CABI Blogs: hand picked... and carefully sorted

Man Flu Really Exists, New Study Shows

Man flu is considered by large segments of society to be the psychological condition of men with colds. It is often said that when men have a cold they think it is a flu and as a consequence they moan more than women and stay longer in bed until they feel better.

Man flu is not to be confused with the current H1N1 pandemic flu which is affecting humans in some 40 countries. There has also been one swine case on a farm in Canada.

Pandemic influenza: the worst economic scenario

The threat of an influenza pandemic has disappeared from headlines again lately, at least in the UK where a political scandal around MPs expenses has driven everything else off the news. But that doesn't mean that the outbreak has died down yet. In fact, just over 1000 new cases have been confirmed worldwide in the last 24 hours. Similarly, although travel warnings that had been in place for Mexico have now been lifted by some countries (including the UK), and cruise lines are planning their return to Mexico's ports, the possible cost to the global travel economy of a full-blown pandemic has recently been released.

H1N1 Flu Panic Hits Pigs and Producers Hard

More than a month since the first reports of influenza in humans in Mexico, the first case of the H1N1 influenza in pigs has been reported. The Canadian Food Inspection Agency (CFIA) announced on 2 May that a H1N1 influenza virus was found in a pig herd in Alberta. Since then, the CFIA has assured the public that the outbreak on the Alberta farm has been fully contained and that additional analyses of the virus have confirmed that the virus is the human strain. It is highly probable that the pigs were exposed to the virus from a farm worker who had recently returned from Mexico and had been exhibiting flu-like symptoms. Signs of illness were subsequently observed in the pigs, but both the farm worker and all of the pigs are recovering or have recovered.

The outbreak came as the World Health Organisation agreed that the virus should be called influenza A (H1N1) rather than “swine flu”.

Although this outbreak remains the only confirmed case of H1N1 influenza in pigs so far, and although in this case the virus was transmitted from a man to the pigs, a number of countries have resorted to using panic measures to prevent spread of non-existent “swine flu” even before this outbreak, which have had a significant negative impact on welfare of pigs and pig farming.

For example, Egypt has reportedly culled its entire pig population (approximately 250,000 animals) without any evidence of disease in pigs, which has prompted the World Organization for Animal Health (OIE) to issue a statement that there is no need to slaughter animals in view of preventing circulation of the influenza A (H1N1) virus.

In Afghanistan, a pig has been quarantined at Kabul Zoo after visitors raised concerns it could infect them with “swine flu”. According to media reports, this is Afghanistan's only known pig, because pigs and pork products are illegal in this country for religious reasons.

The pig industry has also suffered significant financial losses due to the suspension of imports of live pigs and pork products by dozens of countries.

The US National Pork Producers Council (NPPC) has stated that the US pork industry is almost on the verge of financial disaster and has called on everyone working in the pork industry to address “influenza outbreak misinformation”. The NPPC statement also adds that the media still make reference to the current influenza as "swine flu” despite the consensus of international scientific organizations, including the World Health Organization, the World Organization for Animal Health, the Centers for Disease Control and Prevention and the US Department of Agriculture that this is not "swine flu", but influenza A (H1N1).

Since the flu outbreak first hit the news headlines, producers have lost $6 per pig, which has cost the industry about $2.5 million per day, according to the NPPC.

'Swine flu' travel response: pandering to stupidity?

We have been featuring H1N1 influenza heavily here on 'Hand picked' lately, in line with the worldwide headlines the virus has been making since the emergence of an outbreak in Mexico. From the daily travel news alerts which hit my inbox, the virus has not only hit tourism in Mexico severely, but has also raised worldwide fears for possible effects on travel and tourism should the outbreak worsen. But how real is the threat to travellers?

I have a flu – how do I know it isn’t swine flu (H1N1 virus flu)?

Well, I don’t! And I probably will never know. Read on to find out why…

 

Pigs Escape Influenza, but They Get Slaughtered Anyway

Since the first reports of a new strain of H1N1 influenza virus causing human casualties in Mexico, and then in other countries there has been a deluge of news, special reports, opinions and interviews on the topic. Most of them erroneously refer to the disease as “Swine Flu”.

However, according to the Centers for Disease Control and Prevention in Atlanta, the new virus has both human and avian influenza genetic sequences in addition to genetic sequences from swine influenza virus.

Given that the new virus has not been isolated from pigs in Mexico or anywhere else, pig producers and the World Organization for Animal Health (OIE) have justifiably argued that the use of the term - “swine influenza” is misleading and damaging to the pig farming industry. The OIE issued a statement on Monday suggesting that the new disease should be labelled “North American Influenza,” in keeping with a tradition of naming influenza pandemics after the regions where they were first identified, including Spanish flu of 1918 to 1919, Asian flu of 1957 to 1958 and Hong Kong flu of 1967 to 1968.

However, despite the OIE statement and the fact that no case of influenza in pigs is confirmed, individual countries have been introducing various measures to prevent further spread of the disease via pigs. Some countries, including China, European Union and Russia, have banned the import of live pigs and pork products, which has immediately led to a 10% fall in prices of pork meat. Even more drastic measures have been reported in attempts to prevent further spread of “swine influenza”. According to media reports, Egypt has ordered culling of its entire pig population.

It appears that health professionals are taking notice of the importance of using correct terminology to describe the current disease and have been using terms such as “influenza” or “H1N1 virus” rather than “swine influenza”. For example, Dr Margaret Chan, the WHO Director-General, announced in her statement that the WHO has raised the current level of “influenza“ pandemic alert from phase 4 to phase 5, and did not refer to the term “swine flu”. Similarly, the US Agriculture Secretary Tom Vilsack went out of his way at a press conference in Washington to refer to the virus as the "H1N1 virus" stating "This is not a food-borne illness, virus -- it is not correct to refer to it as swine flu because really that's not what this is about."

However, the media still continue to use the term “swine flu” widely to describe the disease, and therefore it is not surprising that pigs are being culled, without any evidence of influenza in pigs.

Masks or Handwashing?

In Mexico and South East Asia, face mask wearing  to prevent spread of respiratory diseases SARS and swine flu is popular with the public and encouraged but the World Health Organisation and national health agencies seem to be recommending masks for healthcare settings only. Whats the evidence that they work?

Health systems: fuzzy or not?

Despite swine influenza calling world experts home to advise their governments, it was business as usual here on Tuesday April 28 at the World Congress for Public Health in Istanbul. Tuesday was the first full day with 9 concurrent sessions. I sought out those which addressed health systems, as this is an area finally recognised as vital if developing countries are to reach MDG targets by 2015, and equally relevant to the expanded EU. No longer does health have to follow economic growth: improved population health is seen as a driver for wealth, its an expectation & a human right. What exactly is a health system? To get a clear definition I had to wait for later talks. One speaker even described it as a fuzzy concept and actually thought this could prove to be an advantage! Meanwhile…

The Brazilian Minister for Health delivered a detailed description of the programmes and restructuring they have successfully delivered…and then dashed back home to deal with the swine fever threat. The Assistant Regional Director WHO Africa pointed out that though her region has benefited from increased resources for health (Global Forum, GAVI etc), they are focussed on a narrow range of diseases…HIV, TB, malaria…and in the past these programmes & donor governments have discouraged reallocation to build-up inadequate health systems.  Recently Global Forum and GAVI have changed their minds recognising that scale up of successful interventions is constrained by inadequate health systems. Apparently, WHO reports concentrated minds wonderfully.

Swine flu or North-American influenza?

A better name for the influenza virus causing alarm around the world may be 'North-American influenza' rather than 'swine influenza' the World Organisation for Animal Health (OIE) has suggested. The reason for this proposal is that the virus has not actually been isolated from pigs to date. OIE points out that in the past, many human influenza epidemics with animal origin have been named using their geographic name, eg Spanish influenza or Asiatic influenza, thus it would be logical to call this disease "North-American influenza".

Swine flu: the long view

Here's a book I located in Global Health Archive on what happened in 1976, when swine flu caused an outbreak in man in the USA. This outbreak was dealt with using a mass vaccination campaign. The political fallout was huge however because the vaccine produced cases of paralysis. It illustrates public health dilemmas when considering vaccination against disease.

At the time no action wasn't an option as the 1918 epidemic loomed large in the public consciousness and that was linked to swine.