Latin America Data Base

Central America is in the very earliest stages of responding to the threat posed by swine flu that has killed over 150 and sickened thousands in Mexico (see SourceMex, 2009-04-29). As yet, cases are few and paradoxically getting fewer in some places as some suspected cases turn out not to be the killer flu. This was the case April 29 in Guatemala, where three cases were reported negative, but a wary Waleska Zecena, director of the Central Nacional de Epidemiologia (CENEPI), is taking no chances and is retesting that last case.

The region is on alert, with El Salvador appearing to have taken the most decisive measures so far. President Antonio Saca has declared a state of emergency and called a press conference to announce it. The decree permits the Ministry of Health to request funds from the treasury to obtain medications and make whatever other expenditures it deems necessary to prevent and treat. It can also call upon the country’s state and military hospitals to provide personnel. Saca said he had ordered the treasury to stand ready to make the disbursements and also to provide personnel to observe people entering the country for signs of the disease. Also, pork imports from the US, Mexico, and Canada have been suspended.

Interrupting commercial flows is a sensitive measure, so Agriculture Minister Mario Salaverria quickly went public to announce, “It is a temporary measure. We must have clarity where and how this problem originated, how this virus is transmitted to humans. It is a precautionary measure we have taken.” He explained that it was not El Salvador’s idea, and it was not alone in doing it. He said it was a joint decision of agriculture ministers of the isthmus at an April 24 meeting.

El Salvador normally imports about 69,000 kg of pork a month from the US and Mexico. Salaverria said that supplies on hand were sufficient to avoid shortages and that domestically grown pigs are constantly monitored and are disease free.

Nicaragua also suspended pork and pig imports but very quickly reinstated pork products other than live pigs, even though, according to an official, Nicaragua does not import live pigs from Mexico. Vice Minister of Agriculture Benjamin Dixon said the decision to rescind the ban came after learning that the flu is not transmitted by consuming pork. It can be passed to people from pigs, but the main vector currently is people.

The region’s health ministers met in Managua on April 28 to agree on an emergency plan. At that time, a single case had been confirmed on the isthmus, in Costa Rica. Attending the closed-door meeting were the ministers of the Sistema de la Integracion Centroamericana (SICA), Guatemala, El Salvador, Honduras, Belize, Nicaragua, Costa Rica, Panama, and the Dominican Republic. Nicaraguan President Daniel Ortega ordered the meeting in his capacity as SICA president pro tem. Ortega wanted a unified response to gather resources and impose controls.

The ministers decided upon health decrees like the one Saca issued, as well as monitoring and mass prevention campaigns. They also contributed to a regional-impact analysis, given the particular vulnerabilities occasioned by poverty and scarce resources. Prevention campaigning involved the media in regionwide messages with recommendations and instructions for personal and collective hygienic practices, and explanations of facts concerning the disease.

In Costa Rica, newspapers carried the messages, along with photos and news of the progress of the flu. Besides the one confirmed case, the population was told of 21 others that turned out not to be the swine flu.

Honduras was reported to have stopped two of its citizens, one deported from the US, another returning from Mexico, who appeared to be sick, and to have detained them pending the results of an evaluation.

By April 29, Costa Rica had two cases. Both had arrived by air from Mexico. Health authorities said they are looking for 92 passengers who arrived on the plane with one of them to determine their state of health. Both of these people were isolated in hospital for a day and then released but quarantined in their homes. Under the terms of an emergency decree, authorities were empowered to do this. “We are allowed as health authorities to take certain legal actions, like, for example, order affected people to stay home in a type of quarantine,” explained Minister of Health Maria Luisa Avila.

In addition to the two confirmed cases, Costa Rican authorities had another 13 under observation.