Should we fear the influenza A pandemic?

THE A (H1N1) flu, known in some parts of the world as swine flu, has been classified as Phase 6, the highest, in the World Health Organisation classification of pandemics, sparking off a panic of sorts, especially among Asian countries which have had to deal with Sars and avian flu among others. While one should not underestimate the need to be careful and proactive with the outbreak, there is a need to be very circumspect about what A (H1N1) — the WHO-given name for this strain of the flu — is.

First, what is a pandemic? According to the WHO, a disease epidemic occurs when there are more cases of that disease than normal. A pandemic is a worldwide epidemic of a disease.

And what does Phase 6 mean? Phase 6, the pandemic phase, is characterised by community-level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5, the WHO says. Designation of this phase will indicate that a global pandemic is under way. Phase 5 is characterised by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent.

What this basically establishes is that the latest flu strain is very contagious and is spreading very rapidly throughout the world. That is only to be expected from any new strain of flu and the WHO is only doing its duty when it points this out. But the alert level does not relate to danger. As the US Centers for Disease Control and Prevention says: A Phase 6 pandemic declaration is based on the sustained worldwide spread of A (H1N1), not the severity of illness caused by the virus. The rapidity with which the virus is spreading is very evident in Malaysia, too. Three days ago, it reported 38 new cases, the biggest one-day jump in cases, bringing the total to 196.

But what one must remember is that this strain of the flu is not as deadly as some of the infections that we have had before, such as Sars or avian flu. Worldwide, some 77,201 cases have been reported with 332 deaths, a fatality rate of 0.43 per cent or less than one in 200 people infected.

The people who are most likely to succumb to the disease are those with pre-existing conditions where their systems have already been weakened. The question we must ask ourselves is whether we are overreacting given that it is not a severe illness. That in no way implies that we drop our state of alertness and preparedness, but that our response should be commensurate with the severity of the disease. Take dengue for instance. Up to June 13 this year, there had been 23,056 cases with 57 deaths. Certainly more can be done to curb this backyard killer, which is carried by mosquitoes.

Cool heads must prevail to find appropriate solutions to the A (H1N1) problem. We need to look at what can be reasonably done.

The Star/ANN