Pandemic Risk: Swine Flu

In response to confirmed human cases of swine influenza A(H1N1) in Mexico and the United States and possible new cases in  Canada and now Spain, a second meeting of the emergency committee of the World Health Organization (WHO) has been brought forward to later today to decide whether to raise the pandemic alert level, currently at 3 on a scale of 1 to 6. Yesterday the U.S. declared a public emergency as the Centers for Disease Control and Prevention (CDC) confirmed 20 human cases of swine flu infection in five U.S. states. This followed Saturday’s announcement by WHO that the current situation constitutes a public health emergency of international concern and could become a pandemic. So far, Mexico is the only country to have reported deaths (103 at last count) from the virus. For more on this story check out today’s article by Donald McNeil Jr in the New York Times. For more information on swine flu check out this WHO FAQ. Dr. Steven Weisbart, I.I.I.’s chief economist and resident pandemic expert can be reached via email at:

One thought on “Pandemic Risk: Swine Flu”

  1. In 1918:

    In large U.S. cities, more than 10,000 deaths per week were attributed to the virus. It is estimated that as many as 50% of the population was infected, and 1% died. To compare, in “normal” (interpandemic) years, it is estimated that between 10-20% of the population is infected, with a .008% mortality.

    The fact the current ‘swine flu’ has shown to be contagious is alarming. So far the virus has shown to have a 6% to 6.3% mortality rate. It may not seem like much, but please consider the following: The deadly influenza panic in 1918 had a mortality rate of under 1%.

    This virus went on to kill tens of thousands of healthy people daily in large cities and up to 100 million people worldwide.

    Viruses like this strain of swine flu, kill their host by over-stimulating active immune systems that are robust and healthy. That is why the victims in Mexico were between the ages of 20 and 45.

    Some have said that no one in the United States has died from the virus, so we need not worry. Experts say it is only a matter of time. The virus is not prevalent enough to reach statistical significance in the United States, with only a handful of confirmed cases. 93.7% of all Mexicans with the virus recovered.

    More cause for worry: The 1918 virus started off ‘mild’ before it mutated into a raging storm. It also does not mean we will see millions of deaths. It is too early to draw sweeping conclusions. Nevertheless, there is potential for a disastrous pandemic. If 50% of Americans catch this flu in the next two years, and the mortality rate stays at 6.3%, we would witness 20+ million deaths.

    This strain of virus is more potent and more deadly than the virus that hammered the world in 1918 and 1919. Viruses come in waves. There are striking similarities to this virus and the virus that killed up to 100 million people in 1918. The first wave is historically more mild than the later waves.

    In addition to this virus becoming more severe, it is mutating faster than previous viruses that we have seen. In addition, this virus is nothing like we have ever seen before because it combines features from viruses natural in different parts of the globe. We are in uncharted territory.

    If it follows the same path as the 1918 flu, we will see very damaging results. However, we must remember we are a global society now and the virus can spread quicker than we have ever witnessed in history. This is very concerning especially since the drugs we have now seem resistant.

    While there have been no deaths in America, it is shadowed by the fact the common variable among the deaths seem to be age. While most American cases have involved the very young and very old (under 10 and over 50) the Mexican cases that ended fatally involved the robust and healthy (over 20 and under 45).

    This virus kills the host by over-stimulating the immune system. The term that is used when the immune system over reacts is called a Cytokine Storm. It is usually fatal. During this “Storm” over 150 inflammatory mediators are released. This would account for the high mortality rate in 1918-19.

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