H1N1: Hopefully, this too shall pass

Kristine Berey

Since the flu-de-jour has monopolized headlines, the smallest cough or sneeze can elicit dirty looks in a bus or supermarket. As passengers or shoppers sidle over to a hopefully less infectious spot, their “bubble” invariably reads: “I hope it’s not H1N1!”.

The perception that H1N1 is to be feared has created what one pediatrician has called “H1N1 psychosis,” as worried people swamp emergency clinics and vaccination sites.

The fact that the virus has been declared a pandemic by the World Health Organization is, in itself, not a reason to panic, says Eric Toner, senior associate with the Center for Biosecurity of the University of Pittsburgh Medical Center.

Quoted in Bioworld Today, Toner says, “ ‘Pandemic’ means a global outbreak of an infectious disease … But the word ‘pandemic’ doesn’t relate to severity of the illness. So we have a pandemic of a virus that causes mild illness, apparently much like we did in the last influenza pandemic.” Dr. Toner predicts that H1N1 will replace the seasonal flu we know starting next year.

Experts say that in most people this virus will resolve on its own, what makes the H1N1 strain somewhat sinister is that it sickens healthy younger people and there is no sure way of identifying yet who is more susceptible to severe illness. If complications develop, they are severe, especially in people with underlying medical conditions. Healthy people born before 1957 are less at risk.

Although the symptoms of a cold, the seasonal and swine flu (H1N1) are similar, here’s how to tell them apart: A sore throat, runny nose and a cough indicate a cold. The same symptoms with fever and fatigue so overwhelming that bed rest is required likely indicate the flu. H1N1 differs from the seasonal flu in that sometimes there is no fever, but vomiting and diarrhea may be present.

If the illness worsens it’s important to seek medical help, as the H1N1 virus tends to attack the cells deep in the lungs, causing rare but serious complications requiring hospitalization in about 1 out of 1,000 cases. According to the Public Health Agency of Canada, warning signs are: fever over 39.5C, rapid breathing or shortness of breath, chest pain, bloody sputum, dizziness or confusion, persistent vomiting, bluish or grey skin colour, and low blood pressure.

“We know that this is now the dominant influenza virus transmitted around the world,” said Dr. Timothy Brewer, director of global health programs for the McGill Medical School and senior advisor for the International Society for Infectious Diseases. “The good news is that since this virus has been recognized, in April, it has been stable, not become more deadly. Most people have mild disease and do well. A very small percentage of people get very sick and it’s even a smaller percentage who die.”

Since Canada’s unprecedented mass vaccination campaign started, people have flooded flu clinics and stood in line for hours waiting to be immunized. However, some are concerned about possible side effects of the vaccines. A recent Associated Press-GfK poll found that 38 per cent of U.S. parents said they were unlikely to allow their children to be immunized. The adjuvanted Canadian vaccine, manufactured by Glaxo Smith Kline, contains squalene and thimerosol, two substances anti-vaccine activists are worried about.

In the NFB documentary film Silence on Vaccine, Lina B. Moreco focuses on families who believe their children have suffered adverse reactions to vaccinations. “I did three years of research and met people who suffered from side effects,” Moreco said. “When I finished the film, the NFB hired a lawyer from outside and from the film board and someone to check the archives I used to make sure I didn’t play with the information.”

Vaccine fears may originate in a 1976 swine flu vaccination campaign when there was an increase of Guillain-Barré syndrome, a neuro-immune disorder. Experts still debate whether it was coincidental or causal that during the campaign 500 fell ill and 25 died in the U.S.

Since then, Dr. Brewer says, studies done on the seasonal vaccine have shown no increase in Guillain-Barré. As well, there are unprecedented tracking systems in the US and Canada to monitor possible adverse reactions. “We’ll have to look and follow after people start using H1N1 vaccines. It’s the only way we’re going to know for sure.”

To date, the vaccine has been tested in more than 40,000 people globally. NDP health critic Judy Wasylycia-Leis says the vaccine seems to be effective and safe. “We continue monitoring, but based on everything I’ve seen and heard, the risks from serious illness are greater than problems you might get from the vaccine.”