Why So Many Swine Flu Deaths In Mexico?

RENEE MONTAGNE, host:

This is MORNING EDITION from NPR News. Good morning. I'm Renee Montagne.

STEVE INSKEEP, host:

And I'm Steve Inskeep. One of the mysteries of the swine flu crisis is why so many people died in Mexico. Forty-two deaths there were attributed to the flu virus. The only other deaths worldwide were in the United States. And even the two who died here with swine flu had other medical conditions as well. NPR's Carrie Kahn has been asking what made Mexico so different.

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(Soundbite of siren)

CARRIE KAHN: I met Josue Mora(ph) and Roselva Garcia(ph) outside the huge La Rasa Hospital in northern Mexico City last week when they came outside searching for something to eat.

Mr. JOSUE MORA: (Spanish spoken)

KAHN: It was the first time in two days the couple had left their 15-year-old daughter's side since bringing her to the emergency hospital with a high fever.

Mr. MORA: (Spanish spoken)

KAHN: He said Andrea came down with aches, fever and a headache. He brought her in immediately.

When I checked back with the Moras the following day, I found out that Andrea had been transferred to a specialty hospital. For the next three days, the family waited anxiously while doctors struggled to bring down her fever.

Getting to a doctor is not so easy in Mexico. The government-run health system doesn't cover everyone, and many can't even afford the nominal fee charged in public clinics, let alone take precious time away from work. So many don't go the doctor right away and they rely too much on over-the-counter medicines.

Mexico's Health Minister Jose Antonio Cordova addressed that in a press conference this week.

Mr. JOSE ANTONIA CORDOVA (Health Minister, Mexico): (Foreign language spoken)

KAHN: He says young people in particular prefer to take something for the symptoms than go to the doctor.

Mr. CORDOVA: (Foreign language spoken)

KAHN: By the time they finally got seen, Cordova said, it was too late.

According to statistics from the health ministry, the majority of the deaths in Mexico were of people under the age of 40, with female victims outnumbering males, and epidemiologist Ethel Palacios says many didn't seek medical attention until seven days after the first symptoms.

(Soundbite of phone ringing)

KAHN: She's part of the team heading up the investigation of H1N1 in Mexico. Palacios cautions, though, that it's too soon to know why the virus was more deadly in her country than elsewhere.

Dr. ETHEL PALACIOS (Epidemiologist): (Spanish spoken)

KAHN: Palacios gave a tour of the National Emergency Response Center. Since the outbreak was first discovered, the center with its hotlines and computerized monitoring system has been operating 24/7.

Epidemiologists from all over the world are helping, including Dr. Marc-Alain Widdowson of the Centers for Disease Control and Prevention in Atlanta. He says one factor leading to a higher mortality in Mexico seems to be the length of time the virus has been in the country.

Dr. MARC-ALAIN WIDDOWSON (Epidemiologist, Centers for Disease Control and Prevention): There are more people infected here and we've had the virus longer, and therefore we're seeing more of all the different types of outcomes than perhaps in other places.

KAHN: Mexican officials point out they alerted the world to the virus, allowing other countries to take full advantage of preventive measures. Dr. Palacios says Mexicans are going to have to learn to change their hygiene habits.

Dr. PALACIOS: Being more careful on, you know, things that you take for granted as a sneeze or a cough and, you know, trying to limit, you know, very close contract when it's not needed.

(Soundbite of phone ringing)

KAHN: The government is asking people to keep wearing your face masks, keep washing your hands all the time, and they also are telling you to try and keep a couple feet distance between you and the next person.

Well, I'm standing here in one of the busiest metro stations in Mexico City, and people here say that would just be impossible.

Ms. MARTINEZ: (Spanish spoken)

KAHN: (unintelligible) Martinez, who rides the metro everyday, says the government officials are crazy. They're out of their mind if they think people are going to stay that far away from each other here.

Another problematic public place where viral exposure is a higher risk is the schools. Government officials are mandating cleanup before most reopen their doors today. But officials acknowledge that hand washing and other sanitary rules will be difficult when up to 30,000 schools don't have bathrooms or running water.

For Andrea Mora, going back to school will have to wait for two weeks. She was just released from the hospital after five days in intensive care. Her parents Josue and Roselva ask me to talk to her on the phone rather than risk the exposure from a visit to their home. (Spanish spoken)

Ms. ANDREA MORA: (Spanish spoken)

KAHN: She says she feels much better and is thankful to be back home.

Carrie Kahn, NPR News. Transcript provided by NPR, Copyright NPR.