Microscopic image of H1N1 strain As the evidence mounts that the H1N1 virus is beginning to stall out at as a “near pandemic” (currently WHO Level 5), what have we learned so far? First, although intense media coverage has sparked the sales of face masks and engendered a great deal of anxiety, CDC and WHO officials and the federal government have managed the outbreak with steady hands and cool heads (VP Biden excepted), resisting calls for borders to be closed; Containment is not feasible in a world so tightly knit by trade and travel patterns. As a prime example of how interdependent we have become, the New York Times noted that the base ingredient for the antiviral drug Tamiflu, shikimic acid, is manufactured mainly in China. Sealing our borders could leave us defenseless against H1N1. Second, geneticists, who are sequencing H1N1 and posting the results on the Internet are beginning to conclude that the virus in its current form spreads barely well enough to keep itself going. The transmissibility appears to be no speedier than ordinary flu which kills 36,000 annually in the U.S.

and an estimated 250,000 – 500,000 worldwide. Third, the story is not over. H1N1 may yet adapt to people in a dangerous way which means that next winter we may be in for an unpleasant surprise. The virus, which so far has resulted mostly in mild illness, may have a much more devastating effect next flu season, which runs each year from November until March. The good news is that scientists should have ample time to create a vaccine for this new H1N1 strain before next October, as vaccines typically take 3-4 months to develop. It is likely that the WHO will recommend inoculation concurrent with the annual flu vaccination. While we watch and wait, we should recognize that the term “pandemic” only describes how widely an infectious agent is distributed, not how severely it affects the population. Unless we see a dramatic change in the next few days, it looks as though the current H1N1 virus will be manageable, at least for the next few months, as it takes up residence in the realm of human antagonists.


About The Author

Frank Gillingham, M.D. serves as Chief Medical Director for HTH Worldwide. Frank has led HTH Worldwide's international business development efforts in Europe and Canada and has been a guest speaker at international business conferences and has authored a series of articles on travel medicine, including pieces on travel information available on the Internet and the role of physicians working with travel insurers. Frank is a Board-Certified Internist and Emergency Medicine Specialist. He is also a private emergency physician in Southern California and a former emergency department director and member of the UCLA emergency department staff. Frank completed residency training at Los Angeles County/USC Medical Center, received his M.D. from Albert Einstein College of Medicine and his B.A. from the University of Pennsylvania .

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