Swine Flu: Your Questions Answered

With swine flu hitting pandemic levels according to the WHO, panic is starting to build across the world.  There is a basis to this madness, as this is a new strain of flu that most of us have never been exposed to before.  Worry about what is reality with all the media sensation is the real madness so we thought we might step in here and give you a little guidance.

Love me - I didnt mean to get you guys sick

Love me - I didnt mean to get you guys sick

An email from a San Antonio “doctor who attended a CDC public health meeting” landed in our inbox this morning and – seeing as Texas and San Antonio are at the forefront of this – we thought we would share parts of it with you.  We’ll take you through some of the claims – many of which you are probably already hearing.

The Email and Our Responses

The virus is infectious for about 2 days prior to symptom onset

This is inline with most influenza viruses according to the CDC and should not cause you to create your own fallout shelter in the woods.

Virus sheds more than 7 days after symptom onset (possibly as long as 9 days) (this is unusual)

Shedding refers to the viruses’ ability to reproduce itself using the cells of your body.  7-9 days is not at all atypical.  Rates of replication will depend heavily on how healthy the person who gets the virus is in the first place but the CDC suggests anywhere from 5-10 days for the seasonal flu varietymaking swine flu very much inline with those figures.

- Since it is such a novel (new) virus, there is no “herd immunity,” so the “attack rate” is very high. This is the percentage of people who come down with a virus if exposed. Almost everyone who is exposed to this virus will become infected, though not all will be symptomatic. That is much higher than seasonal flu, which averages 10-15%. The “clinical attack rate” may be around 40-50%. This is the number of people who show symptoms. This is a huge number. It is hard to convey the seriousness of this.

There is never any “herd immunity” with a flu virus because every year, new strains jump species (usually from chickens in southeast asia) and infect humans.  Typical flu vaccines are merely a guess at what strain will become dominant that year and only offer a 70-80% assurance against infection; that’s assuming they guess right and you are under 65.  Scientists guessed very wrong in the 2003-2004 flu season and if you are reading this, there is a 100% chance you made it through that pandemic successfully.

The stats, as of May 1st - not that bad people

The stats, as of May 1st - not that bad people

Also consider this statistic – the “attack rate” (if you must call it) of any flu is always 100% if you inhale the virus particles – no way around that one.  Unless you have been previously exposed to the virus strain beforehand, you will get sick.  That’s just how the immune system works.  What’s different this time around is that very few people have been exposed to this strain so the infection rates will be much higher – but remember the exact same phenomenon happens in a bad flu season, like back in 2004.

- The virulence (deadliness) of this virus is as bad here as in Mexico, and there are folks on ventilators here in the US, right now. This has not been in the media, but a 23 month old near here is fighting for his life, and a pregnant woman just south of San Antonio is fighting for her life.  In Mexico, these folks might have died already, but here in the US, folks are getting Tamiflu or Relenza quickly, and we have ready access to ventilators. What this means is that within a couple of weeks, regional hospitals will likely become overwhelmed.

Worldwide, the current death rate from swine flu is about 4% by official countsIn America, its essentially zero for now; a single toddler is the only person to have passed away from it – so far.  Typical flu death rates are about 35,000 per year – or about 1% according to widely quoted CDC numbers – effecting mostly the young and old.   Yes, swine flu appears to be markedly more deadly than a typical flu but the real concern about a true pandemic that kills large numbers of people would be a 1918 style Spanish flu.  That type of flu killed the young, healthy people of the world by creating a cytokine storm in its victims – essentially confusing the hell out of the immune system to the point it goes on a rampage, attacking the host it should be protecting.  Preliminary reports do NOT show swine flu doing this.  Avian bird flu (H5N1) however, is suspected to attack in this manner – a topic for another day.

The kill rate from the virus may vary from country to country depending on genetic markers, population-based characteristics (like exposure to other swine-based influenza strains) and most importantly, access to public health facilities.  If you are reading this email in Ghana, you have a lot more to fear than an American.  We have access to clean water, sanitation and the best medical facilities in the world.  You should feel pretty confident in the fact you can walk about 5 feet to any point in your home and pour yourself a cup of clean water that essentially costs you nothing.  If you get sick, your best weapon is hygiene, rest and good food – as we previously reported.

– There are 10-25 times more actual cases (not “possible” cases — actual), than what is being reported in the media. The way they fudge on reporting this is that it takes 3 days to get the confirmatory nod from the CDC on a given viral culture, but based on epidemiological grounds, we know that there are more than 10 cases for each “confirmed” case right now.

If the infection rate really is 25X as high as the reported 4,000 people, the actual death rate from swine flu would fall inline with a seasonal flu at about 1%.  Media numbers are always suspect, especially in times of panic, but this flu is transmitted by air will likely become widespread if it has not already.  There is very little you can do about this – just be smart about washing your hands, avoiding people who are couching – the kinds of things you should be doing during any regular flu season.

- N-Acetyl-Cysteine — a nutritional supplement available at the health food store, has been shown to prevent or lessen the severity of influenza. I suggest 1200mg, twice a day for adults, and 600mg twice a day in kids over 12. It would be hard to get kids under 12 to take it, but you could try opening the capsules and putting it on yogurt. For 40 pounds and up, 300-600 mg twice a day, for less than 40 pounds, half that.

- Oscillococcinum, a homeopathic remedy, has been vindicated as quite effective in a large clinical trial in Europe, with an H1N1 variant.

Herbal health claims from a widely circulated email?  For a change, this email has got some golden nuggets in it.  N-Acetyl-Cysteine (NAC) has seen use as a treatment for bronchitis for almost 20 years now and found to be effective in reducing chronic bronchitis and COPDStudies show NAC results in lower numbers of people coming down with the common cold and flu for those that do, less severe sick episodes.  But remember, these studies are not dealing with swine flu in particular.  The pathology of swine flu is being investigated so it is not yet certain which protocols and supplements will best attenuate the symptoms but NAC is good bet if you get any chest cold, swine flu included.

Elderberries - could work as a tea (leaves are poisonous though)

Elderberries - could work as a tea (leaves are poisonous though)

The science surrounding Oscillococcinum was recently reviewed in the prestigious Cochrane Database, which acts as the general aggregator of all things science on a given issue.  Their take away was mixed.  They claimed the treatment was ‘promising‘ but shied away from declaring oscillococcinum as a panacea for the flu, finding the treatment shaved .28 days (on average) off the flu along with positively affecting the psychology of those who had the flu.   They also added the remedy did nothing to prevent the flu as many marketing claims surrounding this homeopathic remedy claim.

Another review study conducted against flu fighting-herbal remedies during the Bird Flu panic of 2006  found another mixed bag of hope but little evidence with some of the more recent popular herbal treatments.  They reviewed oscillococcinum, Elderberry (used as a tincture and in teas to aid flu fevers) and the Ayurvedic immune-remedy Kalmegh – finding all with great promise but very little science behind them at this point.  (Kalmegh is especially interesting because of its wide range of powers and we hope to cover it individually in a future article).

Echinacea - I work!

Echinacea - I work!

If you are looking for a scientifically proven herb for boosting immune system activity look into echinacea.   Multiple respected sources have endorsed its use [1], [2], as an immune modulator, that helps the immune system better cope with severe attacks like allergens, pathogens and the like.  If you are looking for a good supplement – find one that uses the root of echinacea, as studies suggest that the root has the most immune modulating properties.

Conclusion – Wise Up!

As swine flu mania continues, just stay calm and take a little time to reflect on the good health you have today.  With our increasingly interconnected population, future pandemics are more likely than ever.  Your best defense is a common sense approach to good health and hygiene – as we covered in our last piece about swine flu.  Supplements can help you if you get but remember, humans took over the planet because we used our brains; you should probably continue that rich tradition in the face of media sensationalism.

  • Anonymous

    Thanks for sharing those fruitful information. I really appreciate it a lot!  Swine flue is  became an epidemic decease  in a certain countries. A lot of people die and suffer from that decease. It is necessary to know some information like what you’ve share.
    nutritionist in san antonio

-->