Swine Flu Outbreak
The new Swine Flu that is affecting parts of Mexico and the southern United States is being described by the World Health Organization as “a public health emergency of international concern.” This is a correct way of saying that the swine flu should not be described as a pandemic at this time but this new virus has characteristics which could be leading us to just such a situation. In the days, weeks or even months until scientists can determine the true risk this virus poses, smart organizations will use the time to take further actions to prepare for a pandemic.
A pandemic is defined as a new virus for which humans have no resistance, which spreads, over a large geographical area, through human‐tohuman contact. Such a virus causes serious illness and even deaths to humans.
There are a number of reasons why the medical community is particularly concerned about this swine flu virus causing the next pandemic. The main significant ones are:
- this virus clearly is transmissible human to human, and causes significant illness and death
- the virus is spreading fast and is already seen in two countries
- the virus is affecting young adults in greater numbers than would be expected
A New Virus
Swine flu, which is a H1N1 virus, commonly affects pigs and occasionally can spread from the swine to humans and result in human illness. The key is that in these cases the virus does not spread human to human. In SARS, a corona virus mutated and suddenly an animal virus was causing significant human illness and even death and was transmitted human to human. In the end it turned out that transmission required very close contact and high viral loads, so taking public health measures could stop SARS. In a true pandemic, transmission cannot be stopped and the virus circulates around the world.
This new swine virus is described as a quadruple reassortment virus. It is a combination of four different viruses. These are North American swine influenza, North American avian influenza, human influenza and Euro‐Asian swine influenza. This combination has created a new virus for which humans seem to have no resistance and which can spread human to human. It is very difficult at this point to tell exactly how many people have actually been infected with this new virus. What is clear is that the number is increasing and the virus can cause serious illness and even death.
The question a few days ago was whether the illness being seen in the United States was the same as the flu outbreak that was growing in Mexico. Testing has been completed and proves that the same new virus is causing both outbreaks. This is significant because it shows that the virus is not confined to the area where it mutated and started. It is on the move and in at least two counties already. With global travel, especially Canadian travel to the southern US and Mexico it is fair to assume that it is just a matter of time before we see this virus in Canada as well. Hospitals across the country have already put themselves on high alert for screening sick patients showing up.
The fact that the virus has been seen in the United States and Mexico is also of interest. Public Health officials have always said that the most likely place that a pandemic virus will mutate and come from is south east Asia. In this region people and animals traditionally live in close proximity. The same officials have also always said that we cannot let our surveillance efforts down because a new virus could come from any country. This is a good example because the virus formed in either the US or Mexico. Surveillance of cases will be a challenge, particularly in Mexico where there is not as developed a public health system. The United States will have it’s own set of unique challenges if the outbreak grows because of it’s system of private hospitals with little or no government control. One of the key ways of managing an outbreak is to maintain a consistent approach and this is a big challenge if you can only suggest a course of action.
Who Is Affected?
Traditionally the elderly and people with chronic illness are the most affected by influenza outbreaks. The next group that are affected are young children because of their underdeveloped immune systems. Pandemics can be mild, moderate or severe. A mild pandemic means that while the new virus causes disease, the number of people affected and severity of illness is mild and resembles a normal flu year. In a moderate pandemic a greater number and severity of illness exists such as twice the normal amount. A severe pandemic is what is feared. The 1918‐1919 pandemic is believed to have infected millions and to have resulted in up to 50 million deaths worldwide. Elderly, chronically ill and children were affected in numbers that would be expected for any pandemic but the big difference was that 25‐35 year old healthy people were not only affected in large numbers but they also died. This new swine virus is affecting a large number of young adults. And this is definitely a worry.
What To Do
The spread of a new virus like the SARs virus or a pandemic virus can take months, but can also take place in days. Personally I believe that the spread of a new pandemic virus will occur quickly in days or a few weeks because of current travel patterns. This also says to me that Canada is in line to be one of the early countries to be affected. No one is prepared to say that the new swine virus is a pandemic virus. However, at this point, no one is prepared to say that it is not. Therefore the time to begin to act is now. Organizations with plans need to get them out, explain them to people and begin to implement them. For those without plans it is not too late. Using specially designed software such as pandemic 101, plans can be drawn up in a matter of days and implementation can begin. Individuals, as well, need to plan a home emergency kit to serve in a pandemic or any other disaster. A vaccine to this new virus will not be available for many months and then if developed will be available in limited quantities. Everyone now will be seeking antivirals at once and so planning and other measures become ever more important. It would be a shame to not take advantage of this time at hand and any planning done will not be wasted if this turns out not to be the feared pandemic
Dr. James Young Medical Director AMI Business Resilience Inc.
AMI Business Resilience Inc. and the Pandemic 101 Program. We are a world leader in pandemic planning, training, exercises and certification. We also offer BCP planning, infection control products, table top exercises and online training in English, French and Spanish.
Our world‐class advisory team of Dr James Young and Dr. Ron St. John., who led the provincial and federal responses to SARS in Canada, are available for specific consultation to companies and can apply the invaluable lessons learned in SARS to the current situation. Please do not hesitate to contact me personally, should you have any concerns of questions.
David J. Howell, President & CEO