Swine 'flu: the latest

Latest figures from the World Health Organization on the global Swine 'flu pandemic can be seen here. Since it first appeared back in (was it?) April, the total as at the 6th July had reached a staggering 94,512, with 429 deaths (out of a global population of almost 7 billion). In Mexico (where you will remember it all began), there have been no less than 10,262 confirmed cases in that time, with 119 attributed fatalities. That's a worrying 40 deaths a month.

Meanwhile, if you follow this link you will find the transcript of a Radio 4 'File on Four' programme about the origins of the disease and why it is (somewhat controversially) called Swine 'flu, blaming it all on intensive American pig farming. (You see, it had to be the Yanks!) You'll also find things like this:

[BBC reporter Julian] O’HALLORAN: One leading American expert says the US pig population are an increasingly important reservoir of viruses with human pandemic potential. Do you agree with that?

[Dr Ian] BROWN [of the Government’s Veterinary Laboratory Agency]: I would agree that they’re an important reservoir for influenza viruses. Whether they present increased threat pandemic potential is, I think, as yet unproven. [In other words, a cautious 'not entirely'.]

O’HALLORAN: This all raises the question of whether virologists and doctors working in human health paid enough attention to the novel swine flu virus in pigs after it broke out in 1998 [in the USA].

Er, not really. But here is how O'Halloran's thesis develops later:

... back in America the National Pork Council maintains there is a lack of evidence that industrial pig farming was in any way the cause of the ‘98 flu outbreak in pigs. So far in the USA, more than two dozen people have died of the current swine flu outbreak, and the number of confirmed cases has gone over 13,000. However, public health officials have warned that the true number of cases could be up to ten times greater. Troubling references have been made to the 1918 Spanish flu, thought to have killed up to 50 million people worldwide, because it also started with a limited wave of illness in the spring and summer. So all over the country, hospitals have been gearing up to face a possible deluge of cases in a few months time. And nowhere more so than in North Carolina, where a new swine flu virus first broke out in pigs in 1998.

So, it seems one group (admittedly a vested interest) claims there is a lack of evidence to connect intensive farming to an earlier 'flu outbreak amongst pigs, which the programme seeks to blame for its spread to human beings. But it is 'flu, and a lot of people died of 'flu in 1918. So even though the illness has so far been limited in its spread and mild in its effects, there may be a 'deluge' of comparable cases soon.

Here, then, is the conclusion to the programme (with key phrases highlighted):

O’HALLORAN: The sudden mutation of viruses, and large areas of ignorance about past pandemics, combine to mean it’s almost anyone’s guess whether the coming flu season will be little worse than normal or a great deal more severe. And the exact role of intensive farming operations in the chain of causation of a possible pandemic clearly needs much more investigation. What public health chiefs, virologists and doctors are all agreed on with flu is to expect the unexpected. But despite that dictum, it seems that, to many human health experts, swine flu came like a bolt from the blue, even though there’d been some clear warnings of danger in the last few years from some virologists who had focussed - rightly as it turns out - on the risks posed by disease in pigs.

Finally, if you want to read a first-hand account of the early reactions amongst medical staff in Mexico (which may have something to do with the media coverage now) there is this doctor's diary on the BBC website.

John Richardson
14 July 2009

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