Spreading facts, common sense instead of germs

The government public health experts have a lot of different flyers and other useful guides that help explain what really prevents the spread of swine flu or other infections, and hopefully debunks some of the alarmist or fake advice popping up seemingly everywhere.

Here are a few flyers that I think convey clear messages:

• Swine (H1N1) influenza and you - CDC
• San Francisco Dept. of Public Health - Is it a cold or the swine flu?
• Stopping the Spread of Flu Germs at Work - CDC

The federal government also has developed an outstanding central site for all of its swine/H1N1 flu information - pandemicflu.gov. Everything from clinical recommendations to video chats can be found there. Many local health departments have created flyers with specific information about local resources, such as procedures for getting tested for possible flu. Unfortunately, good information has been hard to find in the major media. Even publications or broadcasts that have had accurate and helpful content have been illustrating their coverage with alarming -- and in many cases, misleading -- images, such as reporters or others wearing surgical masks, which is at best a dubious measure of protection.

Swine flu in Marin: The facts and the questions

Although the Marin County Health Department reported two swine flu cases Tuesday, there are no reports of anyone contracting swine flu in Marin. In other words, the only people who have gotten sick are people who recently traveled to Mexico. So far, of the 64 cases confirmed by the U.S. Centers for Disease Control and Prevention as of midday Tuesday, only one -- in Kansas -- appeared to be person-to-person transmission at home.

The Marin woman, 60, and a 20-month old grandaughter, both of whom recently returned from Mexico, had confirmed cases of swine flu. The child is no longer sick, and the woman has only mild symptoms. Nobody else in the family appears to have gotten the illness, according to health authorities.

The rapid spread of the disease in Mexico, and its growing death toll, poses a number of questions for epidemiologists. So does the relative mildness of the illnesses within the United States. One possible explanation is that the swine flu virus may be losing potency as it is transmitted from one person to the next. Over the next few days and weeks, we will learn much more as physicians report more cases and their sources can be traced.

Because the virus is so easily transmitted, the CDC has recommended steps such as school closures at the first indication that a student has become infected. Keeping an infected individual away from other people is the single most important thing that can be done to reduce risk of spreading disease. Until we know how infectious the strain of swine flu in Marin actually is, people should do what ought to be done all the time: wash hands frequently, cover your mouth with a tissue when you cough, and stay home if you have any signs of illness.

Richard Besser, MD, acting director of the CDC, was quite definitive Tuesday when asked what people should do:

Hand washing. We say it every day. People will get tired of hearing it because we are always going to say that. Hand washing, use of alcohol hand gels can reduce the spread of viruses. And if people take that step, that can reduce the risk that they're going to get an infection. Covering your cough. Not with your hand, but with your arm or your shoulder. That can reduce the likelihood that you are going to transmit a virus.

My earlier post has good sources of updated information. Please email or add comments with questions that you want me to pursue. Let's all stay healthy.

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.

Why widespread fear of swine flu is unwarranted

Widespread concern may be appropriate, but widespread fear is unwarranted -- so far. Reporter Helen Branswell of the Canadian Press has done an article that cogently explains why the World Health Organization has designated the current swine flu outbreak as Phase 4, not the pandemic level, Phase 5. Experience suggests that many flu strains fail to infect more than two or three generations of individuals. In other words, a virus can move from an animal to a first human, from the first human to a second human, and maybe from the second human to a third human. Beyond that is much less likely. If it did occur, then a pandemic -- an infection established in a community and spreading -- would be the likely consequence. CTV.ca | WHO looking for signs of ongoing swine flu spread