Swine Flu Spreads, Fall Flu Season Looms

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Health Officials Warn About Swine Flu's Potential in Fall Even as Some Guidelines Are Eased

By Daniel J. DeNoon
WebMD Health News

Reviewed By Louise Chang, MD

May 7, 2009 -- H1N1 swine flu is spreading faster and wider in the U.S. That's worrisome -- but more and more, health officials are fretting about what might happen this fall.

So far, H1N1 swine flu disease has been milder than originally feared. That's led the CDC to relax some of its original guidelines.

Schools and day care centers need no longer close if a few kids get the new flu. And in communities with known H1N1 outbreaks, the CDC no longer recommends confirmatory H1N1 lab tests for otherwise healthy people with mild flu symptoms.

But that doesn't mean anybody should relax, acting CDC Director Richard Besser, MD, said at today's H1N1 swine flu briefing.

"We are not seeing any sign of this petering out. We are still on the upswing of the epidemic curve," Besser said.

The number of cases is expected to rise as the new flu spreads across the country. But the hope and expectation is that, aided by the warm summer weather that flu bugs don't like, the rate of spread will slow.

That may only be the lull before the storm, Besser warned. What worries health officials is what will happen this fall when traditional flu season begins.

"We don't know what the fall will bring," Besser said. "What has been seen with previous outbreaks is flu goes away in the summer. But during the winter flu spreads better, so the virus could go away and come back."

Besser urged Americans to take advantage of this breathing room. True, H1N1 swine flu could just go away for a number of reasons. On the other hand, it could just as easily become more severe as it picks up elements from seasonal flu bugs.

"This period of time before the fall is critically important for community preparedness should this virus come back in a severe form," Besser said.

There's a lot that governments, communities, and businesses can do. But Besser strongly urged individuals to prepare at the family level. He stressed hand washing, staying home when sick, and covering coughs. He also pointed families to the CDC's pandemic flu web site.

That web site advises families to make preparations for a flu pandemic:

• Store a two-week supply of water and food. During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand. This can be useful in other types of emergencies, such as power outages and disasters.
• Periodically check your regular prescription drugs to ensure a continuous supply in your home.
• Have any nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
• Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.

• Volunteer with local groups to prepare and assist with emergency response.
• Get involved in your community as it works to prepare for an influenza pandemic.

Will there really be a pandemic? The World Health Organization (WHO) has not yet declared one, but it will do so if H1N1 flu takes root outside North America. So far, there has been only sporadic spread.

But the WHO takes pandemics very seriously. Why? Previous pandemics eventually spread to a third of the world's population, said Keiji Fukuda, WHO assistant director-general for health security and environment, at today's WHO briefing.

"When you look at a third of 6 billion people, that is a lot," Fukuda said. "So even if on an individual basis the disease is mild, there are still some people dying and getting pneumonia. Multiply that by the number getting infected, and there are very large numbers of people who could develop pneumonia, require respirators, and die."

"This is a benchmark from the past," Fukuda added. "It is not a prediction for the future."

SOURCES: Richard Besser, MD, acting director, CDC, Atlanta. Keiji Fukuda, MD, assistant director-general for health security and environment, World Health Organization. CDC web site. Pandemicflu.gov web site. World Health Organization web site.

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