One gets the impression from many news stories that the so called “Swine Flu” is going to wipe out humanity.

Calm down and take a deep breath.

One reason that “swine flu” has such an ominous echo is because the last time it threatened, back when Gerald Ford was president, it was believed that swine flu was the cause of the 1918 influenza outbreak, that killed 40 million people, more than all of World War I.

So the news stories are echoing that fear. Here in Asia, the airports have gotten their “thermal scanners” out of storage.  (These scanners were used to screen incoming passengers for fever, and used for the SARS epidemic)

However, since then, newer theories are that the 1918 epidemic was actually a variation of bird flu, that is, the influenza virus included particles from influenza that affects birds.

Bird flu right now is a ticking time bomb, with over 100 deaths, mainly in young people who have been in contact with poultry, in countries as far flung as Indonesia and Nigeria.

But influenza that is mixed with pig influenza is not “new”. It happens all the time.

There are two types of influenza: the ordinary type, that hits nearly every year, and then “pandemics”, such as Asian Flu (1957-58) (believed to have bird virus in the mixture) and Hong Kong Flu (1967-69) (believed to have pork virus in the mixture). Both of these started in Asia, presumably when animal influenza virus combined with human influenza virus and then spread. To make things more complicated, avian type influenza has been identified in pigs.

Why China? Probably because of back yard pigs and poultry on small farms. And of course, there are more such farms in China than elsewhere in the world, and better transportation for the germs to get out.

The present Swine Flu epidemic is believed to have started in a large pig farm in Mexico, although full epidemic studies are not available.

The early reports were that over 100 people died in Mexico. However, only seven of these deaths tested positive for Swine Flu. So the early news stories about the high mortality might not be true.

Indeed, some scientists are quoted in the LATimes as saying that this version is less dangerous than run-of-the-mill influenza, that kills a couple thousand Americans every year.

So essentially, what is going on is a second “influenza” season, with, of course, a lot of people sick at the same time and some even dying of influenza or bacterial pneumonia that they get on top of the influenza epidemic.

…(in) a typical flu season. In the U.S., between 5% and 20% of the population becomes ill and 36,000 people die — a mortality rate of between 0.24% and 0.96%.

The bad news is that it may take three months to get a vaccine to prevent the disease.

But common sense isolation (keep the kids away from Grandmom, avoid crowds, wash your hands a couple times a day, don’t go to work if you feel sick) also will help the virus from spreading.

And, of course, there are now anti viral medicines which, if started early, can decrease the seriousness of the illness.

The currently circulating swine-origin influenza A (H1N1) virus is sensitive to the neuraminidase inhibitor antiviral medications zanamivir and oseltamivir, but is resistant to the adamantane antiviral medications, amantadine and rimantadine.

So the bad news is that the world is probably going to have an influenza outbreak, but it won’t be the “big one” like 1918, but more likely a smaller pandemic such as 1957or 1968.

Chart from Wikipedia:

Name of pandemic Date Deaths Subtype involved
Asiatic (Russian) Flu 1889–90 1 million possibly H2N2
Spanish Flu 1918–20 40 million H1N1
Asian Flu 1957–58 1 to 1.5 million H2N2
Hong Kong Flu 1968–69 0.75 to 1 million H3N2

One more note on mortality.

The Spanish Influenza epidemic of 1918 followed World War I, and some of the excess mortality might have been from the widespread famine at that time.

Also, many of the deaths may have come from secondary bacterial infections: which remain a serious complication of influenza even nowadays.

So the good news is that the Swine Flu epidemic is not a major danger to the world, and there are treatments for those with it.

The bad news is that, like previous influenza pandemics, it may end up killing a million people, many of them young people.

Since the news changes from hour to hour, you need to check up on the headlines (my information may be “old” by the time you read this). And if you get sick, check your local news to see if influenza is in your area.

But this influenza pandemic, is not the “Big one”: waiting in the wings: Bird flu, which some experts think is only a matter of time until it too becomes epidemic.

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The CDC has a swine flu podcast LINK

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Nancy Reyes is a retired physician living in the rural Philippines. She writes medical essays at HeyDoc Xanga blog, but her personal blog is Finest Kind Clinic and Fishmarket.

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