Thursday, April 30, 2009

Swine Flu

Okay, before everybody runs screaming from the building, some pertinent facts about the current flux-du-jour.

Nobody knows how deadly the Mexican flu is, vis a vis "normal" flu yet, because nobody knows how many people have it, and the fatality factor is a percentage of that. Influenza kills a lot of people every year, always has, and this new triple-threat version -- bird/human/swine might or might not be any worse than any other strain.

Why is it killing more people in Mexico than here is still up for grabs. Air pollution might predispose people to lung complications; or maybe the bug has already started to mutate. They do that, which is why there has to be a new vaccine every year.

If you get the flu, there are things you can take to lighten the effects -- Tamiflu™, for instance, but good luck finding it now. And it only works if you take it early in the course of the illness -- first couple days. Stay home, drink a lot of clear liquids, rest, ibuprofen, like that. Not just to keep it from spreading, but to keep from catching something worse while your resistance is down. Mostly what kills people with the flu are secondary pneumonias.

You can't get it from eating pork. The Egyptians are killing all their pigs. They are idiots for doing so. Somebody carrying it is already walking around looking at the pyramids right now, you can take that to the bank. We live in the jet age, and you can seal the borders, but it's usually too late.

And most people won't catch it from pigs, either. It's spread the same way other viruses of like ilk are spread -- in the air, penumonically, and by contact and auto-innoculation. That is, somebody who's got it coughs in your face, or you shake hands with them, and then rub your nose or eyes and give it to yourself. Gets in through the mucous membranes.

You can't get it from a toilet seat, unless you, you know, bend down and put your nose onto the ring and rub it around. If you do that, you deserve whatever you catch.

The best way to avoid this flu -- and others -- as well as most viral upper respiratory infections, is to wash your hands frequently. By which I mean, after touching anything or anybody that might harbor the bugs. Somebody sneezes on their shopping cart and then you wheel it around, you might, for a short time, get something on your hands. Wash them before you touch your face with your fingers.

If somebody sneezes on your shirt, change it.

If your darling grandchildren or children are sniffing, sneezing, have a fever and you want to comfort them, do so at your own risk, and wash your hands afterward. I can trace most of my colds over the last ten years to the darling grandchildren, and it's my own fault.

In the medical community, there is a practice called "sterile technique," sometimes "aseptic technique." You wash your hands, you don't let people sneeze in your face, and if you are in areas where the air is likely to be highly-contaminated, you mask up. Surgeon's mask, even a painter's throwaway will usually do the job.

I worked in a family practice clinic for five years, and during flu season, we saw hundreds of patients every week who had it. I never caught it, never once got sick with something contagious brought in by a patient because I was fanatic about sterile technique.

If you can't wash your hands because you are somewhere it isn't feasible, carry a little bottle of Purell, or alcohol towelettes like you use to clean your glasses. The latter will dry out your hands if you use them too often, but they'll disinfect in a pinch, because the active ingredient is alcohol.

Hot water and soap and a clean towel works better.

They are making this sound scarier than it really is. Don't panic. It's not the Bubonic Plague.


Bobbe Edmonds said...

Steve, please. Enough with the beating around the bush, just spit it out. All this sugar-coating is going to give me diabetes.

What are you trying to say?

Brad said...

Mmmmmm bacon.....

Well, thankfully there has been a case reported in Africa. Yet. I'm headed there tomorrow. We've had a few cases and so far one death here in Houston, 23 month old child.

But I'm with you Steve, wash your hands and watch who you're around. I've talked with my daughter about washing her hands and being careful sharing her toys. And not sharing food or cups or dishes.

Te news is making this out to be the end of times it seems. As with any panic, the retail stores stocking what you want are having a boom business right now.

Brad said...

Sorry, that should have read "No cases reported in Africa"

orclgrl said...

Besides - we don't need to import the Bubonic plague - it happily resides to this date in our western states and approximately 10-15 isolated cases are reported every year. In fact the last major outbreak in the USA was in Los Angeles in 1925...

Worg said...

"They are making this sound scarier than it really is."

That remains to be seen. Keep in mind that 1918 killed 100 million people in a very short time. This one is highly transmissible, was highly lethal in Mexico, is very likely resistant to Tamiflu and Relenza or will be soon, and is already at pandemic level and therefore uncontrollable. Since there is no vaccine, ring vaccination is unavailable as a protective technique.

Most pandemic flus go through an initial infective wave, and then explode later in a second wave when their process of mutation finds a security hole in the human immune system. When this happened with 1918, it went hemorrhagic in a percentage of victims.

And something we have now that we didn't have in 1918 is a large population of immunodepressed people: people with HIV, people with transplants, people on chemotherapy. Expect this one to run a rampage through those groups, picking up genetic knowledge as it goes.

A prominent epidemiologist has been a friend of the family for years and he is very, very concerned.

Chavo said...

I think once the death hit a few thousand, I'll probably panic.

Bubonic plague is often a gift from the squirrels here in the US.

Jay said...

A little common sense goes a long way to stay healthy.
I believe it should be called "Baconic Flu," by the way.

Dojo Rat said...

Are you sure about the toilet seat?

Steve Perry said...

Worg --

Such a thing is always possible, and experts have always believed it was only a matter of time before something came along. This might be it.

On the other hand, I was there during the last great Swine Flu Worry, in 1976, working at a medical clinic. Everybody was terrified that it was going to be the 1918 Pandemic, which did kill millions, because they thought that one was swine flu. (Wasn't. It was avian.)

There was a hastily-prepared vaccine rushed out and massive innoculations.

Turned out to be a cure for which there was no disease. And the faulty vaccine caused a surge in cases of Guillain-Barre syndrome, a neurological condition that causes temporary and almost total. paralysis that can last weeks.

We had a patient with this. The creeping paralysis eventually takes over the lungs. If you are hospitalized and have a respirator, you can survive.
Otherwise, you don't.

Mutations go both ways. Sometimes a bug'll get nastier, sometimes it turns benign. You never know until it happens which way it will go.

Steve Perry said...

Plain old regular flu kills fifty thousand people a year in the U.S, give or take. It's one of the leading causes of death.

I wouldn't start loading the ammo into the bunker just yet.

mIKE said...

For my part, I'm going to stay away from sneezing pigs and birds.

Steve Perry said...

Monday Update:

The Centers for Disease Control and Prevention added new cases to its tally, bringing the total number of U.S. infections to at least 279. Worldwide, twenty-one countries have confirmed more than one thousand cases, most of them mild.

One person has died in the U.S., a toddler from Mexico, in Texas. Twenty-five died in Mexico, and so far, that seems to be it, which, if the percentages hold, makes the Bacon Flu no deadlier than any other kind ...