Terremoto en México: la respuesta en salud del gobierno de la Ciudad de México / Earthquake in Mexico: Mexico City governmentʼs health response

Resumen Ante el evento telúrico del 19 de septiembre de 2017, la Secretaría de Salud de la Ciudad de México (Sedesa) y las instituciones sectorizadas a ella instrumentaron intervenciones en lo inmediato: cada unidad en la red hospitalaria de la Sedesa se preparó para la recepción masiva de pacientes. Se suspendieron las cirugías programadas, se trasladó a los pacientes de urgencias a hospitalización o terapia intensiva y se egresó a aquéllos que pudieran continuar en sus casas, para recibir pacientes con prioridad roja y amarilla. Con la declaratoria de emergencia publicada por el jefe de gobierno la Sedesa, en coordinación con otras dependencias del gobierno de la CDMX, instituciones federales, paraestatales, organizaciones de la sociedad civil e instituciones privadas se instrumentaron los planes, protocolos y acciones definidos exprofeso.

Abstract Before earthquake event of September 19, 2017, the Health Ministery of Mexico City and the institutions sectored to it, immediately implemented interventions: To receive patients with red and yellow priority, each unit in the hospital network of Sedesa, was prepared for massive reception of patients; scheduled surgeries were suspended, emergency patients were transferred to hospitalization or intensive therapy and those who could continue in their homes were discharged. With declaration of emergency, published by the head of government, the Ministery of Health, in coordination with other agencies of CDMX Government; federal institutions, parastatals, civil society organizations and private institutions, implemented the plans, protocols and actions defined exprofeso.

Stories behind the statistics: a review of abortion-related deaths from 2005 to 2007 in Mexico City.

Evidence suggests that restricting abortion does not reduce its occurrence but increases health risk. A qualitative analysis was performed, reviewing the medical charts of 12 women who died from unsafe induced abortions in Mexico City; most deaths occurred before abortion was decriminalized. Women resorted to using unsafe techniques, without medical guidance or under incorrect recommendations by providers, ultimately resulting in the loss of their lives. Postabortion care in private and public health facilities was often inadequate. The cases illustrate the importance of liberalizing abortion laws and improving postabortion care to protect the life and health of women seeking to terminate pregnancy.

Patient characteristics and service trends following abortion legalization in Mexico City, 2007-10.

Legal abortion services have been available in public and private health facilities in Mexico City since April 2007 for pregnancies of up to 12 weeks gestation. As of January 2011, more than 50,000 procedures have been performed by Ministry of Health hospitals and clinics. We researched trends in service users' characteristics, types of procedures performed, post-procedure complications, repeat abortions, and postabortion uptake of contraception in 15 designated hospitals from April 2007 to March 2010. The trend in procedures has been toward more medication and manual vacuum aspiration abortions and fewer done through dilation and curettage. Percentages of post-procedure complications and repeat abortions remain low (2.3 and 0.9 percent, respectively). Uptake of postabortion contraception has increased over time; 85 percent of women selected a method in 2009-10, compared with 73 percent in 2007-08. Our findings indicate that the Ministry of Health's program provides safe services that contribute to the prevention of repeat unintended pregnancies.

Inside the outbreak of the 2009 influenza A (H1N1)v virus in Mexico.

BACKGROUND: Influenza viruses pose a threat to human health because of their potential to cause global disease. Between mid March and mid April a pandemic influenza A virus emerged in Mexico. This report details 202 cases of infection of humans with the 2009 influenza A virus (H1N1)v which occurred in Mexico City as well as the spread of the virus throughout the entire country. METHODOLOGY AND FINDINGS: From May 1st to May 5th nasopharyngeal swabs, derived from 751 patients, were collected at 220 outpatient clinics and 28 hospitals distributed throughout Mexico City. Analysis of samples using real time RT-PCR revealed that 202 patients out of the 751 subjects (26.9%) were confirmed to be infected with the new virus. All confirmed cases of human infection with the strain influenza (H1N1)v suffered respiratory symptoms. The greatest number of confirmed cases during the outbreak of the 2009 influenza A (H1N1)v were seen in neighbourhoods on the northeast side of Mexico City including Iztapalapa, Gustavo A. Madero, Iztacalco, and Tlahuac which are the most populated areas in Mexico City. Using these data, together with data reported by the Mexican Secretariat of Health (MSH) to date, we plot the course of influenza (H1N1)v activity throughout Mexico. CONCLUSIONS: Our data, which is backed up by MSH data, show that the greatest numbers of the 2009 influenza A (H1N1) cases were seen in the most populated areas. We speculate on conditions in Mexico which may have sparked this flu pandemic, the first in 41 years. We accept the hypothesis that high population density and a mass gathering which took in Iztapalapa contributed to the rapid spread of the disease which developed in three peaks of activity throughout the Country.

Identification of influenza A pandemic (H1N1) 2009 variants during the first 2009 influenza outbreak in Mexico City.

BACKGROUND: In March 2009, public health surveillance detected increased numbers of influenza-like illness presenting to hospitals in Mexico City. The aetiological agent was subsequently determined to be a novel influenza A (H1N1) triple reassortant, which has spread worldwide. As a consequence the World Health Organisation has declared the first Influenza pandemic of the 21st century. OBJECTIVES: To describe clinically and molecularly the first outbreak of influenza A pH1N1 (2009) during 1-5 May to establish a baseline of epidemiological data for pH1N1. Also, to monitor for the emergence of antiviral resistance, and mutations affecting virulence and transmissibility. STUDY DESIGN: Samples were collected from 751 patients with influenza-like symptoms throughout Mexico City and were tested for influenza A pH1N1 (2009) using real-time PCR. In the samples that were positive for influenza A pH1N1 (2009) fragments from the haemagglutinin (H1) and neuraminidase (N1) genes were sequenced. RESULTS: A total of 203/751 (27%) patients were positive for the pandemic H1N1 (2009) virus (53% male and 47% female). The 0-12-year-old group was the most affected 85/751 (42%). Sequence analysis showed five new variants of the pandemic H1N1 (2009) virus for NA: G249E (GQ292900), M269I (GQ292892), Y274H (GQ292913), T332A (GQ292933), N344K (GQ292882), and four variants for HA: N461K (GQ293006), K505R (GQ292989), I435V (GQ292995), I527N (GQ292997). CONCLUSIONS: We have provided a baseline of epidemiological data from the first outbreak of influenza A pH1N1 (2009) during 1-5 May in Mexico City. The sequencing of partial fragments of the HA and NA genes did not show the presence of previously described mutations affecting known sites of antiviral resistance in seasonal influenza A such as the H275Y (oseltamivir resistance), R293 or N295 etc.