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Paradigm Shift Intervention Monitoring
the doctors said that to expand their
prevention efforts on Monday will begin a special review of death
certificates issued by the Registry Office in recent weeks and whose
causes are accentuated acute respiratory infections.
This, he notes, as a way to verify that all suspected cases have been addressed, thus ensuring that in case some find it questionable death, initiated investigation into the matter and, if necessary, implement special actions in a certain region.
The above translation describes the review of recent pneumonia deaths in Mexico. The H1N1 index case in Juarez was diagnosed as atypical pneumonia and not H1N1 confirmed. Subsequent cases, including his partner, were also diagnosed as atypical pneumonia, signaling an evolved H1N1 that is not easily detected with routine testing. The rapid evolution has been mentioned in media reports.
The pneumonia deaths also signal targeting of lungs, which can also limit lab confirmation since most samples are from the upper respiratory tract. The lung targeting leads to more severe and fatal cases as well as difficulties in treating these cases, as was seen in cases with D225G.
The emphasis on death certificates raises concerns that the number of deaths is markedly higher than the lab confirmed cases and the spread of the H1N1 is greater than indicated by the confirmed cases.
These latest developments highlight the seriousness of the outbreak and require the immediate release of sequences from these cases.