Swine Flu

It is almost a given that anyone who comments on medical issues should be saying something about swine flu and its implications. What more can we say? The stats and real (and imagined) seriousness and pervasiveness change daily. In the end this is still influenza, a potentially lethal respiratory virus that most people survive. It is spread person-to-person by water droplets produced from coughing and sneezing. It is relatively easy to avoid contact by staying home from work but not so easy to isolate oneself on board a small boat or in a tent when pinned down by a raging storm. Wash your hands and be courteous by coughing and sneezing into the crook of you elbow. When water is not readily available and you have the room, alcohol handwash solution is not a bad idea. As it turns out these are good ideas under any circumstances. Oseltamivir (e.g.,Tameflu – an antiviral) may be beneficial, especially if you are planning to head to Mexico or maybe CA or TX (and now even more places) but at $90+ US for ten 75mg tablets (www.drugstore.com) should this be a high priority; how much would you carry? Over-the-counter medications are of little to no use for treatment or prevention.

If you are worried, go to a reliable source, e.g., www.cdc.gov and not the nightly news cast. Remember, this is a quickly moving medical story. The people who know the most and are honest are likely to give fewer definitive, unequivocal answers than those who are removed from the center but seem to know it all.

Dr. David Johnson
President and Medical Director
Wilderness Medical Associates
Wilderness Medical Associates, Canada

2 comments on “Swine Flu

  1. Mike Motti Mike Motti

    Was just rereading The Great Influenza. The first time the flu spread from the U.S. to Europe in the spring of 1918 it was so mild that some doctors did not think it was influenza at all. At some point it mutated into a more deadly virus and came back to the U.S. in August., and then around the world.

    It ain’t over until it’s over.

  2. DJ DJ

    That is a good point, Yogi. We were not good at prognostications then and we are not so hot now. I recall the fear generated by the prediction of an outbreak of swine flu in the mid 1970’s. Because some felt that it could rival the 1918 flu, a vaccine was produced and everyone was encouraged to receive it. The result? Not much of an outbreak as I recall but I saw more Landy-Guillian-Barre (LGB) syndome in greater varieties than in all of my years of practice since. Many people believed it to be an unfortuante side effect of the vaccine.

    The fact that concern over this present outbreak seems to have flagged (schools are reopening and Canadian students have been released from quarantine in China) does not mean that fascinating internet posts have dried up. The New England Journal of Medicnie has opened their own H1N1 Influenza Center (www.H1N1.nejm.org) complete with basic science, commentary, archival postings from flu epidemics going back to 1837, and an interactive map showing the locations of reported cases. It is interesting that there was nothing in the archive about the LGB cases post-1976. There are projections of worst-case scenarios for the US done by the Northwestern University(http://rocs.northwestern.edu/projects/swine_flu) that are based on the movement of people by way of currency, assuming no efforts at containment. There has even been specualtion on its effect on hogs as food and on hog futures in comodity trading (the price began to rebound earlier in the week).

    You have to love the internet.

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