Wednesday, April 29, 2009

Swine flu: outright lies, hyperbole and grains of salt

Half of what you read about swine flu in the coming weeks will be wrong, and much of the rest you ought to take with a grain of salt.

This doesn't mean you shouldn't be alert, but it does mean the first thing with which you should arm yourself is useful information.

Media are going nuts over this story, and although it's worth the space they're giving it, they're assigning a lot of folks to the flu story who have no understanding of epidemiology and no business writing complicated medical stories.

One thing you'll see is breathless prose about how this is some weird mutant strain of flu virus, a Frankenstein supervirus that combines features of lots of other viruses. Well, no, not exactly.

Here are the exact words of Dr. Richard Besser, acting head of the U.S. Centers for Disease Control and Prevention: “This strain is not unlike other new strains that have emerged. It's an assortment -- it's got genetic components from a number of sources, including human, swine, and avian sources. And that's something that you see with new strains.”

The lead flu story in one of the papers today said health officials “fully expect” deaths. Breathtaking news, but of course there are deaths during every flu season—many, many of them—especially among the very old, the very young, the immunocompromised, those with respiratory ailments and so forth.

As of 11:30 a.m. Eastern Time today, the 30th of April 2009, there was one death and 109 confirmed cases in the U.S. The one death was a toddler with other health problems. That's not to say there won't be lots more. There will be. More than in a bad non-swine flu year? We'll see.

Here's a link with a lot of information: That's an important website, and it is probably the safest place to get your information. Check it before acting on anything you hear on the street.

Is this just an outbreak, an epidemic, or even a pandemic? Some sources use these terms interchangeably. Generally, epidemic refers to a fast-spreading disease, and pandemic means it's really widespread.

Flu epidemics aren't unheard-of. In fact, last year's flu season was considered an epidemic for an eight-week period, according to the Centers for Disease Control definitions.

It's early, but this flu seems to be spreading fairly rapidly. The CDC is still calling it an outbreak, but because it's moving quickly, it probably will qualify soon as an epidemic. Not a pandemic, yet, by CDC definitions, but the World Health Organization has in fact designated it pandemic. Most cases are in Mexico and the U.S., but there are also some in Canada, Israel, Spain, Germany, England, New Zealand, Costa Rica and Austria, at this writing.

They call it swine flu, because it originated in pigs, or has some characteristics of swine flu viruses. Pigs get pig flu just as humans get human flu. But influenza is a cagey virus, it can change and suddenly jump across species lines.

So, sometimes, pigs can get human flu, and humans can sometimes get pig flu. Same with birds and avian flu. This swine flu, a form of Influenza A, mutated to also affect humans. It happens. The CDC says nearly a quarter of pig farmers and one in 10 veterinarians have been infected with some variant of swine flu over time.

But at this point, for the most part, the current strain is spreading from person to person. Pigs are not involved in most new infections in the U.S. And you don't get it from cooked pork. A well-cooked laulau is safe—it's the coughing person serving it that you need to be careful about.

We're seeing a lot of pictures of people running around in face masks. Will this protect you? Maybe, maybe not. “Information on the effectiveness of facemasks and respirators for the control of influenza in community settings is extremely limited,” the CDC says.

As woodworkers know, if you take a deep breath through a cheap facemask, the air just sucks in unfiltered through the sides.

Wearing a mask couldn't hurt, and might help, but you're better off adopting a range of precautions, including staying away from anyone who might be sick and getting a little nuts about handwashing.

The primary way most people are getting it is through contact with contaminated droplets of moisture from an infected person's cough or sneeze, or from the moisture on that person's hands after he or she has coughed into it, or from something they've touched.

If the flu gets into your community, then any cough, handshake, doorknob or shopping cart handle is a potential source. If you have touched a possibly contaminated object, keep your hands away from your face until you can thoroughly wash them.

Here are the state Department of Health's guidelines for protecting yourself:

If you get the flu, unless you get tested, you won't be able to tell whether it's swine flu or some other flu. Flu symptoms, although they can vary in severity, are generally the same: fever (often quite high), body aches, headache, cough, fatigue, nasal congestion or discharge, and sometimes vomiting and diarrhea.

It's unlikely most humans have any resistance to this flu. The Type A H1N1 swine virus—which is the designation for the one causing trouble just now—is quite different from H1N1 human viruses. So having had the human equivalent doesn't protect you from the swine form.

There aren't any effective vaccines for this one, but the CDC is working on it. There are a few antiviral drugs that can help once you've gotten it. If you think you're sick and it might be swine flu, call your doctor for instructions. Some of the medication must be taken early to be effective, so don't waste time.

© Jan TenBruggencate 2009

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