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Apr. 26 2009 - 6:46 pm | 40 views | 2 recommendations | 10 comments

Swine flu: nothing new

The influenza viruses that caused Hong Kong Flu.

Image via Wikipedia

I hate pandemics.  Not just because of the illnesses that they cause, but also because of the fear that ensues.  It doesn’t help when organizations like WHO label them a “public health emergency”.  Simply the word “emergency” seems to make people feel that they are in imminent danger.

The fact of the matter is, swine flu has been hopping from pigs to humans for decades, sometimes causing disease, sometimes not. According to a study done by the Centers for Disease Control, 76% of swine exhibitors at a 1988 county fair had antibodies in their bloodstream indicating a prior swine flu infection, even though the exhibitors showed no signs of illness.  There was also an outbreak of swine flu among military recruits in Fort Dix, New Jersey in 1976, causing severe illness in 13 soldiers and one death.  With this current swine flu outbreak, we simply don’t know what to expect.  There’s been no reliable pattern.  Some people have gotten mildly ill, and some have died.  Some have probably been transiently infected and didn’t even notice.

But I don’t think we need to worry about this pandemic too much, because there’s one thing to keep in mind when news of a unique flu strain breaks:  perspective.  As of this writing, 80 people in Mexico have succumbed to swine flu.  By comparison, the CDC estimates that 36,000 people in the United States die each year of influenza-related illnesses.  And in spite of this, we in the medical community still have a hard time convincing people to get their flu shots.  If you’re not afraid of influenza, then you shouldn’t be afraid of the swine flu.  Even in the event that someone gets infected with swine flu, we have medications with demonstrated effectiveness against the strain that’s currently active.

So I’m not going to say that the swine flu is not a big deal.  Anytime someone dies an untimely death, it’s a big deal.  Anytime a lot of someones die from the same thing, it’s an even bigger deal.  It’s unfortunate.  It’s tragic.  But it’s happened before, and it will happen again.


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  1. collapse expand

    I hope you’re right.

    Meanwhile, millions of North Americans have to decide whether it’s safe to take their kids to daycare or school.

    Millions of travelers need to decide if it’s safe to take that work trip or not.

    The mortality rate in Mexico City is awful.

  2. collapse expand

    76% of swine exhibitors at a 1988 county fair had antibodies in their bloodstream indicating a prior swine flu infection

    Almost a century ago we got ourselves the Spanish Flu (Bird Flu), and now we get the Mexican sequel (Swine Flu).

    It’s a real case for probability. How many times have we been infected by one bird flu or another? Yet once in a blue moon an outlier appears, and rewrites the rules.

  3. collapse expand

    Thanks for this post, Turi.I wonder how people would react to the flu were the media to make as dramatic a fuss about the thousands who die each year of flu in the US.

  4. collapse expand

    I’m happy you wrote about this Turi. I’ve been thinking about this a lot the last few days, wondering how much the media’s focus on swine flu has exacerbated our perception of the risks and probabilities.

  5. collapse expand

    I agree. So far it sounds more like a nuisance than a crisis. Let’s hope it stays that way.

  6. collapse expand

    The thing that worries me about this flu is that people are coming down with it all over the world. It’s not just a group of people at an army base. Also, the virus is a different form of the one that caused the Spanish flu. And the Spanish flu came in two episodes. The first was in the spring and was mild, then the second, in the winter, was the killer.

    I am a worrywart.

  7. collapse expand

    yea nothing to worry about-169 out of 1600-10% death rate-wow
    norm flu-35000 out of 300mill–.001%?
    no one dies in usa cuz we catch/treat early- if we do not close borders-flu will progress farther-and with the “no concern”"nothing new” policy-people will not get treated till to late– why mark levin points to your article – i have no idea- but to me your being misleading and harmful — if your story true than no need for your story-

    • collapse expand

      Whoa, mind your denominators. In your calculation of the “death rate” from “norm flu”, you use the entire U.S. population as your denominator. In the same calculation for swine flu, it appears you’re using the number of suspected illnesses in Mexico due to the swine flu as your denominator. In fairness, it’s nearly impossible to get an accurate denominator for viral illnesses because it’s very hard to get a good count of those that are infected. But if we’re going to use the population of the countries in our denominators, and assuming that 169 deaths in Mexico are actually due to swine flu, then at present swine flu has claimed the lives of 169/110,000,000, or approximately one death for every 650,888 people in Mexico. Estimated influenza-related deaths claim 36,000/303,000,000, or one death for every 8,417 people in the United States. Yearly.

      In response to another comment. See in context »
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    I grew up on a farm and worked my way through college slinging pizzas, walking dogs, and assisting with autopsies. I received my M.D. from the University of Chicago-Pritzker School of Medicine and completed my residency in internal medicine at Boston's Beth Israel Hospital. I then took a faculty position at the newly-merged Beth Israel Deaconess Medical Center, but after two and a half years of commuting in Big Dig traffic with a screaming toddler in tow, I thought I'd try moving back to my home state of South Dakota. I am currently Associate Professor of Internal Medicine and Program Director of the Internal Medicine Residency Program at the Sanford School of Medicine of the University of South Dakota.

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