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Swine flu outbreak - Journalists' questions answer

SMC Alert
28/04/09

IMMEDIATE RELEASE
Science Media Centre


Swine flu outbreak - Journalists' questions answered

District health boards around the country are tonight investigating suspected cases of swine flu as the Ministry of Health's 24 hour Healthline experiences a 60 per cent rise in call volumes as queries flood in from the public.

The latest update on swine flu from the Ministry of Health is here. Meanwhile our colleagues at the Science Media Centre in London have obtained answers to some common questions about swine flu posed by journalists in Britain.

If you have your own questions about swine flu, email the SMC (NZ) on smc@sciencemediacentre.co.nz and we'll endeavour to get our expert panel to answer them.

Questions below answered by Professor Andrew Easton, Department of Biological Sciences, University of Warwick. Answers to the same questions by Dr John McConnell, editor of The Lancet Infectious Diseases can be viewed here.

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1: Can you comment on early detection methods and vaccine synthesis?

A: With regard to vaccine synthesis, the current system of preparation of vaccines will be activated when it is clear that the situation merits it i.e. when the WHO determines that the pattern of infection is such to suggest that the virus represents a significant threat. Having done this there will be a delay as the vaccine candidate is prepared. Most importantly, there will be a necessary delay as the vaccine stocks are produced and disseminated. At best this will take 6 months and possibly more. A concern must be the availability of the materials necessary to generate sufficient vaccine stocks. Current information suggests that there may be a shortfall in the immediate term.

2: Is screening at airports a waste of time?

A: Health surveillance in these situations is always helpful. As was seen with the SARS outbreak viruses can be spread as a result of international travel. The type of screening being done is designed simply to detect travellers with elevated temperatures and that could be due to many causes quite unrelated to flu. This means that the way in which the screen is used is the important factor. It is essential that any response is proportionate and careful.

3: Why does the flu seem to be less deadly outside of New Mexico, is it the disease changing or simply better healthcare in more developed countries?

A: It is probably too early to say. A complete answer would require a lot of information about individual patients and their treatment.

4: What do we know about the disease? What don't we know?

A: We know it is flu and that means we understand quite a lot. However, we are a long way from understanding everything about flu.

5: How quickly might it spread?

A: It might spread very slowly but equally it might spread quickly. At the moment the information is not sufficient to say. It is necessary to monitor the rate of spread as closely as possible and use that to predict likely patterns of spread. The factors that affect spread of influenza are not completely understood.

6: How bad is it going to get?

A: Cannot answer

7: The basic virology of flu -- how do new viruses like the Mexico strain arise? What makes them nasty?

A: Taking the first part. Flu is unusual in that it is able to exchange genes with other flu viruses. To do this two or more different flu viruses must infect the same individual or animal at the same time. Obviously this is rare. This reassortment process generates new gene combinations and it is these that represent the threat since humans may not have encountered them before. With the second part we do not know what makes a 'nasty' flu virus.

8: Why do the US and Mexico flanks of the outbreak apparently look so different?

A: See question 3.

9: Will there be any cross-immunity between normal H1N1 and the Mexico strain?

A: At the moment the information suggests that there is very little if any cross immunity.

10: What plausible explanations are there for the apparent mismatch between what's Mexico and the United States.

A: see Q 3.

11. what are the chances of this year's seasonal flu vaccine containing anything that might offer protection against this strain.

A: If there is an inadequate level of cross immunity as appears to be the case the current vaccine will have minimal effect.

12: A reminder of a timeline for flu transmission including when symptoms develop, when people are infectious and not etc.

A: The best description is available through CDC or WHO.

13: Masks - how useful are they in offering any protection or are they simply a measure that makes people feel better

A: The correct mask can have an effect of reducing risk, though it is difficult to quantitate for a population.

14: What thoughts on international travel - should any further measures be taken to screen people?

A: See Q 2.

15: What are the chances of this strain mutating into a strain that is more dangerous and more virulent.

A: Cannot answer. We simply do not understand what is required for a virus to be more virulent. However, the likelihood must be low or it would happen more often.

16: Estimates of timeline to develop a vaccine - should that be needed.

A: See Q 1.

17: An explanation of how antivirals work

A: The current antivirals inhibit the function of a critical virus protein. This reduces the ability of the virus to grow.

18: Has the focus on H5N1 in recent years led to the risks from an H1N1 strain being underestimated?

A: No. While H5N1 has got a lot of attention especially from the media virologists have always recognised that a different virus may appear to generate a pandemic.

19: How prepared are we and what would happen if it does come here - face masks etc

A: The UK government has a pandemic emergency plan which was prepared some years ago. This has within it the measures possible to try ot reduce the impact of a pandemic. The emergency plan involves the availability of antiviral drugs (which have been shown to work with the latest virus) as well as other measures.

20: Are we all going to die?

A: Yes but probably not of flu and more probably not of this virus.


Notes to Editors
The Science Media Centre (SMC) is an independent source of expert comment and information for journalists covering science and technology in New Zealand. Our aim is to promote accurate, bias-free reporting on science and technology by helping the media work more closely with the scientific community. The SMC is an independent centre established by the Royal Society of New Zealand with funding from the Ministry of Research, Science and Technology. The views expressed in this Science Alert are those of the individuals and organisations indicated and do not reflect the views of the SMC or its employees. For further information about the centre, or to offer feedback, please email us at smc@sciencemediacentre.co.nz.

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