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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.


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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.