One Fl(u) Over the Cuckoo’s Nest: Pandemic Flu After H1N1

Less than a month after the WHO declared the swine flu pandemic over, a new US study has revealed that the H1N1 strain of influenza was in fact even milder than seasonal flu strains. The study also found that like seasonal influenza, children, young adults, pregnant women and people with underlying chronic medical conditions or pre-existing immunodeficiency were at higher risk of hospital admission and serious complications when infected with H1N1.

This is but one in a series of findings in the aftermath of the swine flu pandemic that is changing public perceptions of its severity and the nature of the threat itself, and this change is particularly notable if we observe attitudes towards vaccination. Only a year ago, swine flu vaccines were in short supply worldwide. Today, there appears to be more than enough influenza vaccine to go around. In fact, Australia’s The Age reported that “swine flu doesn’t scare us” and barely 20% of Australians had taken up the offer for a free swine flu jab because it was no longer perceived as a health threat.

However, in this climate of what has been described as a “swine flu fizzle”, experts also warned against complacency and to remain vigilant of other potential pandemics that could happen without prior warning. Avian flu, more commonly known as H5N1, was identified as the next potential pandemic as it can spread quickly and easily from birds to pigs and then to humans. Although no human-to-human H5N1 transmission has been verified, rapid mutations of the influenza virus could still make it possible.  The WHO echoed this call for caution, adding that although the pandemic was over and had only killed 18,600 people worldwide – a far cry from the worst-case scenarios in which authorities said millions could die – that health authorities needed to increase the speed and volume of vaccine production in preparation for the next global outbreak.

The contrasts within the plethora of information being disseminated to the public – on one hand that swine flu is not as severe a threat as we perceived it to be at the outset, on the other hand that we should still be wary of another influenza pandemic that we cannot predict or control – creates conflicted and often confused perceptions of our security and vulnerability with regards to influenza pandemics.  The problem with this is twofold: while viewing the next flu pandemic through worst-case scenario lenses may produce unnecessary panic, not recognizing and taking steps to minimize the risks associated with a potential outbreak could compromise our ability to effectively manage and control it.

It is therefore essential to the effective response to the next pandemic – and the assurance of our health security – that our perceptions of influenza are shaped by a strong grasp of facts instead of rhetoric, a comprehensive understanding of the extent of pre-emptive action we can take, and a measured – not fearful – approach to tackling a new flu pandemic if and when it occurs.