by Charles Ray

Created on: June 13, 2009

The H1N1 influenza virus, commonly called swine flu by many, did not hit as hard as had been feared or anticipated during its inception during the past winter/spring flu season. It has been far milder than many had predicted at the outset, although the number of fatalities in Mexico were alarmingly high.

There was, in the minds of many people, far too much hyping of this outbreak by the media, and a general feeling among many that the government overreacted. To those who would now take the view that the danger is past and we can all go back to 'business as usual,' it would be wise to study the history of influenza pandemics. The Spanish Flu pandemic of 1918 is worthy of careful study in that regard. This outbreak was also mild when it first appeared at the end of the winter flu season, with most of the fatalities confined to people with pre-existing medical conditions or weak immune systems. At the end of the first phase, it seemed to fade away, only to come back in the fall season, mutated into a much deadlier virus for which people had no immunity. The result was millions of deaths of otherwise healthy people who would not ordinarily be affected. Influenza outbreaks typically occur in two to three phases, with the first phases being milder, and as the virus mutates, with subsequent phases more virulent and deadly.

The U.S. Centers for Disease Control (CDC) has published a regular update of the progress of H1N1 on its website, and a look at the numbers, while not a cause for alarm, should cause everyone to be concerned. The number of cases showed a regular increase from week to week, with over 10,000 cases reported in the United States by the end of the first week in June. Most of the cases were in states that border on Mexico, or which have large immigrant populations. The deaths that were reported were mainly people with medical conditions that caused weakened immunity.

Should H1N1 mutate into a deadlier form; one for which we have no vaccine or inherent body defenses, one can expect both the number of infections as well as the number of deaths to be much higher should it reemerge during the upcoming fall flu season. The World Health Organization (WHO) raised the level of alert for H1N1 to 6, or full pandemic in June, an indication that international health officials still believe this to be a virus that has the potential to cause great harm.

It is impossible to predict with any degree of accuracy that H1N1 will come back in the fall in a deadlier form, or that it will reach pandemic level if/when it does. Prudence, as well as the history of influenza outbreaks, dictates that we be prepared for the possibility, however, that it will in fact do just that.

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