Swine Flu: A Perspective
How worried should we be about swine flu? I believe we are overacting. My opinion, informed by current reports, the behavior of past influenza epidemics, and my knowledge and experience as a virologist, is that while this is potentially serious, there is no cause for alarm. Based on what we know today, we should be no more worried about the current epidemic of swine flu than we are about the seasonal influenza epidemics that sweep across the globe each November to March. The current level of concern—including 24-hour media coverage, closing of school districts and restrictions on international travel—is overblown.
There are several reasons for optimism. The epidemic appears to have been detected very early on, giving individuals and public health officials time to react. At present, fewer than 1,000 cases have been detected worldwide. By comparison, seasonal flu affects 15 to 60 million people living in the United States each year and about 600 million worldwide. This suggests that the infection is not as easily transmitted from one person to another as is seasonal flu. And the symptoms of infection seem no worse than those of last year’s influenza—at least for those living outside of Mexico.
The virus is also sensitive to two widely available drugs: osteltamivir and zanamivir. These drugs limit the severity of the disease when taken shortly after the first symptoms appear, reducing the number of people who may die from infection. I predict that far fewer than one million people in the United States will be infected and that far fewer will die of this epidemic did during the last flu season.
That said, we should not be complacent. These are the early days of the epidemic, and there are unknowns. This virus strain, H1N1, is new, and we have little immunity to it—as individuals or as a population. A vaccine for this strain will not be available for at least several months. We also know that influenza viruses have the ability to mutate rapidly, so this current strain could become more infectious and more lethal. The virus could also become resistant to existing drugs, as did last year’s flu. Moreover, all influenza epidemics are serious. Each year about 36,000 people in the United States die of influenza and more than 200,000 are hospitalized.
It is worth taking precautions: most importantly keeping our hands clean (washing with soap and water and using disinfectant gels when outside the home) and avoiding touching our mouth, nose, or eyes. Flu viruses are most easily transmitted by touch: an object handled by an infected person (i.e., money or a door knob) is touched by another person who carries the virus to the susceptible membranes of the mouth, nose, or eyes. Most people touch their faces frequently without realizing it. For a surprise, observe yourself and your friends.
Conclusion: stay clean and careful. But stay calm.