Kerimal Suriel, 11, receives the first part of the H1N1 flu vaccine, a nasal spray, in Boston on Wednesday. In Ontario, the vaccine will be available in November as an injection. Nasal flu spray is not available in Canada.
Swine flu squeezing out the seasonal bug
October 09, 2009
Special to the Star
I had swine flu, er, H1N1, uh, novel influenzaA/H1N1, um, pandemic flu, er, 2009 H1N1, a couple of weeks ago.
At least, I'm pretty sure I had it.
Along with not knowing for sure what to call it, nobody knows anything for sure about this flu.
My family doctor didn't know for sure if I had it. That's because I didn't go to see her.
Like a good citizen, I stayed home instead of infecting unsuspecting seatmates on the streetcar and subway. Less altruistically, I couldn't get out of bed. I didn't have the energy or the willpower.
What I did have were recurring chills, racking cough, nasal congestion, sneezing and a fever.
Even if I had gone to the doctor, I still wouldn't have known for sure if I had H1N1 pandemic flu.
"The instructions now (via the Ontario Medical Association) are not even to test with a nasopharyngeal swab unless someone is really unwell," explains my family physician, Dr. Shawna Perlin.
In July, the World Health Organization advised countries to stop testing suspected pandemic flu cases to confirm the diagnosis.
Health officials are no longer bothering to test for 2009 H1N1 because the virus has become so widespread and dominant, explained Dr. Anthony Fauci, head of infectious diseases at the U.S. National Institutes of Health. It could even be squeezing out this winter's seasonal flu just like it did in South America during their winter.
For the week ending Sept. 26, when I had the flu, more than 99 per cent of influenza A specimens were pandemic (H1N1) 2009, according to the Public Health Agency of Canada.
That's true for the U.S. as well, reports the Centers for Disease Control and Prevention in Atlanta.
However, it's estimated that in the U.S., about 5 to 10 per cent of the population has had the virus and that, by the end of the pandemic in two to three years, approximately 30 to 50 per cent of the population will have had it.
Although we're not getting there as fast, those figures will likely apply to Canada, too, says Dr. Donald Low, chief of microbiology at the University Health Network and Mount Sinai Hospital.
So far in Canada, there have been 78 deaths from H1N1; 24 in Ontario. Approximately 700 to 2,500 deaths are typically attributed to seasonal flu in Canada annually.
"You have a large percentage of population susceptible to this new virus and it's widespread," he says.
That much we know for sure, and also that, so far, most cases are mild. What to call this new virus, first identified about five months ago in a village in Mexico, is much less certain.
Peter Sandman, a risk communication consultant based in New Jersey, suggests that "swine flu" is accurate. "It is indeed a swine flu virus, according U.S., and Canadian flu experts who identified it," he says. "And in May, human-to-pig – and possibly pig-to-pig – transmission was documented in Canada. It is a swine flu virus that has become adapted to humans and is spreading between humans."
But in deference to the pork industry, the World Health Organization now refers to the virus as "influenza A (H1N1)."
Taking into account earlier strains of H1N1 circulating a few years ago and still viable (seasonal flu shots include an antigen for a previous strain of H1N1), U.S. officials opted for "2009 H1N1 flu" while some scientists talked about "novel H1N1."
But that previous strain wasn't a pandemic. Sandman favours calling the 2009 strain "the pandemic flu" because "it's descriptive and tells people what it is, while H1N1, besides being easily confused with other strains of that name, means nothing to most people."
So the latest complete nomenclature, accurate but a mouthful, is "pandemic H1N1 2009 flu" – not necessarily in that order.