Bird Flu? Swine Flu? Mexican Flu?

Last year, it was the bird flu panic. People stopped eating chicken (you can’t get it that way), feeding pigeons, and worried about living along migratory bird routes. Many stockpiled is oseltamivir or zanamivir – antiviral flu medications – and waited anxiously for cases to appear in their neighborhood. The bird flu is still out there (somewhere) and a few cases are still popping up from time to time, but it was not the worldwide pandemic that it promised to be.

Now, we have the swine flu panic and public health departments are gearing up for what could be another potential disaster. Since a particularly-virulent flu bug was the cause of the last worldwide pandemic in 1918 and resulted in several million (yes, million) deaths, we tend to take notice.

This pandemic occurred during the height of the First World War and was erroneously dubbed the Spanish Flu, apparently to take the heat off of the good people in Kansas where it actually started. Other flu pandemics and epidemics have been called the Hong Kong flu since many of these strains were identified first in China, where people, birds, and pigs live in much closer proximity. Since the swine flu appears to have originated in Mexico, I suspect someone will start calling it the Mexican Flu. Influenza by any name is just as concerning.

The swine flu virus tends to live quite contently in pigs, hence its namesake. However, flu viruses have an annoying tendency to mutate and adapt, sometimes making the jump from pigs to humans (or birds to humans). When it jumps species, the next step is the worst of all – human to human transmission. The Type A strain of swine flu (H1N1) is transmitted from human to human. So far, nearly 1300 cases have been reported including over a 100 deaths in Mexico. There are at least seven cases in the U.S. now. Incidentally, you cannot get swine flu from eating pork or pork products. Don’t throw away your stockpile of Spam or Honey-baked Ham.

Today, one case was reported in our local neighborhood at a Catholic school. The school is now closed until further notice and several frightened parents have brought children in to be tested. We have one parent coming in today (in a mask) because her child owns a pig. Although their pig has not traveled to Mexico to visit relatives, they want the child tested. Our local health department has gone into high gear and heightened surveillance to prepare for the worst, should it happen; although when we tried to send in a specimen today, the Health Department was closed! Within the first hours of work today, we have received numerous instructions on the proper way to collect specimens from any person that has vague “flu-like” symptoms such as fever, cough, or sore throat (just about ALL of my ill patients have those).

Several years ago, there were three cases of meningitis at one local high school. For months, people would not even shop in that town, or allow their children to play in the McDonald’s playground. I am surprised there weren’t guard towers and razor wire surrounding the town.

Right now in Mexico City, large gatherings of people such as sporting events or church services have been canceled and millions of surgical masks have been handed out. I haven’t seen this many surgical masks since I went to Japan. In Japan, people often voluntarily wear surgical masks on subways when they are ill to protect their fellow travelers. You don’t really see that level of courtesy in the U.S., where someone is likely to sneeze or cough directly in your face. During the 1918 flu pandemic, movie houses and taverns in the U.S. were closed in large cities and yes, people were wearing cloth masks or handkerchiefs over their mouths and washing their hands.

People tend to panic when these things public health issues happen. Misinformation and fear often trumps common sense. We had a person today, who was exposed to a neighbor, and this neighbor was exposed to a parent who had a child in kindergarten who goes to the school where there was one case of confirmed swine flu. Whew!

A year ago today, my wife and I were driving through Mexico to deliver children’s clothing to an impoverished area in Baja. At that time, we were not worried about influenza, just the drug wars along the border that so far, has taken the lives of over eight thousand people. Medical care in Mexico can be sparse and many of those deaths may have been because people did not have access to medical services soon enough. As of today, there were no confirmed swine flu deaths in the U.S. and I pray that the Mexican health officials can contain this virus before there are any more deaths in this country.

Until the breadth and extent of this potential pandemic is confirmed, people should just relax, get the facts, follow the news, wash their hands, avoid getting downwind of a sneeze, and wait until the public health department offers specific instructions for your particular area.

It is still okay to still eat a BLT.