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Sunday, May 3, 2009

Swine Flu: The 11th Plague or A Treatable Virus?

As each day brings a deluge of apocalyptical news reports chronicling the spread of swine flu across the globe, it is difficult to get a realistic idea of how dangerous this virus truly is.

There recently have been revisions in the death toll reported from Mexico. There are now only 19 confirmed deaths attributed to the swine flu. It seems that the original numbers reported included anyone who died with "flu-like" symptoms. It is important to keep in mind that every year 36,000 people die in the US from the "regular" flu. Without testing for the swine flu virus, it is impossible to tell based on symptoms if a person has the regular flu or the swine flu and by lumping the two together you get an inflated mortality rate.

Even now with Mexican health officials testing to confirm the presence of the virus, it is difficult to calculate a Mexican mortality rate. This is because it is very difficult to know how many people in fact have been infected with the virus. Many people with mild illness may not be seeking medical treatment. So, we know 19 people have died in Mexico but we don't know out of how many infected individuals.

So far in the US, there have been 226 confirmed cases and one death in Texas. However even this is misleading since the toddler who died in Texas was a Mexican child who was brought here for medical treatment. Many news reports state that the child also had underlying medical problems, which may have contributed to his death.

Yet, even with the corrected crude numbers that we currently have from Mexico, it would seem that the mortality rate is higher there than in the US. Why would this be? Again that is unclear. We don't have a lot of information as to what exactly was the cause of death in these 19 cases. Was it respiratory failure, pneumonia, dehydration? We also don't know how long each person was sick prior to seeking medical treatment. Tamiflu and other antiviral medications work best if started within 48 hours of the onset of symptoms. It is very possible that those who died in Mexico were not able to start antiviral medications quickly enough.

Here in the US with all the media hysteria it seems that anyone who even thinks they could be getting sick has rushed to the doctor. This has allowed the Center for Disease Control, CDC, to have a much better idea of the overall number of cases of swine flu and in theory should allow for a doctor to be able to start antiviral medication, if needed, in a timely fashion. The majority of US cases have been mild illnesses. With the number of US cases growing, without any increase in severity, we should be breathing a sigh of relief.

However, we are not out of the proverbial woods yet. Influenza virus is known for its rapid ability to mutate. It is feared that the virus could become more virulent over time. Of course, only time will tell.

The recommendations for what you and your family can do to minimize your risk of being infected with the swine flu are the same recommendations that you hear every winter in order to decrease the spread of regular influenza. Practice good hand hygiene. Wash your hands with soap for 20 seconds or use an alcohol based hand sanitizer. Avoid taking young children, the elderly and anyone who is immunocomprimised to crowded places. If you do get sick stay home from work or school and seek medical attention within the first 48 hours.

For more information about the symptoms of swine flu or its spread in the US visit the CDC's website.