Swine flu

[Frelga]

So. Do we panic yet?

[Teremia]

Apparently we don't panic. But on the other hand, perhaps we should -- well, not panic, exactly, but feel deeply concerned.

The experts on the radio seemed to be pretty clear about recommending people not go to Mexico, even as part of a planned-long-in-advance wedding party. I thought that was rather dramatic.

So far the swine flu in this country hasn't seemed as deadly, but it hasn't really spread into the vulnerable populations yet, either. So this story could go a number of different ways.

In one scenario, the people who get the swine flu this time around are lucky, because when it comes back later supercharged, they'll be the ones with antibodies to protect (that's how the Spanish Influenza worked, right? First came a less lethal variant and then later WHAM).

I'm waiting to see what happens. It's all particularly interesting to me because I happen to be writing a novel (near-future adventure for kids) about a flu pandemic just at the moment.

But pandemics are a bit like earthquakes, in that we KNOW a big one is coming but somehow can't quite get motivated to get ourselves ready for it.

[Primula Baggins]

Not yet.

But let's all be sensible about washing hands, not touching our faces, and staying out of range of people we know are sick even if they're sure it's just a cold. And for heaven's sake stay home if we're sick ourselves.

Let's also consider what might happen if schools and businesses were shut down and we had to work from home eith the kids underfoot. Maybe buy a few extra nonperishable food supplies and some bottled water (we fill old gallon iced-tea jugs and stack 'em in the garage; costs nothing). Also keep your supplies of over-the-counter medicines topped up.

More can be found by visiting the CDC site or Googling. If you steer clear of survivalist nutter sites, there is a lot of sensible information out there, and many of the emergency preparations suggested would apply equally well if you, say, had a severe earthquake or ice storm and the power went out and you couldn't drive around for a while.

Our concern is a big earthquake (there aren't many in Oregon, but every few hundred years we get a Richter 9). Power would be out for a long time and there wouldn't be a lot of food or water to buy. Fortunately we camp; we've even got a big tent we could all live in in the back yard, if the house wasn't safe.

I am not paranoid, not at all. But some preparations are easy, inexpensive, and perfectly sensible.

The identified swine flu cases in this country have all been mild, BTW; it's possible that the virus loose here is a milder mutation of the one in Mexico. And it's remarkable and commendable that the emergency has been identified so early and that within days we are mobilizing to deal with it, worldwide.

Our tax dollars at work.

[Frelga]

Yes, that's what it looks like to me. Thing is, do we really know that this is something new? By last count, there are 20 cases in the U.S. and 40 in Europe, IIRC, few of them serious. In any other year, these would go unnoticed, just part of the general flu statistics.

The news reports don't give complete picture. Back-of-hand statistics suggest something like 10% mortality among the serious cases, but it is unclear how many infections result in a serious case. It is also unclear how that compares to the "regular" human flu. One article I read quoted 30,000 flu-related deaths a year in the U.S. (I hope I'm wrong about it!)

The fear is, obviously, that the new strain will overwhelm the immune systems that are not equipped to fight it. Yet it appears that most immune systems do manage.

Whatever the statistics, I dearly hope that the ill people recover swiftly.

[Crucifer]

So far as I can tell from the France 24 updates I've been getting, only around 20 of the 100 or so deaths were due to swine flu as opposed to normal flu.
How good are the medical services in Mexico? It seems to me that this is not anything significant to worry about.

[Dave_LF]

A few observations that maybe don't add up to anything in particular:
-If this were "the big one", I think it would be everywhere by now. Certainly a strategy as naive as "don't go to Mexico" would be insufficient to stop it.
-It's pretty clear that the odds of survival are good given decent medical care. A developed nation can give 20 flu patients decent medical care without breaking a sweat, but how about 2 million? 20 million?
-Ordinary flu kills more people than most would guess
-This variant, like bird flu and the 1918 variant, seems to play the trick of being more deadly to young adults than to children and the middle-aged. Seems it's the immune system overreaction that gets you.

[Maria]

Seems it's the immune system overreaction that gets you.

Uh oh. I haven't been sick in years. I assume I have a highly efficient immune system. I was beginning to think I was immune to everything. Perhaps I should worry about this one.

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Nah! I just don't get sick anymore. I'm not worried.

edit: Although... I might be a bit concerned about my family if it gets bad.

[Primula Baggins]

Some flu facts and figures are here. Among others:

5% to 20% -- Portion of U.S. population that gets the flu each year

200,000 -- On average, Americans hospitalized with flu complications each year

36,000 -- On average, Americans of all ages who die of flu complications each year

Yes, 36,000 people is a lot (100 per day!), and that's just ordinary run-of-the-mill flu, year in and year out. So hearing about a few U.S. deaths from swine flu will not be cause for panic. Flu is like pneumonia in that it is often the specific, named cause of death for people who were in dangerously poor health already and presumably would have died of their primary disease or something else fairly soon.

Yes, the Spanish influenza epidemic killed lots of young and healthy people, but we haven't seen signs that this is anything like that one.

[River]

The 1918 flu started mild, went to sleep, and came back a few months later more virulent than before. That's the source of concern for this thing. We'll see what happens as the cases develop - there's going to be some lag between getting exposed and getting symptomatic.

I'm watching but I'm not worried yet. Someone in my home has to stay sane about this and apparently S has decided that he gets to be the one that panics. So far, it's just been SARS all over again. Remember that? Killed fewer than the ordinary flu but had everyone in a tizzy because it was new. Same story with the current swine flu (so far).

I wish the press would come up with better names for these bugs. S was fretting the other night and he was referring to the scary strain of bird flu that had everyone spooked a couple years ago as "the bird flu" and this new thing as "the swine flu". But there're lots of bird and swine flus and many of them have jumped to humans.

As for myself, I'd be a prime target for anything that resembles the 1918 flu because I have a very sturdy immune system. I haven't had a flu in almost six years; haven't caught cold in two or three. Evil germs have gone ripping through my former department and former lab and left devastation and sneezing in their wake and I'm standing there saying "Huh, I feel fine." My former labmates hated me for that. My current ones will grow to hate me for that in time. I say it's because I got all the fun respiratory bugs out there while I was in college, but I know that's not true.

[vison]

While I wasn't around in 1918 (surprise!) I knew lots of people who were. Long ago. We knew a few oldtimers who lost several family members, usually healthy young adults. My late father-in-law worked for a doctor during that epidemic, he was the doctor's driver and spent weeks living in the car, just driving the doctor here and there. The doctor survived the flu and died of a heart attack about a year later and everyone put it down to overwork.

I am calmly worried. I didn't get a flu shot this past winter, even though I am supposed to. My son and his wife came back from Mexico last Wednesday and a few days later were called by the Public Health office in their district. They are well, but one of the people at their wedding is quarantined in Toronto - she probably got the bug on the plane home as there were passengers from Mexico City on her plane.

The speed at which these viruses mutate is frightening. Did anything ever come of that research that was done when scientists were looking at the bodies of people who died in Norway in 1918? The bodies were frozen and they were hoping to get some of the virus and take a look at it.

[WampusCat]

I don't panic, but I think there is great cause for concern with this outbreak. Yes, it could fizzle out with no deaths outside Mexico. But there are features to this particular strain that worry epidemiologists. If they are worried, I worry.

(Disclaimer: As a child I wanted to grow up to be a microbiologist and work at the CDC. I've always been fascinated by epidemics, from the Black Death to cholera to the 1918 flu to ebola. So I'm more likely than most to pay attention when the word "pandemic" is thrown about.)

The problem with the flu virus is that it easily mutates. Mutated strains that jump from pigs or birds to humans are particularly dangerous because we have less immunity to them. Once those strains start jumping easily from human to human, the possibility rises of a worldwide problem.

So far, as has been noted, there are no deaths outside Mexico. That's a good sign, of course! But that could change quickly. The stage is set for what could be a terrible pandemic, and officials are wise to alert the public and make preparations -- even at the risk of looking foolish if the outbreak dies down quickly.

Read up on the 1918 flu if you want to know why this is a big deal. My grandparents lived through it, but saw entire families among their neighbors die in a matter of days.

Not that everyone's taking precautions. One of my best friends is a flight attendant who regularly works the route to Mexico City. The airline won't let them wear masks.

[WampusCat]

Cross-posed with vison.

Gina Kolata's book "Flu: The Story of the Great Influenza Pandemic" is an excellent account of the 1918 flu and the attempt to find the virus in frozen bodies in Alaska.

[Frelga]

Do the masks really work against viruses? I've always thought they didn't.

I think this flu is a good indication of how the pandemic could happen. Within days of the outbreak in Mexico, we have cases all the way in New Zealand. Fortunately, so far it appears no more aggressive than a regular flu epidemic.

I think the government needs to get down into the nitty gritty of the planning, because "people get flu symptoms, go to the only emergency room for miles around, and sit there for hours" strategy is going to cost thousands of lives. Their needs to be a quick, flexible network of treatment centers and pathways for acquiring and distributing vaccine and antivirals.

At the risk of sidetracking the thread, I say it has to be government because for a business, there's no money to be made in expensive preparations for something that may never happen. It's the job of the government to handle those things that make no profit for anyone in particular except as spread thinly across the society.

With luck, this will be a great learning exercise, and not much more, relatively and heartlessly speaking.

[Cerin]

I was just reading an article that says that in Mexico, the media is reporting on the possibility that the flu is linked to the mammoth factory hog operation that is in the same area where the flu is said to have originated, and where swarms of flies feeding on the waste are a big problem. I wonder if that would be cause for concern for areas around large pig production facilities here?

However, a municipal health official stated that preliminary investigations indicated that the disease vector was a type of fly that reproduces in pig waste and that the outbreak was linked to the pig farms.

grist

[WampusCat]

I've never heard of flu being spread by flies. Could be possible, I guess.

[Ellienor]

Apparently the current vaccines have no efficacy against the current version of the swine flu. So even had you been vaccinated this year, it wouldn't have helped. It'll take months to come up with a new vaccine.

A year ago I read "The Great Influenza". I'll have to get that other book. I am also fascinated with medical stuff like that. Apparently we are all immune to the 1918 Flu because that is what's been circulating, in one form or another, since then.

Vison, that's scary about your son. Apparently if they've been back 5 days and aren't sick, they aren't going to be. Hopefully that's the case.

[Dave_LF]

Yes, the Spanish influenza epidemic killed lots of young and healthy people, but we haven't seen signs that this is anything like that one.

As I understand it, that's been exactly its M.O. It just appears to be less contagious and less virulent (or perhaps the population at large just has better flu immunity now).

[axordil]

Thisis what does in the young and healthy.

[Frelga]

I was just reading an article that says that in Mexico, the media is reporting on the possibility that the flu is linked to the mammoth factory hog operation that is in the same area where the flu is said to have originated, and where swarms of flies feeding on the waste are a big problem. I wonder if that would be cause for concern for areas around large pig production facilities here?

Cerin, I saw reports of the possible connection to the million pig farm in the area. The American-run company responded that none of those infected seem to have a direct link to the plant, and that the pigs were vaccinated against the swine flu. It seems so far that we have a correlation - huge pig farm, flu outbreak in the same area - but no proof of a causation.

ETA:

Here's a really nifty pandemic monitoring map, as linked on TORC.

[Primula Baggins]

Well, higher up someone posted that the old swine flu vaccine is no good against this.

Flies may not be the vector, I read earlier today (lost the link, sorry); the mutation might have happened in the waste pond water and leaked out from there into the local environment.

Masks don't filter out viruses, but they do keep droplets people have sneezed out from getting into your mouth and nose, a major way viruses travel. I wouldn't bother to wear a mask unless I was working in a hospital or taking care of a known infected person. But it makes sense to be careful not to touch your face, especially mouth and nose, with unwashed hands that have touched doorknobs and handrails and so forth.