Flu Pandemic

The WHO (World Health Organisation) has just upgraded their flu alert from a 4 to 5.

"Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short."

So far, 9 countries have officially lab confirmed 148 cases with 8 official deaths from the H1N1 virus. But these are official figures. Unofficially, it's something like 2500 with the flu and 152 attributed deaths. "Swine" flu is a misnomer. It's actually an assortment of human, avian and swine flu genetic sequences.

Interestingly, the death rate in Mexico seems to be very much higher than in the other countries affected. Some believe that it may have been around for sometime and there is a possibility of tens of thousands being affected. However, it wasn't reported until now, when the death rate started to rise. There is possibly a complicating factor of malnutrition, crowding and poor housing. Also antivirals need to be taken within hours of onset of illness in order to be effective. But the people in Mexico may not have seeked medical advice until it was too late or if at all.

We in Singapore are very much more prepared this time round after the SARS incident. Even in my clinic, all staff each wear an N95 mask and gown. Patients with flu symptoms and a travel history are immediately identified and isolated. Hopefully it's enough to at least slow down the spread of the flu.

Of note, the seasonal flu kills 250,000 people a year worldwide. But we currently have a flu vaccine to prevent this.

In contrast, the Spanish flu in 1918 and 1919 killed some 50 million people worldwide in just that year alone. The virus is also a H1N1 virus. The way it worked in theory was that it overstimulated the immune system, ultimately causing destruction of the lung tissue. Hence the people who died were young adults with strong immune systems.

Interestingly, our current flu vaccines do provide partial protection against the 1918 strain, according to tests done by the US CDC in 2006. But it's yet to be proven if current vaccines protect against the Mexico strain.

Watch this spot for the latest updates.