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If the U.S. swine flu epidemic isn’t over, it certainly looks as if it’s on its last legs. While federal health officials are not ready to declare the threat has passed and the outbreak has run its course, they did report Friday that for the fourth week in a row, no states had widespread flu activity. U.S. cases have been declining since late October.
One U.S. expert said the epidemic has “one foot in the grave,” and there are many reasons to believe there won’t be another wave later in the year.
For one thing, the virus has shown no signs of mutating. The vaccine against it is effective. And roughly half the people in the U.S. probably have some immunity because they were infected with it or got vaccinated.
The World Health Organization is witnessing an international decline as well, and is discussing criteria for declaring the pandemic over. Britain this week shut down its swine flu hot line, which was set up to diagnose cases and give out Tamiflu.
“Clearly, the last four weeks have been one of the quietest January flu seasons I can remember in my career,” said Michael Osterholm, a prominent expert on global flu outbreaks with the University of Minnesota.
Since its emergence last April, swine flu has caused an estimated 15,200 deaths worldwide, mostly in the U.S. — a much lower number than initially feared. The positive outcome is primarily because the virus didn’t mutate into a deadlier form.
Even so, experts have praised the actions of the U.S. and Mexican governments and scientists who quickly developed an effective vaccine.
Criticizing the government for its intense response would be like chastising officials for building dikes in New Orleans to withstand a Category 5 hurricane and then seeing only a Category 3 come ashore, Osterholm said.
“The government did not overreact,” said University of Michigan flu expert Dr. Arnold Monto, echoing Osterholm’s point.
Whether it will stay quiet for the rest of the winter is hard to say, but some experts are beginning to lean that way.
“If it’s not dead, it’s weakening fast. It’s got one foot in the grave,” said Dr. William Schaffner, a flu authority at Vanderbilt University.
A poll released Friday by the Harvard School of Public Health found that 44 percent of Americans believe the outbreak is over.
The Centers for Disease Control and Prevention released numbers Friday showing most states continued to have only occasional flu activity last week. However, only three states had absolutely no reports, and a CDC official cautioned that swine flu is still around and is likely to keep infecting people for weeks or months to come.
“We don’t seem to be seeing the disappearance of this virus,” said the official, Dr. Anne Schuchat.
Whether there will be another wave of swine flu — as was seen in the spring last year and again in the early fall — is a much harder question, she added.
Her comments reflect a raging debate among scientists. One expert told The Associated Press he thinks a spike in H1N1 cases is likely by May, though perhaps a smaller one than last fall. Another said he did not expect another spike. A third predicted another wave, but not until next fall at the earliest. A fourth refused to even guess.
An estimated 70 million Americans have been vaccinated against swine flu through a government campaign that started in October. Counting those who have already been infected and others who were vaccinated, perhaps 40 percent of the public has some immunity to the virus.
However, that means at least half of Americans don’t have immunity, and there are many places that have not been hit hard by swine flu yet, some experts noted.
Also, this is a global disease that can move quickly through air travel, and much of the rest of the world is not vaccinated, Osterholm pointed out.
Experts give health officials generally good marks for their handling of the pandemic, even with months of delays in the production of swine flu vaccine.
About 60 percent of the 1,400 adults in the Harvard poll said U.S. public health officials did a good or excellent job in dealing with the pandemic. More than half said the government devoted the right amount of attention to the outbreak.
The telephone survey was done in late January and had a margin of error of plus or minus 3.2 percentage points.
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Associated Press Medical Writer Maria Cheng contributed to this report from London.
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The new swine flu is scary, no doubt about it. But here’s the information you need to better understand the illness and the ways you can protect yourself and your family from infection.
Understanding the Swine Flu Virus
Human influenza, or the “flu,” is a viral infection that usually occurs seasonally and is transmitted between people. The viruses are categorized into two major types, A and B, and subtypes, named H and N. The current swine flu is a new type of influenza A virus, H1N1, which has not previously been seen. This strain is unusual in that it appears to be a cross between strains that infect swine, birds and human beings. While this new strain may yet present some surprises, we know a lot about how influenza is transmitted and how to slow or break that cycle.
The main way that influenza viruses are spread is person to person via the respiratory droplets of coughs and sneezes. The virus is transmitted when these infected droplets land on the mouth or nose of people nearby or when people touch respiratory droplets on another person or an object, and then they touch their mouth or nose or rub their eyes before washing their hands. Swine flu is not spread by eating pork or other food, and pigs pose little risk of viral transmission.
Protecting Yourself and Your Family from Infection
The bottom line of protecting yourself is to practice good hygiene and avoid coming into contact with the virus.
Keep your hands away from your face or wash them first. Stay away from crowds. Avoid contact with sick people if you can. If you can’t, wash your hands often with soap and water. Be sure to use a paper towel to turn off the faucet handles so as not to recontaminate your hands. The same paper towel precautionary measure applies to doorknobs. If you can’t wash your hands, use an alcohol-based hand sanitizer with at least 60 percent alcohol.
Cover your mouth when you cough and sneeze. Teach your family to do the same and to discard used tissues promptly. If no tissues are available, it is better to cough or sneeze into your sleeve than your hand. They should wash their hands immediately, before they contaminate other surfaces with infective secretions.
Keep ill family members away from others at home and stay at home unless medical care is needed. Masks are most effective when worn by infected people to prevent the spread of the virus, so if you are infected and you must go out, wear a mask to reduce the transmission of infected droplets to others. While masks are not effective against small viral particles that may be airborne, and airborne transmission may occur, large infective droplets are probably a major factor and the one that a mask can best protect against. Wear a mask if you are within six feet of an ill person. N-95 masks must fit tightly to work effectively. Don’t worry if you don’t have an N-95 or a fancy surgical mask. The key to prevention is to keep droplets away from your nose, mouth and eyes. You can use a cloth bandana or similar accessory to cover your nose and mouth. Change paper or cloth masks frequently. (In hospitals, N-95 masks are recommended because of higher exposure rates.)
Seek medical care promptly if you become ill with flu-like symptoms-fever, generalized aches, sore throat, cough, runny nose, vomiting, diarrhea and lethargy-especially if you are having trouble breathing. The antiviral medicines Tamiflu and Relenza are quite effective if taken within the first 48 hours of your symptoms’ appearance. If you are exposed to the new 2009H1N1 virus, you might also benefit from prophylactic antivirals to prevent infection, especially if you have underlying health problems. Check with your doctor.
Warning: Do not give aspirin (acetylsalicylic acid) to children or teenagers who have the flu; this can cause the serious and possibly fatal Reye’s syndrome. NSAIDS (nonsteroidal anti-inflamatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Naprosyn, Midol) and acetominophen (Tylenol) are safe to administer for their symptomatic relief.
Remember, staying away from crowds and using good hygiene can help you prevent the contraction of many flu illnesses and give you some measure of reassurance during this flu outbreak.
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