MODEL IS OPTIMISTIC
Indiana University Rudy Professor of Informatics Alessandro Vespignani, an internationally recognized expert on the statistical analysis and computer modeling of epidemics, said two different swine influenza infection models generated on April 27 both predict about 1,000 cases in the United States within three weeks. There had been 40 cases of swine influenza (H1N1) reported in the U.S. as of 6 a.m., April 28, according to the national Centers for Disease Control and Prevention.
"But this is a worst-case scenario, as we are always working in a worst-case scenario setting," he said of the models performed at IU and Northwestern University. "What we are finding is that this is not a panic situation and that this thing is not ramping up in some crazy way. Right now we are confident that in the next few days things will be more optimistic."
That optimism is due in part to actions taken worldwide, such as the medical alert in Mexico, school closures in Texas, World Health Organization warnings, increased controls at international airports and the availability of an anti-viral drug for treatment. The next 72 hours will be critical, he predicted, and models could change as often as every 12 to 24 hours, based on worldwide events.
FINANCIAL HURDLES
David Orentlicher, M.D. and J.D., is co-director of the Center for Law and Health at the IU School of Law-Indianapolis. He said governments can be slow to react to threatened pandemics for two reasons. First, public health departments and programs tend to be seriously underfunded, and that can make it difficult to detect public health threats early or to mobilize responses to limit the spread of the threats quickly. Second, effective public health strategies can disrupt economic activity (e.g., if travel is restricted), and governments can be reluctant to implement needed public health measures when doing so will have undesirable economic effects.
Orentlicher also noted that economic considerations may drive the public to compromise the public health response. "People may find it difficult to stay home and forego wages when they may be sick or even when they are subject to quarantine," said Orentlicher. "It's important therefore to have provisions for job protection. It also can be important to have government programs to maintain people's income if they must stay home for an extended period and they don't have sick days or vacation time to fall back on."
"WATCHFUL WAITING" IS KEY
One case of swine flu has been reported in Indiana. The state's medical community is on alert and watching for anyone with influenza-like illness, says Greg Steele, associate professor of epidemiology in the Indiana University School of Medicine Department of Public Health.
"Watchful waiting is the key right now for Hoosiers," Steele said. "For the general population, wash your hands, cover your mouths when you cough and sneeze. If you or your children develop flu-like symptoms, seek medical care; do not go to work, and don't send the kids to school if they're sick."
For a good description of flu symptoms, Steele points to the national Centers for Disease Control and Prevention Web site: http://www.cdc.gov/flu/symptoms.htm. He suggests reconsidering any non-essential travel to Mexico, the apparent center of the swine flu outbreak. But don't panic, and don't go to your doctor seeking antibiotics "just in case," he says.
"This is a virus, and antibiotics will not work."
Steele has served as the Indiana state epidemiologist and director of the Epidemiology Resource Center for the Indiana State Department of Health. His research interests include unintentional injuries, childhood obesity and adverse health outcomes.
ADDITIONAL EXPERTISE: For insights from David P. Fidler, the James Louis Calamaras Professor of Law at the IU Maurer School of Law, visit http://newsinfo.iu.edu/news/page/normal/10717.html. Fidler is one of the world's leading experts on global health and international law and has written extensively in this area and consulted widely with governments, international organizations, and non-governmental organizations on global health challenges.
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