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As Swine Flu Scare Abates, Lessons for the Future

Ben Cole, for HealthLeaders Media, May 5, 2009

After more than a weeklong swine flu scare that saw school closings, travel warnings, and a media frenzy, officials around the world are now trying to ease concerns after health officials determined the H1N1 virus is not as deadly as originally thought.

The U.S. Centers for Disease Control and Prevention announced yesterday that closing schools once a student falls ill with swine flu may no longer be worth the toll on students and families, because the illness will soon be present almost everywhere in the country and few cases have been severe. Also on Monday, Mexican officials announced that the epidemic appears to have slowed there and that commerce and government work would restart Wednesday after a five-day shutdown.

The swine flu scare, and subsequent reaction to it, provides examples of the best and worst reactions to what can happen during a pandemic. As World Health Organization Director Margaret Chan, MD, said in a statement last week: “The world is better prepared for an influenza pandemic than at any time in history.”

“Preparedness measures undertaken because of the threat from H5N1 avian influenza were an investment, and we are now benefitting from this investment,” Chan said in the statement. “For the first time in history, we can track the evolution of a pandemic in real-time.”

The quick reaction by the WHO and other agencies to get information out quickly to governments allowed for heightened surveillance, early detection and treatment that potentially saved lives.

As CDC Acting Director Richard Besser said in Monday’s press briefing on H1N1, there are 35 known hospitalizations in the United States and one reported death. Also yesterday, the World's Health Organization reported 898 cases in 18 countries.

“I like to each day put this in context with seasonal flu,” Besser said during the briefing. “With seasonal flu, we see in the United States over 30 million cases. We see 200,000 hospitalizations and, on average, 36,000 deaths.”

Besser was quick to add, however, that the encouraging signs surrounding swine flu were not a signal for people to let up their guard.

“Personal responsibility, the things that we talk about every day about hand-washing, about covering your cough with your sleeve and not with your hand, about staying home when you're sick, about keeping your children home when they're sick, those things are critically important,” Besser said.

These precautions were readily available to people around the world almost immediately after swine flu was detected—helping people protect themselves and their families.

The ease with which swine flu information spread was also a curse, however. With the influx of media coverage, people around the world flooded emergency rooms at the first sign of a sniffle, or sometimes with no symptoms at all, to make sure they did not have the swine flu.

In China, Mexicans visiting the country were rounded up and quarantined. Mexico's foreign minister said Mexican citizens with no signs of infection had been isolated in unacceptable conditions in China, according to an article in the Wall Street Journal. China also created friction with Canada over banned pig imports and a group of quarantined Canadian university students.

But China may have just been reacting to past experiences: Chinese officials were accused of covering up the spread of SARS in 2002 and 2003.

The SARS epidemic, as well as the avian flu scare, has helped prepare countries around the world for a pandemic—even if the swine flu is not nearly as deadly as once thought.

It also encouraged countries to work together to fight the spread: last week Health and Human Services Secretary Kathleen Sebelius announced that the U.S. would purchase an additional 13 million treatment courses to help fight influenza, including the 2009 H1N1 flu virus. The additional treatment courses were added to the Strategic National Stockpile, and HHS began moving 400,000 treatment courses to Mexico to help slow the spread of the H1N1 virus, according to an HHS statement.

Also last week, the U.S. Agency for International Development announced that it is providing an additional $5 million to the World Health Organization and the Pan American Health Organization in emergency support for efforts to detect and contain swine flu in Mexico.

So did the quick reaction by governments around the world slow the spread of swine flu? Did the Internet providing readily available information help people protect themselves against the flu? Did healthcare providers instituting systems to handle an influx of patients with flu-like symptoms save lives?

These questions are almost impossible to answer—it is difficult to determine whether the reaction helped countries save lives, especially since the virus was not as deadly as once thought. But one thing is certain, should another, more virulent flu strain come, the world will be better prepared.


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Ben Cole is an associate online editor with HealthLeaders Media. He can be reached at bcole@healthleadersmedia.com.

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