Swine flu: the next pandemic?
April 30, 2009
An epidemic of swine flu has struck Mexico and promises to escalate into a pandemic if measures are not taken to stem the spread worldwide. Mexico is now in a state of emergency. As many as 81 possible deaths are suspected, and 1,300 are sick as of April 26. Five states and 20 people in the U.S. and Canada have reported cases of the flu. So far cases in the U.S. seem to be mild, and it has not yet been determined why the virus has proven so deadly in Mexico. But Department of Homeland Security Secretary Janet Napolitano has declared a national public health emergency.
One way to stem an epidemic is to isolate, quarantine and treat those who are sick. People are advised to wear masks in public and stay away from crowded places as much as possible. Wash your hands frequently! Vaccines take months to produce. It is not known whether the flu shots you might have gotten earlier this year will convey any immunity to the current strain of H1N1 swine flu circulating in Mexico. The antiviral Tamiflu seems to be effective so far during early stages. There are no travel restrictions in the U.S., but Colorado is looking into having a stock of masks and antivirals just in case, and the Obama administration has released 12.5 million of the nation’s stockpile of 50 million courses of Tamiflu. Colorado’s flu hotline is 1-877-462-2911. Call if you have flu-like symptoms ” fever, sore throat, cough and muscle ache.
Influenza or flu is the oldest emerging disease and is still emerging. The Ancients believed it was caused by the “influence of the stars.” One important characteristic of the influenza virus is its ability to mutate and reassort. One of the common mixing vessels is the pig or swine. The virus is often carried far distances by birds and especially ducks. The duck influenza virus may mix with a pig and a perhaps a human virus and the virus emerging may acquire the required receptors to infect the cells of the human respiratory tract. Occasionally the right mixture can become a deadly combination.
Places where people live in close contact with pigs and ducks are where a lot of these flu viruses emerge.
In 1918 the influenza pandemic killed as many as 50 million worldwide. It was spread by World War I and troops going overseas. Today, about 4,000 people die annually from complications of the flu, usually the young or very old, or people with weak immune systems. This flu strain is unusual in that none of the initial deaths in Mexico were in people older than 60 or younger than 3 years old. The 1918 pandemic also killed people in the prime of life.
The world heath authorities have been waiting for the bird flu, killing people in Asia, to mutate and become a pandemic. People are still dying from it, but so far it does not seem to be spread directly from person to person ” rather by contact with chickens and their excrement. The mutation required would be for the virus to acquire receptors to attach easily to the upper respiratory tract.
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So the flu virus has wings! It can travel in ducks or on planes. A cough in Hong Kong can start a flu epidemic in New York as a person on a plane infects his fellow passengers who then spread it to those they have contact with after they disembark. In several countries, students reported they were ill upon returning from spring break in Mexico. Three teachers and 22 students at a New Zealand high school were reported to be ill after a three-week trip to Mexico. The World Health Organization (WHO) has put the world on alert and is urging countries to boost their surveillance of flu-like symptoms. Only two laboratories thus far, the Centers for Disease Control in Atlanta, and the Canadian National Laboratory in Winnipeg, have the reagents needed to do a positive test for the new flu strain, so all samples have to be sent to these two laboratories. Countries across Asia are gearing up and are taking immediate action in light of this swine flu outbreak. At airports and other border checkpoints in Hong Kong, Malaysia, South Korea and Japan, travelers are being screened for any flu-like symptoms. An alert health care system is the best defense.
Dr. Joanne Stolen recently retired from Rutgers University where she taught microbiology. Her scientific interests are in emerging infectious diseases and environmental pollution. She is now full-time resident of Breckenridge.