Swine Flu Myths
There is a lot of silliness going on about Swine Flu in the media and in the world in general. Here are five of the more prevalent myths:
1. You can get Swine Flu from eating pork/ham/bacon
FALSE. Even if you ate raw pig flesh from an infected pig (Eww), you would be highly unlikely to contract Swine Flu. It is impossible to contract Swine Flu from properly cooked pork, ham or bacon. Apparently the Egyptians are busily killing off all 400,000 of their pigs, to which I say there will be a great opportunity for bacon manufacturers in the near future. Countries banning pig imports are practicing occult protectionism.
2. If Swine Flu becomes pandemic it will kill 50 million people worldwide like in 1918
FALSE. Even if this strain of Swine Flu is as virulent as the 1918 version, the number of fatalities is likely to be much lower. In 1918, mankind had just finished a world war. The nutritional status (and hence immunity) of people was very low, making them susceptible to infection. Most of the deaths were secondary to pneumonia which is treatable nowadays. Not even Penicillin had been discovered by 1918. In addition we also have antiviral agents which, while no cure for influenza, mute the disease and allow the body to combat it more easily.
3. Swine Flu is just media hype
FALSE. The combination of human to human transmission plus the fact that most of the deaths in Mexico appear to be in the 25 – 45 year age bracket (normal flu tends to kill the very young and the very old) indicates that this virus is potentially far more dangerous than a standard flu. It is not as dangerous as something like Ebola or Marburg fever, of course, but it is dangerous. This is not at all like SARS/Bird flu. SARS, though more deadly than Swine Flu, never achieved human to human transmission – the prerequisite for a pandemic.
4. The current flu vaccine offers protection against Swine Flu
FALSE. Apart from a very minor boost to your immune system, the flu vaccine is essentially useless against Swine Flu. It is specifically tailored only for the expected strains of ordinary flu and conveys little or no cross-immunity. If you were going to have the flu vaccine anyway, go ahead, but it will not help you against Swine Flu. A specific vaccine for Swine Flu will undoubtably be made, but will not be of much use to New Zealand. If we have an epidemic (quite likely now), it will be over well before the first vaccine becomes available. The specific vaccine may be useful for the Northern hemisphere’s flu season next year, when there may be a re-emergence of the strain.
Free MacDoctor health tip: Probably the most effective thing you can do to avoid getting the flu, swine or otherwise, is to use alcohol hand wash. You can get the small pocket-size bottles and use it frequently. Most flu bugs are caught from touching contaminated surfaces rather than breathing it in. Masks are only useful if you are going to be near someone with the flu for some time.
5. The antivirals have terrible side effects and will kill more people than the Swine Flu
FALSE. The antivirals effective against Swine Flu, Tamiflu and Relenza do have a number of side effects, typically nausea, vomiting and dizziness. But the most widely publicised side effects on the internet are hallucinations and delirium. These were observed in children prescribed the drug in Japan. However, an excellent study on the drug showed that these side effects were just as common in patients who were not prescribed Tamiflu, indicating that this is a problem with influenza, rather than with the antiviral agent.
The World Health Organisation has increased their alert level to 5, indicating that a pandemic is now almost inevitable. Bear in mind, however, that we essentially get a pandemic of influenza every year. Although this virus is likely to be significantly more dangerous than the standard influenza virus, it is also likely to turn out more like the Hong Kong flu pandemic rather than the 1918 Spanish flu pandemic. There will be some tragedies and some disruption to life – but the world will not come to an end.
At least, not yet.
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May 1 09 12:02 pm
Thanks- this is very helpful.
Chthoniid’s last blog post..Praying Mantis shots
May 1 09 12:43 pm
It sure is–and a whole lot better than the hysteria and half-baked ‘information’ available through the media.
May 1 09 1:08 pm
Surely, MD, the “nutritional status” etc in 1918 is a red herring, the point was it killed disproportionate numbers of the young and fit. I recall reading that the US Army in France was disproportionately affected, because they were “young and fit”, and not nutritionally challenged at all. I agree that the death toll is almost certain to be lower, much lower as a percentage and probably lower absolutely, largely because of advances in treatment.
We don’t yet know just how lethal this strain is, too soon to tell. In 1918-19 there were two waves, an early wave in June – August which was noticed but caused few deaths, and a later wave from October or so on which was not only more deadly, but extremely rapidly transmitted. Credible accounts suggest that a barracks room could be apparently unaffected at the start of the day, and yet have something like 80% of the occupants struck down and essentially confined to bed by late afternoon. Deaths could occur with 24 hours but typically took longer. We’re not at that sort of stage yet, and in Europe the presence of enormous armies with concentrations of people in close quarters probably contributed to the rapid spread.
Nutritional status was a likely factor in the spread of the disease, as were the crowded living conditions and poor sanitation. While it is true that the 1918 virus appeared to induce a fatally excessive immune response (hence killing the fit and healthy), that by no means removes the possibility that nutritional status play a significant role. Poor nutrition will make you more susceptible to flu but will not mitigate a massive immune response – starving people can still have anaphylaxis , for instance.
May 1 09 2:57 pm
Hi there, the link to the study included goes to a login page which I assume is for medical professionals and not laymen? If there is a chance to publish the name and details of the study, and any links that we could use to find out more about it, that would be appreciated.
May 1 09 3:58 pm
Oops, found my way in. This does not look like an excellent study to me concerning the safety of Tamiflu. The study was funded by Roche, who own and manufacture Tamiflu, and one of the two authors, Dr William A. Blumentals, PhD, also works for Roche (as he can be reached at william.blumentals@roche.com).
The results of the study are also quite disgusting in that in a number of different areas the study’s authors concluded that the occurrence of neuropsychiatric events was lower ‘within the 14 day period’ than those in the control group (ie take Tamiflu to reduce the possibility of neuropsychiatric events!).
The study is quoted here, under “Safety outcomes for all patients”:
“In the 14 days after the index date, significantly fewer patients prescribed oseltamivir experienced any of the CNS-related or neuropsychiatric events, or, specifically, a psychiatric event, an episode affecting consciousness, or other type of episode ( Table 4 ). There were no significant differences in rates of encephalitis, movement disorder, stroke, or seizure between the oseltamivir and control groups within 14 days. By 30 days after the index date, significantly smaller proportions of patients in the oseltamivir group experienced any of the CNS-related or neuropsychiatric events of interest, including a psychiatric event, an episode affecting consciousness, movement disorders, seizure, stroke, or other types of episode, while percentages of cases of encephalitis were similar in the 2 groups ( Table 4 ). None of the events was more frequent in the oseltamivir group during either the 14- or 30-day period.”
I reckon that these are the most unbelievable statements that could possibly be made about a drug for which the FDA has added a warning label stating that there could be side-effects of, “delirium, hallucinations, or other related behaviour” (ie self-harm) after over a hundred adverse incident reports over a single year period.
Macdoctor, can there be any possible justification for the results of this study given the huge and obvious conflict of interest that underlies this study, and the actions of the FDA to re-label this drug to include harmful side-effects? (at least in the US).
May 1 09 4:30 pm
Here is an excerpt from the Tamiflu (Oseltamivir) wiki page indicating that when Roche gets involved in researching its own drugs such as Tamiflu, the result will be unbiased research of the highest order,
“In October 2006, Shumpei Yokota, a professor of pediatrics at Yokahama City University, released the results of research involving around 2,800 children which found no difference in the behavior between those who took oseltamivir and those who did not. A media source notes that Chugai Pharmaceutical Co. (which produces Tamiflu in Japan) gave Yokota’s department 10 million yen (US$85,000) over five years.”
Chugai Pharmaceutical Co is a 50% owned subsidiary of Roche, according to the wiki authors.
May 1 09 4:37 pm
Please note Macdoctor that I take this issue very seriously and in no way do I think that you have merited any sort of criticism from your blog which is excellent. But I do think that the idea that Tamiflu has more drawbacks than advantages is a serious issue that deserves a heck of a lot more talk than it is currently getting. After all, where I live, we have completely sold out of Tamiflu at $75 a pop even before it became available today without prescription, which a serious issue. Thanks
May 1 09 10:18 pm
Johnnieboy:
Sorry to take so long to get back to you. Unfortunately I do have to occasionally earn a living
When I use the word “excellent” for a study, I mean that the methodology and analysis of the study was well done. While I understand your concerns about possible bias, most studies of this nature are funded by the drug company concerned and are often run by employees. As long as their methodology is clear and the their interests properly declared, I don’t have a problem with this.
I note that Roche still co-operated with the FDA advisory, even though it was clear that the episodes of delirium being reported from Japan were anecdotal and chiefly paediatric and even though they had this particular study demonstrating that the drug was probably not the cause. To me, that says that they are erring on the side of caution rather than attempting to make a quick buck.
I don’t accept your implication that the study was suggesting that taking Tamiflu would reduce neuropsychiatric disturbances. In fact the closing line is “Following on from this study, further investigation of these events in influenza and the effects of treatment with neuraminidase inhibitors is warranted.” This is usually taken as an invitation for a more independent study to be made – preferably a randomised, double-blind trial.
FTIW I think Tamiflu should only be available as a scripted item. Making it over-the-counter is a dumb idea designed to let the worried well deplete all the available stock.