Fear as killer disease stalks Mexico streets
Doctors report hundreds queueing at hospitals as death toll rises to more than 80

In a usually seething, teeming metropolis of 22 million souls, this Sunday in Mexico City was like no other before it. Mexico city is in an unprecedented lock-down, ground zero in a swine flu outbreak that has killed more than 80 people in Mexico in two weeks, has spread from New York to New Zealand, and which threatens to become a global pandemic. For inhabitants of Mexico City, crammed together in one of the most densely populated urban centres of the world, it is the ultimate nightmare: a deadly virus in their midst.

At the few Catholic churches which had not cancelled their services, priests gave communion in the hand rather than on the tongue. Outside the sprawling Metropolitan cathedral in the heart of the city, families who had arrived to have children confirmed read notices declaring that no such ceremonies would go ahead.

People emerging from the subways were greeted by soldiers and health workers handing out surgical masks – tapa bocas, literally covers for the-mouth. People have been warned not to kiss or shake hands in greeting. The US embassy told its tourists to keep six feet away from other people.

The streets around the central square, the Zocalo, and the oasis of Chapultepec Park, normally bustling with life, were eerily quiet. Many bars, restaurants and clubs had followed the Government's advice to shut. At the giant Aztec football stadium, Club America played Guadalajara in front of 105,000 empty seats. Schools have been ordered to shut until 6 May and businessmen are wondering how many employees will show up this morning.

Adding to the sense of alarm, the city's Mayor said yesterday that two more people had died of swine flu overnight, and three other deaths are suspected to have been caused by the new strain. He urged anyone with symptoms to seek medical treatment, and doctors reported that hundreds of people were thronging hospitals. Mindful of the need to protect tourism and limit the spread of the disease, Mexican airports were broadcasting warnings yesterday telling people not to board planes if they felt ill.

What was dismissed for several weeks as a late-season return of the winter flu has quickly turned into a major public health alert. The Mexican President, Felipe Calderón, making up for lost time, proclaimed a swine flu emergency that gives him the power to order quarantines, curtail transport and suspend public events. "The Federal Government under my charge will not hesitate a moment to take all – all – the measures necessary to respond with efficiency to this respiratory epidemic," he declared. "It's a grave problem, a serious problem, but we're going to overcome it."

The first known death was reported on 13 April in the southern province of Oaxaca, the Mexican Health Minister said, but he admitted that earlier cases could well have gone undetected. Officials began noticing a spike in flu cases as early as late March. Instead of tapering off near spring, the number of cases tripled. Day after day, the cases of severe respiratory problems accumulated, but it took several weeks before it would become clear that a new form of flu, most likely unaffected by vaccination, was responsible.

As a result, investigators now face a difficult task in trying to isolate the origins of the outbreak. No reports have surfaced so far of any connection to the pig farming industry, and all the signs point to the disease being spread by human-to-human contact, making it particularly difficult to combat. Health workers who had contact with other victims began to join the list of people becoming infected. A mass vaccination program was aborted last week after it became clear the new strain is most likely resistant. Even after the first death, it took five days before the first of 14 mucus samples were sent to the US for testing. Mexico lacks the scientific know-how to conduct such tests, and it seems to have been only the emergence of the strain in the US that pushed Mexican health authorities into action.

Health officials have now found suspected cases in 16 Mexican states, although the population density of the capital has meant that most of the deaths have been in Mexico City. The deaths appear to be concentrated in healthy adults in the 20-40 age group, instead of among the young and elderly normally affected by flu. At least 20 deaths are confirmed across Mexico. As of Saturday night, 1,324 patients were hospitalised with flu-like symptoms. Swine flu is suspected in a total of 86 deaths so far, the country's Health Minister said.

Mexico has a million doses of antiviral medicine, easily enough to treat the cases so far, the World Health Organisation said, adding that it believed authorities can handle the outbreak. But ordinary Mexicans are taking few chances. Wearing two blue surgical masks and a heavy coat, 31-year-old Daniela Briseno swept the streets in Mexico City. "I should be at home," she said, "but I have a family to support."

(By Stephen Foley, The Independent, 27/04/2009)