The Other-White-Meat Flu
May 1, 2009
The 100-day president is going through some tough times: a crashed economy, two foreign wars, and now an outbreak of influenza that is on the verge of being declared a pandemic. But for all the hype generated by the 24-hour news cycle, President Obama can still take solace in the fact that swine flu is not that bad. Or at least not yet.
In recent years, fears of a pandemic have been associated with the spread of avian influenza, which in turn has been likened to the threat posed by the 1918 influenza pandemic that killed millions. There are several associations here that need to be broken to understand the threat swine flu actually poses (or doesn’t).
The 1918 pandemic was devastating for two reasons. First, it spread very easily from person to person. Second, it was deadliest among the most productive members of society: the tranche of adults from 20 to 40 years of age. In 1918 flu, young adults died because their robust immune systems reacted more strongly to the viral infection. Their immune overreaction generally caused fluid buildup that in turn caused their respiratory systems to fail, which if not lethal in itself, could lead to deadly secondary infections.
Swine flu, while communicable from person to person, doesn’t appear to trigger the same kind of reaction from young adults. In other words, while it has sickened hundreds, it doesn’t seem to cause deaths among the majority of those who have to leave their homes each day to go to work and make the world turn. And that’s very good news.
Even if it did, we live in a radically different world than that of 1918. We now have antibiotics and antiviral medication to treat not only secondary bacterial infections but also primary viral infections. Although there are questions about the continued efficacy of these drugs during the course of a pandemic, even if swine flu were as aggressive as 1918 flu, it would most likely not mean a death sentence for otherwise healthy individuals. Moreover, governments around the world are constantly working to improve their preparedness so that they can respond effectively to prevent or slow the spread of dangerous diseases—of which SARS is just one example. And then there is private industry. From developing drugs like Tamiflu and Relenza that are effective against swine flu to designing genetically engineered vaccines, the biotechnology sector’s vast array of resources in the long-term fight against emerging diseases should not be dismissed.
To be sure, swine flu still poses a threat, but the threat should be put into context. To date, cases of swine flu are far less numerous than those of ordinary “seasonal” flu—a disease that kills more than 30,000 Americans a year, yet one we face without undue concern. For those with compromised immune systems or without access to medical care, complications due to H1N1 viral infection could be serious. But that is not any different from infections with regular influenza strains, or even standard bacterial infections like strep throat. Granted, there is also the possibility that the virus could mutate, becoming more easily transmissible or more lethal. But that kind of mutation doesn’t seem to have happened yet.
Mutation is a matter of probability. Using the lottery as an analogy, the fewer times you play, the fewer times you could potentially win the jackpot. Containing the spread of the virus will reduce the risk that it will mutate into a more dangerous form, which is something public health officials should be concerned about. For now, the public at large should be aware but need not be worried. Chances are that if you’re healthy and have access to good medical care, getting swine flu will not be much different from getting regular flu.
Ethan Wais is a research assistant with the Homeland Security Program at the Center for Strategic and International Studies.