In light of the recent swine flu outbreak, HCJB Global Hands' Hospital Vozandes-Quito (HVQ) in Ecuador is tracking new flu cases and leading Ecuador in monitoring the threat of pandemic influenza.

"We've been thinking the world is ready for a flu pandemic, but we've been focusing on the avian flu," said HCJB Global missionary Dr. Richard Douce, an infectious disease specialist and resident expert on influenza in Ecuador.

He and Ecuadorian Dr. Wilson Chicaiza have been actively tracking flu cases at HVQ for nine years in collaboration with the U.S. Navy tropical medicine lab in Lima, Peru. As a result of the data collected, they have isolated two types of influenza and are now watching for the latest strain in Ecuador.

Douce said he is concerned about the swine flu outbreak for three reasons: it is happening outside the normal flu season; it is attacking young adults at a higher rate; it has already expanded from North America to Europe and now South America with a confirmed case reported Wednesday by Peruvian Health Minister Oscar Ugarte.

HVQ is taking precautionary measures since the swine flu virus could appear in Ecuador at any time. Chicaiza, Douce and other specialists are educating staff on proper procedures for handling patients exhibiting symptoms. The swine flu virus is also a type A influenza that mutates quickly and has the potential to be a pandemic. 

"The goal is to contain the illness to provide time for a vaccine to be introduced," said Chicaiza. Staff members are preparing to isolate patients with suspected cases and send patients home with masks. The hospital has also ordered supplies of the antiviral medication Tamiflu, thought to combat the latest virus.

The latest strain of the swine flu virus, influenza A (H1N1), is similar to the strain in 1918 that killed 40 million people. Thankfully, vaccines, antiviral drugs and surveillance programs like the one at HVQ have radically changed world preparation and response to influenza outbreaks.

As a sentinel hospital, HVQ tracks cases in Quito and helped start an influenza surveillance program in Ecuador's largest hospital, Hospital del Beneficiencia in Guayaquil. Flu cultures are now sent from both Quito and Guayaquil to Lima for registry with the U.S. Navy laboratory.

Along with the culture, a rapid test is done at the bedside. With this test, doctors can identify Influenza A or B from the patient within 10 minutes. The viral cultures that are sent from HVQ to Lima, Peru, are subsequently sent to the Centers for Disease Control and the World Health Organization.

Ecuador's equatorial location makes it ideal for tracking new cases and strains of the influenza virus. No seasonal trends of influenza are present, in contrast to areas lying farther north or south with distinct winters and summers.

"It's like every month is flu season" Douce explained. "Influenza is a common infection here, but most people don't realize it." Douce and Chicaiza will continue to monitor influenza cases, a work that is essential in leading Ecuador in awareness and preparation for the potential spread of swine flu.