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Fear and loathing of the flu

Posted Apr 29 2009 10:29pm
As I've tried to put the finishing touches on my book proposal and my career as a graduate student, I couldn't find anything to write about.

A'vast ye swine! Now there is.

To paraphrase FDR, sometimes it's the fear of the disease that's more damaging than the disease itself. The fear-of-pandemic syndrome is always a media sensation, no matter what the cost.

Here's some facts on swine flu, courtesy of Dr. Geoffrey W. Rutledge of

There is quite a buzz about the Swine Flu outbreak that has so far caused 1,995 hospitalizations and an estimated 149 deaths in Mexico, especially after the US department of Health and Human Services declared a public health emergency, and the World Health Organization (WHO) declared that the swine flu outbreak had reached "phase 4", just one step away from a worldwide pandemic.

The swine flu is caused by the influenza A (subtype H1N1) virus that normally causes respiratory infections in pigs. This virus is not the same as the previously identified human form of influenza A subtype H1N1, and it is not expected that this year's influenza vaccine, which does protect against the human H1N1 flu will provide good protection against the swine flu.

So the concern is that the illnesses and deaths that occurred in Mexico could represent the beginning of a serious influenza outbreak. Of greatest concern is the possibility of a repeat of the famous influenza pandemic of 1918-19 that killed about 50 million people in the worst global epidemic in human history. That pandemic of "Spanish flu" (an avian variant of influenza A H1N1) killed more people than died during World War I, and more than died during the four years of the "Black Death" or bubonic plague, from 1347-1351. But, don’t go building an underground bunker just yet…

The data provide some hopeful news regarding this outbreak. So far, unlike the swine flu cases in Mexico, all the U.S. cases of swine flu have been less severe and have not threatened the lives of any of those affected. The second piece of hopeful news is that we are at the end of the natural influenza season, so the seasonal factors that lead to enhanced transmission of the virus are not present. It's hard to predict these events, but I'm quite hopeful that the outbreak will not turn into a major pandemic within the U.S.

Here are some resources that you may find helpful if you would like to learn about the swine flu virus and the potential for a widening outbreak of influenza in the U.S.

- A great starting point for information about swine flu is the WellPage on this topic, which lists the articles from the HealthBlogger network, and also shows valuable links in the Trusted Web Resources and News sections:

- HealthCentral has created a special page on the Swine flu at

- The Center for Disease Control (CDC) reports a total of 40 confirmed U.S. cases as of 4/27/2009, of which 28 were in NY, 6 in California, and the rest in TX, KS, and OH. Daily updates of progress of the outbreak are issued by the CDC at

- You can find a comprehensive and understandable summary of the virus causing this illness on the World health Organization website:
Note that in this document, the question "Where have human cases occurred" is not fully answered, because it leaves out several countries such as Mexico, Canada, England, and New Zealand, where confirmed cases have occurred.

- One thing that does help restrict the spread of the infection is treating close contacts of infected people with the right anti-viral medications (the CDC defines "close contact" as coming within 6 feet of a person with confirmed swine flu). The CDC recommendations for who should be given preventive treatment (prophylaxis) are at
and the actual treatment dosages are at

- A great resource to help understand the patterns of influenza outbreaks in the U.S., and to see where we are in the annual flu season cycle, is the Google flu trend application, at
http:// /. This shows that there is no evidence yet of a widening pandemic in the U.S.
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