What’s the big deal about swine flu?

Monday, 27/04/2009 ≅13:22 ©brainycat

You've no doubt heard about the latest swine flu outbreak. If you're like me, you found yourself curious why this particular outbreak is worth so much attention. I poked around teh intertubes for awhile, and found out why swine flu is such a big deal.

Swine flu is a generic name for a class of viri that was responsible for the 1918-1919 pandemic that killed 2.5% of the world's known population. This latest variety of H1N1 is believed to have killed anywhere from 60 to 100 people in Mexico already, and cases have been reported around the globe already. This variant includes some proteins also found on the SARS virus H5N1. It is unclear at this time if this has any effects on it's communicability or lethality. The death rate in Mexico is not definitively known, but reports indicate it's about 7%, plus or minus a point or two. This, I believe, is an inflated rate, as it only counts the number of diagnosed survivors. No doubt quite a number of people got sick but did not seek hospitilization.

While "normal" flu viri kill less than one half of one percent of flu patients a year, these pandemic flus kill several orders of magnitude more. Being healthy is somewhat of a liablity, as the stronger the immunological response you can muster, the more phlegm is developed, which can drown the patient or invite massive secondary bacterial infections. Of course, immunocomprimised patients are always at risk.

Fifteen percent of the diagnosed patients in the US had taken the flu vaccine. The vaccine is tailored every year to strains that are expected to spread, but these projections are made months before flu season and prognosticating plague is a less than exact science. Personally, I wound up in the hospital with life-threatening intestinal flu the year I tried the vaccine, so I haven't touched it since.

This flu is probably more dangerous than H5N1, the famous avian flu. It's spreading faster, and has at least the same lethality if not more. Fortunately, we have drugs to combat it. Or rather, some people do:

The article went on to state that only up to a quarter of a given Western nation population (except Great Britain at fifty percent) can be treated with antiviral drugs from government stockpiles during the first pandemic wave. This would mean, as Australia's Dr. Buddhima Lokuge et.al. states (see eMJA article), Australian government stockpiled antivirals "will be limited and reserved for those on a confidential rationing list." The United States public are in the same boat and face an identical government policy situation -- selective rationing:*)

In economic news, analysts indicate that for the most part the scare has had a negative impact on the markets, but Roche (the manufacturer of Tamifil, manufacturer of the drug that the flu responds to the best) has gone up.

Will 2009 be remembered as the year the epidemic started? Will history's recollection overshadow the first non-white president for a submicroscopic sliver of protein and RNA? Will the wildly disparate availability of medicine and medical care be the catalyst for worldwide revolution? Hopefully not the former, hopefully the latter.

EDIT 4/29/2009
It appears the H1N1 swine flu has arrived in Seattle.



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