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April 27th, 2009
12:32 PM ET

Deciphering swine flu in Mexico

By Dr. Sanjay Gupta
CNN Chief Medical Correspondent

It's 4:30 a.m. here in Mexico City, and we are outside the largest public hospital in the city. Some of the earliest cases of swine flu were brought here and many of them died.

It is clear to us now that for the first several days, the doctors had no idea what was killing their patients. At first, they told me, they thought it was just a late-season flu, but one thing kept nagging at them: Patients who typically die from flu are elderly or very young. But this flu was striking people in their 20s, 30s and 40s. I immediately recalled my reporting on SARS and avian flu. It’s counterintuitive; typically, someone with a weakened immune system would be most at risk - the elderly and young - but in this case, it is people with the strongest immune systems. Why? At least in the cases of SARS and avian flu, it was not so much the virus that did the killing, as the body’s response to it – an overwhelming immune response, with inflammation that was deadly to the patients. Think about that. A stronger immune system means a stronger response and a more likely death. The same thing was seen during the 1918 pandemic that killed at least 50 million people worldwide.

In Mexico City, doctors were mystified, until someone brought up the possibility of this being caused by a virus the world had never seen. Two weeks of testing later, this new variant of the swine flu was discovered. The symptoms are similar to the more common flu, but there seem to be more gastrointestinal symptoms and it often appears with a sudden onset of dizziness.

This is not a pandemic, not yet. But, it is an outbreak and doctors here are scrambling to figure out where it started. They guess a pig farm, but there are no pig farms in Mexico City, so the search has to be broadened. Most likely Patient Zero came from a small city outside Mexico City. But, from where? And is it possible to contain it? We are investigating in Mexico City.


soundoff (692 Responses)
  1. Abel Bertaud

    The young people in Mexico City smoke more than other young adults in other parts of the world. Mexico City is also one of the top 3 contaminated/smoggy cities in the world. This may be why the young people in Mexico City are the only ones dying from the flu.

    Someone should investigate this.....

    April 27, 2009 at 13:05 | Report abuse | Reply
  2. R. Langston

    Dear Dr. Gupta,

    Could the severe symptoms of this flu be a result or response of the human body to the relatively high elevation of Mexico City. With increase in elevation, the partial pressure of oxygen in the atmosphere drops. Is there any data showing severity of symptoms at different elevations? It seems from the reporting that cases in the US are less severe or is it just coincidence?

    Thanks
    R. Langston

    April 27, 2009 at 13:22 | Report abuse | Reply
  3. DrD11

    The crucial question now is prevention.(and How)
    What are the guidlines to the population,in prevention of this flu?
    Are the guidlines satisfactory-sufficient.
    How much emphasis should be put on increasing vitamins intake:C,B complex,niacin.?
    Should we sound the alarm and get them panicky?or should be non-chalant and tel them:Don't worry be happy?
    These are decision to take now!

    April 27, 2009 at 15:20 | Report abuse | Reply
  4. david mueller, old microbiologst

    I was involved with the fiirst swine flu back in the 70's or was it 80's? As older folks remember, the nation received a swine flu vaccine, actually 2. The monvalent that was associated with G/B sydrome and there was a bivalent for medical staff. Since this new strain contains Swine RNA, might there be some protection in people that received that vaccine 30 years ago? I hope scientists are noting who isgetting sick.

    April 27, 2009 at 15:22 | Report abuse | Reply
  5. MAVM

    Is there any validity to the thought that one reason this flu is NOT hitting 60-80+ year olds is that people in this age group may have immunity to influenza A viruses of 1957 and 1968....or even to the 1918 Flu as my 90+ year old grandparents may have.

    April 27, 2009 at 15:44 | Report abuse | Reply
  6. Joan Fishbein

    Just watched Swine Flu news conference. No one mentioned the fact that airlines like Delta share planes and crews with AeroMexico. Is this practice going to be stopped? Crews may carry the disease without exhibiting the symptoms. It seems to me, also, that planes that have been used flying passengers to and from Mexico shouldn't be used to fly passengers in the U.S. This is common practice. At least on Delta.

    April 27, 2009 at 15:51 | Report abuse | Reply
  7. Lori Alcantar

    This comment is for Dr. Gupta. I'm a native Californian currently living in Guadalajara and this morning the authorities notified the general public that as of tomorrow classes in all schools will be postponed unitl May 6th. There is concern amoung the population but still everyone seems to be not to nervous about the situation. Yesterday traffic was very light aroung the whole city and this morning it was not bad which I guess in this case is not a good thing. On the local news here in Guadalajara they have reported people in isolation in some hospitals until they have been tested but so far no one has tested positive. Thank you and keep up the great reporting! I can always count on CNN to keep me informed although I'm very far from home.

    April 27, 2009 at 17:08 | Report abuse | Reply
  8. Rhonda Moore

    Hi Dr. Gupta:

    Why wern't all the kids at the prep school in New York screened for the virus. There were 100 or more sick with syptoms of the swine flue, but only 28 tested.

    Thanks

    Rhonda Moore

    April 27, 2009 at 18:18 | Report abuse | Reply
  9. harvey

    would finishing the border mandate that congress pass'd a few years ago help prevent a potential epedemic in the United States?

    April 27, 2009 at 20:15 | Report abuse | Reply
  10. Jaeger

    I almost hate to even think to ask this question, but given the apparent complexity of this virus and the fact that this has not been seen before, is there any possibility that this virus is a bio-engineered strain – perhaps a bio-terrorist attack.

    April 27, 2009 at 21:03 | Report abuse | Reply
  11. Rebecca coppola

    I think this flu is more widespread than realized. I think most people, myself included go to bed when they have the flu and not to the doctor. Most doctors in the past few weeks didn't know to test for this flu. Only people who went to the doctor who had the flu and got tested for it show up. So who really knows how many cases are out there.

    April 27, 2009 at 21:19 | Report abuse | Reply
  12. Jimmy

    Probably from the hills outside Mexico City. People defecate all along that it dries up and blows into the city. Wouldn't be to far to stretch the imagination to think perhaps some infected pigs did it.

    April 27, 2009 at 21:45 | Report abuse | Reply
  13. Arthur Goodcoff

    The strain is more severe in Mexico because of the misuse and overuse of anti-infectives that are available over-the-counter there causing a stronger more severe mutation to occur.

    April 27, 2009 at 21:56 | Report abuse | Reply
    • Eli King

      Shells answer man things hes a doctor now..yah yah yah yah!

      July 22, 2010 at 21:16 | Report abuse |
  14. The End Is Near

    The end is near! We're all doomed! just kidding =)

    April 27, 2009 at 22:12 | Report abuse | Reply
  15. sue

    I know we don't want to scare people, but I think it would be wise to advise preparing people to stay at home by buying food and water for a couple of weeks. I don't think you are giving people enough information. Even it is mild we may have to stay home for a couple of weeks.

    April 27, 2009 at 22:16 | Report abuse | Reply
  16. Pip

    The students from that catholic prep school in ny clearly got sick on their spring break trip to Mexico. But not all the students at that school who got sick went to Mexico. This is a catholic school. In the Catholic religion, to take communion the cup is shared, meaning, they all drink from the same cup. I wonder if that could have lead to others getting sick.

    April 27, 2009 at 22:16 | Report abuse | Reply
  17. kate

    If Mexico is the source of the swine flu – why are we not closing our boarders to anyone coming in from Mexico?

    April 27, 2009 at 22:34 | Report abuse | Reply
  18. Border security Now President Obama

    This is yet another reason why President Obama must secure our border with Mexico. The last thing we need are thousands of infected illegals swarming into Calfornia, Texas. and Arizona.

    CLOSE THE BORDER UNTIL THIS PANDEMIC IS UNDER CONTROL

    April 27, 2009 at 22:38 | Report abuse | Reply
  19. misterb

    how about Veracruz with that little boy who lived near a Virginia-based pig farm. That whole village got sick and it's been stated that he just recently tested positive for the swine flu. Back in February when he (and others in his village) got sick the officials thought it was just the regular seasonal flu.

    April 27, 2009 at 22:41 | Report abuse | Reply
  20. Victoria

    Dr Gupta,

    According with the CDC web site, they estimate that an average of 36,000 people die in just in the U.S. alone each year from the regular flu. Why all the fuss over this strain of virus? I understand that some people have died in Mexico from it but couldn't it also be the health care system there?

    The CDC also estimates that "Globally, there are an estimated 50 to 100 million cases of dengue fever (DF) and several hundred thousand cases of dengue hemorrhagic fever (DHF) per year" and we never hear about this (even though that there are about 100-200 cases of Dengue fever in the US each year) and if you ask most people in the US no ones knows what Dengue fever is...

    Why is the swine flu such a big deal?

    April 27, 2009 at 23:15 | Report abuse | Reply
  21. Deb

    The hand washing and masks are great preventative measures, but let's not forget spitting. Spitting was punished by fines in the early 1900s, because it was rude and spread germs. I can picture some guy taking off a face mask to spit, or worse, blow their nose without tissue right onto the street!!!

    April 28, 2009 at 01:01 | Report abuse | Reply
  22. Nell

    Thank you Doctor Gupta, for a candid and interesting look into the challenges the medical community faced and is facing.

    April 28, 2009 at 09:16 | Report abuse | Reply
  23. Theresa

    In regards to the swine flu, I have noticed during my 14 years of working in a research clinic for natural medicine with a doctor who has practiced natural medicine for close to 40 years that a regimen of zinc gluconate lozenges and beta carotene significantly help in preventing the contraction of flu. The zinc gluconate makes the mucous membranes slippery so the germs don't stick and the beta carotene boosts the immune system. There are other natural remedies to address this issue, but the zinc gluconate and beta carotene are quick, easy and usually effective. Add this to washing the hands, and most people should be able to avoid catching the swine flu.

    April 28, 2009 at 09:57 | Report abuse | Reply
  24. Bob Blum

    Yesterday, in response to a question, Dr. Gupta indicated that paper respiratory masks didn't have much effect on stopping infuenza virus due the the small size of the virus.

    I disagree. The main benefit of the masks is that they serve as a barrier to the mouth and nose preventing people from infecting themselves by putting their fingers in their mouth or nose. This is a large benefit.

    April 28, 2009 at 10:12 | Report abuse | Reply
  25. Mary

    I assume this strain of flu will remain in the environment even after this outbreak is over. If we don't build anti-bodies to it now don't we risk getting this same flu sometime in the future? I do worry about my kids getting the flu, especially the youngest, but when they do get it and recover, they are stronger going into the future.

    April 28, 2009 at 10:21 | Report abuse | Reply
  26. Student

    If the majority of deaths are actually being caused by “an overwhelming immune response, with inflammation that was deadly to the patients. Think about that. A stronger immune system means a stronger response and a more likely death,” why then is there not a medication dispensed that can quell this immune system response? With all of the focus on the shortage of Tamiflu, would something that can counteract this response not be a viable alternative?

    April 28, 2009 at 10:28 | Report abuse | Reply
  27. mirace

    I'm quite puzzled after listening to various reports about the flu and how the government of mexico and other countries like China is dealing with it. Why masks? Shouldn't there be a bottle of hand sanitizer on every corner, train stations, airports, stores, and other transportation areas for the public to use in all parts of Mexico? If you have ever been on a cruise ship, you know what I am referring to.

    April 28, 2009 at 10:47 | Report abuse | Reply
  28. Becky McEllistrem

    Why not close the school year early for young kids since we're so close to the end of the year anyway.

    April 28, 2009 at 11:01 | Report abuse | Reply
  29. Karen P

    Good for you being down there in the thick of it all reporting! It is this kind of reporting that the world (and the media) are sorely lacking during this frightening wekk of the swine flu outbreak. I think it's great that you are applying your intuitive knowledge of health matters to this unique situation – rather than just feeding us dry content about how many swine flu cases there are today so far, or reminding us to wash our hands. The people want to know why it is killing who it is killing, what can be done about THAT, and the precise location and circumstances that came about at "ground zero" in that small, nondescript Mexican pig-farming village that brought us to this point.

    Would the way to stop this virus killing perhaps be to somehow slightly suppress the patient's immune systems so that their immune response to this new virus doesn't kill them?

    More please!!! And stay safe....

    April 28, 2009 at 11:38 | Report abuse | Reply
  30. Mary

    I heard on jane velez mitchel show last night on HLN..that "factory farming" in this case pigs, could cause the virus, with their in-humane
    treatment of by placing the pigs in tight living conditions. The picutres they showed were disturbing. , factory farming should be disucssed more by the media, cnn and the connection to the possiblity to a virus or worse. Factory farming should be a topic for cnn to inform the public of its exsistence and its horrible conditions, and how it CAN be a health issue for everyone concerned if these factory farms continue.

    April 28, 2009 at 11:59 | Report abuse | Reply
  31. Sherry Concee

    I left from the Cancun airport yesterday, heard nothing about the Swine Flu, I arrived to the Detroit Metro airport and I was just handed a piece of paper that says a little about the swine flu. Crossed the border to get back to Canada, no one looked at me to see if I had a temp. or asked how I was feeling. This was yesterday at 5pm, if I would have known it was this bad I wouldn,t of went home. Heard nothing aboujt it the whole week when I was at the Riviera Maya.

    April 28, 2009 at 12:04 | Report abuse | Reply
  32. Marie Walker

    Note: Sebelius, Obama's choice for Health and Human Services secretary is not yet in position - the GOP has blocked this and continues to threaten filibuster to keep her from being placed.
    There will be a vote tomorrow, which will require 60 votes since the GOP will use filibuster to stop it. So we have a shortage of management for a medical pandemic. Call your senator.

    April 28, 2009 at 12:09 | Report abuse | Reply
  33. HMMM

    I would like to know why mainstream media has placed no emphasis on the fact that the hybrid flu virus contains obvious gene splicing and is not natural. Therefore, it is man made and someone is guilty of a despicable crime.

    April 28, 2009 at 12:11 | Report abuse | Reply
  34. bethyp

    I want to know why this is such a big deal, when according to the CDC and other sources, 36,000 Americans die annually from the flu virus, and another 200,000 are sickened. This swine flu doesn't appear to be killing more people than any other year, at least not yet. Is it because it is a novel strain? Because it apparently is hitting young, healthy people (vs. elderly and babies)? Because it has spread internationally? What about all the other bugs that travel around the world with humans? Why the panic?

    April 28, 2009 at 12:12 | Report abuse | Reply
  35. Steve Danbury

    Why the big deal about a few people with the flu. Why is there no attention paid to the tens of thousands of people that have contracted LYME disease? Better yet, could it be because it was a bio-weapon designed by our own DOD on Plum Island, NY that would expose the Federal government to a class action law suit that would stop the country cold.
    Reporting Swine Flu is like reporting a bloody nose and not reporting the atom bomb.
    Wake report real news.
    Steve Danbury
    Wenatchee, WA

    April 28, 2009 at 12:15 | Report abuse | Reply
  36. scared

    We need more answers this could get out of control!

    April 28, 2009 at 13:36 | Report abuse | Reply
  37. Capt. Ann

    I think with this swine flu coming into the U.S., we can create jobs
    for our Homeland Security and protecting the borders by having
    our border patrol, coast guard, national guard, US Citizens who
    show their legalization or immigration papers, put these people
    to work by cleaning our border offices, immigration offices, and
    making sure our border patrol, coast guard, immigration officers,
    national guard, marine patrol, any of the airports, airline employees,
    cleaning and spraying the areas, and not to make panic, and
    even our friends on the Canadian borders, do the same, this
    could create jobs in the sector of Homeland Security, and
    spray areas thoroughly, supply our border patrol guards, and
    immigration offices, with masks, latix gloves, and of course,
    how about the telephones we use, spray them with Lysol,
    so this way America, our borders, our airlines, our airport
    lobbies, bathrooms, as you are all saying it is taking us to
    be responsible, how about Homeland Security take some
    responsibility, and give some of our jobless, some jobs to
    take up the slack of unemployment, of course, I would
    suggest background checks to these future employees, but
    lets get a grip on these borders, so you know that anyone
    flying, or coming across the borders via car, trucks, visitors,
    know, that we and our President is on top of the cleaning
    of our own offices, and taking the responsibility to our own
    Nation to protect all that works for the borders, and Homeland
    Security, Immigration, and ensure they don't pass it on to
    others coming into our country to visit the beauty of our nation.

    So, lets take it upon ourselves to wash our hands, but lets help
    our fellow offices of Homeland Security to have our President
    help them too, to keep and make sure airlines, airports, transit,
    buses, subway employees, etc, are provided for also, and
    take on that responsibility too. That can create new jobs
    all over the United States.

    Isn't that part of the recovery act.

    Thanks for listening,

    Capt. Ann

    April 28, 2009 at 14:13 | Report abuse | Reply
  38. Mary

    We all need to refrain from 'panic', with all the medias reporting so many things, between the television and the internet. I will stick to cnn for updates and dr. gupta to ease my panic. The problem being though as the days pass you can start by saying to one person """"this rose is red"""" by the time it gets to per person number 100 its,,""this tulip is spotted green and dangerous""" Word of mouth can sometimes do more harm than good, so rely on a trustworthy news media/dr/ and stay calm for all concerned.

    April 28, 2009 at 14:17 | Report abuse | Reply
  39. Sue

    I'd like to know if this is a TRUE(caps used only for emphasis,) pandemic. To me, "pandemic" signifies that the illness is on all but two of the continents. That isn't the case here. So I would classify it as an EPIDEMIC. For clarity's sake, which is the proper term?

    April 28, 2009 at 15:05 | Report abuse | Reply
  40. Janice Scafard

    Thank you, I got my question about the annual flu vaccine in the FAQ. However, I am very concerned after seeing all the people in Mexico wearing face masks and handling them any old way with their hands, then going about their business. This could cause an even quicker spread. You see them putting the mask up and down, touching the infected area. They should be removed only by the strings,discarded, then the hands washed. I am a retired OR nurse in her seventies, I don't think the correct handling of masks has changed much

    April 28, 2009 at 15:07 | Report abuse | Reply
  41. Bradford

    Does CNN feel any kind of guilt for all this over exaggeration and fear mongering? I know fear = profits but how do you all sleep at night?

    April 28, 2009 at 15:09 | Report abuse | Reply
  42. SERIO

    One more chance for CNN to denigrate Mexico's reputation, redneck's like Capt Ann beleives this is coming "into" de US for what they learned from CNN, experts don't don't know where is coming from but Capt Ann knows is coming from Mexico to the US. Ignorant, Yes is true there was more incidents in Mexico City, but why nobody is saying the first infected arrived from Canada to Mexico city?

    Definitely Abel Bertaud never been in NYC where they smoke 24/7 and live amount rats.

    have a nice day everyone..

    April 28, 2009 at 15:16 | Report abuse | Reply
  43. BruSki

    In determining the outbreak's origin, wouldn't it seem logical to determine the earliest cases of the strain found in medical professionals? It would seem that if the "ground zero" case was Mexico City, then some rural farm-worker probably contracted it, and when the virus became too much for the person, he/she would've gone to see a medical professional or ER. This would've exposed the MP (and staff) to the virus. Simply find the earliest cases involving medical staff...then audit their patient cases up to 7 days prior. Makes sense to me....

    April 28, 2009 at 15:26 | Report abuse | Reply
  44. Katie

    What is the projected longevity of this outbreak? For instance, we often think of a "cold and flu" season. Is this outbreak something that will peak and then eventually decline over time?

    April 28, 2009 at 15:29 | Report abuse | Reply
  45. bigstretch

    Its not a pandemic yet but the seeds of panic have been planted. The High Altitude, High air pollution, High smoking rate, High poverty rate of Mexico city are all factors in young persons deaths. There is no way for the world to protect itself from a pandemic. It is just going to happen regardless. What is more probable is that the panic will cause more deaths than the illness. The world economy could collapse as a result. Developing countries are the most suseptible to world wide economic collapse. The world wide media must stop the infection of panic and start reporting facts.

    April 28, 2009 at 16:01 | Report abuse | Reply
  46. Chantal

    This is the first I have heard of gastrointestinal upset and 'sudden onset on dizzyness" as being symptoms of swine flu.

    Strange that I have not heard or seen this before. All of the news sources I have looked have not mentioned these.

    April 28, 2009 at 16:05 | Report abuse | Reply
  47. Joanne

    I justwish that to protect others from being infected, that people wear the masks that are given properly, cover both your nose and mouth, this is a serious health hazard, simple precautions can help others immensely. Simple hygeine goes a long way.

    April 28, 2009 at 16:17 | Report abuse | Reply
  48. Juliet

    CNN is behaving irresponsibly by spreading unnecessary terror throughout the US about the swine flu. Granted, swine flu has the potential for very serious consequences, but a nuclear bomb in North Korea has at least as much potential to be very serious, and that isn't getting 24/7 coverage. Stop the terror. Enough. Behave.

    April 28, 2009 at 16:37 | Report abuse | Reply
  49. TonyCurtis

    Sometimes, the truth is much more boring that TV and the movies, to those looking for some kind of perverse thrill out of THE FLU.

    And shame on all of you who are using this as an excuse to be xenophobic and racist. You didn't care when bird flu was in China, because it wasn't "here".

    April 28, 2009 at 17:00 | Report abuse | Reply
  50. Ben

    I disagree with what Abel Bertaud said about smoking in Mexico city. Here in the U.S. people smoke at a higher rate than anybody else in the world. I what he said is true then we should see many deaths in the near future.
    Also, Mexico should kick out Dr. Gupta from the country. It is amazing how a professional doctor like him disobeys government orders and enters a hospital where people are sick and worried. How would you feel if the media comes to your hospital and invades your privacy when you are fighting for your life?

    April 28, 2009 at 18:07 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.