Chance of second wave of swine flu this winter

Updated April 8, 2010 07:06:01
Until this time last year few of us had ever heard of the H-1-N-1 flu virus or swine flu. However, in late April 2009, the World Health Organization declared a "public health emergency of international concern" and it all spiralled from there. Since then there have been hundreds of thousands of confirmed cases in 213 countries and territorities and over 17-thousand deaths. For the first installment of Pacific Beat's weekly health and education segment, Geraldine Coutts asks: was the reaction generated by last year's outbreak justified?

Presenter: Geraldine Coutts
Speaker: Dr Jacob Kool, Medical Officer, Communicable Disease Surveillance Response , World Health Organisation, Fiji.


KOOL: It was truly a pandemic. It went through basically all the countries of the world except for a very few exceptions. But it's a good question, it wasn't that devastating, it turned out to be quite a mild illness. The severity of this pandemic influenza is about the same as what you see with seasonal influenza, except that it affects younger age groups.

COUTTS: And do we know why it was affecting younger age groups, because that got a lot of news coverage while the swine flu was at its peak?

KOOL: Yeah I think that's usually a typical thing of pandemics because it's such a new virus people don't have any antibodies, not any resistance against it. Normally you grow up and you get infected by seasonal influenza every few years, so you have some antibodies and the seasonal flu strains are always more or less the same. So when you grow up you develop resistance and so when you get to younger middle age you don't get ill anymore. So if you have a pandemic of a totally new strain then it affects all those age groups just as much.

COUTTS: Dr Kool, our area of interest of course is the Pacific. How badly affected was the Pacific by swine flu?

KOOL: Yeah it went through the Pacific just like through the rest of the world. A lot of people were infected. We don't know exactly how many. The officially reported number of laboratory confirmed cases stands at just below 2,000 cases for the Pacific but it's clear that there must be several hundred-thousand infected at least. I think like here in Fiji like in the other countries, almost everybody either knows someone who had it or had it themselves.

COUTTS: Now Dr Kool is the reason because the Pacific is experiencing a population explosion and therefore a lot of its population is young, as you've just described it affected the young, is that why the figures were so high in the Pacific?

KOOL: Yeah the Pacific has a lot of high risk people as well and the Pacific of course is more isolated, so people here may not have been as exposed to other viruses like the rest of the world. But we have the most high risk groups for developing severe disease, because even though I said it is a relatively mild disease, if you have a risk factor like heart disease or pregnancy then you are quite at risk of severe disease or even death. And we know that in the Pacific well we have a reported number of death of 21, but it's likely higher than that. And yeah the rates of pregnancy are quite high in the Pacific, the rates of heart disease, diabetes, asthma, overweight, those things are all some of the highest in the world so we have the highest risk groups and risk factors. And these people should actually still be worried about it. If they're not sure that they have had it, they should definitely be vaccinated against the disease.

COUTTS: Well I was going to ask you about that too because we've got winter coming up again, so we're not actually done with swine flu? There's a second round of it that we might see this winter?

KOOL: Yeah most pandemics, like we saw in 1918 and there were three pandemics last century - 1918 and 1957 and 1968 - and all of them you saw notable wave, and sometimes the second and third waves were more severe. For example the Spanish Flu in 1918, the first wave was relatively mild and all those deaths that you always hear about occurred in the second and third waves. So nobody knows for sure if they'll be a second wave. It really depends on how many people in the population are already infected. Usually a second wave will happen during the winter time, in temperate regions. Here in the tropics we basically follow either the northern hemisphere or the southern hemisphere flu season. And the one in the southern hemisphere in Australia and New Zealand is just round the corner, it usually starts around May and the peak is usually in August. So travellers will then bring it to the Pacific if they have a second peak.