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Thursday, August 13, 2009

Swine Flu, Diabetes and Good Sense

I have become increasingly concerned about the implications of the H1N1, or Swine Flu, epidemic for people with conditions such as diabetes which weaken their immune systems.

I was initially quite dismissive of the danger. I also have hypogammaglobulinemia. I travelled around the world during the SARS scare and wandered places like Cambodia, India, Egypt and Mexico last year without catching anything. Living in a small seaside village I had taken a pretty casual view of the pandemic until it hit my own family members down south in Melbourne. The good news is that they have recovered well, but that tended to grab my attention.

So I checked on some statistics. And I was shocked.

Australians are travellers, both internationally and domestically. Consequently viruses can very swiftly jump between continents and states, city and country. We started with a few minor cases despite fairly strict precautions at airports. Then we had a cruise ship infected which dropped passengers in Brisbane and Sydney. Then it hit Melbourne and spread like wild-fire; but it's not just in the big cities, we have had cases dotted all over, from the bush to the outback.

For Australia the difference between the statistics in May and today, as we passed through our winter, are quite dramatic. These are the official statistics from the Australian Government Department of Health through the Australian winter:
[note: up-dated 11th October - Alan]

_____________Cases____Deaths
17-May-09______30_______1
14-Jun-09_____1515____not given
17-Jul-09_____11962______31
12-Aug-09____28307_____100
17-Sep-09____36210_____172
09-Oct-09____36895_____185

Surprisingly those numbers have not really been making big news headlines in my town. Maybe we have become desensitised to news on subjects like this; I certainly had.

For readers outside Australia this web-site appears up to date and accurate: http://www.flucount.org/. You will notice that although the USA has the worst numbers, those in Australia and South America are disproportionately high on a population comparison. Considering that America has a population of over 300 million and Australia is a little over 21 million this list of the top three is a worry:

Most Infected Countries:
[up-dated 11th October]

United States: 44555 cases, 821 deaths
Australia: 36895 cases, 185 deaths
Mexico: 36593 cases, 248 deaths

A couple of things stand out. The higher proportional numbers south of the Equator indicate that the winter season definitely accelerates the rate of infection. A surprising point in the Northern Hemisphere statistics is the difference in death rate between European countries and North America. It looks like US medical staff would be wise to spend some time chatting to those in Germany and Greece. So would ours. Americans and Europeans should pray that the virus loses its present dramatic ability to spread before the northern winter.

The good news is that it is not as deadly as first thought in the general population; the bad news is that it is rather dangerous for those with reduced immune systems such as people with other illnesses or for pregnant women.

Getting back to diabetes, a reduced immune system can be one of the side effects of our condition. I don't suggest that we should panic but we should certainly be aware of those around us and the risks from this virus.

As a consequence of my hypogammaglobulinemia I have always taken a little extra care with my personal hygiene when travelling. I don't suggest that you need to become as obsessive as Adrian Monk, but there are times when I could be mistaken for him. For example, I never touch any exposed surface in a public lavatory or a doctor's office or reception with my bare skin; whether that is my hands or any other part of my anatomy. I have little habits I have developed for that, such as carrying my own pen for signing forms in the doctor's reception or in a pharmacy. Consider the person who touched that pen before you, and why they may have been seeing the doctor or chemist.

I can't improve much on the excellent advice in this Australian Government H1N1 page for Individuals and households. I suggest you read that and adapt it for your own situation.

Once again I don't think it is cause for panic, just for good sense and caution. It certainly won't stop me travelling. My other affliction, wanderlust, has struck again and we are off to New Caledonia for 8 days on Saturday. I've also bought the tickets to go to South America next March; provided that they'll let me in while this pandemic is happening.

Cheers, Alan
Everything in Moderation - Except Laughter.