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Paradigm Shift Intervention Monitoring
Similarly, vaccination fences
implements the authority to prevent the spread of the virus within 50
block radius of the infected areas where they reside, are progressing
slowly, since the authority has implemented only 9 near of the 28 that
yesterday would be required to perform.
"It is a process that takes time, strategy, resources and analysis? A fence can not be done overnight," justified and Undersecretary of Health, Felipe Fornelli Lafon.
Fornelli, along with the director of the Health District II, Hector Puertas Corners, noted that to date has been applied to a biological population of 5 000 318 people, who are resident within 50 square blocks of housing sick with influenza.
They stressed further that the Ministry of Health has implemented 110 000 doses of vaccine against H1N1 influenza "and is expected to arrive this week's figure of 120 thousand," he said.
The above translation describes use of vaccination “fences” to control the spread of H1N1. These approaches are destined to fail. Vaccination is most useful when administered prior to an influenza outbreak. The novel H1N1 was noted in Juarez, Chihuahua in March and has spread rapidly. Recently a red alert was issued for Tamaulipas in northern Mexico because of a spike in suspect H1N1 cases and the government announced a plan for training courses on treating H1N1 patients in the ICU.
Moreover, anecdotal reports describe emergency room patients with breathing difficulties and nose bleeds, as ICU beds fill up in Chihuahua and other states in northern Mexico, raising concerns that D225G and D225N are present, as seen in Ukraine.. The novel H1N1 is spreading rapidly and vaccination campaigns are unlikely to significantly slow the spread.
Recently released sequences reveal a novel H1N1 with changes seen in US patients were infected after vaccination. The novel H1N1 has receptor binding domain change A189T as well as S165N, which generates a new glycosylation site, which made aid in immunological escape by hiding antigenic sites. Moreover, one of the isolates from a fatal case had D225N, which is likely present in the second fatal case since the HA sequence, other than D225N was identical and the other fatality was a likely contact of the first fatal case.
Anecdotal reports describe closely related sequences in other countries, including additional sequences with D225N
The novel sub-clade is expected to continue to spread and severely tax health care delivery in northern Mexico. The reports of these outbreaks on the Texas border raise additional concerns supported by reports of linkage of initial cases to Las Cruces, New Mexico and Odessa, Texas.
Release of 2011 sequences from the United States is long overdue, as are sequences from Central and South American countries with increases in H1N1, including Venezuela where the speech of president Hugo Chavez was canceled because of “strong” influenza.