Will the swine flu pandemic turn deadly in the U.S.?

Posted by CurrentMedicine.TV On April 28, 2009 – 6:49 pm in: Infectious Disease, Internal medicine, Op-Ed, Policy, Swine Flu

Unlike the 2005 Bird Flu scares, this current swine flu seems certain to become a worldwide pandemic. The virus has already mutated and jumped to human-to-human transmission and is on several continents. However, it is not certain whether it will turn into a deadly outbreak like the 1918 flu pandemic that killed millions. The virulence of this pandemic will determine whether nations close borders and economies suffer.

What is known now? The White House held a briefing today on the Swine Flu. It is encouraging that the dozen or so cases in the U.S. have not resulted in deaths and only one required hospitalization. However, this may be very unreliable given the early stage of the pandemic. If the early detection and treatment of modern medicine can prevent deaths, then the governments of the world will likely not begin quarantine measures that would be comparable or worse than the post-9/11 impact to the economy.

Deaths from swine flu, not just confirmed cases, will be the crucial parameter that will determine the threat level enacted by the CDC. The CDC has a five-level response system modeled after the hurricane response system. Category 1 assumes that 90,000 deaths will occur. Category 5 assumes 1.8 Million deaths will occur. A Category 5 pandemic would be equivalent to the 1918 flu pandemic. More details on these plans can be found at the following links:

WHO categories for pandemic and response measures

CDC categories for pandemic and response measures

How can swine flu be treated? A vaccine will not be made in time to treat the current pandemic. However, this virus seems to be susceptible to neuramidase drug therapy (Tamiflu, Relenza). Homeland Security said that it has 50 Million doses stockpiled and is releasing a portion of that to the states now.

In summary, the current outbreak is a pandemic because of its global reach. It will certainly spread much more and affect virtually all of the United States. However, the strain of virus seems to be treatable with proper I.V. fluid support and neuramidase drug therapy. If that is the case, then higher levels of response from the CDC will likely not be enacted and borders should remain open. The situation is very dynamic