Amanda Ripley

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Swine Flu: What Matters (and What Doesn’t)

26th Apr 2009 posted in Disaster Behavior

YOU GOTTA LOVE A POTENTIAL PANDEMIC WITH A NAME LIKE SWINE flu. Takes no prisoners. Very old world.

But so far, the reporting on swine flu has been very new world: reactionary, shallow and lacking context. That’s a shame since context is all that really matters in this story.

So let’s break it down:

The Numbers:

The numbers are not impressive unto themselves so far. About 20 cases in the U.S., with no deaths and only one hospitalization. That number will go up as everyone starts paying more attention—and identifying more cases. But for now, this is a pretty mild flu in the U.S. (By comparison, about 36,000 people die of regular flu-related causes in the U.S. each year.)

In Mexico, the numbers are more dramatic—although no one really knows what they are yet. The process of identifying the specific strain is maddeningly slow. But it’s safe to say that there has been a significant uptick in the number of serious pneumonia cases, and most of the patients identified so far appear to be under 50. So the strain in Mexico seems to be much more virulent, and no one really knows why yet.

Why This Matters:

The reason why all of this matters—and why the U.S. has declared a public health emergency—have to do with the behavior of the virus. So the numbers are not the main event, even though the media will obsess over the numbers (because what else is there to do?).

OK, so to put this in context: we are all waiting around for a pandemic flu to hit. Or we should be. In the past 100 years, Americans have endured three pandemics—in 1918, 1957 and 1968. As the American Public Health Association puts it, “We’re overdue for another pandemic. It’s not a question of if, but when.”

What is a pandemic flu? And does it look like this?

A pandemic flu is different from the regular flu. A pandemic flu happens when a new virus spreads around the world, causing serious illness and spreading easily from one human to another. It’s a big deal because it can kill many thousands of people (and shut down economies).

So that hasn’t happened yet here, and it probably won’t. But swine flu is worrisome for two reasons.

First, this is a new virus. It has genetic characteristics not seen in U.S. swine flu before. This matters because it means we don’t have a lot of immunity to this virus.

Second, this flu is spreading without contact with swine. That is alarming because it means it could be very efficient in moving through communities of humans. BUT it is not the first time swine flu has spread without any swine involvement.

What does any of this have to do with pigs?

Pigs are a nasty petri dish for flu because they can get both bird and human strains of flu. That means they can then act as a test tube for creating brand new viruses—to which we humans have no immunity.

Are we all going to die?

No. Well, yes, eventually. But for now, we just don’t know if this is the much-awaited Big One. A useful literature review from 2007 found a 14% fatality rate in past cases of swine flu. Whether that means anything about this strain, we don’t know. (By comparison, during the worst week of the 2007-2008 season, the regular flu had a mortality rate of about 9%.)

We do know that it appears to be receptive to drugs, which is great news. The sooner you get on these drugs after you get sick, the better. And a vaccine may be possible, but it will take at least a few months, according to the CDC.

What are the symptoms?

Same as a regular flu—fever, cough, chills, sore throat, aches, pain, general misery. Possibly vomiting or nausea.

What can we do?

Sounds simple but it can make all the difference: Wash your hands—and take your time. Cover your mouth when you sneeze. Stay home if you are sick. If you are the boss of other humans, encourage them to stay home if they are sick.

Two sites with the most useful information so far:

Clinicians’ Biosecurity Network (run by the Center for Biosecurity at the University of Pittsburgh Medical Center)

CDC Swine Flu Investigation