Editorial

Swine flu (H1N1) dominated the health news in 2009, garnering mass hysteria, but since then, H1N1 has all but disappeared in the media. Technically known as H1N1/2009, swine flu’s name is born of its ancestry: a fusion of two swine strains, one from Asia and another that had surfaced in the 1990s in US factory farms. H1N1 spread rapidly around the world, infecting tens of millions, exposing dire flaws in the abilities of governments and companies to handle a flu pandemic. Fortunately, the strain was far less virulent than originally feared, killing about 19,000 people. Had last year’s H1N1 been marginally more virulent than it turned out to be, the discussion right now would have been about why the pandemic preparations failed to protect the population, rather than why global health authorities over-reacted.

Is it still a pandemic and does the public need to fear a mutated version? Surveillance systems report that there are still H1N1 2009 viruses being found in individuals with influenza. Both the Centres for Disease Control (CDC) and the World Health Organisation (WHO) are still calling the H1N1 virus a pandemic.

These organisations believe that actual data on hospitalisations and deaths is grossly under-reported. Data is gained only from laboratory-confirmed outcomes and unfortunately that includes incomplete testing, inaccurate test results or diagnoses that attribute hospitalisations and deaths to other causes, such as secondary complications of influenza. The concern at this point is that the virus may mutate such that vaccinated individuals may not be protected, or that the virus may develop resistance to current antivirals, and the latter has been seen in close to a hundred cases to date.

Clearly, the virus continues to circulate and people do continue to get sick with H1N1. Indeed, an upsurge of cases is being seen, at the time of writing. For this reason, WHO and CDC urge vaccination saying that complacency should be avoided and that most people would still benefit from vaccination. For those already vaccinated, immunity should last around 90 years or until the virus mutates drastically. Health authorities, as always, are urging all, particularly children and adults in high risk groups, to have the seasonal flu jab, which includes H1N1 protection this year.

Thus far, thousands of doses have been given locally with none of the fanfare, furore and posturing that occurred last year. It behoves us all to get our shot and save ourselves a week of misery, at the very best. For example, in the UK, there are currently over 300 individuals battling in intensive care after catching flu. There have been close to 20 deaths from flu so far this season. Uptake for the seasonal flu jab has been lower this year and doctors must keep repeating the same exhortations for the vaccine to be taken.

The effects of flu are not to be underestimated. It is not the same as getting a cold and can seriously affect one’s health. Pregnant women are also being offered the seasonal jab because the complications of flu are more severe during pregnancy and because this affords the baby some protection against the flu in the first crucial months when the vaccine does not work.

A new strain of swine flu circulating through pigs shows that the pandemic version has jumped from humans back to pigs, where it is evolving in new and unpredictable ways. This strain is not particularly virulent but this finding simply emphasises the need for continued vigilance. Swine flu is not going away and the jab is the only simple protection that medical science can provide.