U.S., Mexican health experts meet to plan flu strategy

SAN DIEGO — Health experts from the United States and Mexico, countries that together have accounted for about half the world's swine flu cases, are shoring up their defenses ahead of a second wave of infections expected this fall.

They're stocking up on supplies such as masks and antiviral medications, encouraging one another to rest up before flu season hits and considering the postponement of elective surgeries to deal with any surge in flu patients.

These strategies emerged Thursday at the Courtyard Marriott in Old Town, site of a two-day workshop on the H1N1 virus that drew about 80 public-health officials from southwestern states and Mexico.

Participants also reflected on their experiences in dealing with the initial outbreaks of swine flu that would gradually broaden into a global pandemic. San Diego County reported the world's first cases in April, and Mexico became the epicenter of infections and deaths during the peak of the crisis.

“We learned that we need to be very nimble in terms of geting resources to the table,” said Dr. Gilberto Chávez, California's top epidemiologist. “A response like this is like fighting a fire. You need to be involved 24 hours a day.”

Dr. Leticia Wong, the surveillance epidemiology coordinator for Baja California, said the United States recorded 36 percent of the world's confirmed swine flu cases and Mexico logged 14 percent as of mid-July.

Epidemiologists stress that reported cases of H1N1 pale in comparison to actual infection figures because of inadequate specimen collection, limited lab testing and other factors.

Looking ahead to the regular flu season, the U.S. Centers for Disease Control and Infection estimate that 40 percent of Americans could come down with swine flu in the worst-case scenario.

Scientists are working on ways to manage a resurgence of H1N1 until improved response plans are in place, a vaccine is ready and hospitals are better equipped for an influx of patients.

“We live in a global village and have no choice but to work hand in hand at every level,” Dr. Martin Cetron of the CDC said during an introductory panel at Thursday's workshop.

People in attendance suggested ways to improve on the generally well-regarded work by public-health agencies during the spring outbreaks of swine flu, which took the world by surprise with the speed if not the severity of its spread.

Several health officials said the best cooperation would include the sharing of epidemiological information, surveillance techniques, diagnostic tools and lab technology. They also discussed how to streamline operations, such as how to deliver lab supplies and pick up lab specimens more efficiently.

At the workshop were epidemiologists, lab directors and managers of programs that provide early warnings about infectious diseases. They belong to federal, state and local agencies in the United States and Mexico.

They came from California, Arizona, New Mexico and Texas, and from Baja California, Sonora, Chihuahua, Nuevo Leon and Tamaulipas.

Chávez said the only northern Mexican state with no one in attendance was Coahuila.

A major message of the workshop was that while swine flu is widespread, it's not following the same infection and virulence patterns everywhere.

For example, cases of H1N1 continue to mount in San Diego County this summer, but not so much in Imperial County. And while there was a lull in Tijuana in recent weeks, new cases cropped up just this week.

By now, health officials said, it's more important to count the number of hospitalizations, deaths and patients who are resistant to antiviral medicine than to tally the overall total of confirmed cases.

Two interpreters stationed in a glass cubicle in the hotel's main ballroom allowed those who weren't bilingual to understand all that was said. It was one small reflection of how these cross-border health officials are collaborating.

Echoing essentially every speaker's theme, Dr. Michele Ginsberg, chief of community epidemiology at San Diego County's Health & Human Services Agency, told the crowd just before lunch that continued teamwork is crucial.

“Anyway you look at it, we're all in this together and hopefully we'll be able to share our strengths and deal with this appropriately,” she said.