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Tourists with face masks arriving from Mexico City at Frankfurt international airport on April 28

Swine flu continues to dominate global attention on April 28, and it remains unclear why deaths presently are confined to Mexico. Mexico has reported 152 deaths presumed to be associated with the swine flu, but has only confirmed that 20 of the deaths were of individuals infected with the swine flu, a number that has remained the same for several days. Nearly 2,000 people have been hospitalized in Mexico, although more than half of those have been released.

There is speculation that one death in California may be related to swine flu, but there has been no confirmation thus far, meaning that all confirmed deaths are still in Mexico. At this point, it is still not clear to the medical community — much less to us here at STRATFOR — what is happening in Mexico, or why the deaths have been confined within Mexico’s borders. The distribution of deaths presumed related to this flu strain is scattered around the country, from Baja California to Oaxaca, but deaths are concentrated in Mexico City.

Though the disease has spread all over the world and has an incubation period of only 2-3 days (according to the U.S. Centers for Disease Control and Prevention), deaths from the disease have spread neither north to the United States, nor south to Guatemala. The myriad countries reporting infections — both confirmed and unconfirmed — have reported only mild to moderate cases of swine flu.

STRATFOR has speculated on some of the possible reasons for this discrepancy, but we remain unsure of the explanation, and wonder if there is not a cause endemic to Mexico — be it a massive failure in the health care system, or the presence of a whole different disease.

This is not to say that there have not been hospitalizations in other parts of the world, but frankly, that is normal for influenza, which kills thousands of people every year (though not at quite the rate currently seen in Mexico). STRATFOR is following the spread of the disease as it makes its inevitable way around the world, but it is not yet clear that this will turn out to be a serious problem. As long as swine flu continues to spread to other countries in a nonlethal way, the real mystery remains focused on why so many have died in Mexico.