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One reason there have been so many deaths in Mexico is likely that many of those first becoming ill already lived in reduced circumstances, with little clean water, heavily polluted air, a shortage of nutritious food and almost no medical care. Without an adequate medical care system, Mexico did not discover the outbreak in time to keep it from becoming a somewhat localized epidemic. It is likely that the current epidemic continued for a period of time, infecting large numbers of people who never sought medical care and never came to the attention of authorities. Our porous border, with constant traffic from Mexico, created the ideal scenario to become a widespread pandemic situation. As usual, Mexican citizens with serious illness headed for better medical treatment in the United States if they were close enough to the border or affluent enough to get on a plane-a sensible decision in the face of scarce local medical care. Because of a large tourist industry, visitors from around the globe were exposed to the virus before it was ever discovered to be a local problem.

Usually, the first "wave" of an influenza pandemic lasts from six to eight weeks among whatever population is exposed to the virus. In situations such as is presently occurring common sense tells us that this timeframe may be extended as the infected travel to new areas and spreads the virus among new victims. Therefore, the first wave might last three, four, five months before it peters out by having no new hosts to infect. Some areas may not experience any cases of this type of influenza at all. Already it appears many fears of a fast-spreading pandemic were overblown: the virus is not spreading like a brand-new, fast moving virus so it s likely at least some of the population in the United States already has enough residual immunity to some parts of the mix to prevent infection.

The reason vaccine makers are hurrying to create a vaccine is because flu has a bad habit lying low for a period of 6-12 months before coming back to infect those it missed the first time. This is the second, and in some ways, most dangerous wave. Often, while lying seemingly dormant within a few host victims, the virus may mutate enough to become virulent even to those that experienced infection during the first wave. A carefully crafted vaccine may work to protect victims from the second wave. However, haste in creating a vaccine can have unintended consequences such as we experienced in the 1975-6 swine flu outbreak.

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