Like you, I can’t read the paper or turn on a television or radio without hearing about the H1NI influenza. As I’ve done radio interviews for radio stations around the country on the topic, I find many are asking the same questions. Here are my answers.
1) Everyone seems to be panicking about the swine flu. How worried should I be?
Quite honestly, we’ll only know in retrospect – and perhaps not until after the next influenza season has passed. Why? Because all flu viruses are constantly changing and mutating. Therefore, there is no way to know so early in the research of this virus what exactly will happen.
Don’t forget that the worldwide pandemic of 1918 that killed up to 100 million people actually started with a mild outbreak in the spring of 1918 (actually in March) and was followed by a devastating and deadly flu season the following fall and winter.
Nevertheless, at least so far, this particular outbreak seems to be far less widespread and dangerous than a typical flu season.
Even if there are more swine-flu deaths outside Mexico – and public health experts predict there very well may be – the H1N1 (Swine flu) virus would have a long way to go to match the roughly 36,000 deaths that seasonal influenza causes in the United States EACH year.
In fact, since January of this year, more than 13,000 people have died of complications from seasonal flu, according to the Centers for Disease Control and Prevention’s weekly report on the causes of death in the nation.
No fewer than 800 flu-related deaths were reported in any week between January 1 and April 18, the most recent week for which figures were available.
Worldwide, the annual death toll from the flu is estimated to be between 250,000 and 500,000.
2) Do face masks work? Why aren’t more people wearing them?
The U.S. Food and Drug Administration-approved facemasks work well in a hospital setting where a patient is known to be at risk for an infection. Immune-compromised patients wear masks to protect them from others germs and patients with certain contagious diseases, such as tuberculosis, that are passed on through the respiratory tract.
However, for a virus that is a small as the H1N1 virus, there is no evidence that facemasks would work at all.
Theoretically, they may be of some help. But, what has been shown to work far better is to reduce risk of contact with the H1N1 virus (or, in fact, any infectious virus or bacteria) by washing or sanitizing our hands frequently, staying home if we are sick, and avoiding sneezes or coughs into our own. Also, use tissues rather than handkerchiefs and dispose of the tissue after a single use.
If you’re going to try a face mask, remember that it needs to be changed frequently because breathing will cause the mask to get damp and a damp mask may allow more viruses and bacteria to pass through.
Nevertheless, let me re-emphasize that a face mask not only won’t prevent tiny viruses, like the H1N1 virus from getting through, but it may do harm by giving your a false sense of security. Worse yet, it may tempt some people who are sick to go out in the community and potentially infect others.
According to the CDC, the only facial apparatus that is likely to protect you from the H1N1 virus is what they call a “respirator,” which refers to an N95 or higher filtering facepiece respirator certified by the U.S. National Institute for Occupational Safety and Health (NIOSH).
3) Are the two drugs against the flu as good as some reports make them out to be?
The two newest antiviral medications, Relenza and Tamiflu, may help prevent caregivers and household contacts, as well as some high-risk patients, from getting the H1N1 flu.
And, for those who catch the flu, these anti-viral medications must be started within 48 hours of the onset of symptoms. Research has shown these medications, which are very expensive, may shorten the illness and reduce its severity by 25 or 30%, but we don’t know if they will prevent deaths or severe illness.
Tamiflu (oseltamivir) costs over $90 for a prescription and Relenza (zanamir), which is an inhaled powder, costs over $60 for a prescription.
What worries most public health officials is that people will take them indiscriminately and, as a result, resistance to the drugs could develop quickly.
Because this year’s vaccine probably doesn’t work for this strain, what will happen in the fall?
Researchers have already identified the genetic code of the new H1N1 flu strain and are hopeful they can come up with the right combination of strains to give us the greatest protection next fall.
And to those who worry about side effects from the vaccines, you will be reassured to know that today’s vaccines are much safer and have far fewer side effects than past vaccines. This is because (1) they have much less viral material and (2) they have more of a safe, generic adjuvant or “irritant” in them. This adjuvant gets the immune systems to provide protection with less side effects than the viral material alone.
4) What about some of the older and far less expensive anti-viral medications? Can they be used?
This H1N1 (Swine flu) virus is sensitive (or susceptible) to the neuraminidase inhibitor antiviral medications zanamivir (Relenza) and oseltamivir (Tamiflu).
Unfortunately, it is resistant to the adamantane antiviral medications, amantadine (Symmetrel) and rimantadine (Flumadine).
5) Can Taking Tamiflu Unnecessarily Hurt You?
The CDC says only patients who are exposed to the H1N1 flu need to consider taking the medication.
Dr. Martin Blaser, of New York University, told CBS News that taking Tamiflu unnecessarily creates a public health danger.
“It’s not a good idea to have it at home just in case because the more people who have it, the more people who use it, the sooner resistance will emerge,” Blaser said.
Unfortunately, some are turning to the Internet. Online Pharmacy Direct Response Marketing said sales of Tamiflu have spiked 800 percent in the last week. AccessRx reports a 62 percent increase in sales.
To buy Tamiflu in a pharmacy you need a prescription – online you may not.
CBS News ordered Tamiflu with just a few clicks of a mouse and a $160 charge on a credit card. They just typed in that they had fever and flu, and then checked the informed consent agreement saying they consulted a doctor.
An online doctor supposedly reviewed the case and CBS News purchase. But nobody called or even e-mailed with questions, CBS reported. A few days later, the drug was in hand.
The CDC said other Web sites, are falsely claiming their medicines prevent H1N1.
And reselling Tamiflu on sites like Craigslist is illegal.
In addition, there’s no guarantee that what you are receiving is not counterfeit when you order over the internet.
7) So, why do you say I should not panic?
There are at least seven reasons, according to WebMD, not to over worry or panic.
- Most swine flu cases have been mild, so far. Severe cases have been seen mainly in Mexico, for reasons that aren’t yet clear. But most swine flu patients have recovered without being hospitalized.
- You’re not defenseless against swine flu. Simple things – washing your hands, not touching your mouth, eyes, or nose, and trying to avoid close contact with sick people — can go a long way toward reducing your risk.
- Most swine flu cases so far have been pretty much like normal, seasonal flu. Swine flu and seasonal flu share symptoms, and spread the same way.
- How much do you worry about seasonal flu? Maybe you should give garden-variety flu a little more respect. In a typical U.S. flu season, an average of 36,000 people die of flu or flu complications, and about 200,000 people are hospitalized. Swine flu hasn’t come anywhere close to that.
- Swine flu’s future is unknown. No one knows where swine flu is headed – for better or for worse. “You don’t know if it’s going to fizzle out in a couple weeks or become more or less virulent or severe in the diseases it causes,” CDC Acting Director Richard Besser, MD, said on April 29. “If we could see into the future [that] would be absolutely wonderful, but that’s not the case. That’s why we’re being aggressive” in seeking to limit swine flu’s impact on human health.
- The world is more prepared than ever. Remember bird flu? When that was the “it” virus several years ago, the global health community ramped up its pandemic preparations. As a result of that work, “the world is better prepared for an influenza pandemic than at any time in history,” WHO Director-General Margaret Chan said on April 29.
- Pandemics aren’t all deadly.” If the World Health Organization declares swine flu a pandemic, that’s all about the spread of the virus – not the severity of the illness. In the past, some pandemics have been mild, while others have been severe, notes WHO spokesman Gregory Hartl, adding that “people should act with common sense, not with panic.”