Pandemic (H1N1) 2009 in Marginalized Populations | CDC EID

EID Journal Home > Volume 16, Number 8–August 2010

Volume 16, Number 8–August 2010
Dispatch
Pandemic (H1N1) 2009 Surveillance in Marginalized Populations, Tijuana, Mexico
Timothy C. Rodwell , Angela M. Robertson, Norma Aguirre, Alicia Vera, Christy M. Anderson, Remedios Lozada, Lwbba Chait, Robert T. Schooley, Xing-quan Zhang, and Steffanie A. Strathdee
University of California, San Diego, California, USA (T.C. Rodwell, A.M. Robertson, N. Aguirre, A. Vera, C.M. Anderson, L. Chait, R.T. Schooley, X.-Q. Zhang, S.A. Strathdee); and Patronato Pro-COMUSIDA, Tijuana, México (R. Lozada)

Suggested citation for this article

Abstract
To detect early cases of pandemic (H1N1) 2009 infection, in 2009 we surveyed 303 persons from marginalized populations of drug users, sex workers, and homeless persons in Tijuana, Mexico. Six confirmed cases of pandemic (H1N1) 2009 were detected, and the use of rapid, mobile influenza testing was demonstrated.
The first declared influenza pandemic in 40 years likely originated in March 2009 in La Gloria, Veracruz, a small rural town in southern Mexico (1). The virus responsible for the outbreak, identified as a novel influenza A (H1N1) virus, now referred to as pandemic (H1N1) 2009, spread quickly. By the end of 2009, ≈70,000 cases were confirmed and 944 deaths were recorded in Mexico (2), and >600,000 cases were reported worldwide (3).

When pandemic (H1N1) 2009 first emerged there was concern that Mexico–US border cities, which have served as corridors for binational transmission of infectious diseases (4), might become overwhelmed by the disease before national surveillance resources could be mobilized. Of particular concern was the fact that traditional hospital-based disease surveillance would miss the emergence of pandemic (H1N1) 2009 in the dense, highly mobile (5), marginalized border populations. Furthermore, the poorest and most underserved border populations, composed of the homeless, commercial sex workers, and those with alcohol and drug abuse problems, have disproportionately high levels of diseases such as HIV (6) and tuberculosis (7), illnesses suspected of increasing vulnerability to acquiring and dying of pandemic (H1N1) 2009 (8,9). We report the results of an enhanced surveillance effort to detect early pandemic (H1N1) 2009 cases and assess perceptions of the pandemic and risk factors associated with acquiring the disease in marginalized populations in Tijuana, Mexico.

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Suggested Citation for this Article
Rodwell TC, Robertson AM, Aguirre N, Vera A, Anderson CM, Lozada R, et al. Pandemic (H1N1) 2009 surveillance in marginalized populations, Tijuana, Mexico. Emerg Infect Dis [serial on the Internet]. 2010 Aug [date cited]. http://www.cdc.gov/EID/content/16/8/1292.htm

DOI: 10.3201/eid1608.100196