Sunday, April 26, 2009

Swine Flu Update!

Swine Flu Update!

The front page of this morning reports that 20 people have died from “swine flu” in Mexico City, with 48 more deaths possibly attributable to the outbreak. 11 cases have been reported in the US.

A Kansas couple with a mild form of the illness has been allowed to stay at home because, according to their doctor, they “understood the gravity of the situation and are very willing to isolate themselves.”

Such an individual public health consciousness is something that was rarely seen during past smallpox outbreaks in the Americas (when, for example, recently-inoculated and likely contagious carriers continued to go about their daily lives), and is still sometimes breached in important circumstances today—for example, in the case of the man who boarded a plane with multidrug-resistant TB.

A British Airways flight attendant is believed to have come down with the disease en route from Mexico to London, and is currently being isolated in London’s Northwick Park hospital.

According to the Guardian, “People in Mexico City were being ordered not to kiss or shake hands. Football matches went ahead without spectators, theatres, shops and museums were closed, staff were inside locked schools scrubbing classrooms with disinfectant, and health workers patrolled buses, ordering sickly looking people home.

“…Any doubts over the extent of the emergency were dispelled last night by the sight of soldiers handing out blue surgical masks to pedestrians and motorists along Mexico City's central boulevard, Paseo de la Reforma.”
It’s rare to see a modern-day epidemic change the face of a city so drastically. The Guardian’s description recalled the “empty city” scenes described in Pox Americana during the smallpox epidemics in the Americas during the 17 and 1800’s.

The virus has been classified as A/H1N1, a mix of human, bird, and pig viruses. Unlike avian flu, this strain appears to be transmissible from human to human, and thus has sparked WHO fears of a pandemic.

The cases have ranged from mild to severe, and it’s interesting to note that all of the US cases have been mild. Could this have to do with genetic differences? And, in that case, could it maybe shed light on the reasons why smallpox or other past epidemics had such varying effects in different populations? Or is it more likely (because of the small sample size) simply chance? A difference in the virus, itself? Differences in access to health care?

The CDC has already created a vaccine “seed stock” genetically matched to the new virus, which could be used to get started producing vaccine if they decide it is necessary.


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