Two Towns, Divided by a Border -- and by Perception of Risk in Outbreak

By Karl Vick
Washington Post Staff Writer
Thursday, April 30, 2009

CALEXICO, Calif. -- It's a border, not a barrier, yet the money-changers on the Mexican side wear rubber gloves and face masks. And 50 feet to the north, Raul Martinez changes pesos into dollars with his bare hands, and not a stitch covering a smile that turns rueful when he's asked why.

"I don't know why," said Martinez, 58, chuckling at either his bravery or his delusion as the reality of the border in the time of swine flu comes home: "It's the same air!"

Calexico and Mexicali, its neighbor to the south, blend as charmingly as their names, two towns in two countries separated by an international boundary but united by much more, at least under normal circumstances. But with the emergence of a virulent strain of influenza deeper in Mexico, a border population that moves daily between the countries has begun to act as though people are simply safer on the American side, complicating efforts to contain the outbreak, according to public health specialists.

The risks were made clear Wednesday when a Mexican child became the first fatality in the United States. The 23-month-old infant fell ill while visiting relatives in Brownsville, Tex., on one side of a border that roughly 600,000 people cross on a typical day, south to north.

Both Sides at Equal Risk

In Washington, lawmakers in both parties called Wednesday for tighter border controls, including possibly closing parts of it. Senior government health and security officials insisted that doing so would have "marginal" medical value because the virus has already spread across the United States. Nevertheless, the panel's chairman, Sen. Joseph I. Lieberman (I-Conn.). warned the Obama administration to consider tighter checks, such as on Mexican temporary workers, "because I think if you don't, there will be growing pressure to really close the ports of entry."

More than 40,000 people file into the United States from Mexicali every day, the third-highest-volume crossing point after San Ysidro, Calif., south of San Diego and El Paso. Customs and Border Patrol officials say they have detected no slackening since the U.S. government advised against "nonessential" travel to Mexico.

Most people who cross make a round trip daily, rotating in and out of the downtown U.S. border station that on the Calexico side pedestrians approach on a plaza shaped like a circle.

"I'm on my way to school," said Jennifer Talamamtes, 11, a sixth-grader at Rockwood Elementary in Calexico. Born on the American side, she had spent the night with her grandmother in Mexicali, where more people were wearing the surgical mask she was only half-wearing, tucked under her chin.

"Everyone's laughing at me" on the U.S. side, she said. "Everyone says that there's more sick people in Mexico than in California."

There are, but on the border the constant traffic makes the distinction largely irrelevant to health officials. "Pathogens do not recognize the geopolitical boundaries established by human beings," noted a 2003 Centers for Disease Control and Prevention report establishing a cross-border disease surveillance program. The report noted that data across the 1990s found increased risks for "certain foodborne, waterborne, and vaccine-preventable diseases" in U.S. counties within 60 miles of the border, compared with non-border states.

And indeed, the five swine flu cases confirmed in Imperial County, which contains Calexico, is one more than reportedly found in Mexicali, a city of 900,000. Perhaps more significantly, county health officer Stephen W. Munday noted that none of the five -- nor the five confirmed through Tuesday in neighboring San Diego County -- had recently visited Mexico.

The implication, Munday said, was that the bug came from carriers in the immediate area.

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