CHICAGO - A 5-year-old Mexican boy takes ill in his dusty village. He coughs, he sneezes, he gasps for breath.
Hundreds of Edgar Hernandez's neighbors in La Gloria — villagers who live among smelly pig-breeding farms that attract swarms of flies — already have flu-like symptoms. After they complain repeatedly, government workers arrive to conduct medical tests.
Edgar recovers, but his illness remains a mystery to his family — at least for a while.
A 9-year-old boy arrives at a medical clinic in Elyria, Ohio, an industrial city 20 miles southwest of Cleveland. He has a sore throat, body aches, fever and dizziness.His mother consults a pediatric nurse practitioner, Sally Fenik; she thinks it's strep throat or an allergy. She also mentions to the nurse they've just returned from visiting relatives in Mexico but doesn't think it's swine flu because no one else in the family is sick.
But on her way to work, Fenik has heard a radio news report about swine flu turning up in states bordering Mexico. She's far away, in the industrial Midwest, but remembers thinking, "Boy, I hope that doesn't start spreading and getting worse."
After a rapid strep test on the boy comes back negative, Fenik does a nasal swab.
A half-hour later, the lab calls. It's the type of influenza linked to swine flu virus.
This past Sunday, the Centers for Disease Control and Prevention confirmed the third-grader from Ohio had swine flu. And then on Monday, the Veracruz governor swooped in by helicopter to La Gloria to tell Edgar's mother what medical experts already know — the kindergartner was Mexico's first confirmed case of swine flu.
Two boys, two pieces of the puzzle
Two boys in communities 1,700 miles apart — two pieces of a vast epidemiological puzzle.
In this age of global trade and travel, the swine flu outbreak has proven itself a global illness — a strange new virus that respects no border as it hopscotches from the dirt roads of Mexican villages to the concrete canyons of big-city America to a glittering Hong Kong hotel.
The list of the nationalities of some of its victims, in the last week alone, reads like the index of an atlas: Austria, Britain, Canada, Germany, Israel, Mexico, the Netherlands, Spain, Switzerland, the United States.
It even stopped a superhero in his hairy tracks: Hugh Jackman canceled an appearance in Mexico City to promote "X-Men Origins: Wolverine."
No one knows precisely where the swine flu virus will pop up next.
All they know is that it will.
"Influenzas are hard to predict," Dr. Gregory Gray, director at the Center for Emerging Infectious Diseases at the University of Iowa College of Public Health, said at midweek. "I don't think this will go away in a few days. The way it's moving and the way air transportation goes ... I think this thing is going to spread to every continent in the next week."
'No idea where it came from'
Where and how it all began is a medical mystery.
But one of the first hints of trouble surfaced toward the end of winter, just when the flu season should be wrapping up. It came from the Mexican state of Veracruz — a region that includes a high plain that supplies Mexico with much of its cured pork products and has many villages that are surrounded by pig-breeding farms.
Edgar Hernandez lives in one of them, La Gloria, a hillside hamlet (population 3,000) where people started complaining of bad colds at the end of February. On March 23, Veracruz health officials arrived to take saliva samples.
About a third of some 1,300 townspeople who sought medical attention — 450 or so — were diagnosed with acute respiratory infections and given surgical masks and antibiotics.
Edgar fell ill a bit later; the energetic 5-year-old retreated to his bed with a high fever. Other kids in his school already were sick.
People in his town have long complained that some of the pits that hold pig waste are not properly lined; they fear their groundwater is contaminated. They're frustrated and angry, too, about the stench and the swarms of flies that invade their village.
Granjas Carroll de Mexico, half-owned by U.S.-based Smithfield Foods Inc., operates dozens of farms around La Gloria. Smithfield said in a statement this week that it has found no signs or symptoms of swine influenza in its herd or its workers.
Whether La Gloria is ground zero in this outbreak is not yet known.
Mexican health officials downplayed the possibility, pointing out Edgar had the only positive saliva sample among just 35 people tested for the new virus. It wasn't until last week that authorities confirmed the little boy was infected with a new H1N1 strain — a strange hybrid of pig, bird and human flu virus.
Two children from La Gloria died before being tested; their parents refused to let them be exhumed.
Mexico's chief epidemiologist, Dr. Miguel Angel Lezana, says officials haven't ruled out Mexico, the United States, Asia or Europe as the origin of the swine flu virus.
The CDC has no firm answers either.
"We have no idea where it came from," says Michael Shaw, the CDC's associate director for laboratory science. "Everybody's calling it swine flu, but the better term is swine-like. It's like viruses we have seen in pigs — it's not something we know was in pigs. It doesn't really have any close relative."
By early April, the Veracruz government notified Mexican authorities of a possible flu outbreak in La Gloria. This alert happened to come around Holy Week, a time when lots of people in this largely Catholic country travel to visit family.
On April 12, Mexican health authorities notified the CDC and the Pan American Health Organization of the unexplained cases of severe respiratory illness.
One day later, people started dying.
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