After several years of educating myself so that I could answer anxious
questions from my patients about nerve gas, anthrax, swine flu, mad cow
disease, West Nile virus, SARS, and now bird flu, I find myself thinking
wistfully back to 1963 when, as a 10-year-old, all I had to worry about was
total nuclear annihilation.
Pandemic bird ("avian") flu is the latest in a series of health
problems that have kept us in a heightened state of alert lately. This cannot
be good for anybody's sanity. We are wired evolutionarily for brief surges of
adrenaline, "fight or flight" responses that briefly put us in
overdrive. But what engine can remain in overdrive for years at a time without
becoming seriously fried?
Why do half of Americans fear the H1N1 swine flu vaccine more
than pandemic flu itself?
It's a problem that bedevils the huge effort now underway to offer the
vaccine to all Americans who want it.
"People have concerns about vaccination ... despite the clear message from
all of us in public health and doctors throughout the health care field that
vaccine is our best tool to protect against the flu," CDC director Thomas
Frieden, MD, said at a news conference aimed at convincing U.S. residents...
I try to provide logical advice about fears that might just prove real. At
the same time, I like to point out that bird flu at present is mainly a problem
for birds. It is a contagious disease caused by influenza A viruses --- so far
passed easily among birds, but not humans. To date, health experts know of
fewer than 200 cases of human infection worldwide, and these are almost
entirely in patients who had close contact with sick birds. The few cases of
human-to-human transmission have required very close contact with an ill
The truth is, health experts don't know what will happen if bird flu is able
to spread easily from human to human. Previous flu pandemics (1918, 1957, 1968,
and 1977) may be of little value in predicting a pandemic today. On the one
hand, airplanes will help spread the virus more quickly than in the past. But
on the other, we have far more sophisticated tools for early detection and
treatment than we've ever had before.
Meanwhile, what can you do for yourself and your family?
Skip antivirals. Resist the temptation to stockpile
antivirals such as Tamiflu. Shortages created by hoarding would hamper the
ability to treat patients with regular flu, which affects millions of people
and kills about 36,000 annually in the United States. In addition, bird flu
virus will likely become resistant to antivirals if people overuse them.