Story Summary: If these resources are not already overwhelmed, one wonders how they will cope if there is a further rise in swine influenza A cases combined with the work generated by Australias normal influenza season, he writes. This compares to annual figures of about 18 000 hospitalisations and 3000 deaths directly or indirectly attributable to seasonal influenza. Meanwhile, Professor Peter Collignon, an infectious diseases physician and microbiologist at the Australian National University, has filed the following analysis for Croakey: This current Swine flu virus spreads easily but it only has relatively low virulence (aggressiveness) levels. It causes less serious disease than what we see predicably every year from the spread around the world of new seasonal flu strains. This is effectively, the approach that Canada and most parts of the US have taken. More than 99% of people who become infected with this virus have had only mild symptoms and fully recover within a few days. We have been spending too much time monitoring, testing and treating these people. The problem at the moment is that those who are most at risk will have difficulty being seen by healthcare professionals, because too many of the 99% (because of fear, public health directions and other reasons), are in the queue in front of them at doctors surgeries and emergency departments. On current data it looks likely that there is less than 1 death for every 10,000 people infected and these deaths are occurring mainly in those with risk factors (diabetes etc). Some have argued that we need to keep a more aggressive response, re quarantine of those not ill, school closures etc, because second and third waves of infection will occur and then there is a high chance that the virus will have mutated to become more virulent – as they say happened in 1918/19. In general the effect with most viruses is that they usually become less aggressive with time – not more. )Antibiotic resistance in bacteria is a continuing and rapidly growing global problem, especially in developing countries. In Australia, we remain much more fortunate with much lower antibiotic resistance rates. Thus we would not expect to have very high mortality rates associated with this virus in this country, providing we can readily identify and promptly treat those with complications. With a virus of such low comparative virulence it is very doubtful however that closing schools and keeping people away from school and workplaces in home quarantine when they are asymptomatic, is an appropriate response. There was however a relatively rare side-effect from the vaccine that lead to an excess (in about 1 per 100,000 vaccine recipients) of Gilluiane-Barre Syndrome – a form of ascending neurological paralysis. The implementation of stricter controls via the different phases of a Pandemic plan, should only be adopted when a new influenza strain looks likely to arrive in Australia that is both hyper-virulent AND spreads easily. The very early approach of most of the US and Canada, to treat this as seasonal influenza, seems a more appropriate current response than our prolonged and ultimately futile attempts at containment in many Australian States. The Croakey blog is a forum for debate and discussion about health issues and policy. Publishers: Eric Beecher, Diana Gribble. Level 7, 22 William St, Melbourne, 3000….Read the Full Story

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