Abstract

In April 2009, Mexican, American, and Canadian authorities announced a novel influenza that became the first pandemic of the century. We report on lessons learned in Mexico. The Mexican Pandemic Influenza Preparedness and Response Plan, developed and implemented since 2005, was a decisive element for the early response. Major lessons-learned were the need for flexible plans that consider different scenarios; the need to continuously strengthen routine surveillance programs and laboratory capacity and strengthen coordination between epidemiological departments, clinicians, and laboratories; maintain strategic stockpiles; establish a fund for public health emergencies; and collaboration among neighboring countries. Mexico responded with immediate reporting and transparency, implemented aggressive control measures and generous sharing of data and samples. Lessons learned induced changes leading to a better response to public health critical events.

Highlights

  • In 2009, the Mexican Federal Government was prepared to detect and respond rapidly to the emerging threat from the A(H1N1)pdm[09] influenza virus

  • Weak regulatory and logistic frameworks: The strategic stockpile of oseltamivir was stored in bulk powder containers, with the Pandemic Influenza Response Plan (PIRP) stipulating that reconstitution would be carried out at Institute of Epidemiological Diagnosis and Reference (InDRE) and the Public Health State Laboratories (PHSL) network

  • Response and preparedness are a must: Centers for Disease Control and Prevention (CDC) estimates that 105,700-395,600 people worldwide died from a cause associated with AH1N1pdm[09] influenza; 80% of deaths are estimated to have occurred in people younger than 65 years of age.[11,12,13]

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Summary

Introduction

In 2009, the Mexican Federal Government was prepared to detect and respond rapidly to the emerging threat from the A(H1N1)pdm[09] influenza virus. On April 14 and 15, 2009, the Ministry of Health (MOH) received notification of pneumonia cases affecting mostly young adults from Oaxaca, San Luis Potosı, and Mexico City Samples from these cases were analyzed at the Laboratory for Epidemiological Surveillance of the Institute of Epidemiological Diagnosis and Reference (InDRE); either the result was negative or found to be positive for influenza “A” using Reverse Transcription Polymerase Chain Reaction (RT-PCR) but could not be further subtyped. Pandemic preparedness collaboration among private businesses with the public sector is critically important This mechanism failed to provide vaccines on time for the Mexican population.

Developing an effective surveillance and diagnostics system
Health system fragmentation
Information system maturity
Responsible science communication and media
Healthcare provider planning and preparedness
Weak regulatory and logistic frameworks
Lack of emergency funds
Lack of state and local engagement in PIRP development
Access to emergency funding
Strengthening information systems
Access to life-saving medication
Conclusion
Findings
Declaration of conflicting interests
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