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Border Disease Program Helped Sound Alarm on Swine Flu

Above: Pedestrians stand in line at the United States-Mexico border while wearing a surgical masks at the Port of Entry on April 27, 2009 in Tijuana, Mexico.

Audio

Aired 5/7/09

The first two cases of swine flu were confirmed in San Diego. Five days before Mexico City shut down, the Naval Health Research Center and a little know border health project identified two children with the virus. The border project has quietly monitored disease along the US Mexico border for the last ten years. KPBS Border Reporter explains how the group helped sound the alarm bells on the swine flu epidemic worldwide.

— The first two cases of swine flu were confirmed in San Diego. Five days before Mexico City shut down, the Naval Health Research Center and a little know border health project identified two children with the virus. The border project has quietly monitored disease along the US Mexico border for the last ten years. KPBS Border Reporter explains how the group helped sound the alarm bells on the swine flu epidemic worldwide.

A network of about a dozen hospitals and clinics dots the border from San Diego to Texas. Doctors at each one are part of a program that monitors patients for infectious disease. When someone tests positive, doctors send the results to the Border Infectious Disease Surveillance program.

"Its nitty-gritty epidemiologic work that’s done all over the world. Its just that we’re trying to put a little more focus on this part of the world and make sure we get good information."

Stephen Waterman is an epidemiologist with the Centers for Disease Control. He runs the program.

"We probably get several hundred swabs a year from both sides of the border."

He says that’s just for garden variety influenza. It was one of those swabs that helped raise the red flag on swine flu. Now. jump back about three weeks…

"We had this sort of interesting situation."

A ten year old boy catches the flu in San Diego. He goes to Balboa Hospital.

"It was sort of an unusual virus."

Doctors were flummoxed. "It didn’t react to the usual tests." And they sent the virus to the CDC. A day or two later, a nine year old girl gets sick. She’s 100 miles east in Brawley.

"She went to the Brawley Clinic with a fever, about 104 degrees, and a sore throat and was tested there."

The Brawley Clinic is part of the border surveillance program.

"And it is the same untypable strain."

That means doctors know it is the flu, but not what kind. So, doctors sent the girl’s test to the CDC. Meanwhile, the 10 year old San Diego boy’s results come back.

"And it turned out to be a unique swine virus."

And then, the Brawley test came back.

"And it was confirmed at CDC also to be this same unique swine virus strain that had never been seen before. And when we saw two of them within a couple of days of each other, with no history of swine exposure, immediately the alarms went off that this could be a person to person easily spread virus."

A new strain to which the whole world might be susceptible. Waterman says this all came together on a Friday night. He says there were conference calls with the San Diego and Imperial County Health Departments, and then with the CDC.

Several weeks before, Waterman says they’d talked with Mexican officials about unusual outbreaks of flu there.

"The feeling was wow, this was a big deal. And we’ve really got to jump on top of this and people went out late in the evening and started interviewing the cases and just started going to work."

The pigs at the Imperial County Fair the 9 year old Brawley girl had visited were one line of investigation. Waterman says getting more swabs from people along the border was another priority. He flew to CDC headquarters in Atlanta. While he was there, the first cases of swine flu in Mexico were confirmed.

CDC emergency officials rushed Waterman to Mexico. They tapped him because of his decade of experience working with Mexican health officials along the border.

"Had to have my wife send me some clothes and they’re stuck in customs in the airport in Mexico City, so I don’t have a lot of variety in what I am wearing."

Despite the fashion crisis, Waterman says the surveillance work along the border helped health officials respond to the swine flu crisis quickly.

"We’ve been able to pick up a number of important outbreaks over the year, but this is the biggest one. So, yeah, I think, we worked very hard for ten years. You just got me there for a second. It’s a little bit gratifying to see that we could do this good public health work."

Waterman says he’ll be in Mexico for another week. He’s working with Mexican epidemiologists to piece together what happened and determine if swine flu is under control. The team will also provide recommendations to the group that makes next year’s flu vaccine.

Amy Isackson, KPBS news.

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