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Human swine flu - why all the hype?

Professor Robert Booy, University of Sydney
1 June 2009

Professor Robert Booy is Head of Clinical Research at the National Centre for Immunisation Research & Surveillance (NCIRS) based at the University of Sydney. He is also an advisor to government on influenza. Below he expands on the issue of hype in the reporting of human swine flu (H1N1 Influenza 09) and why we need to take the outbreak seriously.

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Some commentators, six weeks into the epidemic, have gone public this week criticising the attention given to swine flu. They say it's no different to seasonal flu and what's all the fuss?

In fact since the very first week of this 'media circus' it has been apparent that the virus was not behaving like a deadly pandemic virus as I, among others, pointed out.

In the USA only about one in 1000 people proven to have the disease have died. This virus has been deadly to traditionally high-risk people with chronic medical conditions (chronic conditions of heart, lung, kidneys, liver, diabetes) and pregnant women BUT not the elderly.

H1N1 human swine flu is spreading primarily in school students and young adults, 'super-spreaders', for one reason or another BUT not those older than 50 who were around when H1N1 was still causing trouble back in the 1950s..

So why all the hype?

There are at least two reasons for real concern.

1. we don’t have a vaccine (yet) so high-risk younger people will die of this infection.
Most of these young people are vaccinated against garden-variety flu but that's not good enough - no cross-protection. This new strain has mutated so much the virus's outside coat (which antibodies AND immune cells attack) is about 25% different to this season's vaccine.

2. because the new virus is so different a large proportion of people aged under 50 will get infected and although most will do just fine, after millions of infections in humans the virus just might learn some new tricks through mutation that make it far more virulent (or nasty) than it currently is....

Then when you consider the many more millions who will fall ill in Africa and Asia, the level of concern rises even further. But mostly because they have no effective western drugs, no intensive care and scant likelihood of being prioritised for the vaccines being developed. No wonder the Indonesians are suspicious of western experts and won’t share the bird flu isolates they're finding there.

Relatively cheap drugs called statins that are used to control cholesterol have real potential, if used early, in treatment. And cheap enough to have relevance to the third world.

We are doing urgent research on Chinese traditional medicines to identify strong candidates for the treatment and prevention of influenza...

A collaborative international effort is required to quell this virus.. and it should be taken seriously AND put into context AT THE SAME TIME...

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