Swine Flu

As cases of swine flu are being confirmed around the world, governments are ramping up their disease control plans to hopefully minimize the effects of this infection. According to the World Health Organization, "Given the widespread presence of the virus…containment of the outbreak is not feasible. The current focus should be on mitigation measures." This means that preventing spread of the virus is not likely, and treating outbreaks will be important in minimizing the numbers of people who might become ill and potentially die.

Swine flu is no different that any other influenza-like disease when it comes to symptoms:

• fever,
• cough,
• sore throat,
• chills,
• body aches, and
• fatigue.

Aside from the chills and shakes, these sound similar to the symptoms of a severe cold. Whether that's all there is or whether a person will become significantly ill is difficult to predict. Individuals with poor immune systems such as infants and the elderly, those undergoing chemotherapy treatment, or taking medications that impair immunity are at higher risk for more severe illness. But even healthy people can become sick. The virus spreads by aerosol droplets, meaning that secretions from an infected person can be spread into the air by coughing or sneezing. It's the close contact with an ill person that causes the disease to spread. And a person may be contagious for 24 hours before any symptoms occur.

How a community, a hospital, or an individual deals with the potential for infection will help decide how fast and how far it will spread.

Prevention begins with decreasing contact with other people. Mexico had soccer games played in empty stadiums, and public transportation was curtailed. Schools were closed in New York City, San Antonio, and San Diego after children who had traveled to Mexico on vacation returned with the swine flu infection. Travel advisories worldwide were posted to avoid not only Mexico, but also the US and Canada.

Hospitals have plans developed to isolate patients who may present complaining of flu-like illnesses. Patients may be placed in isolated rooms and made to wear surgical masks until they are examined and screened to make certain that influenza is not the cause. This may become a significant burden on hospitals and clinics if too many people show up to be seen. Imagine what would happen if waiting rooms were overwhelmed with coughing people. It would be difficult to isolate each one.

People need to remain calm in the face of a constant barrage of press releases that act as a scoreboard for where and how many swine flu cases have been found.

• If there are cases of swine flu in the area, prevention starts with avoiding crowds of people.
• Other prevention issues are mostly common sense, like good hand washing and getting plenty of rest and fluids to maintain a strong immune system.
• If symptoms do begin, it is worthwhile contacting your family physician, health department, or local hospital to ask what to do.
• Staying at home and preventing disease spread to others is the likely first step.
• Advice about supportive care such as fluids and fever control measures may be given by phone.
• Prescription medication for oseltamivir (Tamiflu) or zanamivir (Relenza), anti-viral medications that can treat swine flu, may be also prescribed, but some health care providers may want to examine a patient before prescribing these drugs.

Influenza may cause some people to become very ill. Dehydration and pneumonia are major complications of influenza. Regardless of the altruism of not exposing other people to infection, people should seek medical care if it is needed.

The story of swine flu will be played out in real time over the several days or month(s). Previous epidemics have taught the world many lessons in how to deal with the potential spread of an influenza virus. History will judge how well we have learned.

Reference: World Health Organization; Statement by WHO Director-General, Dr. Margaret Chan 27 April 2009; "Swine Flu."