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Swine Flu: The New Pandemic
Swine Flu: The New Pandemic
Swine Flu: The New Pandemic
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Swine Flu: The New Pandemic

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About this ebook

Contents

Introduction

1. Pandemic Basics

2. 1918 versus 1976

3. The Swine Flu Timeline

4. All You Need to Know

Bibliography

Index

LanguageEnglish
Release dateSep 30, 2009
ISBN9780470592687
Swine Flu: The New Pandemic
Author

Marc Siegel

Dr. Siegel is a prolific writer, a Clinical Professor of Medicine at New York University School of Medicine, a Medical Director of Doctor Radio at NYU and SiriusXM, a Fox News Medical Correspondent, a frequent columnist for the Los Angeles Times, the New York Post, Slate, FoxNews.com, National Review Online and Forbes Online, and a member of the board of contributors at USA Today.

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    Book preview

    Swine Flu - Marc Siegel

    001

    Table of Contents

    Title Page

    Copyright Page

    Dedication

    Introduction

    Chapter 1 - Pandemic Basics

    The Spanish Flu

    Flu Origins

    Other Twentieth Century Pandemics

    The H5N1 Bird Flu

    Chapter 2 - 1918 versus 1976

    The Blue Death

    1976 Swine Flu

    The Swine Flu Never Came

    Guillain-Barré Syndrome

    Then and Now

    Chapter 3 - The Swine Flu Timeline

    April 2009: The Worried Bus Driver

    May 2009: Boots on the Ground and Press Conferences

    June 2009: The First Wave?

    July 2009

    August 2009

    Late August 2009: The President’s Council of Advisors

    September 2009

    Chapter 4 - All You Need to Know

    Essential Questions and Answers

    Bibliography

    Index

    001

    Copyright © 2009 by Marc Siegel. All rights reserved

    Published by John Wiley & Sons, Inc., Hoboken, New Jersey

    Published simultaneously in Canada

    No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600, or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008, or online at http://www.wiley.com/go/permissions.

    Limit of Liability/Disclaimer of Warranty: While the publisher and the author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor the author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

    The information contained in this book is not intended to serve as a replacement for professional medical advice. Any use of the information in this book is at the reader’s discretion. The author and the publisher specifically disclaim any and all liability arising directly or indirectly from the use or application of any information contained in this book. A health care professional should be consulted regarding your specific situation.

    For general information about our other products and services, please contact our Customer Care Department within the United States at (800) 762-2974, outside the United States at (317) 572-3993 or fax (317) 572-4002.

    Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. For more information about Wiley products, visit our web site at www.wiley.com.

    eISBN : 978-0-470-59268-7

    To my beloved son Samuel Benjamin Siegel

    Introduction

    Contagions are not new. They have existed throughout history, and one might say the perception that your neighbor will one day infect you has interfered with social intercourse throughout time. Infectors are perceived as dirty, unkempt, secret germ factories. They are not people we love easily. Whenever I see a patient in my office who says he has been exposed to scabies or bedbugs, I can’t get out of there fast enough or wash my hands frequently enough. And keep in mind that I am a physician who has written about overblown perception of risk; I can only imagine how a person on the subway feels sitting next to one of these patients.

    Since the microscopic culprits of infections are themselves unseen, they are perceived by potential victims as mysterious, imagined as deadly, and subject to immediate exaggeration and distortion. With the contagions throughout history, there always have been two problems: the contagion itself, as well as the sense that the outbreak or epidemic is far worse than it actually is. This is the prime reason why regional quarantine, or roping off a region, doesn’t work to contain an emerging bacteria or virus. People who are afraid tend to take fewer precautions, as the powerful emotional brain interferes with the ability to reason. Not only that, but as occurred during the massive Black Death in fourteenth century Europe, when more than a third of the population became infected over a three-year period, regional quarantine was ineffective; those who were restrained tended to panic and attempt to escape. That sense of terror has been transmitted down through the centuries to today even though, with the aid of modern medicine, we have less reason to be afraid.

    As I will describe in chapter 2, fear of another 1918 not only fueled the vast overreaction to a potential pandemic in 1976, but it also influences how we react and overreact to the real and emerging pandemic now. The powerful mental gates of heavy emotion cause us to alternatively overestimate and then underestimate a problem. And it isn’t only flu. The human response to contagions always has been out of proportion to the risk. In this book I cover both the real and the imagined concerns about influenza, the way that history both informs the debate but also sets us up for a hair trigger response. After all, conditions have changed drastically since 1918, and we have all these ways to combat contagions that we lacked back then. Plus, the deadly virus that evolved via likely mutation and returned with a vengeance that fall represented an extremely unlikely historical occurrence.

    Still, we are informed by our emotions at least as much as we are by the facts. It is not surprising that among my most flu-literate patients is Arnold, a ninety three-year old whose grandmother died of the Spanish flu when he was an infant. But it isn’t this man who is most worried; he says that though his grandmother died, she died of pneumonia after recovering from the flu. Arnold also points out that several other family members had milder cases and survived. Arnold is not really afraid of the flu; he sees it in perspective, based on his personal experience. But everyone else in his family, his children as well as his grandchildren, are worried, and they call me every week to find out when the H1N1 swine flu vaccine will become available. Their negative imaginations are fueled by Arnold’s story from his infancy; they imagine the dark rooms and the brooding, downtrodden faces far more than he does. Responses to an emerging contagion are fueled as much by worries and rumors as by facts. A study from England warns that the antiviral drug Tamiflu may be poorly tolerated and ineffective in children, and this quickly becomes dogma despite a mass of evidence (including my own) to the contrary. I lose an important medical arrow from my quiver. Next, fears are stoked that the new vaccine could cause ascending paralysis (Guillain Barré syndrome), just as the last swine flu vaccine appears to have done in one in one hundred thousand patients. But even if that worst case scenario turns out to be true, there is an important difference between today and the 1976 swine flu scare. This time there is a real pandemic virus, infecting many millions. We need the vaccine.

    Contagions throughout history have been characterized by intense emotions that accompany killer pathogens. These emotions are understandable. Our primitive fear of death is tied to the unknown, connected by our lifeblood to an invisible microbe.

    1

    Pandemic Basics

    In 1997,

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