Monday, April 27, 2009

10 more things you should know about H1N1 (swineflu)

Influenza virus Swine flu (or A/H1N1/Mexico09 as we should start calling it) has been keeping me busy over the weekend. On Saturday I published 10 things you should know about swine flu and since then I've been keeping up a stream of filtered, referenced information about the outbreak on Twitter and via this RSS feed. I've had some flak from a few people along the lines of "You are irresponsible, you are causing panic", so I guess it's time for:

10 more things you should know about swine flu:

1. Why are you doing this?
Aside from my 30 years experience in virology (look me up on PubMed if you want to check my credentials), over the years I've received thousands of pounds of charity money to promote the public understanding of science. This is it folks.

2. Why is this happening now?
Influenza pandemics occur every 10-30 years. We're overdue for a pandemic - we've been waiting for one for the last 10 years.

3. So why wasn't this outbreak predicted?
In a way, it was, but not with this strain of influenza (we've been watching other strains such as H5N1 and H9N2 closely for years). Influenza virus is genetically unstable and inherently unpredictable. This just happened to be the strain that got the "lucky" genetic break. H1N1 influenza does seem to be rather good at human pandemics though.

4. What is going to happen with this outbreak?
We don't know. Influenza virus is genetically unstable and inherently unpredictable. It could be that the whole thing fizzles out in a few weeks. It's also possible that this virus mutates into a much more harmful strain, capable of causing the type of harm (a "cytokine storm") the 1918 H1N1 pandemic strain caused - possible, but unlikely. We simply don't have enough information to know at the present time. Fortunately, worldwide surveillance and tracking of influenza is highly sophisticated and goes on constantly. This will give us the answer in a few weeks time.

5. Can this strain of flu be treated?
At the present time, yes. This strain is sensitive to the newer anti-influenza drugs, of which developed countries have large stockpiles. This season's influenza vaccine also includes an H1N1 component, and which it's unlikely that this will prevent infection with the current strain, it may offer people who have been vaccinated (the most vulnerable groups such as the elderly and medical staff) some degree of protection.

6. What if the virus becomes resistant to drug treatment?
That's probably not such a big deal. To be effective, the drugs need to be started very early after infection, probably before most people have been properly diagnosed. Drug-resistant virus would pose more of a threat to very susceptible patients, but won't make too much difference to most people. A pandemic is a worldwide event and drug treatment will not be available anyway to most people in developing countries where the majority of cases will occur.

7. So what can we do about this outbreak?
Stay informed, get educated, follow professional advice. If you're told to wash your hands frequently, stay at home if you feel ill, or even not to go to that conference or cancel your foreign holiday (we're not there yet), do it.

8. So what are you personally doing to prepare?
Staying informed, seeing how the situation develops, not panicking. Thinking about what I would do in the event that the situation took a turn for the worse. The place you live in, your country and large organizations you may work for will have pandemic preparedness plans. Find out what they are (Google is your friend) and think about how you would mitigate the effects of a pandemic on your personal, social and professional life.

9. More Information:

10. Want to ask a question?
Ask away: