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Will swine flu turn pandemic?

On Monday night, the world appeared to move closer to a flu pandemic with the World Health Organisation (WHO) raising its alert level one notch higher. In recent years, public health experts have worried over the possibility of a deadly bird flu known as H5N1 acquiring the ability to pass easily from one human being to another. But now the threat of a pandemic is coming from an entirely different flu virus, tagged as H1N1, which originated in pigs. (The ‘H’ and the ‘N’ in the names of the viruses indicate the types of two proteins they possess.) The epicentre of the swine flu outbreak is quite clearly Mexico where more than 1,600 people are believed to have caught the disease and already over 150 of them have reportedly died of it. Although neighbouring United States as well as Canada, Europe, Israel, and New Zealand also have people infected with the new strain of flu, outside Mexico the disease has generally been mild and no one so far has succumbed to it. The rapidity with which the virus has claimed new victims and its geographical spread led the WHO to raise its flu pandemic alert level to Phase 4, just two steps short of a full-blown pandemic. “The change to a higher phase of pandemic alert indicates that the likelihood of a pandemic has increased, but not that a pandemic is inevitable,” said the international health body in a statement, adding: “As further information becomes available, WHO may decide to either revert to Phase 3 or raise the level of alert to another phase.”

There are many important unknowns about the swine flu outbreak, which health professionals and scientists are working frantically to clarify. A key unknown is the transmissibility of the virus. If one person gets infected, how many people on average would that person infect in turn? The transmissibility of the virus will determine what measures are needed to curtail its spread. Another puzzle is why the severity of the disease has been so much greater in Mexico than elsewhere. Despite such uncertainties, waiting it out is not an option available to any government at this juncture. Fortunately, concerns over the H5N1 bird flu have improved pandemic preparedness across the world. It is time now to put those plans into action. In India, as elsewhere, the government must be ready to act swiftly and sensibly should cases of the disease begin to surface at home. What would be the best ways to limit the spread of the disease within the country and in communities? Is the country’s stockpile of anti-flu drugs sufficient and how will those drugs be deployed? Are the country’s hospitals and the medical community ready to meet the challenge? While there is no need to panic, the government must not be caught off guard.

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