Health: Should we still be worrying about swine flu?

Should we still be worrying about swine flu?

With the threat of swine flu looming over us, some experts believe we'd be better off building up a natural immunity to the disease by catching it, rather than being immunised, avoiding it or taking drugs. We consider both sides of the swine flu debate.

Confirmed cases of the bug have steadily crept up in the UK, with 278 at the last count (including 13 Rangers fans) but despite mass fear about its lethal effects, many of those who have suffered and survived claim it's no worse than catching a cold.

In Mexico, where the virus originated in pigs, the death toll has been recalculated from 159 cases to just 56.

So have we overreacted to the threat of swine flu? Or is a more dangerous strain developing, ready to hit us this winter?

According to the World Health Organisation (WHO), swine flu is currently rated as a level five threat. A "flu pandemic" is declared at level six.

This might sound bad, but the Professor of Virology at the University of Reading, Ian Jones, says it's not an indication of the flu's severity.

"There is still confusion in the public mind about the word pandemic. It doesn't mean severe infection, it simply means a very widespread infection, freely transmitting on a global scale."

Swine flu outbreaks have already forced several schools to close, including Eton College, and there are fears it could spread when children go back after the summer holiday.

Virology expert Professor John Oxford warned this week that the return to school, work and university in September could give the virus an "opportunity" to become a pandemic, before a vaccine becomes available from October.

But Prof Jones believes it's more likely to spread in November, the start of our normal flu season.

"There's no doubt that we can't eradicate the virus and so the spread will continue and probably will accelerate as we go into the traditional flu season.

"But I don't think there's any evidence that it will be any more severe in its second wave.

"Professor Oxford's point about children going back to school, the congregation of people, is correct, but the normal flu season is thought also thought to be related to the fact that people tend to crowd together in wetter, colder times of the year, they're indoors rather than outdoors, and that accelerates transmission."

Gaining immunity

How quickly swine flu will spread this winter will depend on how many people have already caught it and built up an immunity, say the experts.

"Once a person is infected and has cleared the infection, they're immune, the virus can't go there. So once 'herd immunity', as it's called, in the population, builds up, then the virus will be less and less of a problem," says Prof Jones.

The current outbreak is a new strain of influenza A virus subtype H1N1, a relative of pig flu that has already existed in America for the past 10 years, he explains.

Unlike the lethal H5N1 strain of bird flu, which reared its ugly head here in 2005, swine flu doesn't have to adapt itself to infect humans, meaning we might not see a stronger, mutated version appear later this year.

"In past epidemics, the virus has been adapting to human transmission because it was effectively a bird virus. But in this case, it's definitely a pig virus, a mammalian virus.

"Having said that, were it to come back in a slightly more dangerous form, then there's no doubt if you've been infected with the mild form, you'd be resistant. You would almost certainly be protected come the winter."

That's not to say we should all go out and try to catch swine flu.

The Health Protection Agency is collecting data from 3,300 GP surgeries around the country, in an effort to learn about this strain of swine flu.

They are advising people to take precautions against catching the disease and/or spreading it.

Pox parties

In the 1950s, before the days of mass immunisation, parents used to hold measles parties to infect their children with the disease, so they would then build up a natural immunity. Chickenpox parties also became popular.

While Prof Jones acknowledges the benefits of building up antibodies to combat future strains of swine flu, he agrees that pox parties are definitely not to be advised.

"I don't think we should go back to the days of chickenpox parties. The virus will spread in the community anyway as we're seeing, but I don't think there's a case for purposeful mixing and trying to persuade people to go and catch the flu.

"Not least because some of the people you'll be suggesting go down the road and shake hands with someone who's got it might actually have an underlying health problem. In that case, any infection is actually much more significant for them, not just this one. I wouldn't be encouraging it at this time."

Children appear to be more at risk of catching swine flu, because their immune systems are more "naive", as well as the frail and elderly, who are more susceptible to respiratory conditions, says Prof Jones.

The symptoms

If you do catch swine flu, expect to have symptoms similar to a mild respiratory disease, such as a sore throat, aching joints, shivering and feeling cold.

"In people who've had it and have recovered, the symptoms are no different from what you'd consider a common cold, so you're feeling down and out for a couple of days and then you appear to get better over the course of seven to ten days," says Prof Jones.

"If you suspect you have the symptoms, then seek treatment from your GP who might prescribe you with Tamiflu."

While a vaccine to prevent swine flu is still being developed, those who catch it are being treated with the antiviral Tamiflu.

It has mild side-effects, which include nausea and vomiting, but it's generally "well-tolerated", so don't be afraid of the treatment.

"If it's prescribed within two days of infection, it effectively stops the virus spreading as widely as it would otherwise do, both in the individual and to contact members," says Prof Jones.

While we're right to be vigilant about this new strain of flu and follow good hygiene guidelines, we shouldn't be overly concerned.

"One of the dangers if you raise concerns too highly is that everyone checks themselves into accident and emergency and everything gets clogged up when actually they don't need to be there," says Prof Jones.

"If you do get the infection and the predominant outcome is not serious, at least you'll be less worried about it."

Swine flu precautions

The Health Protection Agency gives the following advice:

1. Practice good basic hygiene, wash hands frequently with soap and water to reduce the spread of virus from your hands to face or to other people.

2. Clean hard surfaces frequently using a normal cleaning product.

3. Cover your nose and mouth when coughing or sneezing, using a tissue.

4. Dispose of dirty tissues promptly and carefully.

Advice for travellers

1. Travellers should continue to be aware of the risk of swine flu and anyone experiencing flu-like symptoms during a stay in a country affected by swine flu should contact a health professional and inform them of their symptoms.

2. Anyone who becomes ill on their flight home should alert cabin crew to their symptoms.

3. Travellers returning from a country affected by swine flu who become unwell with flu-like symptoms within seven days of their return should stay at home and contact their GP or NHS Direct on 0845 4647.

4. To access the Department of Health Swine Flu Information line when abroad, call 00 44 207 928 1010.

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