Yes, the WHO has just declared a global flu pandemic, labeling the swine flu unstoppable. Just when we thought the H1N1 virus was about to disappear from our horizons like the previous pretenders, it makes a new claim for world attention, letting us know it has no intention of going into hibernation yet. Since the first few cases were diagnosed in Mexico about 2 months ago, the virus has spread to 100 countries worldwide affecting over 77,000 people and causing about 300 deaths. Yes, technically, it meets all the criteria of a global pandemic but the world is lucky that the present strain of H1N1 virus is comparatively mild mannered, just causing mild symptoms.
Only 1 in 3 people infected by the virus are symptomatic and many people make a full recovery without needing medical treatment except for pregnant women, children, elderly people and people with underlying medical illnesses in whom complications can develop. The last time a global flu pandemic was declared was in 1968 when the more sinister H3N2 virus left 1 million deaths in its trail. This figure however pales when compared to the worst global flu pandemic in modern times, dubbed the Spanish flu, in 1918 which affected close to 40% of the world’s population and killed about 50 million people.
The present swine flu is caused by a strain of the same H1N1 which causes seasonal flu but with a different genetic make-up. It is an admixture of genetic materials from pig, bird and human flu but it is now thought to be wholly a human disease and spreads from person to person via coughing and sneezing. In flu epidemics, there are usually 3 levels of alert (i) Containment; where the main aim is to stop the spread of the disease as much as possible by confirming every suspected case in the laboratory and giving them anti-viral drugs, usually tamiflu (ii) Outbreak management; at this stage, it is no longer possible to contain the spread of the virus. In hot-spot areas, suspected cases are given anti-viral treatment by doctors even without laboratory diagnosis and (iii) Treatment stage where people with minor symptoms, their contacts and other people at risk of having the infection are given anti-viral drugs. At this stage, vaccines are also given in order to confer herd immunity to the population at large.
And talking about herd immunity, some parents in UK have toyed with the idea of organizing "swine flu parties" for their children in order to expose them to the virus with the aim of conferring early immunity on them. This is because the virus, as it is now, is mild and it is better to be infected and have immunity against the virus before it mutates and becomes more dangerous. This is similar to what some parents do with chicken pox; by exposing their children to the chicken pox virus early, the children develop the disease, which usually has a milder course in children and then acquire life-long immunity to the virus. This approach to the swine flu virus has however been frowned upon by public health authorities since the course of the infection can not be fully predicted at present. Even though all the headline health news are dedicated to swine flu at the moment, it is worth remembering that seasonal flu poses more public health threat because it kills as many as 500,000 people yearly, and very soon, we will be moving into the seasonal flu season.
Whether a major catastrophe can be prevented will depend on how vigilant and how prepared many health authorities are to dealing with the pandemic.
