"Swine flu" is no cause for panic, but a good cause to wash your hands

by: John Cmar, MD
Faculty, Division of Infectious Diseases
Sinai Hospital of Baltimore

Anyone exposed to the media reporting on "swine flu" this past week could come away with the impression that the whole of civilization is soon to collapse under the weight of a pig-fueled pandemic. Needless to say, this isn't going to happen. There was was much uncertainty at the start of the outbreak and several questions do remain. That noted, the hard work of the CDC and the WHO has given enough answers for all of us to proceed with our normal daily activities with informed awareness.

Swine influenza is respiratory disease of pigs that is caused by one of several types of influenza virus. It rarely causes disease in humans, and when it does, it has only briefly been transmitted from person to person. The virus involved in the current outbreak is a new strain of type A H1N1 influenza that resulted from the mixing of the genes of swine, avian, and human viruses during animal infections. This is similar to how previous influenza pandemics have started, such as the 1918-1919 "Spanish flu." In these instances, the result was a virus that could be easily passed from person to person, and could cause human infections much more severe than seasonal influenza. At this point, however, the latter seems not to be the case.

As of the time of this post, the WHO has identified 367 confirmed cases of this swine-origin influenza and 10 deaths in 13 countries. There have been 141 cases confirmed in the US, and only one death reported. At this time, there have been no confirmed cases in Maryland, but 8 probable cases have been identified, 4 of which are in Baltimore county. A probable case is defined as someone with an acute febrile respiratory illness who tests positive for influenza A virus, but negative for the seasonal H1 and H3 strains.

While no cases have been confirmed in our area yet, it is very likely that there will be shortly. This is a cause for caution, not panic, as this strain of swine-origin influenza virus seems to be causing illnesses that are not much more severe or fatal than seasonal influenza at this time. If you develop fever >100 F with cough or sore throat, and have either traveled to an affected area within 7 days, or been exposed to someone is ill who has traveled to those areas, stay at home and call your doctor. LifeBridge Health is working closely with the Maryland DHMH, and is well prepared for any cases that may occur.

As with seasonal influenza, the most important thing that you can do to prevent getting infected with the new strain of swine-origin influenza virus is to wash your hands often, especially after being in a public place and before touching your eyes, nose, or mouth. There is no reason to wear a mask in general situations, or to avoid public air or ground travel, to prevent getting the virus. If you do have a respiratory illness, there are several practical steps you can do to avoid transmitting it to others. Wash your hands, especially after coughing, sneezing, or wiping your nose. Cough or sneeze into the crook of your arm instead of your hands when possible, or an immediately disposable paper tissue. Finally, stay away from crowded living areas, and avoid close contact with other people.

Myself and Jackie Daley, Director of Infection Prevention and Control at Sinai Hospital, will be on the Ask the Expert show this Sunday, May 3, from 08:00-09:00 EST on WHFS 105.7 FM radio to discuss the current state of the swine-origin influenza outbreak, and to take any call-in questions. Please tune in to hear the latest news, and feel free to give us a call. Further updated information can be found on the websites of the Maryland DHMH, the CDC, and the WHO.

Oh, yeah, for good measure - wash your hands.