Swine Flu Reaching Epidemic Levels; Rapidly Killing Healthy Victims

According to the Daily Mail, an otherwise-healthy six-year old English girl died of the swine flu two days after the onset of symptoms. She was not given TamiFlu after an initial misdiagnosis. A 64-year old doctor died of swine flu after treating infected patients. Until recently, swine flu victims suffered from underlying diseases that contributed to their deaths, but recent victims seemed to be otherwise healthy.

As the disease reaches epidemic levels in parts of England, an article published in Nature concludes that the swine flu was similar to the 1918 pandemic flu. Both penetrate lung cells deeper than do the usual strains of flu, thereby causing more damage and higher casualties.

Did the United States just really luck out, or is our medical system better, or should we be concerned right now?


  1. The Daily Mail is a tabloid. I've read the nature article (doi:10.1038/nature08260) and the "similarity" of the current H1N1 swine flu to the 1918 spanish flu is limited to a moderate antigenic cross-protection, saying absolutely nothing about its pathogenic potential. Furthermore, the cross-protection chart has not 1 but 2 discreet spikes, the 2nd corresponding to the H1N1 russian flu that emerged in the 1970s... considering that we're talking about antigenic similarity between H1N1 strains, that's not surprising in any way, and is not informative in a public health sense.

    Furthermore, CDC data that I've had a chance to look at suggests that while the swine H1N1 appears to be penetrating somewhat deeper into lungs, and is associated with more severe symptoms, as well as a number of characteristic symptoms rarely associated with circulating flu viruses, the overall lethality of the newly emergent strain is not significantly (p>.05) higher than the circulating strains.

    Finally, current data indicates that the swine-origin H1N1 is actually transmitted less efficiently than circulating flu viruses, if attack rate among confirmed exposures is significantly lower. It is, however, circulating off season, which raises some concern.

    Overall, there appears to be NO reason for panic... LITTLE cause for concern... but ADEQUATE cause for caution. Certainly it wouldn't hurt to include this virus in the vaccine formulation for next year's flu season.


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