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Paradigm Shift Intervention Monitoring
After a man recently died after being
diagnosed with H1N1 and the record number of H1N1 deaths in
Juárez, Borderland residents took big steps to stay healthy on
More than 200 people received the influenza vaccine through the City of El Paso Department of Public Health at the Bassett Place Mall in Central El Paso.
The clinic was due to start at 10 a.m., but residents were so eager, they lined up early.
"By about 9:30 a.m., we already had 45 to 50 people here," said Gloria Alba, a public health nurse.
The above comments describe vaccinations in response to the confirmed H1N1 fatality in El Paso. However, the spike in pneumonia and influenza (P&I) deaths in El Paso, as well as the H1N1 deaths across the border in Juarez, suggests that a vaccination campaign against the Chihuahua sub-clade will have limited success.
Sequences from fatal cases in Chihuahua are closely related to sequences released by the Air Force, which included isolates from vaccinated patients. These sequences have the receptor binding domain change, A189T, as well as a new glycosylation site created by S165N, which are important changes linked to the vaccine breakthrough. A precursor to this sub-clade was isolated in Texas, A/Texas/03/2010, and the more recent isolate, A/Texas/07/2011 is virtually identical to the sequences from Chihuahua. Moreover, one of the first cases in Chihuahua was from El Paso, suggesting that the vaccination problems associated with the Air Force sequences will also apply to the H1N1 circulating in El Paso, especially H1N1 associated with the spike in P&I deaths, which coincides will the unusually timed H1N1 outbreak in Chihuahua.
A similar vaccination effort has been ongoing in Chihuahua, but the week 14 report from a southeastern area in Juarez had a dramatic spike in influenza-like illness, providing further evidence for limited success with the late season vaccination campaign involving “fences”.
Release of sequences from the 43 P&I deaths in weeks 14 and 15, as well as severe cases in El Paso would be useful.