Q: Is the A (H1N1) flu really that dreadful? Are we not too overly concerned with it? The disease is in the news everyday and opening of classes in the college level have been postponed. Is all this fuss warranted?

--Myrna S., San Pedro, Laguna

A: In retrospect, it certainly looks like the world’s governments, including ours, have overreacted during the initial stages of the A (H1N1) flu pandemic—but this is understandable. When the A (H1N1) virus first surfaced in Mexico in early April, it had all the attributes of a microorganism that can cause a catastrophic pandemic that can rival in destructiveness many of the influenza pandemics of the last century, including the Spanish flu of 1918 that killed millions (estimates range from 40-200 million) of people worldwide.

Like the Spanish flu, which was caused by a flu virus that originated from animals (i.e., birds), this current A (H1N1) flu is caused by a novel influenza A (H1N1) virus that has jumped from animals (pigs) to humans. Likewise, it has acquired the capability for sustained human to human transmission. In addition, since it is a novel virus, there is no vaccine against it and most people will probably have little or no immunity to it. But the behavior of the virus in the last few weeks indicates that it is not as dreadful as initially thought.

It is becoming evident that the A (H1N1) virus is not as highly communicable as initially feared. Although the virus has managed to spread across many countries (73, as of June 8), it has infected only 25,288 people. In the Philippines, the first case of A (H1N1) flu was reported on May 22, and as of June 8, there have only been 46 reported cases. Although one can argue that the virus was contained as a result of drastic measures governments have implemented, a really highly communicable virus, according to many experts, cannot really be contained and its spread is explosive.

It is also becoming apparent that the A (H1N1) virus is benign, or at least not very virulent. Most people who have become ill with the virus simply experienced typical flu symptoms and recovered without requiring medical treatment. Outside of Mexico, very few deaths have been attributed to the virus. The fatality rate from the A (H1N1) flu, even when the cases in Mexico are included, is a mere 0.5%, only about half of that of dengue.

In short, getting infected with the A (H1N1) is no more dreadful than getting infected with the other seasonal flu viruses that are ever present worldwide. The danger that this current A (H1N1) flu will spread more widely throughout the world still exist, but it is becoming clear that it will be no more fatal than the existing human flu viruses.

Acknowledging the benign nature of the A (H1N1) virus, our Department of Health (DOH), through Secretary Francisco Duque III, has announced last June 8 that it is shifting its control strategy for the virus from containment to mitigation. This means the government will veer away from contact tracing and instead focus on controlling the disease, i.e., early detection and aggressive treatment of cases. The DOH also said that those manifesting with mild symptoms including students and office workers, can be managed and monitored at home and only patients who develop complications need to be hospitalized. School authorities are however enjoined to notify the DOH if there is an unusually high number of influenza-like illnesses in their schools so that it can investigate. Offices are likewise advised to immediately inform DOH regarding these cases.

The DOH secretary also said that there is no need to wear masks, quarantine entire rooms or floors and suspend business activities on account of the A (H1N1) virus.

(E-mail inquiries on health matters to: medical_notes@yahoo.com or at wellbeing@mb.com.ph.)