Global flu outbreak is possible - experts

Source - Sapa - October 08 2009

Johannesburg - The world is about 10 years overdue for a major global flu pandemic and the swine flu outbreak may well be the first wave, an expert said on Wednesday.

Lynne Webber of the National Health Laboratory Service in Pretoria urged people to remain cautious and report illnesses to their doctors, although swine flu cases were declining.

Webber referred back to the history of the previous worldwide outbreak of the H1N1 virus in 1918, sketching a bleak picture of how the virus took the world by storm, killing millions of people just after World War 1.

Then, the pandemic had three phases, of which the first was just a mild respiratory infection, while the second and third phases killed millions of people around the globe.

"It is looking all right at the moment (in South Africa). Cases reported are on the decline as we are heading into the summer season, but we have to be alert of what flu can do," said Webber, who also heads the virology department of the University of Pretoria.

"Doctors and patients still need to be alert as there are still many people are still travelling around the world."

She said according to epidemiologists the world was 10 years overdue for a major flu pandemic, which normally hit every 25 years.

"We may be in the first wave of the pandemic, with other waves still to come, or it may be that the virus changes by next year," she said.

South Africa was definitely part of the worldwide H1N1 pandemic, with just under 200 deaths reported.

"This is an unremarkable figure as it is not more than recorded in other flu seasons, but the H1N1 virus is highly contagious."

She said people were scared of it, because of the major impact it had on the world in the 1918 outbreak.

Webber said there was a global shortage of the drug, Tamiflu, which is used to treat cases of swine flu, and that the virus was already showing signs of drug resistance.

"We don't have enough supplies and medical doctors have to select the right patients to be treated with the drug," she said.

There were strict criteria set out for a doctors to use the drug on patients.

"For patients who are not too ill, the best treatment is to go home and get some bed rest," she said.

The best way to prevent becoming infected was to simply wash your hands.

"It sounds like old fashioned 'ou tannie' advice, but it works," she said.

Webber said there was currently a vaccine for swine flu in production in Australia, and that it would probably be ready in April or March next year, but as a developing country, South Africa would probably stand in the back of the line to get it.

"There is also the possibility that the virus might mutate before the vaccine is ready and that it will be ineffective anyway."

She said those most likely to be affected by the virus were older people, young children, pregnant women and people who had other medical conditions.

"I am particularly concerned about smokers as their lungs are already damaged by the smoking and the virus affects the lungs.

"Young, fit people have also died from the illness," she said.

"Exercise is deadly when you have influenza."

Webber said South Africa was "incredibly" well prepared to handle any further swine flu outbreaks and that steps had been taken to prevent any eventuality during the Fifa 2010 World Cup.

"The National Institute of Communicable Diseases is watching out for it and doctors are educated and aware to send patients who are very ill with influenza to hospital," she said.