Mexico Hurried to Build Testing Lab for Swine Flu

By William Booth and Joshua Partlow
Washington Post Foreign Service
Friday, May 8, 2009

MEXICO CITY -- The staff was overwhelmed. The director was sleeping only a few hours a night. The telephones kept ringing and ringing as thousands of saliva samples from sick patients were rushed in. But the national testing laboratory was unable to identify a deadly new strain of swine flu.

Mexican President Felipe Calderón and international health authorities were demanding the most basic answers about the outbreak, but the National Institute of Diagnostics and Epidemiology here in the capital did not have enough genetic-screening machines -- or technical expertise -- to provide them.

The genetic decoders, called real-time polymerase chain reaction machines, cost $30,000 each. The national lab's staff had only one, purchased weeks earlier, and barely knew how to operate it.

This crucial gap was one reason there were so many unanswered questions about the epidemic in the first days -- such as how many people were infected.

"They were not prepared," said Jonas Winchell, chief of the response and surveillance laboratory at the U.S. Centers for Disease Control and Prevention in Atlanta, who flew to Mexico City on April 26 to help build a lab operation to test for swine flu virus.

But in a remarkable turnaround, the Mexicans and their international collaborators built a swine flu testing facility almost from scratch -- and in less than a week went from near-panic to competently processing almost 500 tests for swine flu a day. The rapid creation of the Mexican laboratory has been applauded by public health experts in Europe and the United States as a sign of Mexico's outsize role in confronting the potential pandemic.

Asked at the beginning of the epidemic what he needed most, Miguel Ángel Lezana, the government's top epidemiologist, told The Washington Post, "We have to develop, we have to enhance our laboratory capabilities in order to make use of these advanced technologies."

Lezana, who heads Mexico's National Center for Epidemiology and Disease Control, said the development of testing laboratories is "essential in order to provide diagnosis faster." He said he hoped to have a network of regional labs operating within six months.

Mexican health officials confirmed that they were confronting a new swine flu virus on the evening of April 23, when they heard the news from their counterparts in the United States and Canada who had tested samples sent to national labs in Atlanta and Winnipeg.

Winchell arrived in Mexico City on the evening of April 26. The next morning, he was at Mexico's national institute, along with Ute Stroeher from the special pathogens program at Canada's National Microbiology Laboratory.

"They didn't have the reagents, the protocols, the clean rooms, the technical expertise or the machines," said Winchell, who praised his Mexican counterparts for their speed in developing testing abilities.

Celia Alpuche, the director of the national institute, was under tremendous pressure from the Calderón administration to start producing answers. "It was very tense. The pressure was mounting," Winchell said. "The wolves were at the door."

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