Thursday, April 30, 2009

Swine Flu and You

What kind of doctor would I be if I didn't blog about Swine Flu today? There is so much information out there, streaming in from the radio in my car, the television on the kitchen counter and from multiple sources in my email. In the interest of keeping this simple, here are ten basic facts worth understanding:

1.There are two important issues: contagion and virulence.

2.Contagion (how readily the virus can spread) is clearly in play here. We know that this new Swine Flu virus has emerged in dozens of countries. It most likely will emerge wherever there are humans. The rapid emergence of the virus in many different places in the world accounts for the WHO's increasing the alert to a Level Five yesterday.

3.Virulence(or the severity of disease) of this microbe is still unclear. Although the mortality rate for Swine Flu in Mexico is over 10%, the data so far in the US and elsewhere do not bear this out. Perhaps there have been many more undiagnosed cases than were tested. Obviously this would increase the denominator and lower the mortality rate.

4. It is quite possible-but not known for sure yet- that for most people this Flu will not be more severe than the regular seasonal flu.

5.The seasonal flu vaccine is not effective against the Swine flu as far as we know.

6.The drugs that can be used to treat swine flu should not be used preventatively unless a clear diagnosis of the new virus has been made or there is a high likelihood that it will be. Health departments have clear guidelines about this. Although some pharmacies seem to be out of the drugs, there is a huge amount in the US government's stockpile.

8. Preventative treatment --say after exposure to a person with fever, but not diagnosed with Swine Flu or merely to "prevent" contracting the Swine Flu is not effective, advisable or even ethical. We all bear some responsibility for the judicious treatment of these cases and preserving the drugs for those who really need them.

9.Inappropriate use of the anti-viral drugs will only increase the likelihood of this Flu Virus becoming resistant to the medications we have.

10. What can we do to prevent the Flu? Wash hands frequently and well. And sneeze or cough in a conscientious manner: into the bent elbow without "aerosolizing" the spray.