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Some fear flu rebound as Mexico seeks 'normalcy'
(Agencies)
Updated: 2009-05-05 08:26

"It's clear that it's just about everywhere in Mexico. I think now there is considerable person-to-person transmission," Widdowson said. And now that the virus is taking off in the US, chances of severe cases could rise as well.

"We've seen in many of the cases in Mexico, there's been sometimes five to seven days of being mildly ill with increasing respiratory distress and then being hospitalized, and then spending five days or a week in hospital, so that's a timeline of two weeks," he said.

As of Monday, Mexico had 727 confirmed cases, and US case grew to at least 300 in 36 states. Globally, the virus has reached more than 1,276 people in 20 countries -- still in its early stages, to the World Health Organization.

The WHO was studying whether to raise the pandemic alert to 6, its highest level, which would mean a global outbreak has begun. WHO uses the term pandemic to refer to geographic spread rather than severity. Pandemics aren't necessarily deadly. The past two pandemics -- in 1957 and 1968 -- were relatively mild.

"We do not know how long we will have until we move to Phase 6," WHO Director-General Margaret Chan said. "We are not there yet. The criteria will be met when we see in another region outside North America, showing very clear evidence of community-level transmission."

The Southern Hemisphere is particularly at risk. While Africa still hasn't reported any A (H1N1) flu infections and New Zealand is the only country south of the equator with confirmed cases, winter is only weeks away. Experts worry that typical winter flus could combine with A (H1N1) flu, creating a new strain that is more contagious or dangerous.

The latest figures from Mexico suggest the virus may be less lethal and infectious than originally feared. Only 38 percent of suspected cases have turned out to be A (H1N1) flu, and no new deaths have been reported since April 29. But Cordova acknowledged that about 100 early deaths in which the flu was suspected may never be confirmed because mucous or tissue samples were not collected.

Widdowson, of the CDC, said it's too early to say the outbreak is waning in Mexico, but the signs of progress are clear.

"What we have not seen in Mexico City is a huge, runaway epidemic, and I think that's totally clear. The hospital capacity has not been exceeded. So there hasn't been anything like the kind of picture that people might expect from a severe flu," he said. "I think that gives us optimism."

Good hygiene can be a challenge in Mexico's crowded schools. Some in rural or poverty-stricken areas are dirt-floored, tin-roofed shacks without bathrooms.

Ten-year-old Carolina Arteaga illustrated the problem as she wandered a downtown Mexico City street Monday with the plastic cup she uses to beg money from people outside gleaming office towers. She had no surgical mask, no gloves, and with grubby fingers she eagerly rubbed the few coins people had deposited her cup.

"I forgot it at home," the fourth-grader said when asked why she didn't have her mask.

Carolina will soon be returning to school and says she knows to wash her hands frequently. But because she needs to collect money to help her mother buy food, such instructions probably won't be carried out.

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