I can’t turn on the television or radio or pick up a newspaper without hearing about the new flu strain epidemic. Note: I am calling it the “new flu strain” epidemic rather than the swine flu epidemic. And I confess, although I am not overly alarmed by what we know so far, my public health training has me concerned and intrigued by this story too. As I do countless radio interviews for ABC News on the subject, I find that everyone is asking the same smart questions.
1) Since this flu strain apparently originated in pigs, should we avoid pig products altogether?
Although pigs are great incubators for many different strains of viral influenza, there is no evidence that pigs are infected. Even if pigs were currently infected somewhere in Mexico, eating cooked pork products would not pose a risk for influenza (other infectious illnesses trichinosis can occasionally result from poorly cooked). Influenza viruses live in the respiratory tract and infect our nasal and upper respiratory passages, not our gastrointestinal tracts. The confusion I think comes from naming this the swine flu epidemic rather than just calling it what it is – a new flu strain epidemic. Calling the strain the swine flu strain is understandable since this new strain has a mixture of genetic material including material that originated from pig viruses.
2) Everyone seems to be making such a big deal of the swine flu epidemic. How worried should I be?
We will only know in retrospect, likely next year after the next flu season has passed, whether to be very worried or not. Since all influenza or flu viruses are constantly changing and mutating, there is just no way to know so early in the research of this epidemic what exactly will happen. And as historians have long reminded us, the pandemic of 1918 started with a mild outbreak of the flu in the spring followed by a devastating and deadly flu season the following fall and winter. When it comes to risking our health and potentially our lives, it is always better to be safe than sorry even if that means directing much of our attention in the media to understanding more about this virus.
3) Do facemasks work? Why aren’t more people wearing them?
FDA approved facemasks work well in a hospital setting where a patient is known to be at risk for an infection. Immune compromised patients wear masks to protect them from others germs and patients with certain contagious diseases such as tuberculosis that is passed on through the respiratory tract wear masks to protect others. There is no good evidence that facemasks would work in the community although it makes sense they could be of some help. What we do know works is to minimize contact with the virus by washing or sanitizing our hands frequently, staying home if we are sick, and avoid sneezing or coughing in our own hands or within 6 feet of others. A Facemask needs to be changed frequently because our own breathing will cause the mask to get wet. A wet mask allows more viruses and bacteria to pass through. Finally, a facemask doesn’t prevent tiny particles such as some viruses from getting through so it may not work anyway. To me, facemasks give a false sense of security and may tempt someone who is sick to go out in the community and potentially infect others.
4) Are the two drugs against the flu as good as some reports make them out to be?
The two newest antiviral medications, Relenza and Tamiflu, may help prevent caregivers and household contacts from getting the flu, however for people that are already infected and sick they must be taken early in the illness to do any good. Research has shown that they shorten the illness by a day or so but I know of no evidence that they will prevent deaths or severe illness. What worries me the most about advertising these drugs is the fear that people will take them indiscriminately and resistance to the drugs could develop quickly. Of course this warning applies to antibiotics for bacterial infections too however the flu virus seems to mutate faster than most other infectious agents.
5) Since this year’s vaccine probably doesn’t work for this strain, what will happen in the fall?
Researchers have already identified the genetic code of the new flu strain and with more information on the severity and type of strain that is infecting people, laboratories are hopeful they can come up with the right combination of strains to give us the greatest protection next fall. And to those who worry about side effects from the vaccines I can reassure you that today’s vaccines have much less viral material and more of a safe generic adjuvant or “irritant” in them to get the immune systems attention and so are thought to be much safer.
I welcome your thoughts and questions.
Marie Savard, M.D. is ABC News Medical Contributor. Her new book, Ask Dr. Marie: Straight Talk and Reassuring Answers to Your Most Private Questions, will be available in August.