Friday, September 11, 2009

Concerning the H1N1 Flu Pandemic

Alert, yes; Alarmed, no

Knowledge is prevention. Foresight is prevention. Avoiding, to the extent possible, any illness, injury, suffering; this is the best political action.

I, who in the 1960s implemented the National Plan for the Prevention of Mental Retardation in Infants, will certainly not support a reduction in preventive health and safety measures when faced with natural or man-made disasters. To the contrary.

But as a citizen and a “specialist” I do believe it is my obligation to demand an urgent moderation of the excess publicity and scientific inaccuracies that are giving rise to so much concern, both locally and at the international level.

The H1N1 virus spreads rapidly but its pathological effects are sensibly fewer that those of the “seasonal” flu. It can’t be said that one was killed by the H1N1 virus or that he died from Influenza A, but rather –since almost all deaths occur in persons suffering from serious illnesses- that he died with the virus, which may have, at most, complicated his clinical condition and accelerated the fatal outcome.

Statistics concerning the morbidity and, particularly, the mortality rates of Influenza A should thus be based on strict criteria and society should “return to normal”, as Spain’s Minister of Health has urged us to do, while as it becomes necessary and appropriate, establishing a rigorous protocol for protecting those most vulnerable to contagion.

The Medical Association has likewise accurately warned that “an exaggerated level of anxiety has been created with respect to Influenza A”.

We have many problems to resolve, so many that we should not allow ourselves to be overly distracted by this one. If not, we will have missed a great opportunity to make radical changes in our social, economic and environmental system.

Therefore we need less frenzy and more scrupulous attention to a possible (but improbable) mutation of the virus, such as the one that, in very different and precarious health conditions, caused the “Spanish flu” of 1918-19. (By the way, it was given that name not because it originated in Spain, but rather because although it originated in the United States, the countries then at war did not want to release that sort of information.)

With the exception of 1968-69, mutations in the seasonal flu virus have rendered it less contagious, have been limited to specific areas, and from a global perspective, have had little impact on health overall. H1N1 is very contagious, but mild. H5N1 is not very contagious, but it can be very serious.

Polyvalent vaccines provoke a response in patients’ immune systems, producing antibodies against different types of viruses, which have been duly deactivated.

H1N1 is “stronger” than the three viruses considered responsible for the “normal” flu, so it is very possible that those infected with Influenza A will not suffer symptoms of the illness caused by the other “weaker” viruses.

The ease with which virus sequencing can be carried out today enables us to rapidly detect alterations, so that any change in viral structure can be immediately publicized.

Several days ago the WHO announced that the H1N1 virus has not mutated in the Southern Hemisphere, where it has coincided for several months with seasonal flu. It is thought that the situation will be the same in the Northern Hemisphere. But we must be alert.

In addition to mutation, the development of strains that are resistant to natural immunity or vaccines must also be taken into account.

We hope that, as was the case five years ago with the “bird flu”, the number of victims will be very few and panic will be controlled, avoiding social unrest and unnecessary concern.

Rather than economic or media interests, let’s let science provide the authentic reference as to how to manage a pandemic, which in this case is benign… taking all necessary precautions in the event that it ceases to be so.