Posts Tagged ‘virology’

I find it incredibly surprising that many who read about the human swine flu outbreak chalk it up to a media sensation instead of a viable health concern.  Whether the outbreak concludes in a pandemic or by fizzling out much like the previous human swine flu of 1976 probably depends on how well this outbreak is contained.

Main concerning points of this flu are three-fold:

• While the mortality rate of this disease cannot yet be determined, taking initial reports into account, you’re looking at approximately a 10% mortality rate.  That’s the number of deaths (approximately 150 at this moment) divided by the number of cases (approximately 1,600).  These figured are sure to be reevaluated as more cases are found and more deaths occur.   (As a point of interest, the avian flu/SARS has a mortality rate of over 50% of confirmed cases.)
• The infection seems to spread rather easily.  One could say that a mere 1,600+ cases in a city of 22 million doesn’t constitute a big infection, but it’s growing every day.  In the United States alone the number of confirmed cases has almost doubled every day.
• This infection isn’t just swine-derived, but is actually a hybrid of two separate swine flus, a human flu, and an avian flu.

Another interesting point about swine flu has been the World Health Organization‘s response.   Already under fire for not moving into Phase 4 on April 24th, there’s some cause for concern on why they’ve yet to declare a Phase 5 Pandemic Alert.  Simply put, their definition of Phase 5 is:

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Swine flu meets the very first criteria defined in their statement: human-to-human spread of the virus into at least two countries in one WHO region.  You could also argue that it meets the definition for Phase 6, which is defined as:

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

With infections now reaching Mexico, United States, Canada, Spain, Scotland, Israel, New Zealand and perhaps more (possible cases were reported in Australia, France, Germany, Sweden, Norway, and South Korea), you could reasonably say that at least Phase 5 has been reached.  Higher community-level outbreaks in Europe are probably needed for Phase 6.

But the question is whether the WHO has thus far acted more in the interest of politics and economics rather than health.  When acting as the world’s main health organization, it’s prudent of them to act in the best interest of doctors, scientists, and the general public.  If the issue’s severity warrants the closing of borders and mass transit to contain the disease, which is one of the first and best ways to stop an infectious disease, then the determination needs to come swiftly.  If they’re worried about causing panic or adversely affecting politics or economies, then they need to reevaluate their Pandemic Alert phases and perhaps institute separate ones for health officials and the public.

It will be interesting to see how this disease continues to spread and what short- and long-term effects it has on pandemic preparedness and the WHO’s determination and communication of such issues.