How Dangerous is the Swine Flu?

So far, it seems like the illness associated with swine flu is similar in severity to seasonal flu. As of May 6th 2009, there have been a number of deaths in Mexico and two deaths in the United States. Most cases are far less severe and are go away by themselves. This is typical of seasonal flu as well. In Mexico, the diagnosis has been less clear and the CDC has not confirmed that these were really cases of swine flu. Most public health authorities are indicating that at this time, the flu is not resulting in severe illness in most people.

Still, the picture is quite murky at this point. This is a new virus and the experts don’t know what’s happening yet. All of the attention in the media is in part because government officials are trying to prepare for the unknown. It's also because the media likes to have a big story to talk about. But I want to share a few important points about the behavior of viruses because it can help you understand whether this flu is really dangerous.

Some people have underlying conditions that put them at greater risk of complications from flu. For example, diseases that suppress or impair the immune system can result in more severe illness or increase risk of bacterial infection on top of the flu. This includes diabetes, chronic lung or kidney disease, treatment with immunosuppressive drugs or systemic steroid medications for arthritis, organ transplants, or other inflammatory conditions. Smokers are at greater risk of bacterial infection in cases of flu. So smokers and people with certain illnesses are at higher risk from getting sick and dying. See for severe illness or risk of complications.

The other concern is that flu viruses mutate. Mutation is when the genes of the flu virus change and the virus then behaves differently. That can make it more easily transmissible, more intense in the way that it attacks the body, or more difficult to treat with antiviral agents. The virus lives ‘in the population’. It survives by reproducing itself in infected people and passing on to other people. When it reproduces, it can mutate. And the reproduction and transmission is what enables it to travel from state to state or country to county, mutating along the way.

So let’s sum up the last paragraph because it’s important. The two main points are that the virus mutates, and that it travels around the world population over the course of months or years. We know of this from studying previous flu outbreaks. And this raises a note of caution that we all need to keep in the backs of our minds. The most severe flu outbreak in history was the pandemic of 1918. According to a recent historical account that I read, the ‘first wave’ of flu North America wasn’t that severe. It was much like the seasonal flu, just like this current strain of swine flu. In 1917, most people weren’t dying from it. But then the flu traveled around the world three times over the course of 18 months. When it came back in the fall of 1918, it was deadly. In the United States there were 700,000 deaths attributed to the flu. Most of them were in healthy people between 15 and 40 years old.

Things were much different in 1918 than they are now nearly 100 years later. A concerning difference is that back then there was no air travel. So spread of the flu didn’t happen as quickly as it is likely to happen now. There are other differences that are reassuring: we have much better ability to track and monitor these things, we have better supportive medical care to prevent complications, and we understand the microbiology of influenza better than we ever have.

The bottom line is that the future of this flu is uncertain. It’s important that you stay tuned in to evolving information. So check this site for updates, or follow the official site of the Centers for Disease Control. Please read all the articles under the heading ‘Protecting Yourself and your Family’. Don’t panic. Stay calm and think straight. If you’re anxious, check out the stress reduction resources in boost your immunity.