Health - TX

Operational Biosurveillance - biosurveillance.typepad.com - October 1, 2013

Mexico is reporting upwards of 44 cases of cholera now with one fatality involving Hidalgo State and Mexico City.  The appearance of cholera in Mexico City is deeply concerning from the standpoint of the "tip of the iceberg": we only know of the recognized cases.  There are likely others out there.

A couple of points about this:

1. Totally expected to see expansion of the Nepalese cholera from Haiti to the DR, to Cuba, and now to Mexico. It is likely to include many other countries in that region before all is said and done.

2. It is likely to spread in Mexico in 'fits and starts' due to lack of indigenous immunity and will cause disruption.

3. It will likely spread along trade and migrant labor routes to the US and other countries doing business with Mexico.

4. Communities in the US may be caught unawareness due to basic expectation of border communities in Texas serving as "canaries in a coal mine" for the rest of the country. We propose the migrant labor routes penetrate deep into the US and far from these border communities.