Getting the flu right

Public health professionals and the politicians to whom they report must find the right balance between panic-mongering and complacency.

pig flu 248.88 (photo credit: AP)
pig flu 248.88
(photo credit: AP)
It was obviously only a matter of time until the A (H1N1) - swine flu influenza - virus made it to our shores. Indeed it happened more swiftly than anticipated. There was no reason to think Israel would somehow be spared - not in our interconnected world. Still, fears of a deadly outbreak - even if the World Health Organization and local public health services rightly gear up for the worst - are a bit exaggerated. This isn't to say that raising the pandemic alert to the second-highest level isn't an eminently sensible precaution. WHO was right to do so globally and Israeli public health authorities were right to follow suit. Better safe than sorry. It also makes sense to ensure that adequate supplies of drugs like Tamiflu are on hand. They do not cure the disease but do relieve some of the symptoms and reduce the potential for serious complications like pneumonia. That said, on an individual level, there is no cause for undue anxiety - to say nothing of panic. Israelis need to retain a sense of proportion. Thus far only three cases have been confirmed in Israel. These patients are in excellent condition and were never very ill. They all contracted the A (H1N1) virus in Mexico. There has been no contagion, so far, in Israel. Other suspected cases weren't due to swine flu. Even if some infection does manifest here, this would still be far from the dreaded epidemic. Moreover, the cases here, as elsewhere outside Mexico, were very mild and easily treatable. The Mexican exception is indeed mystifying. Flu viruses of all types continuously mutate and it's conceivably possible that diverse varieties evolved. According to initial Mexican reports, A (H1N1) has taken the lives of 7% of patients there. This rate is extremely high and may indeed be inflated. These statistics may well be due to misdiagnosis or to initial infection numbers far higher than assumed. Even ordinary seasonal flu, generally a minor nuisance, kills about 1% of all who contract it. Especially vulnerable are the very young, very old and patients with compromised immune systems who fall prey to complications, of which pneumonia is the most common. In the lethal Spanish flu pandemic of 1918 the death toll stood at 2.5%. The Mexican figures, therefore, raise many doubts, even if we factor in the dynamics of poorer sanitation, nutrition, air quality and hospital facilities. OUTSIDE Mexico, risks are lowered when authorities are on guard. In most countries, Israel included, there is heightened vigilance at airports and other entry points to screen arriving passengers. It's also important to realize that the symptoms of A (H1N1) aren't all that distinct from other influenza, although suspicions need be aroused chiefly when fevers higher than 38º Celsius present themselves along with marked respiratory distress. Since the mutation in question is new, little clear data is available regarding symptomless carriers. This obliges all of us to be more mindful than ever about elementary hygienic safety measures, including washing hands frequently, and covering our faces when coughing or sneezing. This is a good time to inculcate such behavior into the youngest members of our society. It's particularly important not to send sick youngsters to kindergarten or school, as is unfortunately the habit of all too many working Israeli parents. Israeli authorities sometimes go to extremes - either wrongly dismissing real dangers or unnecessarily magnifying unlikely ones in order to cover themselves. Real danger appears to have been overlooked in the case of a couple, just arrived from Mexico, who came to Tel Aviv's Ichilov Hospital last week complaining of flu-like symptoms but were not running temperatures. They were sent home and could have infected others. Several days later both returned to hospital with fevers. The husband has already been confirmed as ill with A (H1N1). The opposite occurred in Ra'anana where parents shut down the Dekel Elementary School because a nine-year-old, who visited Mexico, was ill. She only had a mild throat infection. Public health professionals and the politicians to whom they report must find the right balance between panic-mongering and complacency. And the rest of us can help by being responsible citizens.