Pan(dem)ic!

It's official. The swine flu pandemic is now a -- drum roll please -- pandemic. The World Health Organization made the assessment today as the global infection tally climbed to nearly 30,000 cases, including more than 100 deaths.

The last time a flu outbreak reached phase 6 on the WHO's six-point scale was 41 years ago when the Hong Kong flu of 1968 killed around 1 million people. That might sound like a lot, but the ordinary flu usually kills several hundred thousand people each year as it is.

Now that the dreaded but long-awaiting P word has been uttered in the hallowed halls of Geneva, should we all start to freak out? "There is no need to panic," Adam Kamradt-Scott of the London School of Hygiene and Tropical Medicine said in a statement, "and should you start to feel unwell, stay at home."

But isn't this some drastic new stage of the influenza immolation? "It is important to remember that 'pandemic' is just the public health way of saying 'there's an awful lot of it about,'" said Robert Dingwall of the University of Nottingham, in a statement.

So, nothing has really changed? “The announcement reflects the worldwide spread of the virus meaning that the definition of a pandemic has been met," said the University of Reading's Ian Jones, in a statement. "However the virus itself has not changed so there is no reason at present to suggest anything but a mild albeit widespread infection."

Well, there you have it. It's back to square one, or rather Phase 6. It seems like we need a Spinal Tap-esque flu scale where the WHO can crank the alert status all the way up to 7 should this virus get worse. Do these ratings actually tell us anything meaningful?

Elie Dolgin -- Associate Editor, The Scientist

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MING127735 wrote:...

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Pandemic is a technical term that just means it is spreading everywhere. It doesn't mean severity of disease.

WHO started tracking this one because of the apparently larger than normal mortality in Mexico to start with.

The seasonal influenza spread each year is technically a pandemic - so there is no reason to expect that out-of-season influenza pandemics need to be more severe. But as everyone ought to know influenza still kills a few hundred thousand individuals each year. The out-of-season viruses often pose higher risk because A) people aren't expecting influenza out-of-season; B) They are new strains which have little existing resistance in the population.

The US CDC has a scale for severity in Beta (last time I was looking at it) called the Pandemic Severity Index. I doubt this outbreak would rank very high on that.

But it still remains that influenza is a lethal disease, and it's no reason to pooh pooh it. WHO has pointed to possible increased susceptibility in fragile populations - such as the Canadian inuit - to help highlight that influenza is still serious business.
Could other indigenous populations (Australian aborigines, Japanese ainu, low population Chinese groups etc.) also be at high risk if exposed to the virus?

WHO has pointed to possible increased susceptibility in fragile populations - such as the Canadian inuit

Cite on fragile populations?

Sorry, not inuit, other indigenous Canadian First Peoples... (to my defnece CIDRAP made the same msitake)

CIDRAP - CIDRAP News learned on Jun 10 that some of the Canadian indigenous groups that have been hit by serious cases of H1N1 influenza are not Inuit, but rather are among the groups known in Canada as First Nations or aboriginals. In particular, a Canwest News Service report referred to hundreds of cases and 20 hospitalizations at St. Theresa Point, a First Nation in northern Manitoba.

Jun 9, 2009 (CIDRAP News) – An official from the World Health Organization (WHO) said today that health experts are closely monitoring novel H1N1 influenza infections in Canada's Inuit populations, following reports that the communities are seeing more than their share of severe cases.

Keiji Fukuda, MD, told reporters at a press briefing, "We can say now that we know a larger number than expected of young Inuit people developed serious illnesses and had to get hospitalized."

He added that the WHO doesn't know if the trend is linked to socioeconomic factors, genetic factors, or chronic underlying diseases, and commented that Inuit groups were hit hard in some earlier pandemics. Fukuda is the WHO's assistant director-general for health security and the environment.

More info

"Swine Flu" is a seriously misleading name. Technically it's a swine/avian/spanish flu mix. Regardless, during the last swine flu epidemic we had huge numbers of deaths, reaching into the thousands, but only eleven CONFIRMED cases world-wide: ten in America and one in Mexico. That's it. Eleven proven death, big panicked numbers. We are merely watching history repeat itself, word for word. Like television, nothings on in politics but reruns.

If we ever do get hit by a big plague, there won't be anything we can do about it because it will be resistant to every antibiotic we use. In the long run, the only safety mechanism against disease is a healthy immune system sustained by real food and dirt.

DonaldTS444103 wrote:
If we ever do get hit by a big plague, there won't be anything we can do about it because it will be resistant to every antibiotic we use. In the long run, the only safety mechanism against disease is a healthy immune system sustained by real food and dirt.

This is bollocks.

There are plenty public health systems and programs which would definitely qualify as "safety mechanisms" against disease.
If a healthy immune system was the only mechanism for disease, immunocompromised people would have a lifespan of microseconds.

Let's start with ... hmmm ... basic hygeine ... then move onto quarantine, screening procedures, waste management, disease surveillence ... and possibly most important amongst these public education programmes on the aformentioned. All of which were employed before the invention of modern medicines. And if we add modern medicine to this list we have antivirals, vaccines, antibiotics, anti-fungals, biologics etc.

And as for mega-resistant plagues - that's totally irrelevant scenario. Nevermind that antibiotcs are already useless against viral infections (but can still be useful in viral plagues to help thwart concommitant infection with bacteria) - but we are much more likely to be threatened by plagues that are susceptible to some form of treatment, but may require us to identify said treatment. Wouldn't that just be rather stupid to just give up about it (or do something silly like eat dirt).

Thanks Michael.