The big story today is that the “Swine Flu” is going to kill us all and lead to a breakdown in society, an economic crisis, bodies being burned in the streets, martial law and so on.   I’m a bit sorry to say that for those who have been so eager for doomsday, this is probably going to be a big disappointment.   Hundreds of cases have been reported in Mexico and now cases are confirmed in several US States as well as numerous Latin American countries.   It seems that the virus originated in Mexico, as many of the cases can be linked directly to individuals who have visited the country recently.

In California, Governor Schwarzenegger has declared a state of emergency. Some reports indicate that he might resort to traveling back in time to prevent the flu from ever occurring or having his arm morph into a machine gun that shoots little capsules antibodies so that  he can fight the flu directly.   (Okay, just kidding about the last part).

Meanwhile, the US President is already seeking 1.5 billion dollars to fight the problem.   Ever noticed how he has a tendency to ask for huge amounts of money before he even decides what it’s going to be used for or what the cost of combating a problem will actually be?

What is Swine Flu?

Swine flu gets its name from the fact that it is common in pigs and is known to cause epidemics in pig populations.   The virus can also effect humans who acquire it from pigs, especially those who work on pig farms, as butchers and so on.   Occasionally a strain of swine flu will mutate in a manner that allows it to be easily passed on by human-to-human contact and thus is not limited to those who come in contact with an infected pig.

To be specific, swine flu is a subtype of influenza.  In this case, the virus in question is a sub-strain of type N1H1 variety of influenza A.   There are three distinct varieties of flu virus, A, B and C and of those there are distinct subtypes and then individual viral genetic lines.   Thus, this virus is Influenza, type: A, subtype N1H1, strain (North America 2009 Flu.)   It is something of a misnomer to call it “swine flu” because thus far it has not been confirmed in any pigs, however the N1H1 subtype is the most common in pigs by far and is known for previous outbreaks of pig to human flu, so it is presumed to be of swine origins or at least a descendant of a swine-based virus.

The reality, however, is that this is now really human flu.  It could also be called avian flu, as it does appear to share some of its genetics with strains associated with birds, but that could make it even more confusing.  

More info on the naming of the flu strain here.

Why is this type of flu so bad?

It’s not. At least, not in most people and compared to flu outbreaks of the past, the effects of this flu strain appear to be pretty unremarkable.   Some strains of the flu spread easily from person to person, while others are not so easily spread.   This one appears to be one of the more easily spread strains, but it’s not as if it is drastically more contagious than anything we’ve seen before.   It’s not a super-virus or any kind of thing that is orders of magnitude worse than other flu strains.

For the average person, getting the swine flu is going to mean a miserable few days, including vomiting, congestion, body aches, tiredness, mild fever and so on.   A sufferer may lay in bed for a while, eat some chicken soup, drink some gingerale and then feel better within a week at the most.   It can be deadly, however, but that’s generally something that one only finds in portions of the population that have badly compromised immune systems.   For those who have full blown aids, are receiving heavy chemotherapy, newborns, the very old and in generally poor health, this disease could be fatal.

Of course, one must bare in mind that individuals in the affore mentioned population groups can be killed by any strain of the flu and many other diseases that are commonplace and generally not considered to be a big deal to most healthy individuals.   This is not to say that it will be fatal, even to those in compromised health.   The disease can be treated and if proper treatment is given early on, the probability of death will be low.

It is very important to note that news reports on the number of deaths associated this the recent flu outbreak can be very deceptive.   There have been 172 confirmed cases in Mexico and 26 confirmed deaths.   On the surface, such numbers would seem to indicate that the disease killed more than one in six who get it, but this is not necessarily the case.   In most cases, only the most severe cases of such a disease are ever reported, and most healthy individuals who contract such a condition would just have stayed home and recovered on their own.   This effect is even more pronounced in a country like Mexico, where health care may not be as avaliable as in other more industrial countries.   There may very well be tens of thousands who have contracted the flu in Mexico, and just spent a couple of days taking it easy, perhaps chalking it up to a bad bottle of Tequila the night before.

There has been some speculation of further deaths, including two in the United States.  However, a number of students in at least two New York City schools have tested positive for the flu and reports are that they recovering well and are not believed to be in any critical danger.   This is likely to be the story for most people who might get the flu.

Is it treatable?

Yes.  There is no cure for the flu, in the same way that many bacterial infections can be cured by antibiotics, but there are treatments that can inhibit the virus’s means of reproduction and when given early on have been shown to be quite effective against the flu, including the swine flu.   The two that have proven to be effective in treating this strain are Oseltamivir, marketed under the trade  name  Tamiflu and Zanamivir, marketed under the trade name Relenza.   There may be other antiviral drugs that can help, but those two are the best established as effective.    It is believed that M2 inhibitors, a completely different class of antiviral drugs than oseltamivir and zanamivir may also prove effective, as they are known to be of use in other influenza A strains.

It’s definitely a relief thing to have at least two drugs that are effective against the virus, especially given that they’re quite different in their chemistry.   Both oselamivir and zanamivir are types of Neuraminidase inhibitors, although they accomplish this differently.  It is believed that this approach should be relatively difficult for the virus to develop a resistance to (M2 inhibitors have seen problems with resistance development), because neuraminidase is a very fundamental enzyme to how the flu works, and is vital to the process that allows the flu to invade host cells.   Still, in the event that the virus does manage to develop a resistance to one of the drugs, it’s always good to have multiple weapons in one’s arsenal.   It’s worth noting that due to concerns over the “Bird Flu” over the past years, a number of countries and public health agencies had already taken the precautions of stocking up on these drugs.

Beyond direct treatment of the flu, there is also symptomatic treatment.   Many who die of the flu die of respiratory complications, so treatment with a ventilator or oxygen could be a life saver.   Also, while antibiotics can’t help with the flu, they can be used to treat opportunistic infections that may arise due to the weakened state a flu patient is in.   It is well known that those suffering from the flu may develop more serious bacterial infections.   Indeed, some information indicates that bacterial infections, not the flu itself killed most of those who sucumbed to the infamous 1918 flu epidemic.   This is really no surprise, the strain placed on the medical system of the time, combined with many sufferers of the flu being placed in bacteria-infested and overcrowded hospitals made further infection a major risk.

Is there a vaccine?

No, not yet.   However, those vaccinated against other strains of the flu may receive some limited protection.   There does not appear to be any scientific reason why this strain could not be prevented by vaccination, but the process of culturing and testing such a vaccine will take some time.

What should you do?

Don’t panic or anything.  There’s no need for that, and in many cases these kind of events are only a big deal because so many people make a big deal about them.   If you suspect that you might maybe possibly have the flu, but you’re otherwise fairly healthy, then don’t go calling 9-1-1 and rushing to the emergency room.   Our health care system does not need the additional load of panicked people who are not in any acute danger stampeding the place.

However, if you are in a condition that has left your immune system compromised or has otherwise made you more susceptible to infection, then by all means, notify your doctor at the earliest inkling that something might be wrong, because early treatment is very important.   The same should go for anyone who you might know who could be in a demographic group which is in danger.   So, if your 95 year old grandmother seems to be getting the sniffles, then get her checked out, even if you’re not entirely sure it’s anything.   In that case, better safe than sorry.

Oh, and for god’s sake, wash your hands, regularly.   You should do that anyway.   And don’t just run them under the water, either.   Get them good and lathered up and then scrub them well.  Germicidal hand gel may be helpful too, but it’s no substitute for a good washing.

Finally a little perspective:

This virus is a new strain for which humans do not have any previous natural immunity and no effective vaccine.  It’s a strain of Influenza A that is easily transmitted from human to human.   This is the same kind of scenario that was seen in outbreaks in 1968, 1976, 1998, 2007 and on other occasions.  Just like now, there were several outbreaks around the world.

And yet… the world continues to exist.

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This entry was posted on Tuesday, April 28th, 2009 at 9:28 pm and is filed under Bad Science, Good Science, History, Misc, Politics. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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