Laura Verónica Rosales is on the verge of death.
The body is still alive, but her brain shut down on Wednesday.
The young woman, barely 30 years old, is in an existential, legal and statistical limbo: until it can be officially certified as a death, Rosales will not be included in the list of deaths due to the outbreak of aseptic meningitis that has been in suspense in Durango since mid- October.
If no one gets ahead of her, she will be the 24th person to die from the disease, —so far there are 22 women and one man—, which originated in four private clinics in the city.
“My daughter lasted two weeks well, we talked, she ate herself, they gave her treatment… But 14 days ago she had a stroke.
The day before yesterday he was diagnosed with brain death.
She now only has a ventilator and medication to control her blood pressure, ”says Enrique Rosales (49 years old), her father,
Local authorities close the Hospital del Parque, one of the clinics involved in the meningitis outbreak. Ángel Meraz
The cause of the disease is an invisible killer with a Latin name:
Fusarium solani,
a fungus that is normally found in plants, although this time it appeared in four batches of bupivacaine, a local anesthetic used in caesarean sections and other short operations, which explains that the vast majority of those affected are young women.
It's an outlier: The disease, which inflames the tissues covering the brain and spinal cord, usually occurs through direct contact with another infected person, and in its most common form is transmitted by a virus.
Brain death is a devastating process.
In Mexico, euthanasia is not legal, so the only thing left for the Rosales family is to wait until the vital signs gradually fade away, in an irreversible process that can last several days, postponing an inevitable reality: Laura Verónica Rosales is dead.
She has been since September 15, although she could not have known it then.
That day she underwent gallbladder surgery at the Hospital del Parque, one of the four centers with infections.
Soon after, she began to have a headache, to feel that her foot was falling asleep.
On the news they started talking about meningitis.
The first victims died.
On November 13, the young woman went to Hospital 450 for tests. Two days later they told her that she had to be admitted.
She no longer set foot on the street.
The mystery, what everyone is wondering these days around here and still no one can understand, is how the fungus made the leap from vegetables to cerebrospinal fluid of the more than 70 infections that the Ministry of Health (SSD) has confirmed so far .
The hypotheses range from the reuse of syringes to the poor preservation and handling of medications.
The company that produces the drug, Pisa, distributes internationally.
There have only been cases in Durango.
Enrique Rosales does not shed a tear: he is from that generation that was taught that men do not cry even at the death of a daughter.
But there are other manifestations of sadness: the dragged voice, the shrunken shoulders, the lost gaze.
“I'm really screwed, the net.
I haven't worked for three weeks, they fired me for being here, but I don't care.
My brothers have been helping me financially.
[Laura Verónica] has two children, one 11 years old and the other one.
The older one already asks, we are going to take him to a psychologist so that he can prepare him because he thinks that his mother is going to leave ”.
“That's how it is in Durango.
Here everyone has a price”
Experts agree that this is a historical meningitis outbreak: there is hardly any scientific literature on the fungus, there are almost no references to follow.
Mortality can exceed 50% of patients, which means that, like Rosales, many of those infected began a countdown the day they were infected.
According to a study, if those affected are treated before presenting symptoms, the risk of death could drop by up to 40%.
The main objective of the authorities now is to identify and find everyone who could have been exposed.
The list they manage is more than 1,800 people.
Among them is María Eugenia Fernández (61 years old), who underwent surgery on October 22 at the San Carlos Hospital, another of the medical centers involved, and this Friday she has come to 450 to have the tests done, although at the moment she has not have symptoms.
“I feel fear, stress, anguish, impotence… I am very stressed, I need psychological support, I think all of them.
I am taking medication for anxiety.
I trust the medical services, but this exceeds limits”, denounces the woman.
The entrance to the operating rooms of one of the hospitals involved in the outbreak, closed by the health authorities. Ángel Meraz
The problem with
Fusarium solani
is simple: if you inject an anesthetic containing a fungus into the spinal cord, the defenses, no matter how young and healthy the person, can do little.
It is as if a city protects itself from a siege with strong and robust walls, but the enemy lands in the central square.
The neurologist Luis Ángel Ruano Calderón, the mind behind the medical strategy that has been followed against the disease, explains it this way: “Our patients are immunocompetent [capable of producing a normal immune response], not immunocompromised [with weakened defenses], as usually happens in these cases.
That's the main problem: they are healthy women with a central nervous system infection from a fungus.
It makes it even worse."
Anesthesiologists from the four hospitals involved are being investigated.
This newspaper has tried to contact them, but for the moment they have declined to respond.
On December 5, the State Prosecutor's Office issued seven arrest warrants for the "administrators and owners of the private hospitals [el del Parque, el Santé, el Dikcava y el San Carlos]" where the outbreak originated, but it was too late and to when the police wanted to arrest them, they had already fled.
They are still fugitives.
“We filed a complaint, although he has not done anything.
That's how it is in Durango.
Here everyone has a price,” says Rosales with contained anger.
"The pain is incredible, it doesn't even allow me to get up"
Marta Esmeralda León (33 years old) wears a probe in her nose and sunglasses to protect herself from the light.
She can't even look directly at her phone, because the brightness of it increases her headache.
She is one of the meningitis patients admitted to the 450. “It's not one of my best days, my eye hurts a lot.
It is a painful and desperate process to be here.
Without being at home with my children, working, leading a normal life... It's unfair.
The pain is incredible, I cannot explain to you in what magnitude, it does not even allow me to get up, ”she explains by video call.
“Everything is difficult: being in the hospital bed for so long, being separated from your children…”.
The conversation is interrupted because her tears prevent him from continuing to speak.
"She can no longer continue, they beat her to following her," Diego León, her father, says on the screen, with a broken expression.
A while before, in the parking lot, León Sr. recounts that on August 1 the young woman underwent surgery for an ovarian cyst at the Hospital del Parque.
The pain started a few days later.
She was followed by a pilgrimage by doctors and neurologists, concerned that she might be dealing with a tumor.
“We only saw her pain.
When the first news came out that there were patients with the same symptoms, we came [to 450] and they immediately admitted her.
It has been a very difficult month.
One is in the room so calm when the rumor comes out that a patient died.
The others are sad, discouraged, think they are going to die.
It is very hard for them when another dies.
One as a parent has to be patient, but we feel courage, helplessness, uncertainty.
The girls are dying and one no longer thinks which one is going to be saved, but which one is going to die tomorrow”.
It seems that the treatment of León, who works in the Ministry of Education and is studying to be a teacher, works, although the damage persists.
“Sometimes she doesn't move, she doesn't speak, she doesn't do anything, she remains very serious enduring her pain.
We see her and we despair ”, continues her father, a peasant from a town in the mountains.
Her daughter has two children, eight and 13 years old.
“The children are already desperate, they have not seen their mother for a month.
It is very hard for them, she is her mother and they miss her.
As grandparents we do what we can, but it's not the same”, laments the man, protected from the sun by a cowboy hat.
Irasema Kondo, Secretary of Health of the State of Durango, during the interview with EL PAÍS. Ángel Meraz
Irasema Kondo, Secretary of Health of Durango, explains in an interview with EL PAÍS: “It is the most difficult fungus to treat of those that could have caused the infection.
Doctors have investigated everything, but once [patients] have intracranial bleeding it is very difficult for them to survive.”
This explanation is useless to the relatives: they criticize that there are no detainees, that it is still not clear how the outbreak began.
“There was no source contamination in the drugs, but we still don't know what was contaminated.
I understand that you think that time has passed without results, but these types of tests take time and we cannot make pointers lightly.
If there was responsibility on the part of the SSD, of course we will point it out, but today we are calm because we have done everything that corresponds to us and a little more ”,
When it all started, Christian Herrera (33 years old), a gynecology specialist, was one of the doctors who treated the first four patients at the Maternal-Children's Hospital: “Maybe I'm paranoid, but if it keeps up, the 450 can to collapse.
Intensive care is full of patients with meningitis, and the other diagnoses?
The patients are afraid, the relatives are afraid.
Today we had to do a procedure and the patient preferred to be put to sleep rather than have the blockade [local anesthesia].
The same anesthesiologists have changed their techniques”.
The IMSS (Mexican Institute of Social Security) hospital and the ISSSTE (Institute of Security and Social Services for State Workers) have also received cases.
Some relatives of meningitis patients attend a mass outside the General Hospital 450. Ángel Meraz.
For the moment, the treatment continues, but the families face uncertainty: some with a maddening countdown;
others cling to the hope of medical miracles.
No one has assumed the political responsibility of carrying 23 deaths behind their backs.
“The doctors make us doubt everything, today they declared that it may not be the fungus.
They are protecting someone, they are giving another direction to the truth.
What's going on?
We filed a lawsuit and we have no response.
The doctors say that the patients who come out will have irreversible sequelae.
More than 20 children have been left without their mother.
There must be those responsible.
That they do the impossible, that they give them a guarantee of life”, claims Diego León.
The man is tired, he wants to go back to the mountains, but he is terrified of being detached from his daughter and that the worst will happen any night:
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