Over in the Hilton, this reporter thought she would attend a Science Track panel with pertinent, timely, and important information: “Influenza, Swine Flu, and You.”
Dr. John Cmar, who does Infectious Diseases outreach in Baltimore television and print media, Dr. Steven Novella, a neurologist who hosts The Skeptics’ Guide to the Universe, and Dr. Rachael Dunlop, a regular at the Australian site Skeptic Zone Podcast, each provided the audience with information about the flu in general and the current “new” version of H1N1 in particular, as well as some humorous background information on conspiracy theorists who post on the web about the flu.
Influenza is a complex virus with several different iterations, some of avian, some of swine, and some of human origin. The “H” in H1N1 refers to the human component, and the “N” of the swine component. In nature, a diverse pool of combinations of “H”s, “N”s, and other genetic parts make up the various forms of flu, both seasonal and specific.
Viruses are changing all the time. Antigenic drift is the subtle difference in a virus that occurs as it moves from host to host. These slight changes are the reasons why there is no cure for a cold. Each of us builds up an immunity to a particular virus whenever we either get sick or get a flu shot. As the virus drifts, its new form can invade us once more, but we are usually only mildly affected since we have immunity to one or more similar strains. Antigenic Drift, on the other hand, is a more radical change in a virus, involving major chunks of DNA. The new strain is significantly different leaving us with virtually no immunity. The flus of 1918, 1957, and 1968 involved antigenic drifts, and the new H1N1 virus of 2009 is another example of drift.
Conspiracy theorists believe the new version of H1N1 has been manufactured by the Illuminati as a way to take over the United States. Some of the details involve late night spraying of a sleeper form of the virus that is activated by nanites we’re exposed to and … well … I refuse to reprint any more of the absurdity. Suffice it to say, H1N1 is real, and we all must ready ourselves for its wrath.
What makes the current outbreak unique is that it occurs outside of the seasonal “normal” time for flu cases to appear. As the virus works its way through the parts of the world that are currently in their seasonal flu cycle, it will likely drift, but how it will drift is a mystery. Dr. Cmar used a hurricane analogy to explain how and why we should prepare. As the hurricane builds, people are warned to prepare for the worst and hope for the best. No one knows for sure if it will be a tropical storm or a category five when it hits land, but if it’s your house on the ocean, you don’t want to wait until a 20-foot wave is about to wipe you out before you buy some plywood. Our flu preparations are similar, in that it takes time to manufacture large quantities of an effective vaccine and we don’t want to wait until the 20-foot wave of patients is about to swamp the hospital before the staff are prepared both economically and intellectually.
The actual prevalence of the H1N1 strain is difficult to pin down, especially since the expense of testing everyone who presents with flu symptoms is prohibitive. Medical personnel focus more on pediatric patients, those with compromised immune systems, and those with life-threatening forms of the virus. Since widespread testing isn’t likely ever to occur, we must assume the number of cases to be larger than is documented.
The discussion turned to our current complacency about the virus. We cannot afford to assume that this strain won’t be any different from a typical winter cold. Luckily, the H1N1 flu hasn’t been as virulent (a measure of how sick a virus can make you) as the 1918 strain, but it could drift into that category over the coming months. The reason SARS appeared and then petered out quickly was its lack of genetic stability (a measure of how quickly the virus “burns out” as it adapts). The H1N1 has shown itself to be moderately transmissible (a measure of how easy a virus is to catch). To simplify, it’s not as easy to catch from a sneeze or a cough. You’re more likely to catch H1N1 from a surface such as a doorknob or elevator button. In other words, someone who had the virus on their hand touched the table, then you touched the table and either ate or touched your eye, and so the virus found its way in via your mucus membranes.
How can we protect ourselves?
1) If you’ve been out in public, wash your hands. Especially before you eat.
Yes, this means you! Sing “Happy Birthday” to yourself while you wash your hands to make sure you get soap all over. Make sure to rinse them thoroughly and dry with a clean towel.
2) If you need to sneeze or cough, do it into the crook of your arm.
That way, your germs won’t get on your hand to be given to others via the elevator button or a hand shake. (Or using your phone or your keyboard at work–I know you do it!)
3) If you get sick, stay home.
Generally, you are contagious for about five days after the symptoms first appear, as happened to me when I got the flu. (I don’t know if it was swine or not; the health care people told me to stay away from people until the fever was over.) You will know if you have a “real” flu, and not just a cold, if you feel REALLY, REALLY bad. (When I got the flu recently, I hadn’t felt that sick since I had the measles in my teens. Believe me, you’ll know.)
Products like Tamiflu don’t cure the flu; they simply make the symptoms last for a day or two less than they would have otherwise. It is NOT a cure. And since it’s only effective at the start of the symptoms, when you are most contagious, you really shouldn’t be going to the doctor to get some, essentially spreading the virus on your journey. The only people who tend to benefit from taking such a product before they catch the flu are those who have a substantially compromised immune system and are at high risk of dying if they catch the flu.
Take care this flu season. And go wash your hands.
Yeah. Right now!
[For more updates about H1N1, check out the Centers for Disease Control and Prevention website.]