The 2009 outbreak in humans of a new flu strain, genetically related to Swine flu, though it has not been isolated in pigs, is probably a mosaic of swine, bird, and human flu viruses, but is actually of unknown origin. Thus, the very name is misleading since the disease cannot be transmitted by eating pork. Yet the Egyptian Government has destroyed perhaps 300,000 animals (a political ploy against Coptic Christians?), and Russia used the flu panic to ban pork imports from Spain and Canada. Moreover, U.S. immigration phobics see the “Mexican flu” as a fresh reason to argue for a wall along the border-even though the first case was probably seen in this county! Then too our panicky V.P unwittingly made the case against travel by Amtrak.
This strain transmitted from human to human, appears in most cases so far to resemble the usual yearly flu, being clinically mild, with exceedingly low mortality. Haunted by memories of the 1918-19 pandemic when 50-100 million died world wide, sensational media coverage erupted along with excessive or inappropriate warnings by some health authorities, and governments, and even the World Health Organization (WHO). We are presently awash in hysteria, even now as this particular epidemic cases appears to be in decline.
You may recall those terrifying forecasts during the avian flu panic of 2005 (deaths to date: 257, according to the World Health Organization) and the SARS panic of 2002-2003 (774 deaths). By contrast, garden-variety flu typically kill upwards of 36,000 Americans a year.
A recent article in The Times of London notes that in 1919 precautions included mustard baths, Bovril (a meat extract), gargling with salt water, and especially port wine.
As noted in the Wall Street Journal, there are no longer “… several million exhausted… (soldiers) living in filthy conditions and close quarters along two sides of a 450-mile (war) front. Or troops and sailors being moved in crowded trains and ships, or being treated in overcrowded hospitals. And at least in Western cities, it is no longer typically five-to-a-room in squalid tenement housing.” As science writer Wendy Orent has pointed out in the New Republic, “Only the precise conditions of World War I’s Western Front — a true disease factory — could have created a flu as virulent as the one responsible for the 1918 pandemic.”
No one can predict, of course whether a more virulent strain of flu may evolve in the fall, causing another epidemic with more severe clinical consequences. We will have to watch what develops in South America in the next few weeks, since this is a harbinger of a possible second wave that usually strikes in the colder months in the northern hemisphere.
But as to a pandemic, WHO almost had it dangerously wrong when Dr. Chan, its Director General threatened to go to “category 6.” As Dr. Henry I. Miller, an epidemiologist, noted in a letter to the New York Times,“a warning system based solely on how widely a virus has spread, but that does not consider the nature of the illness it causes is intrinsically flawed…it would classify as “pandemics” the frequent but largely inconsequential outbreaks of virus-caused colds and gastroenteritis.”
Yes, epidemic flu may yet turn out to be a significant problem this year, as indeed it had been in 1957, 1968 and numerous other times in history. But another 1918? Highly unlikely in this day and age. All we can do is assess the risks, be ready for surprises, and stay calm in a world that has always been full of uncertainty.