Pandemic: Is it time to get scared?

By Dr. Craig van Roekens

For the Times Herald-Record
December 13, 2006

The media transmits the latest fear, outbreak and disaster instantaneously. Avian flu pandemic is on the way!

With so many things to worry about from killer bees to flesh-eating bacteria, not to mention death and taxes and the kids' education, do you really need to worry about one more problem?

Apparently, much of the government, as well as the health-care and emergency preparedness community, feels you do.

In fact, just as we get ready for another winter flu season, emergency drills involving pandemics and respiratory illnesses are taking place statewide using federal funding and coordinating multiple agencies, hospitals and counties.

So, just a refresher.

Pandemic is Greek for worldwide outbreak. Influenza is just one of many viruses affecting humans. There are two basic strains of influenza, A and B, with many different serotypes.

Every year, the virus changes somewhat and is either stronger or weaker. Every year, vaccine makers attempt to devise a vaccine that will be effective based on predictions of serotype mutations.

Unlike polonium 210 or anthrax, influenza is contagious. It is spread human to human via airborne transmission of inhaled droplets as well as by hand-to-hand contact. Influenza is typically even more contagious than TB or smallpox.

The concern about the highly lethal H5N1 avian flu strain identified in eastern Asia is that the human reservoir does not have any significant immunity to this virus and we have no clearly proven effective anti-virals.

So far, human-to-human transmission of this avian strain appears quite limited. Even so, whether it is this or another novel strain of influenza or even another virus, it is likely there will be another pandemic.

In 1918, flu pandemic was responsible for perhaps 50 million worldwide fatalities, with almost 1 million U.S. deaths, including at least 12,000 in New York.

More recent pandemics were not nearly as devastating. The 1957 pandemic caused 70,000 U.S. deaths, the 1968 pandemic 34,000.

As a U.S. citizen with access to the best acute health-care in the world, you may feel safe. But computer simulations as well as tabletop drills suggest otherwise. In the event of a pandemic, orderly mass vaccinations, antiviral distribution, work stoppages, quarantine or shelter-in-place will be challenging at best.

Complacency is not likely to confer survival advantages. So please read on and consider taking these minimal steps:

s Wash your hands. Often. Your mother was right.

s Eat your chicken soup, eat your vegetables and fruits, get some exercise, get some sleep, and be happy. Your grandmother was right.

s Please cover your mouth when you cough or sneeze, please wear a hat, and please stay home if you're sick. Your teacher was right.

s Get your flu shot (barring contraindications), maintain your own emergency plan with food, medicines, communications, meeting places, medical and critical information, and try to stay rationally informed. The government and health community are right.

Emergency physicians and nurses, first responders, hospitals, health departments, local, regional and state officials are all preparing, but nothing will be effective without your help.

Have a healthy, happy, safe holiday season, and please wash your hands.

On the Web

For more information about flu pandemic preparedness, go to:

www.pandemicflu.gov

www.cdc.org

www.health.state.ny.us


Dr. Craig van Roekens is emergency physician director of Vassar Brothers Medical Center in Poughkeepsie and is an active leader in local, regional and state emergency preparedness issues. He, his wife and their triplets want you to be prepared.