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Novel H1N1 and the Arrival of Flu Season

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Novel H1N1 and the Arrival of Flu Season

Flu typically gets a boost when school starts back in session... swine flu is no different.

It crept in at the end of the last flu season, but it didn’t come on little cat’s feet. A new form of swine flu, novel influenza virus A (H1N1), swarmed through Mexico, killing as it went. And then the first identified cases began occurring in the U.S. Suddenly swine flu was on everybody’s lips.

But here in the states, swine flu didn’t seem to be as lethal as it appeared in Mexico, and the populace quickly became complacent, even irritated, at what it saw at best as a media frenzy over a non-issue or, at worst, a deliberate attempt to boost profits for drug companies and vaccine makers.

Perhaps it’s a reflection of a poor American education in science, or maybe it’s an inability to retain scientific information, that has left so many people asking, “What’s the big deal?”

Familiarity does indeed breed contempt, and Americans are familiar with the flu, given that it comes around every year. Most get through it after a week or so of feeling miserable, but the families of the 36,000 people (on average) it kills every year will tell you it’s something to take seriously. And the particular strain of swine flu now known as novel A (H1N1) has demonstrated some peculiarities that cause great concern in those responsible for the health of the world.

First, there’s those deaths in Mexico,  which no one is yet able to explain. Did people die because they lacked access to proper treatment? Did many more people actually contract the virus than was initially believed, which would make the lethality of the virus less than what it appeared? Or has the virus become less lethal as it spreads?

That third possibility raises its own concerns, as the first wave of the pandemic 1918 flu virus, the one that all officials fear ever seeing again, was incredibly lethal but the second was not; and then the third wave came back lethal again and killed over 21 million people, some dying within 45 minutes of feeling ill.

As data becomes available it’s  scrutinized heavily for clues to the lethality of the virus and any genetic changes that might make it even more so. Currently, it’s bad enough. Novel influenza A (H1N1), according to a study published by Eurosurveillance, the monitoring arm of the European Centre for Disease Prevention and Control, may be two to three times as deadly as the regular, seasonal flu we’re accustomed to, though there is still not enough data to determine a definite case fatality rate. That won’t happen until the flu has made its way throughout the entire population—and at that point, it might not be any more lethal than seasonal flu.

More disturbing, though, is who dies. In a regular flu season, old people, infants, and those with a compromised immune system are most likely to die from an infection; 90 percent of deaths are among the elderly. With swine flu, however, 51 percent of deaths are occurring in the age group 20-49; and some of those deaths, disturbingly, are in young adults with no underlying conditions which might make them more susceptible to flu.

Obesity, by the way, is a risk factor for complications from swine flu infection, so now there’s one more reason to start losing that extra weight.

Officials say it’s possible that older people have some sort of immunity to the current swine flu due to exposure to other swine flus in the past, in particular the epidemic of 1957—but if you’re over 49, you shouldn’t count on that. When older people do become infected, their mortality rate is higher than with other flus.

Since swine flu first made its appearance, it has steadily made its way throughout the world, infecting a population that is predominantly susceptible. In America alone, at a time when flu normally falls off the reporting radar, it’s estimated 1 million people have been infected, and 586 have died. Once schools throughout the nation open their doors to students again this month, it’s believed that cases of swine flu, as happens every year with regular flu, will increase dramatically. We’re already seeing this at the college level—currently over 200 students at WSU in Pullman have flu symptoms, and seven have tested positive (as of August 31) for swine flu. (Not everyone is being tested.)

Although knowledge about this strain of flu increases every day, recommendations to protect yourself from becoming infected or from spreading the infection remain the same: wash your hands frequently, sneeze into your elbow, don’t hang around sick people, stay home if you’re ill. Be aware that those infected can spread virus a full day prior to showing symptoms—so washing your hands after touching public objects (for example, the handle of a grocery cart) is a good idea.

The CDC has recently issued an advisory asking that you do not partake in “swine flu parties.” Reminiscent of earlier years, when parents sought to expose their children to infections like chicken pox and measles, some have taken to hosting swine flu parties so that people can become exposed now, just in case the virus mutates in the future and becomes even more lethal. Although swine flu may appear to be mild in most cases, CDC points out, “There is no way to predict with certainty what the outcome will be for an individual or, equally important, for others to whom the intentionally infected person may spread the virus.”

Although swine flu is currently the dominant flu strain throughout the world, seasonal flu is still out there, and recommendations for vaccinations remain the same. A vaccination for novel influenza virus A(H1N1) is currently undergoing human testing, and is expected to be available by mid-October. Because availability is limited, the vaccine will initially be offered only to pregnant women, those who live with or care for children under the age of 6 months, health care personnel, those from age 6 months to 24 years old, and those from age 24 to age 64 who are at high risk due to chronic health disorders or who have compromised immune systems. That’s an estimated 159 million people, yet the first shipment of vaccine is only 52 million doses, and it is not yet known if one dose will be sufficient. It’s expected that each week an additional 20 million doses will be available.

Because the strains are genetically different, the immunization for seasonal flu is not expected to offer any protection against the swine flu strain. Everyone is encouraged to get a flu shot for the seasonal strain, however, as an immune system compromised by seasonal flu can be more susceptible to swine flu.

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Landon Otis

Tagged as:

health, pandemic, H1N1, swine flu, vaccinations, 1918 flu pandemic

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