John C Kim and International Adoption Video

Monday, April 27, 2009

My predictions for swine flu

Here's what I think will happen with swine flu.  As of this writing, Monday, April 27 there are five states affected with 20 cases. Generally, there is a direct connection between transmission and travel to Mexico. However the swine flu appears to be fairly efficiently transmitted between people. And it is likely to spread fairly rapidly over the next several weeks. The virus has killed between 20 and 100 people in Mexico. Several thousand people had appeared to have been made ill. This is probably a fairly significant underestimation. There is no reason to think that in crossing the border, the virus will be nicer to Americans. But who knows? There will likely be documented cases found in Illinois over the next several weeks. Nationally, there will likely to be a handful of swine flu related deaths. This will intensify national hysteria.
The virus so far appears to be effectively well controlled by the two most common antiviral flu medications, Relenza and Tamiflu. They have some side effects that are generally well tolerated.
The question will come up, whether to treat or not, just to stay home or not. I think around here, people will want to be treated. There may be sporadic reports of Tamiflu or Relenza shortages and will increase anxiety. Whenever there are shortages of anything people sometimes freak out. There probably will be plenty of Tamiflu as we did not use nearly as much as we did last year and the CDC has stockpiled 50 million doses. However, there may be local and transient shortages and that will add to the excitement.
The interesting thing about the Mexican experience is that most of the severe cases and deaths involved healthy young adults. This echoes the 1918 influenza pandemic signature. The most vulnerable populations typically, i.e. the youngest kids and oldest adults appear not to have been severely affected.
Currently, as of this morning the CDC is generally recommending home isolation of cases as most cases appear to be fairly mild. They want us to stay at home for seven days after becoming ill. Or at least 24 hours after symptoms have resolved whichever is longer. 
How information will  be transmitted will be interesting. I predict a twitter storm of swine flu information and it will be useful/hazardous mode of communicating public health information/panic about swine flu. 

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Personal Web site for John C Kim: KIDDOC.ORG

I am a pediatrician specializing in General Pediatrics, International Adoption Medicine, and in the diagnosis and coaching of families pursuing joy.