Mexico flu response helped world prepare

MEXICO CITY (Reuters) - Criticism is growing louder in Mexico over the government shutting down public life to stem a flu epidemic but many experts believe Mexico's apparently quick and forceful actions could keep people safer in other countries.

Factory owners, restaurant owners and ordinary Mexicans are upset about temporary closures of everything from soccer stadiums to assembly lines, which is hurting the economy.

"From a global public health view, it was a very courageous decision and probably helped to minimize the spread outside of Mexico," said Timothy Brewer of McGill University Medical School in Montreal.

The disease, commonly called swine flu, is suspected of killing more than 100 people in Mexico, although estimates on the death toll have fallen sharply in recent days. Only 26 flu deaths have been confirmed by laboratories, Mexico says.

Sunday, as Mexico said it was past the worst, people in the capital were frustrated by lost wages and fed up with staying in their homes.

"They should open everything back up so we can work," said Alberto Vazquez, 28, who washes cars for a living at a park in Mexico City.

"These last days have been hard on us. If we don't work, we don't eat," he said.

Nevertheless, Mexico's cooperation with international researchers appears to have helped set in motion a global effort to quickly contain the H1N1 virus, which has killed just one person outside Mexico, a Mexican toddler visiting Texas.

The United States has declared a public health emergency, and said it would distribute a quarter of its stockpile of antiviral treatment to states. Countries around the world launched public awareness campaigns advising how to avoid catching flu.

MYSTERIOUS VIRUS

Mexican health officials say they began noticing an abnormally high number of flu cases in mid-March. By mid-April, Mexico had sent samples of mysterious viruses to be identified in Canada and had discussed the outbreak with the United Nations' World Health Organisation.

On April 21, the U.S. Centers for Disease Control and Prevention identified a new type of flu in two U.S. children. It turned out to be the same strain as the virus from Mexico.

With information from the Canadians, Mexico confirmed on April 24 the new virus was killing people. The WHO activated its command centre for acute public health events. Within a week Mexico was shutting down its economy.

"I would have no criticism of Mexico," Michael Ryan, the WHO's director of global alert and response, said at a news briefing Saturday in Geneva. Authorities in Mexico "have been exceptionally responsive to requests of information."

The WHO said it has confirmed H1N1 flu infections in 20 countries. A top U.S. health official said the new flu might not be more severe than what would be seen during normal seasonal flu, the virus could still have a "significant impact" on people's health.

Health experts say Mexico's response contrasts sharply with the way China covered up an outbreak of the deadly SARS virus in 2002. SARS, or severe acute respiratory syndrome, killed more than 800 and infected 8,000 people around the world in 2003 before it was brought under control.

"It appears, given the amount of resources ... that the initial moves in Mexico certainly seemed appropriate," said Scott Lillibridge, of the University of Texas Health Sciences Centre in Houston.

Within Mexico, the public healthcare system has been widely criticized for reports of patients being turned away from hospitals. Responding to both that criticism and the charge that it overreacted by shutting down businesses, the Health Ministry has replied that it has done its best and that public safety trumps the economy.

Some scientists have also criticized the data released publicly by Mexico. Since the crisis began, Mexico's Health Ministry has released a shower of numbers on flu cases and deaths that at times appeared contradictory.

"We were starting off a week ago with only the Mexican data and the data was, I think, horribly unreliable," said Tim Sly, an epidemiologist at Ryerson University in Toronto.

Mexican officials said they may never know how many people died of the new flu strain, as some victims were buried before they could be tested. Officials have scaled back their original estimates.

But health experts note that tracking outbreaks of new diseases is notoriously tricky, and that Mexico did its job by sharing information that led to sounding the global alarm.

"The rest of us had the benefit of knowing what was going on in Mexico first," McGill University's Brewer said.

(Additional reporting by Catherine Bremer and Louise Egan in Mexico City, and Maggie Fox in Washington)