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DR. MARC SIEGEL: The Most Powerful Virus Is Fear Not Flu

AlaskaDenise

In Memoriam
With a new swine flu strain spreading among close to 1,000 people in Mexico and at least eight in the U.S., and with 61 reported deaths in Mexico, the most powerful virus pushing out its tentacles is not flu but fear. We are afraid of what we don?t know and what we don?t understand.

We hear about an unseen killer and we worry that we will be next. The best antidote for this kind of fear is the facts.

So let me take on the fear-laden terms. The first is pandemic. A pandemic means a new flu virus infecting people in several areas of the world at the same time. It can be mild, moderate, or severe. Everyone knows about the 1918 Blue Death that killed over 50 million people worldwide, but how many people realize that the last pandemic, in 1968, ameliorated by vaccines, antibiotics, and public health measures, killed only 32,000 in the U.S. and 700,000 worldwide, less than many yearly outbreaks.

The current swine flu outbreak is not a pandemic, as the outbreak is confined mainly to Mexico, but if it does become one, it is far more likely to be the 1968 variety because of modern public health measures and because we have been exposed to several parts of this virus before and have an immune memory to it.

Precautions like isolating sick people and use of the anti-virals Tamiflu and Relenza in order to decrease severity are wise precautions.

Wise too is closing schools in Mexico to prevent spread (schoolchildren are notorious flu spreaders), provided that this measure doesn?t send the world the wrong message that a massive pandemic is in the offing.

The second scare term is the pig itself. Pigs scare us. They are filthy noisy creatures. They are also loaded with flu viruses. This strain occurred because a bird virus mixed with at least one human virus and two pig viruses. Flus are changing all the time so a new strain
isn?t really a surprise.

We also need to be cautioned by the lessons of history. Back in 1976 an emerging swine flu virus appeared to be responsible for the death of a military recruit at Fort Dix (this later turned out to be erroneous), sparking a massive public hysteria fueled by Center for Disease Control press conferences.

I was reminded of this Friday when the CDC again spread fear about an emerging swine flu. We need to remember that fear causes people to take less precautions, but fighting contagions requires more precautions.

In 1976 Gerald Ford, trying for election, ordered 40 million vaccinations over a three to four month period of time, probably leading to almost 1,000 cases of ascending paralysis from the hastily made vaccine (Guillain Barre Syndrome) and driving most of the vaccine makers out of business. We certainly don?t need a repeat of this performance, in advance of any real worldwide threat.

Thirdly, we are also afraid because this disease is emerging in Mexico, a foreign land to the south over which we have no control. But fear of an unknown land doesn?t automatically translate to an American health risk. We are wise to have our scientists and public health officials tracking the outbreak, but we are not wise to anticipate the worst.

Like all flus, this one causes great fatigue, muscle aches, fevers, sore throat, nasal congestion, stomach upset, but is generally curable. The greatest risk is from secondary infections like pneumonia or ear infections, especially in the chronically ill. But in the U.S., if it spreads here, these problems are much more easily treated than in rural Mexico.

We should be comforted by the time of the year. This is the end of the flu season, not the beginning. Flu viruses thrive in the low humidity of winter, not summer. It is very likely that this outbreak will die out automatically as the summer comes. It will remain necessary to track it because it could reappear in the fall, but it is very unlikely that it will erupt into a pandemic this summer.

I am glad that this outbreak is a swine rather than a bird flu, not because pig viruses are intrinsically safer than bird viruses, but because the greater lesson to guide us here comes from the 1976 pig hysteria, rather than from the 1918 bird flu plague.

Marc Siegel MD, an associate professor of medicine at NYU Langone Medical Center, is a FOX News Medical Contributor. He is the author of ?Bird Flu; Everything You Need to Know About the Next Pandemic?, and ?False Alarm; the Truth About the Epidemic of Fear.?

http://foxforum.blogs.foxnews.com/2009/04/25/dr-marc-siegel-the-most-powerful-virus-is-fear-not-flu/
 
Re: DR. MARC SIEGEL: The Most Powerful Virus Is Fear Not Flu

We need to remember that fear causes people to take less precautions, but fighting contagions requires more precautions.


Fear is the only reason people take precautions.

Fear is the little voice that tells us to move back from the edge, to slow down, to move out of the way of the speeding bus, to stop before we speak that last word that will take the argument uneccessarily beyond words.

Fear is the part of our brain that informs us of the presence of danger. It reminds us of pain from the past to help us avoid pain and injury in the future.

Fear is a reasoned response to the presence of danger.

Lack of fear in the vicinity of danger is not reason but stupidity.

What Dr. Siegel may be thinking of is "panic".

Those of us alive today are here because fear informed our ancestors of danger, prompted them to respond and allowed them to survive.

Our western society has become for many of us so lacking in fear in our everyday life that we willingly pay money to bring it into our lives - for our entertainment.

We have lived without fear for so long (except in our movies or our vacation adventures) that we believe it should be banished or we believe it is only a tool of those that seek to manipulate us.

Panic is a curse, but thankfully it is both rare and mostly fleeting. The panic over panic is overblown and should drive neither risk communication nor policy.

Fear is a gift. It tells us to take precautions. Fear tells us to learn about the danger that gives it life and tells us to learn how to avoid that danger.

To say that fear causes people to take less precautions is like saying pain causes people to take less precautions.

We need to learn, we need to prepare, we need to be ready and willing to respond to things of which we are afraid - including potential pandemics.

Without a reasonable, rational and proportionate fear of a potential pandemic - heartbreakingly few will be motivated to become either informed or prepared until it is too late for them to accomplish either.
 
Re: DR. MARC SIEGEL: The Most Powerful Virus Is Fear Not Flu

H1N1 has returned again. The most powerful virus is the ignorance in preparation and response, or the apathy of others to fail to stress it.

Dr Siegel said,

I am glad that this outbreak is a swine rather than a bird flu...
An H1N1 is an H1N1 is an H1N1... History Matters (to some). H1N1 has always been considered as the next potential pandemic through its abilities to change.

"When he compared the 1918 virus with today's human flu viruses, Dr. [Jeffery] Taubenberger noticed that it had alterations in just 25 to 30 of the virus's 4,400 amino acids. Those few changes turned a bird virus into killer that could spread from person to person."<sup id="cite_ref-1" class="reference"></sup>- Link

Add in swine or other mixing vessels, you have the making of a re-emergence of a virulent influenza. H1N1 and H5N1 have both been actively followed due to their virulence.

I wouldn't be so quick to place judgment unless you live in the industrialized world where previous vaccinations are the norm and not the exception and may (or may not) provide some protection.

The initial 1917-1918 flu season was initially mild in most areas, followed by the rapid emergence of a killer flu that was likely originally of avian origin, combined with human characteristics, and probably mixed in a swine vessel before going h2h. The resulting flu was an H1N1 strain that killed 40-100 million people.

Yes, there were probably problems in the vaccine of 1976 that was hastily produced and that may have caused reactions, but the preparedness and response messages that happened in 1976 more than likely stopped a potential pandemic in its tracks worldwide. While the 1976 H1N1 was called the "Swine Flu Scare", the preparedness and reactions saved lives.

Everyone really knows there is no such thing as an avian, swine, equine, canine, or human virus anymore.... a virus mutates (recombines, shifts, or drifts) constantly to achieve characteristics suitable for its survival in whatever host it chooses.

The current "swine" flu virus is actually a virus with human, swine, and avian sub-strata and components. That should raise a red flag.

Most folks who have been following and researching flu epidemics understand that almost all the pandemics of the 20th century occurred after the use of "swine" as the mixing vessel.

Ref CDC Topic: http://www.cdc.gov/Ncidod/EID/vol12no01/05-1254.htm
[FONT=Arial, Helvetica, sans-serif]1976: Abortive, Potentially Pandemic, Swine Influenza Virus Epidemic, Fort Dix, New Jersey (H1N1)[/FONT]
[FONT=Arial, Helvetica, sans-serif]1977: Russian Flu, a Juvenile, Age-restricted Pandemic, and the Return of Human H1N1 Virus[/FONT]
 
Re: DR. MARC SIEGEL: The Most Powerful Virus Is Fear Not Flu

While the 1976 H1N1 was called the "Swine Flu Scare", the preparedness and reactions saved lives.

perhaps the 1976 H1SwN1 tiny-epidemic should be called the "Swine Flu close call".

We could be glad that this current swine flu isn't like the H5N1 BF, with it's high-path mutations.

.
 
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