Wednesday, 16 December 2009

Swine Flu...

Interesting article from the New England Journal of Medicine regarding Swine Flu (link via the ever thought provoking Schneier on Security blog) about Swine Influenza. A short quote from the article reads:
This is the story line for most headline-grabbing illnesses — HIV, Ebola virus, SARS, typhoid. These diseases capture our imagination and ignite our fears in ways that more prosaic illnesses do not. These dramatic stakes lend themselves quite naturally to thriller books and movies; Dustin Hoffman hasn't starred in any blockbusters about emphysema or dysentery.
Published at November 25, 2009 (10.1056/NEJMp0911047)
The Emotional Epidemiology of H1N1 Influenza Vaccination
Danielle Ofri, M.D., Ph.D.

Now while no-one is doubting the seriousness of a new type of flu strain - they happen evey year, many times - the hysteria generated about Swine Flu has dwarfed other issues in the media. The rush for the vaccine here in Finland has been interesting to watch. One can sympathise with the officials to a point but when only hysterical, scare mongering information is being released - I guess balanced reporting doesn't make headines - then one must be more skeptical than usual, though if I recall corrected this NPR episode had a very good report on the issue.

One thing that amazed me was the queues at health centres in Helsinki and the capital region of Finland for the vaccine. At the time only risk groups were being vaccinated (babies, small children, those with respiratory illnesses) and this resulted in long queues both inside and outside (the weather at the time was -5C I remember in one news report) health centres. Now, think for a moment, if you have a highly contagious, respiratory illness then the worst thing you can do is to gather large crowds of people together for long periods of time (some who might already be incubating the illness too)....?   As the vaccine takes two weeks to become active within the body then there's a very good chance that you've accidentally created the conditions to spread the virus much more. Anyway, swine flu has dropped from the Finnish media almost totally with the occasional report on the still-yet-to-come-but-really-it-is-and-please-be-as-scared-as-possible second wave; which we've been told has already hit many countries, but not Finland...

As for the spread of the disease, the wikiedpia article on the 2009 H1N1 outbreak has an interesting quote backed up by data from the CDC:
With respect to the current swine flu pandemic, influenza surveillance information is available but almost no studies have attempted to estimate the total number of deaths attributable to swine flu. Two studies have been performed by the CDC, however; the most recent estimates that there were 9,820 deaths (range 7,070-13,930) attributable to swine flu from April to November the 14th.[16] During the same period, 1642 deaths were officially confirmed as caused by swine flu.
For comparison here's a link about the 1918 outbreak and from the 2009 pandemic wikipedia article a comparison of the various major outbreaks against "seasonal" flu (with all the linked left in for reference):

Pandemic Year Influenza virus type People infected (approximate) Estimated deaths worldwide Case fatality rate
Spanish flu 1918–1919 A/H1N1[154] 33% (500 million)[155] 20–100 million[156][157][158] >2.5%[159]
Asian flu 1956–1958 A/H2N2[154]  ? 2 million[158] <0.1%[159]
Hong Kong flu 1968–1969 A/H3N2[154]  ? 1 million[158] <0.1%[159]
Seasonal flu Every year mainly A/H3N2, A/H1N1, and B 5–15% (340 million – 1 billion)[160] 250,000–500,000 per year[147] <0.1%[161]
Swine flu 2009 Pandemic H1N1/09 > 622,482 (lab-confirmed)[162] 11,033 (lab-confirmed; ECDC)[2]
≥8,768 (lab-confirmed; WHO)[163]

Finally, the definition for Pandemic with some extremely interesting figures between various diseases and background information on exactly what Influenza is and what the family of influenza viruses (Orthmyxoviridae) are.

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