Tuesday, April 28, 2009

Swine Flu Musings

There is, perhaps, an over-abundance of articles out there right now concerning the Swine Flu. I'm feeling a bit reluctant to add to that onslaught of information, but still I feel obligated as a patient/public health advocate to at least point you to some excellent resources and reflect on some of our past influenza and other contagious-disease outbreaks.


A few months ago I wrote very generally about Influenza, a.k.a. "The Flu". Key points from that blog entry: influenza is a viral illness characterized by high fever with chills, significant muscle aches, headache, sore throat, and a cough that produces phlegm. Nausea and vomiting may occur, but are not the primary symptoms.

Most healthy adults who contract the flu are miserable for a few days, but can recover with fluids, over-the-counter flu meds, and lots of bed rest. Individuals at risk for more serious consequences include anyone weakened by an underlying acute or chronic condition, the elderly, and infants/young children. (Please, if you do become ill, be nice and stay home until you're well, particularly avoid those most vulnerable to spare them, if possible.)

What is the Swine Flu?

Swine Flu is actually a vague name for an influenza virus that originates in pigs and hogs, but mutates to become infectious to humans. One thing about influenza viruses that makes them hard to fight is their ability to change over time in subtle but uncanny ways. You cannot "catch" the current Swine Flu virus from pigs and hogs, but you can contract it from other humans who are infectious. There has been some recent debate regarding the "public" name of the current Swine Flu, with some suggesting it should be called the Mexican flu.

(Side note: All viruses have a "scientific"/official name, this Swine Flu is a Type A influenza and is officially called the H1N1 virus.)

Been There, Done That?

In 1976 an unusual outbreak of Swine Flu infected soldiers at Fort Dix, New Jersey and led to concerns that a Swine Flu epidemic could sweep the nation. In short order a vaccine against this flu strain was prepared, and a campaign was launched encouraging the public to be immunized.

Health care workers are on the front lines of exposure and are always urged to be vaccinated so that they don't fall ill and be unable to perform their jobs in times of health crises. As a 16-year-old (kitchen) employee at Community Memorial Hospital in Monmouth, Illinois, I remember being offered the vaccine "for free", but I wasn't keen on taking any shot that wasn't forced on me and quietly deferred.

No epidemic of Swine Flu emerged in 1976-1977, but the massive vaccination campaign DID result in unintended consequences. A number of individuals who were immunized became almost immediately afflicted with a rare auto-immune, neurologically debilitating syndrome, called Guillain-Barré (pronounced: "GEE-ann Bah-RAY"). The vaccination program was abruptly halted as a result.

Don't Get Me Wrong

The government took note of lessons learned from the 1976 Swine Flu immunization program. But the legacy of that hastily-prepared 1976 vaccine lives on in the memory of the baby-boomers and could lead to some public reluctance and resistance when a new vaccine is developed in response to the current expected pandemic.

As a historically-inclined and health-minded individual, I'm all too familiar with the tragic deaths wrought by the Spanish Influenza during the 1918 pandemic. More recently our nation and the world managed to dodge some significant "bullets" (cannon-balls, really) as both the deadly SARS virus and the Avian (bird) Flu were contained before the North American continent was affected. Because of our good-fortune in avoiding these highly-publicized illnesses, it concerns me that the public may have grown complacent and/or skeptical of our susceptibility.

Prevention and Preparation--Not Panic

That's my motto on everything health-related. First and foremost avoid infecting others by staying home from work or school when you are ill. Cough or sneeze into a tissue—and then throw it in the trash to avoid contaminating surfaces. No tissue? Cough or sneeze against your sleeve to spare your hands from the germs. Keep your hands clean and keep them away from your eyes, nose and mouth, because they are the portals of entry for influenza germs. Drink plenty of fluids while convalescing from the flu; high fever speeds up metabolism and causes significant dehydration. You'll feel worse if you aren't replacing your fluid losses. When appetite wanes due to the illness, force yourself to consume calories in chicken soup, hot tea with honey & lemon and flavored popsicles.

Having extra supplies on hand is recommended for any emergency. In a worst-case-scenario for a pandemic illness, supply chains and deliveries to your local store could be disrupted. Having an extra supply of non-perishables and sundries will at least save you from going to the store if you fall ill. Check to make sure you have plenty of your prescribed medications on-hand. (Make sure inhalers are full and available if you or your family members use them.) Stock up on over-the-counter fever and flu medications. (Avoid giving aspirin-based medications to anyone under age 18 with flu-like symptoms to prevent Reye’s Syndrome; stick to Tylenol or Ibuprofen.)

Ensure your pantry has an adequate supply of easy-to-prepare foods including canned: meats, fish, soups, fruits and vegetables. Keep canned or bottled juices and bottled water on hand, and be sure to keep some flavored popsicles in the freezer. Crackers, peanut butter, dry cereal, rice, applesauce, and granola bars are also recommended foodstuffs for emergency situations. Don’t forget to have plenty of pet food on hand, along with baby food and formula if appropriate.

Sundries to have onhand for any preparedness kit: an adequate supply of soap, hand sanitizer, tissues, baby diapers, toilet paper, paper towels, detergent, and garbage bags. I’d suggest having a non-electric can-opener, fresh batteries and a flashlight.

Flu Pandemic Information

Keep informed by seeking advice from reliable sources. The federal government’s website (http://www.pandemicflu.gov/) is providing up-to-the minute information on this influenza. No computer? No problem. Multi-lingual health experts at the Centers for Disease Control and Prevention (CDC) Hotline will answer yours questions at any time: 1800-232-4636).

The Health and Human Services Interagency Public Affairs Group on Influenza Preparedness and Response, is responsible for coordinating pandemic-related information across the federal government. Check out their website for up-to-date information about this emerging influenza pandemic, and take a look at their suggested pandemic flu planning checklist for individuals and families. The Centers for Disease Control CDC Swine Flu page is an additional, frequently-updated, excellent source of relevant information.

A footnote

In preparing this entry I came across a 2005 OP Ed piece, "Grounding a Pandemic,"written about the Avian Flu by (then) Senator Barack Obama and Senator Richard Lugar, both then members of the Senate Foreign Relations Committee.

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