Guatemala is a small country in North America, population, 13 million. It may have some important lessons to teach us about what H1N1 is doing. Two recent stories, one from SDP Noticias and the other in El Mercurio emol prompt several observations.
1. Two recent patients appear to have had HIV/AIDS. How many people with HIV/AIDs have died of the new H1N1 in other countries? Is this one of the “underlying conditions” referred to in US case reports? If this is a risk factor, it should be explicitly named.
2. The case fatality rate is very high in Guatemala: 2%. This could be because many cases have not been reported. Or it could be because Guatemala is a poor country and most of the ill do not get Tamiflu. If it is the latter, we really, really need to know this. Seroprevalance studies should be conducted in Guatemala and the results released as quickly as possible.
3. There isn’t much Tamiflu in Guatemala. Is this why so many people are dying? If so, then what is happening in Guatemala today may happen in rich countries when their Tamiflu runs out or Tamiflu resistant strains become dominant.