What you need to know about swine flu

The news that a Marin woman and her grandaughter contracted swine flu on a recent trip to Mexico clearly indicates that we need to be careful, but my experience as a health care journalist and working in health care settings for more than 20 years tells me that there is a big difference between caution and alarm. In this case, prudence and caution make sense. First, some facts:

• Swine flu, like other flu bugs, is a virus that is transmitted by tiny droplets usually found in mucus. Most flu is transmitted from one human to another, although infections like this are thought to originate in animals with human contact.
• There is no evidence of risk of catching swine flu from eating pork or other animal products.
• Most of the cases of swine flu that have been reported so far in the United States have been relatively mild and with typical flu symptoms (fever, muscle aches, nausea.)

  We do not yet know enough about why so many fatalities in Mexico have occurred, but the flu is one of the biggest killers worldwide every year, so some deaths are to be expected.

• Everyday precautions -- like thoroughly washing hands -- will do more to protect each of us from any kind of flu than most of the other steps being touted by supposed media experts or concerned neighbors.

Perhaps the best news is that the sequence of events underway, so far, maps almost exactly to what was predicted in advance. In other words, most of the planning by government and health agencies worldwide looks to be on-target.

The World Health Organization currently calls the swine flu a "pandemic risk," not a "pandemic." This is an important distinction. Right now, there is no evidence that the flu is spreading rapidly beyond the initial outbreak communities. If that were to change, the level of precautions would, too.

For example, if there is evidence that these two people in Marin have in turn infected others, and then we have evidence that those individuals passed the infection along again, health officials would likely order a cancellation of large group events and potentially ask employers to allow workers to stay home. This "isolation in place" technique is critical for anyone who has flu symptoms, but if the outbreak spreads, it also keeps healthy people from contracting the disease.

Meantime, this is a good opportunity to make sure you or your families have appropriate emergency supplies on hand. This means nonperishable foods, a good supply of water, extra supplies of any necessary prescription medicines, and things to help pass the time like a deck of cards. And since we are in earthquake country, don't forget things like a flashlight and a wrench to turn gas valves off.

What you do not need: I've heard people rushing to buy surgical masks or "N95" protective masks. If you get the flu and must go out in public, wearing a surgical mask will help protect others around you, but you are better off staying home. The N95 masks are really only suitable for health care workers who are taking care of sick people. These masks are not very comfortable, are often worn incorrectly, and are not very useful for widespread use except in the most extreme circumstances. (For more information on protective measures, visit the CDC web site.)

And while disinfectants may be a good idea, plain old soap and hot water works just fine. Antibacterial gels may be convenient to keep in the pocket when a sink and soap aren't handy, but it's the alcohol in them that protects you -- not the antibacterial characteristics. (There's actually some evidence that widespread use of antibacterial gels and soaps promotes resistant bacteria, too.)

For Marin County's recommendations, visit the county Health Department web site and download its flyer on family precautions. The county has also created an RSS feed for swine flu news.

The San Francisco Department of Public Health also has compiled many excellent resources and links on its swine flu web site.