Life in the Fast Lane: H1N1 Pandemic Dynamics in Mexico's Central Influenza Corridor

The H1N1 pandemic spread from rural Mexico through Mexico's Influenza Corridor. It has now become established in the rest of the world. Although surveillance mechanisms in Mexico were adequate, Mexico did not have the infrastructure to identify quickly the emergence of this novel strain. Mexico's reaction in contrast to the initial steps associated with the 2002-2003 SARS' outbreak was swift and immediate. Mexico's public health officials took immediate massive social-distancing measures, which were effective over a short-time scale. The “second” wave has now hit Mexico and the rate of infections has far exceeded those over the months of April through June 2009. Central Mexico's Influenza corridor, the large movements of individuals in and out of Mexico's Metropolitan area (a region that includes a fifth of Mexico's population), and past strict social-distancing measures, no equivalent measures were taken in Canada or the USA, seemed to have had a dramatic effect on the ongoing influenza dynamics within Mexico. Many questions remain: Did the social-distancing measures (no longer in effect) combined with summer school breaks not only slowed down the first wave but also resulted in a less manageable second wave? Is the lack of advanced diagnostic facilities and uniform surveillance systems, common in poor nations, “good” for the rest of the world? What will be the impact of the limited access that the have-nots (individuals or nations) have to adequate supplies of antiviral drugs and/or the H1N1 vaccine on the dynamics of H1N1? What will be the impact of delays in the distribution of a limited supply of H1N1 vaccine on local outbreaks, particularly in developing or poor nations? What are the “optimal” public health policies for non-wealthy nations? What have we learned from Mexico's experience?