we will have a high risk of infection, be fully protected.

?No queremos causar p?nico, pero tampoco podemos ocultar la realidad. -We do not want to cause panic, but we can not hide reality. ?Hay epidemia o no hay epidemia? Is there no epidemic or epidemic? se le inquiri?. he inquired.

??No, no hay epidemia! - No, no epidemic! ?No hay epidemia de influenza! There is no epidemic of influenza! respondi? el subsecretario. replied the undersecretary.

El secretario de Salud, Jos? ?ngel C?rdoba Villalobos, admiti? que el gobierno federal no cuenta en estos momentos con vacunas suficientes ante una emergencia, pero aclaro que de ser necesario las comprar?n para evitar que el mal se expanda. 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.

Pidi? a los mexicanos no alarmarse por los brotes de influenza que han surgido en el territorio nacional. He asked the Mexicans do not be alarmed by the outbreaks of influenza that have emerged in the country. ?El llamado a la poblaci?n es que no haya p?nico, hay que cuidarse si se tiene un problema respiratorio, quedarse en casa y ver al m?dico para que puedan ser atendidos?, pidi? el titular de la Ssa. "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.

Ante la posibilidad de que este brote estacional se extienda con mayor velocidad en el pa?s y cobre la vida de m?s personas, aclar? que no se trata de una epidemia; para ello tendr?a que afectar a m?s de cinco millones de habitantes de la poblaci?n nacional. 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.

?Una pandemia es cuando ya se extiende a la mayor parte de la poblaci?n, estamos hablando de un cinco a diez por cierto de la poblaci?n?, explic?. "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.

Sin embargo, reconoci? que es necesario estar en una alerta epidemiol?gica, por lo que esta dependencia buscar? obtener cerca de 400 mil vacunas para el personal de salud, con el fin de prevenir un brote entre m?dicos y enfermeras, para que puedan atender a los pacientes sin ning?n problema. 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. Asimismo, especific? que durante el invierno aplicaron 19 millones de vacunas, por lo que descart? que se trate de una falla en la campa?a de vacunaci?n. It also specified that it applied throughout the winter 19 million vaccines, it denied that it is a failure in the vaccination campaign.

?Es una prolongaci?n de la ?poca estacional de la influenza que normalmente se termina en febrero, pero estamos viendo casos en marzo y abril y que muy probablemente est? relacionado con una epidemia de Estados Unidos y que tambi?n gener? algunas defunciones y es la colita de la epidemia lo que no est? afectando a nosotros?, se?al?. "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.

En entrevista, el doctor Santiago Echeverria Zuno, director de Prestaciones M?dicas del IMSS, asegur? que el brote de influenza ?no es algo significativo que conduzca a una alarma generalizada?. 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."

?Simplemente tenemos algunos casos m?s de los que normalmente deber?amos de tener en estas ?pocas del a?o, pero alarma no hay?, reiter?. "We simply need some more of that normally should take these times of year, but no alarm," he said.

El funcionario inform? que el sistema de vigilancia epidemiol?gica especial que implementaron al fin de semana en el IMSS para registrar probables casos de influenza arroj? m?s de 500 en todo el pa?s durante los ?ltimos cinco d?as. 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.

En conferencia de prensa, el subsecretario Mauricio Hern?ndez se?al? que, a diferencia de a?os anteriores, en los que los picos invernales que son noviembre y diciembre, hoy se est? observando un exceso de casos durante este abril. 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.

?Algunos casos tienen manifestaciones graves, que han ocasionado muertes y hospitalizaciones. "Some cases are severe, that have caused deaths and hospitalizations. Estos se presentan en adultos j?venes, principalmente porque es el grupo que no vacunamos?, explic?. These are young adults, mainly because it is the group that did not vaccinate, "he explained.

Esto sucede porque la poblaci?n m?s vulnerable a contraer esta enfermedad son los ni?os menores de 36 meses y los mayores de 60 a?os. This is because the people most vulnerable to contracting this disease are children under 36 months and older than 60 years.

Sobre el origen del brote, Hern?ndez dijo que la epidemia procede de Estados Unidos, donde ya est? de salida. On the origin of the outbreak, Hernandez said that the epidemic comes from United States, where it is already out. ?Este virus que viene recorriendo las poblaciones, y la relaci?n climatol?gica de por qu? tenemos este pico ahora en abril, no lo tenemos claro; no sabemos cu?l es la explicaci?n, si es las caracter?sticas de la humedad, las caracter?sticas de sequedad que hay en el ambiente?, dijo. "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.
Los decesos ocurrieron ayer en hospitales del IMSS; el gobierno admite que las defunciones aumentar?n The deaths occurred yesterday in hospitals of the IMSS, the government admits that deaths will increase Ayer, s?lo en el Instituto Mexicano del Seguro Social (IMSS) diez personas murieron por neumon?a at?pica presumiblemente causada por el virus de la influenza estacional; seis fallecimientos se registraron en el Distrito Federal. Yesterday, 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.

En tanto, la Secretar?a de Salud inform? que en la presente temporada (de octubre a marzo) creci? tres veces el n?mero de casos probables y confirmados de influenza, comparado con los dos periodos anteriores. 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.

El reporte del IMSS, en poder de Exc?lsior, revela que del viernes 17 de abril hasta las 17:30 horas de ayer, ?nicamente en las unidades del pa?s del instituto 28 personas perdieron la vida por esta causa. The report of the IMSS, in power Exc?lsior, 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.

El foco de las defunciones est? en la capital de la Rep?blica, donde se concentran 17 decesos. The focus of the deaths in the capital of the Republic, where there are 17 deaths.

No obstante, hay desconcierto entre las autoridades sobre la cifra exacta de defunciones. However, there is confusion among the authorities on the exact number of deaths. La Secretar?a de Salud tiene registradas 20 muertes desde el 18 de marzo hasta ayer por la ma?ana. The Health Ministry has recorded 20 deaths since March 18 until yesterday morning.

De ellas, seg?n la Ssa 13 ocurrieron en el Distrito Federal, cuatro en San Luis Potos?, dos en Baja California, y una en Oaxaca. Of these, 13 occurred as the SSA in the Federal District, four in San Luis Potosi, Baja California in two, and one in Oaxaca. Cinco de las muertes en la Ciudad de M?xico se presentaron entre s?bado y domingo. Five of the deaths in Mexico City were between Saturday and Sunday.

Por ello, la dependencia federal puso en marcha una alerta nacional para tener una vigilancia estrecha de las hospitalizaciones y de las defunciones que se pudieran asociar a este padecimiento. Therefore, the federal agency has launched a national alert for a close surveillance of hospitalizations and deaths that could be associated with this disease. Se trata de una ?red de notificaci?n negativa?, que significa que inclusive los hospitales que tienen cero casos tienen que notificarlo. This is a "negative reporting", which means that even hospitals that have had no cases to report.

El subsecretario de Prevenci?n y Promoci?n de la Salud, Mauricio Hern?ndez ?vila, reconoci? que ?desafortunadamente los padecimientos van a crecer porque hay pacientes graves que est?n entubados y la mortalidad en ellos es alta?. 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."

El funcionario admiti? que todav?a no se sabe cu?l es el curso que tomar? el virus, ni si lleg? ya a su m?ximo nivel de afectaci?n. The official admitted that it is still uncertain what course to take the virus, or if already reached its maximum level of involvement.

?A?n no sabemos qu? curso va a tomar este pico de reactivaci?n. "We still do not know what course you are taking this revival peak. Lo sabremos m?s o menos en una o dos semanas, ya que tengamos reportando a toda la red de hospitales que echamos a andar?, refiri?. 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.

Sin embargo, tanto la Secretar?a de Salud como el IMSS insistieron en que la poblaci?n no debe de preocuparse, porque no existe epidemia, y s?lo hay una alerta por el fen?meno in?dito de que casos de influenza se est?n presentando fuera de temporada. However, the Ministry of Health as the IMSS insisted that people should not

 

[alert]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

A Latin American source. This source has bungled facts before on other outbreaks, but its numbers are worth seeing here. This is the first article that mentions 23 hospitals in DF. If one hospital reported 10 deaths yesteday alone, and the outbreak has been going on for over a month, and there are 23 hospitals in DF, how many people do you estimate have died in DF alone?

Remember they are still only reporting one case in Oaxaca, and we have read of at least three deaths (maybe five) and at least two ill HCW.

The Mexican officials are having trouble catching up with the death count.

http://www.prensa-latina.cu/index.php?option=com_content&task=view&id=73601&Itemid=1

Causing 20 deaths from flu outbreak in Mexico
jueves, 23 de abril de 2009 Thursday, 23 April 2009

23 de abril de 2009, 10:11 M?xico, 23 abr (PL) La secretaria de Salud de M?xico report? que a 20 se eleva hoy el n?mero de muertes por un brote de gripe detectado en el territorio nacional. April 23 2009, 10:11 Mexico, April 23 (PL) The secretary of Health of Mexico reported that today stands at 20 deaths for a flu outbreak detected in the country. El comunicado de la entidad gubernamental niega que exista una epidemia, en tanto aclara que en esta ?poca de primavera es poco usual que se registren tantos casos de contagio, lo que ocurre ahora en la poblaci?n que es menos vulnerable. The communique from the government denies that there is an epidemic, and explains that in this time of spring is unusual that so many cases are recorded of contagion, which now occurs in the population that is less vulnerable.

Tras precisar que la situaci?n no es como para crear un cuadro de alarma, se deben acentuar las precauciones ante s?ntomas de la enfermedad, como fiebre, dolor de cabeza y congesti?n nasal, ante lo cual se llama a la ciudadanìaa acudir de inmediato a centros asistenciales. After clarifying that the situation is not to create a table of alarm, should emphasize precautions before symptoms such as fever, headache and nasal congestion, to which the citizen is called aa ? go immediately centers.

Los 20 casos de deceso se registraron hasta hoy en cinco entidades federativas: 13 en el Distrito Federal, cuatro en San Luis de Potos?, dos en Baja California y otro en Oaxaca, estos dos ?ltimos estados ubicados en los extremos norte y sur del pa?s. The 20 cases of death were recorded so far in five states: 13 in the Federal District, four in San Luis Potosi, two in Baja California and one in Oaxaca, the latter two states located in the north and south.

El reporte precisa que los fallecidos por la gripe son personas entre 25 y 45 a?os de edad, cuando lo normal es que esta enfermedad afecte principalmente en el invierno a ni?os menores y personas mayores, con m?s de 60 a?os. The report states that the dead from the flu are people 25 to 45 years old, when it is likely that this disease affects mainly children under the winter and the elderly, with more than 60 years.

Ante esta situaci?n, se informò que el ministerio mexicano de salubridad adquiri? 19 millones de dosis para vacunar a ni?os y ancianos, as? como el personal hospitalario. In this situation, ? was reported that the Mexican Ministry of Health purchased 19 million doses to vaccinate children and elderly, and hospital staff.

Se precis? que se mantienen ingresados en 23 hospitales del Distrito Federal 144 enfermos con s?ntomas de neumon?a, asociada a la gripe, por lo que a la capital del pa?s se le ubica como el centro del actual brote del padecimiento. It was explained that remain hospitalized in 23 hospitals in the Federal District 144 patients with symptoms of pneumonia associated with influenza, for which the capital is located as the center of the current outbreak of disease.

 

[Thornton]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

There is no report of spread outside of Mexico yet. The CDC in its briefing today acknowledged the illness in Mexico but does not have a link with the illnesses in California and Texas.

 

[alert]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

There is no report of spread outside of Mexico yet. The CDC in its briefing today acknowledged the illness in Mexico but does not have a link with the illnesses in California and Texas.

There is the one suspected case mentioned above in isolation in Ontario. Can you post a link to that CDC briefing?

 

[sharon sanders]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

http://www.flutrackers.com/forum/showthread.php?t=100020

 

[alert]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Thank you very much. If 7 swine flu cases recoved without serious pneumonia or ARDS, I think I can now safely say the illness in Mexico is probably not swine flu. Everyone who gets it gets severely ill. The HCW who got infected in Oaxaca both developed severe pneumonia.

Also note that the Diario (the source that started this a week ago) is no longer mentioning specifics - how many ill, etc. They can't keep track.

 

[gsgs]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

this would be a novel, reassorted virus which is prone to
mutations and further reassortments, that could quickly change the clinical
symptoms.

But, shouldn't they have detected it by now, if it were
swine flu ?
or H5 or H7 or whatever

 

[Treyfish]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Ssa called for calm in cases of influenza
Jose Angel Cordova explained that hospitals in the Federal District, San Luis Potosi, Baja California Norte, Oaxaca, Tlaxcala, Hidalgo and Veracruz, health fences were installed to prevent the spread of the virus.

Thu, 23/04/2009 - 13:21

A researcher performs tests for influenza vaccine. Photo: Do I need special Influenza? These are the symptoms

Mexico City .- The Health Secretary Jose Angel Cordova Villalobos reported that only seven states of the republic "fortunately" focuses on health alert for unusual "outbreak of the epidemic of seasonal influenza," and reiterated that have so far 20 people died, and no more, because of the virus.

C?rdova Villalobos explained that in the hospitals of the Federal District, San Luis Potosi, Baja California Norte, Oaxaca, Tlaxcala, Hidalgo and Veracruz, were installed two fences that are limiting health access for patients and families, installing isolation wards, to vaccinate medical staff to avoid infection and to get this and the donation of 200 thousand to buy vaccine and another 300 thousand doses.

"They are fortunately only seven Mexican states that have not been affected and that is why a pandemic," he said after referring to the alert will remain as long as necessary until there is a reduction of cases they were still entering some cases to hospitals. "

On the Union of Health claims that so far 500 workers have been infected and that this weekend, this figure will increase to 500 thousand, C?rdova Villalobos said, "but may be mild influenza, we have not had so far, fortunately, No worker who has had severe influenza or casing have needed. "

After the inauguration of the forum "Current status and challenges to address addiction in the workplace" by Margarita Zavala, wife of the president, C?rdova Villalobos said the 28 deaths reported by the IMSS does not necessarily reflect cases seasonal influenza virus.

The IMSS reported cases of death due to respiratory problems overall, there is no evidence that it is for influenza, even now, there are patients with HIV who have respiratory problems that they cause death, such as Pneumocystis pneumonia, but pneumonia is not caused by influenza virus.

"We can not mix all the details until we have confirmed by the complications of influenza in the past month, in the age group 5 to 65 years," he said.

Similarly reported that young people are being "involved in a more virulent" with the virus and this "probably is because they were not vaccinated and never lost or antibodies.

Meanwhile, Mexico is working in coordination with United States and Canada to study the virus, "the diagnoses were made initially in the Indre in Mexico but we are taking information with Canada and United States to see if it is not otherwise viral threat. "

Responsible for health policy of the country reiterated that this is not a "pandemic" but to "an epidemic outbreak, so" we must remain calm.

"Families must cooperate in the sense that if they have symptoms with your doctor, if they do not sneeze directly toward each other, and if they have no problem hello or kiss or hand, not sharing utensils if they are not washed or pallets, in order that this can somehow transmit the virus because it is coming very easily, even a sneeze. "

In an interview, C?rdova Villalobos blamed the medical staff who are now very worried because the outbreak of influenza, which have not come in time to apply the vaccine. "Some believe they are immune to all, the truth is not true, there are places where staff were vaccinated at 80 percent but there are others who do not reach or 15 percent."

The SSA is currently working with the authorities of the Ministry of Education so that where teachers identify a child is sick it is returned to his home.:tiphat:http://www.milenio.com/node/203916

 

[HenryN]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Thank you very much. If 7 swine flu cases recoved without serious pneumonia or ARDS, I think I can now safely say the illness in Mexico is probably not swine flu. Everyone who gets it gets severely ill. The HCW who got infected in Oaxaca both developed severe pneumonia.

Also note that the Diario (the source that started this a week ago) is no longer mentioning specifics - how many ill, etc. They can't keep track.

There is little doubt that the cases in Mexico are swine flu. You are only citing the most severe cases. One case of swine flu in the US was on a ventilator.

 

[Treyfish]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Quer?taro detected eight probable cases of influenza
The deputy director of the Epidemiology Department of Health state that the state agency ordered its 280 health units to intensify the search for possible cases and vaccinating the population, after the national alert after the deaths of 20 individuals from March to date the country.




Thu, 23/04/2009 - 15:55

Queretaro .- The Deputy Director of Epidemiology of the Ministry of Health State, Martina P?rez Rend?n, which analyzed eight reported probable cases of influenza in the state, recorded so far this year.

The official estimated that next week could inform the public if they are real cases of influenza.

He explained that the state agency ordered its 280 health units to intensify the search for possible cases and vaccinating the population, after the national alert after the deaths of 20 individuals from March to date in the country.

Quer?taro argued that maintaining the operational and strengthens the application of vaccines in health, for the deaths as a result of the influenza virus that spread increases during the winter season and continues this season in the heat .

September 2008 to last February, were implemented more than 184 thousand doses to children under five years of age and adults older than 65 years, but the population is susceptible to infection, so it will expand the vaccination.

The head of Preventive Medicine, Epidemiology and Statistics, Institute of Social Security and Services for State Workers (ISSSTE), Juan Carlos Aguilar Davis said it is very important that people go to health units to seek attention.

The ISSSTE used 308 doses of the vaccine until March 18 at the medical unit of El Marqu?s, 53 Cadereyta, 900 in Ezequiel Montes, 99 Tequisquiapan, Tolim?n 135, 331 in San Juan del R?o, 184 in Arroyo Seco and 99 in the capital.:tiphat:http://www.milenio.com/node/203957

 

[alert]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

There is little doubt that the cases in Mexico are swine flu. You are only citing the most severe cases. One case of swine flu in the US is was on a ventilator.

Can you give me a link that says this about the ventilator? If this is true, you're probably right - although I still want to know about that detection of the coronavirus.

 

[alert]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

My reading of the CDC briefing contains:

4. All confirmed cases have recovered.

That would seem to contradict that one of the cases is on a ventilator.

 

[Treyfish]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

embassy for us in mexico...nuttin! http://mexico.usembassy.gov/eng/eacs_sheet.html
no public annouincements http://mexico.usembassy.gov/eng/eacs_public_announcement.html
nothin from canada, england, australia or the us

 

[alert]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Canada has put out a health alert, but you're right - nothing from any other country. We need to get an alert out on Promed. Can somebody send some of the more alarming articles to ProMed?

 

[Treyfish]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Reported 79 cases and 13 deaths related to influenza in Mexico City

El secretario de Salud del Distrito Federal, Armando Ahued, llam? a los capitalinos a acudir al m?dico en caso de tener alguna infecci?n de v?as respiratorias y les pidi? que ?de ninguna forma se automediquen?.​

Health Secretary of Mexico, Armando Ahued called the capital city to see a doctor if you have any respiratory tract infection and asked them "in no way automediquen.

• 
• 
• 

Jue, 23/04/2009 - 16:13​

Thu, 23/04/2009 - 16:13

Pidi? tambi?n tomar medidas higi?nico-diet?ticas.​

Also requested to take action on diet and hygiene.

Foto: H?ctor T?llez​

Photo: H?ctor T?llez

Ciudad de M?xico.- El secretario de Salud del Distrito Federal, Armando Ahued, inform? que en la ciudad de M?xico existen 79 casos cl?nicamente compatibles con la influenza en 23 hospitales y se han registrado 13 decesos relacionados con esa enfermedad.​

Mexico City .- The Secretary of Health of Mexico, Armando Ahued, reported that in Mexico City there are 79 cases clinically compatible with influenza in 23 hospitals and 13 deaths have been associated with the disease.

Entrevistado luego del acto en el que se celebr? el segundo a?o de que entr? en vigor la Ley de Interrupci?n del Embarazo, llam? a los capitalinos a acudir al m?dico en caso de tener alguna infecci?n de v?as respiratorias y alert? que la influenza es altamente contagiosa.​

Interviewed after the event which was held in the second year of the entry into force of the Interruption of Pregnancy Act, called the capital city to see a doctor if you have any respiratory tract infection and warned that the flu is highly contagious.

"Que vaya a nuestros centros de salud, los 28 hospitales del gobierno de la ciudad, o acuda al ISSSTE, el IMSS oa donde acostumbre ir, pero que de ninguna forma se automedique", puntualiz? Ahued Ortega.​

"To go to our health centers, 28 hospitals of the city government or go to the ISSSTE, IMSS, or usually where to go, but in no way automedique," said Ortega Ahued.

Pidi? tambi?n tomar medidas higi?nico-diet?ticas, como lavarse las manos y abstenerse de salir de sus casas o de asistir a la escuela si presenta s?ntomas del mal.​

Also requested to take action on diet and hygiene, including washing hands and refrain from leaving their homes or to attend school if you have symptoms of evil.

"La influenza es altamente contagiosa, por lo que estornudar o toser puede ser el medio de contacto.​

"The flu is highly contagious, so they sneeze or cough can be the means of contact.

"Quien est? enfermo que no comparta alimentos, cucharas o bebidas con otras personas, no acuda a lugares p?blicos, ni salude de beso o de mano a nadie, que se cubra la boca y que, si se limpia con un papel, lo deposite en una bolsa de pl?stico. Tratamos de minimizar el riesgo de contagio", puntualiz?.​

"Anyone who is sick who does not share food, drinks or spoons with other people, not go to public places, or health of a hand or kiss anyone, who is covering his mouth and, if cleaned with a paper, placed in a plastic bag. We try to minimize the risk of contagion, "he said.

Tras indicar que la Secretar?a de Salud (SSA) coordina los esfuerzos en este tema, dio a conocer que ese organismo federal efect?a un monitoreo diario de todas instituciones p?blicas y privadas para llevar el seguimiento respectivo.​

Noting that the Health Secretariat (SSA) is coordinating efforts in this matter, announced that a federal agency conducts daily monitoring of all public and private institutions for follow-up.

El funcionario capitalino coment? que la Secretar?a de Educaci?n P?blica, en coordinaci?n con la SSA, tom? la decisi?n de mandar una alerta a los maestros, padres de familia y ni?os para que, quien se enferme, de inmediato asista al m?dico y evite sitios concurridos.​

The official said that the City Department of Education, in coordination with the SSA's decision to send a warning to teachers, parents and children to who gets sick, the doctor immediately and avoid attending crowded places.

Aclar? que no todas los casos son provocadas por la influenza.​

He clarified that not all cases are caused by influenza.

Hay bacterias de otro tipo, "por eso es importante que no se automediquen ni tomen antibi?ticos hasta que el m?dico sea quien lo prescriba".​

There are other bacteria, so it is important not to take antibiotics automediquen or until the doctor who is prescribing. "

Se?al? que no se trata de una epidemia.​

He noted that this is not an epidemic.

"No es una epidemia, de ninguna manera; es un caso at?pico y un alargamiento del periodo estacional de la influenza".​

"There is an epidemic in any way that is unusual and a lengthening of the period of seasonal influenza.":tiphat:http://translate.google.com/transla...io.com/node/203965&sl=es&tl=en&history_state0=