Patient zero? Mom of first confirmed case talks

By Olga R. Rodriguez

updated 9:11 p.m. ET April 28, 2009

LA GLORIA, Mexico - Everyone told Maria del Carmen Hernandez that her kindergartner's illness was just a regular cold. But it seemed like the whole town of 3,000 was getting sick.

As early as February, neighbors all around her were coming down with unusually strong flu symptoms — and the caseload kept growing. When state health workers came to investigate March 23, some 1,300 people sought their medical help. About 450 were diagnosed with acute respiratory infections and sent home with antibiotics and surgical masks.

Five-year-old Edgar Hernandez was still healthy then. Hernandez wanted to keep him home from school so he wouldn't get sick, but her husband said, "We can't be afraid of what might or might not happen."

Then he came home with a fever and a headache so bad his eyes hurt. She took him to a clinic, and after a few days of antibiotics, he, too, recovered.

No one told Hernandez that her son had become Mexico's earliest confirmed case of swine flu until the Veracruz governor helicoptered in on Monday. But Edgar's case confirmed for residents what they already believed: Their hillside town is ground zero in the epidemic.

Local health officials and Federal Health Secretary Jose Angel Cordova downplay claims that the swine flu epidemic could have started in La Gloria, noting that of 35 mucous samples taken from respiratory patients there, only Edgar's came back positive.

'How will we ever know?'
Confirmation that the boy was infected with H1N1 — a strange new mix of pig, bird and human flu virus that has killed as many as 152 people in Mexico and now spread across the world — wasn't made until last week, when signs of the outbreak elsewhere prompted a second look at his sample.

Swine flu at a glance Key developments on swine flu outbreaks: — Deaths: 160 in Mexico, eight confirmed as swine flu and rest suspected. One confirmed in the U.S., a 23-month-old child in Texas visiting from Mexico. — Sickened: 2,498 suspected and 93 confirmed in Mexico. Confirmed elsewhere: 93 in U.S.; 16 in Canada; 14 in New Zealand; seven in U.K.; three in Germany; 10 in Spain; two in Israel; one in Austria, one in Peru and one in South Korea. — Confirmed U.S. cases by state: 51 in New York; 14 in California; 16 in Texas; three in Maine; two each in Kansas and Massachusetts; and one each in Indiana, Ohio, Michigan and Nevada, according to CDC and states. — U.S. Food and Drug Administration issues emergency guidance allowing certain antiviral drugs to be used in broader range of population if needed. Public health emergency declared and roughly 12 million doses of Tamiflu from federal stockpile to be delivered to states. — Cuba bans flights to and from Mexico; Argentina suspends flights from Mexico; U.S., European Union, other countries discourage nonessential travel there. Arriving travelers questioned at Mexico’s U.S. border and world airports. Cruise lines avoid Mexico ports. — Mexico suspends all schools until May 6. In U.S., some schools closed in Illinois, New York City, Texas, California, South Carolina, Connecticut, Minnesota and Ohio. — In Mexico City, surgical masks given to the public, venues closed and public events canceled. President assumed new powers to isolate infected people. World Bank loaning Mexico more than $200 million. — Egypt begins slaughtering nation’s roughly 300,000 pigs as a precaution. — World Health Organization raises alert level to phase 5 of 6. Source: The Associated Press

"If the people who are supposed to be familiar with this didn't know what it was, how will we ever know how my son got it?" Hernandez said Tuesday.

Hernandez said doctors came from Jalapa, the state capital, and Veracruz city to see Edgar in the weeks after he was tested. But they said nothing, "they just wanted to see him." A team came again last weekend, after federal officials confirmed the swine flu cases late Thursday and started closing schools and canceling events in Mexico City.

Again, they left without saying anything, she said.

Cordova insists the rest of the community had suffered from H2N3, a common flu, based on other 34 samples. While Mexican authorities haven't determined how or where the swine flu outbreak began, Gov. Fidel Herrera said Tuesday that "there is not a single indicator" suggesting it started in La Gloria.

'This is what we had'
But Jose Luis Martinez, a 34-year-old resident of the town, made the swine flu connection the minute he heard a description of the symptoms on the news: fever, coughing, joint aches, severe headache and, in some cases, vomiting and diarrhea.

"When we saw it on the television, we said to ourselves, 'This is what we had,' " he said Monday. "It all came from here. ... The symptoms they are suffering are the same that we had here."

Two infants died of pneumonia during the La Gloria outbreak. They were buried without testing.

Alexandre Meneghini / AP Maria del Carmen Hernandez, 34, is the mother of Edgar Hernandez, a kindergartner who had the first confirmed case of swine flu.

Townspeople blame their ills on pig waste from farms that lie upwind, five miles (8.5 kilometers) to the north. The toxins blow through other towns, only to get trapped by mountains in La Gloria, they say. They suspect their water and air has been contaminated by waste.

Granjas Carroll de Mexico, half-owned by Virginia-based Smithfield Foods, Inc., has 72 farms in the surrounding area. Smithfield spokeswoman Keira Ullrich said the company has found no clinical signs or symptoms of the presence of swine influenza in its herd or its employees working at its joint ventures anywhere in Mexico.

Animal health expert Peter Roeder, a consultant to the UN's Food and Agriculture Organization, said many possibilities exist for how the virus first jumped to humans, and that it could have happened months or even a year ago.

Roeder said it's possible someone tending the pigs could have passed a human influenza virus to a pig already infected with another type of swine flu, and then that pig could have also come into contact with a bird virus. Then, the new H1N1 virus formed could have been transmitted back to the workers.

But that's just a theory — and no one has any evidence that it happened in La Gloria.

U.S. swine flu deaths hit double digits Britain criticized for efforts to halt spread Could H1N1 become resistant to drugs? MSN's swine flu coverage Discuss: How concerned are you?

"It's all surmise," Roeder said by phone from the Philippines. "The only thing that we know is that we have a virus that is transmitting between people and it is causing some concern."

But residents say they have been bothered for years by the fetid smell of the farms. Local health workers intervened in early April, sealing off the town of La Gloria and spraying to kill flies people said were swarming around their homes.

When Associated Press journalists on Monday entered a Granjas Carroll farm that has been the focus of community complaints, the cars were sprayed with water. Victor Ochoa, the general director, required the visitors to shower and don white overalls, rubber boots, goggles and masks and step through disinfectant before entering any of the 18 warehouses where 15,000 pigs are kept.

Ochoa showed the journalists a black plastic lid that covered a swimming pool-size cement container of pig feces to prevent exposure to the outside air.

"All of our pigs have been adequately vaccinated and they are all taken care of according to current sanitation rules," Ochoa said. "What happened in La Gloria was an unfortunate coincidence with a big and serious problem that is happening now with this new flu virus."

Mexican Agriculture Department inspectors found no sign of swine flu among pigs around the farm in Veracruz, and say that no infected pigs have been found yet anywhere in Mexico.

Martinez and Bertha Crisostomo, a liaison between the villagers and the municipal government of Perote to which La Gloria belongs, say half of the people from the town live and work in Mexico City most of the week, and could easily have spread the swine flu in the capital, where most of the swine flu cases have been confirmed.

Edgar, however, has never left the Perote valley. The family doesn't own pigs or work near them. Edgar's father, a bricklayer also named Edgar, only works in the area — not Mexico City.

'He's with the Virgin now'
Residents here are certain Edgar was not the only swine flu victim in their town.

Juan Rodriguez died of pneumonia Feb. 9 at age 7 months. His grandmother, Josefina Mendoza, 71, said doctors have come to interview the infant's parents.

Irene Bonilla, 23, said her 2-month-old boy, Yovanni Apolinar, died March 12. No one has interviewed her but reporters.

Neither family wants the children's bodies exhumed for testing.

"Why?" Mendoza said. "It's been months since he died. The child has made his peace with God. He's with the Virgin now."

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