Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

The weekend news has been full of alarming statistics about a new Swine flu, Influenza A H1N1, that has affected almost 1500 people in 3 states in Mexico and is now in the United States and perhaps other countries as well.  This influenza outbreak has its own fingerprints.  It is spread from pigs to pigs and then from pigs to humans. Now it has developed human to human transmission.

It is also unusual in that it has appeared in warm weather, since most influenza viruses do their dirty work in the fall and winter seasons.  The illnesses reported over what has been estimated to be a month’s time in Mexico have been more severe than those we have seen in the United States with a death toll of almost one hundred.  The early news is that this influenza virus may be sensitive to Tamiflu and Relenza if these drugs are taken within 48 hours of infection.

The women who gave us updates about this emerging infection over this weekend have taken a very measured approach.  Their information about systems and people in place to monitor this Influenza outbreak in Mexico and throughout the United States was very reassuring.

  • Dr. Margaret Chan, director-general of the WHO organized an emergency meeting yesterday to review all the available information and create a plan for observation and evaluation of this developing Influenza outbreak.  She was straightforward with the remark that with the outbreak, “has pandemic potential” simply “because it appears to be transmitted from human to human.”  But she was clear that it was far too early to even discuss whether a pandemic would occur.
  • At the Centers for Disease Control, it was  Rear Admiral Anne Schuchat alerting the nation that the strain in the U.S. appears milder than the one in Mexico; that the spread is nonetheless rapid; that the world’s current vaccine stockpiles appear adequate for now, but that it’s past time for more and better vaccine stocks to be developed.

  • And this afternoon, Director of Homeland Security Janet Napolitano declared a public health emergency in order to be out in front of this public health problem. Such a declaration, early in a crisis, frees up resources that can help.   It is the same kind of preparation this administration wants to demonstrate for all potential disasters such as hurricanes.  Federal officials have stressed that they are taking a very aggressive approach to preparation:  12 and half million doses of Tamiflu have been made available to the states (http://abcnews.go.com/Health/ColdandFluNews/Story?id=7434061&page=2).  Napolitano also reassured the public that even if this is the small outbreak we anticipate we can’t be certain that we won’t have more outbreaks of this virus in the future and we must be prepared.
http://www.youtube.com/watch?v=CPpTsi4zkC8

All agreed: there’s no cause for panic. However, it is prudent to take measures that will decrease exposure to potentially infected people. Public health officials have urged a return to the basics:

  • Anyone with the symptoms of the flu, fever, cough, muscle aches, stay at home until 48 hours after the symptoms have abated after evaluation by medical personnel.
  • This is another opportunity to discuss the need to avoid coughing and sneezing without covering the mouth and nose.
  • And that old standby, proper hand washing technique:  Not only should everyone wash their hands frequently, but the hand washing after exposure to surfaces used by many other people should be especially meticulous.  Use soap and water and pay attention to nails, then wash the hands for the entire time it takes one to sing “Happy Birthday.”  A brief rinse of the hands really does no good.

Finally, stay away from crowded places unless you have no choice.

Most pressing, we need to use this event as an opportunity to push for the research and development of both new influenza vaccines and ways of producing millions of these vaccines quickly when that pandemic does come.  We have almost no support for vaccine R&D and the antiquated methods for vaccine production are shameful.  There is a reason for this.

Future epidemics will occur.  It is just a matter of time.  And despite our internet connectivity around the world — statisticians, epidemiologists, dedicated public health officials — we are still missing critical pieces of prevention and treatment.  Key among those pieces are better vaccines. The research and development of enhanced vaccine production methods do cost money:  Maybe this can become a priority, just like saving bloated banks.

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