Swine Flu: Info for You & What to Do (Part 1)
A Life Alert Special Report

by Dr. Don Rose,Writer, Life Alert

By now, most if not all of you know that a new strain of flu has emerged from Mexico and, as of this writing (May 1, 2009), has led to cases in the United States and other countries. Our two-part Life Alert Special Report provides some facts, analysis and other useful information that you should know.

What is the best way to refer to this new strain of influenza (i.e., flu)?

The scientific term is “H1N1” but most people (and most members of the media) have been using the term “swine flu” because it is thought to have originated in pigs. Some argue that it should be called the “Mexican flu” since Mexico reported the first cases of this new strain.

President Obama referred to the new flu as H1N1, perhaps because pork producers are currently facing a huge marketing problem with the name “swine flu” and, naturally, they are asking people to stop using that term. Some media outlets are also using the term H1N1 instead of swine flu, or using both terms.

What are some current facts about the 2009 outbreak of H1N1 (swine flu)?

An April 29, 2009 AP report states: “The virus, a mix of pig, bird and human genes to which people have limited natural immunity, had spread to at least nine countries. In the United States, nearly 100 have been sickened in 11 states.”

The Centers for Disease Control and Prevention (CDC) says: “Spread of the swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose. Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.”

Why is this new flu worse than a “normal” flu that appears each year? Why is everyone alarmed?

One of the main reasons for alarm is that the age group affected by the new swine (H1N1) flu is different than the groups typically affected by “normal” seasonal flu. The cases of death from a seasonal flu, during flu season, tend to involve the two ends of the age spectrum: the elderly and very young. In contrast, early numbers pertaining to the new strain “show that previously healthy people ages 25-45 make up the largest number of reported Mexican swine flu cases,” according to USA Today. The scary part is that this is “roughly the same age group hardest hit in the 1918 flu pandemic” which killed tens of millions of people worldwide.

The WHO (World Health Organization) raised the pandemic alert level to Phase 4, then to Phase 5. What does this mean?

The Phase 4 level indicates “that human-to-human transmission [of the virus] is causing community outbreaks.” (Source: USA Today, April 28, 2009.)

An April 29 report from the Associated Press said that the pandemic alert level was increased again, to Phase 5, noting that “[i]t was the first time the WHO had declared a Phase 5 outbreak, the second-highest on its threat scale, indicating a pandemic could be imminent.”

Should I worry about a pandemic if H1N1 has not affected anyone near me?

Excessive worrying is probably not warranted if H1N1 has not affected people in your general geographic location, but you should keep track of news reports and get a daily feel for how and where the virus is spreading. You want to know in what direction(s) the virus is propagating and how fast. From the aforementioned AP report:

"It really is all of humanity that is under threat during a pandemic," WHO Director General Margaret Chan said in Geneva.

Does a Phase 5 pandemic alert level mean that a global epidemic, affecting thousands or even millions of people, is sure to occur?

No.

Possible, yes. Phase 5 means a pandemic “could be imminent” -- but it is NOT certain. Repeat: it’s NOT guaranteed that a worldwide pandemic will result from the current outbreak. When the government said that people should not panic, they were absolutely right. The worst case is by no means a foregone conclusion, and panicking only leads to irrational behavior.

While a pandemic (i.e., global epidemic) may eventually occur, swift and strong action on a global scale greatly increases the odds of preventing it. So far this kind of decisive action seems to be occurring, with strong steps being taken in Mexico (school closings, widespread use of facemasks), the U.S. (border screenings, enhanced airport safety procedures) and other nations. Raising the pandemic alert level sounds scary, but has the beneficial effect of mobilizing necessary resources and can also help motivate those who need to take action.

How many H1N1 cases have been reported in the U.S.? How many deaths?

According to the April 30, 2009 edition of Daily Health News (from healthfinder.gov): Swine Flu Infections Surpass 100 in U.S... As of this writing, there has been only 1 reported death in the U.S. from the new flu (First Swine Flu Death Reported in U.S.). This would put the U.S. death rate caused by the new strain of swine flu at around 1 percent or less.

Note, however, that this single fatality could actually be classified as a Mexican flu death, since the toddler who died came to the U.S. from Mexico. In this case, there are still no deaths in the United States from the 2009 H1N1 virus outbreak.

What are the statistics from Mexico thus far regarding swine flu cases?

USA Today (April 28, 2009) states that “Mexico is reporting nearly 2000 suspected cases and” (according to the Associated Press) “up to 149 suspected deaths.” The figures according to an April 29 AP report were “168 suspected deaths” and “the virus is believed to have sickened 2,498 people across Mexico.”

This works out to a death rate between 6.7 and 7.5 percent, assuming these numbers are accurate (which is not guaranteed, since the figures may rise over time, and we might not be getting accurate stats from Mexico in the first place).

The AP also reported on April 29 that “confirmed swine flu cases doubled to 99, including eight dead.” Note how these confirmed numbers are much lower than the suspected numbers, but the death rate is similar -- about 8 percent when using the confirmed figures.

Why does the H1N1 swine flu seem to be having a harsher effect in Mexico than in other nations?

The USA Today article quoted above asked this question, and others in the media have also been seeking a reason. However, there is still no clear answer as to why this year’s swine flu has only proved fatal in Mexico. Some theories:

• Since the new virus has infected so many more people in Mexico, the odds of the virus infecting people with weaker immune systems goes up, hence a higher number of deaths would be likely.

• Since the virus infected citizens of Mexico before anywhere else (that is, has been present in their population for a longer time), any long-term effects of the virus would naturally be likely to occur first in Mexico, including lethal outcomes.

• Although USA Today reports that “Mexican officials are reporting a swine flu death rate approaching … 8% to 10%”, it is possible that “many more Mexicans actually have had swine flu than health officials realize because their illness was milder and they never saw a doctor.” An increase in actual swine flu sufferers in Mexico, if true, would mean that “the death rate could be far lower.” For example, if the total number of Mexicans infected by the new flu is actually around 10,000, the H1N1 death rate in Mexico would only be about 1.5 - 1.7 percent (using suspected death figures) or as low as 0.1 percent (if you use confirmed deaths). The final true numbers may not be known for days, weeks or even months.

• The Mexican government might be underreporting the total number of citizens affected by this year’s swine flu. Why? Perhaps to avoid widespread panic and social disorder, or to prevent a total meltdown of the Mexican tourism industry. Perhaps it’s a desire to wait until more facts are in. Or a bit of all three.

Any of the above theories, or a hybrid of them all, might explain why many more severe cases of the new H1N1 flu (including deaths) have been reported by our southern neighbor.

Is there any good news or signs of progress coming from Mexico?

Yes. The April 29 AP report states that “only 1,311 suspected swine flu patients remained hospitalized, and a closer look at daily admissions and deaths at Mexico's public hospitals suggests the outbreak may have peaked during three grim days last week when thousands of people complained of flu symptoms.”

Final Thoughts

For more information and analysis related to the 2009 H1N1 swine flu outbreak, again in question-answer format, see Part 2 of this two-part article.

The information provided above is, to the best of our knowledge, reliable and accurate. However, while Life Alert always strives to provide true, precise and consistent information, we cannot guarantee 100 percent accuracy, and our articles do not offer medical advice. Readers are encouraged to research statements made, use any resource links provided, and talk to health or medical professionals in order to gather more information before drawing conclusions and making decisions.

For more information about Life Alert and its many services for seniors and younger adults nationwide, please visit the following websites:

http://www.lifealert.com
http://www.seniorprotection.com
http://www.911seniors.com