The Swine Flu Scare: Ten Most Common Myths About H1N1

The fall flu season is already upon us, a lot of anxiety is starting to build up about the new H1N1 strain of the Influenza A virus, or "swine flu". But, the media coverage surrounding the new flu strain seems to be doing more to confuse, rather than inform, so we decided to pull together ten most common myths about H1N1 with a little explanation of why these myths arose in first place.

Myth #1: You can get H1N1 from the vaccine

WHO says there will be variations of the H1N1 vaccine this season -- most vaccines will contain inactivated virus made in eggs, some will be killed virus vaccines made in cell cultures and a few will be live attenuated virus vaccines. What are the H1N1 vaccine dangers? The vaccine batches containing the killed virus have zero chanceadjuvants added to the vaccine to boost the immune response can potentially be harmful. However, no vaccines come with lethal mercury adjuvant Thimerosal any longer. But, it is a point of caution. Also, since the virus is grown in eggs, it is possible that some tiny concentrations of egg proteins will remain in the vaccine, putting people with egg allergies in danger. Also, sometimes when people get a vaccine, they can develop flu-like symptoms in the first 24 hours after the shot. But, it is just a consequence of building a immunological response. After all, vaccines trick your body into thinking it is fighting a real infection, so some immune response symptoms, including fever, body aches and tenderness are expected.

of causing an infection in the vaccine recipient. Juts because the virus that is killed can't biologically infect. On the other hand, batches containing live attenuated virus are a different story. In this case, a live virus gets weakened by chemicals to handicap it and prevent it from actually infecting the recipient's cells. These vaccines are much better at evoking an immune response because the body reacts stronger to a virus that is still live. But, viruses are notorious for mutating fast. And, with live vaccines, there is always a slight chance that the weakened virus will "revert" (i.e. switch its genes back to become a functional virus again) and cause infection. However, the probability of a reversion is always very slim. Another thing to note is that

Myth #2: This pandemic is going to be as deadly as the 1918 Spanish Flu

The 1918 Spanish Flu pandemics killed 25 million people in its first 25 weeks. The global death toll for the 2009 H1N1 pandemic stands at around 5,000 from when the count began in May of 2009. So, there is a clear difference when it comes to the number of victims in the same period of time. So, expecting a repeat of the 1918 pandemics is not backed up by numbers at this point in time.


Myth #3: Tamiflu can cure the virus

Only partially true. It is true that Tamiflu can help reduce the intensity of infection if taken in the first 24-48 hours of the exposure. What the drug does (and Tamiflu is a drug, not a vaccine -- which is another myth in itself), is it prevents flu virus particles from budding out from infected cells and spreading further, hence the virus concentration is kept in check by Tamiflu and illness does not progress as much. However, if Tamiflu is taken later than in the first 24-48 hours of the exposure, the concentration of virus reaches high titters, and Tamiflu is no longer able to control virus concentrations and illness severity.


Myth #4: If you have flu symptoms now, it has to be swine flu

Not true. Seasonal flu and swine flu share the same symptoms. Without a lab test, it is difficult to tell the difference between the two. Swine flu is just as virulent as the seasonal flu (causing the same degree of damage), but slightly more contagious (more chance of getting infected upon exposure).

But, nobody canceled other flu strains that are spreading around just as much as the H1N1 virus does. So, not every flu symptom should be attributed to H1N1.


Myth #5: You can get the virus from pigs, so you should not be eating pork

No, you can't get the virus from eating pork, as long as the meat is properly cooked. Direct interaction with pigs can lead to infection, however. Because swine flu is spread by respiratory route, i.e.: via sneezing and coughing that  spreads infectious aerosols, it is only direct contact with living pigs that can lead to viral transfer. This can happen in farm workers and any other people who have to deal with pigs on a daily basis. In fact, direct interaction of humans with pigs is how the new H1N1 arose in first place. Influenza virus contains eight DNA segments that can get mixed. Sometimes two virus particles can infect the same cell and exchange DNA segments, forming two novel viruses. That is exactly what happened this year. A strain of flu that only pigs get sick from must have exchanged DNA with the flu strain only prevalent in humans to produce a new virus that no one one the planet had the specific immunity for.


Myth #6: There has never been swine flu outbreaks in human history before

Genes of human and swine influenza viruses have mixed before, but never in this combination, so although the 2009 Influenza A Subtype H1N is a new strain, swine flu did cause outbreaks in the past. Swine flu outbreaks happened in 1976 and 1998 in the U.S.,  in 2007 in the Philippines, and of course there are speculations that even the 1918 Spanish flu had some swine flu genetic elements.


Myth #7: It’s only the younger people and people over 65 who are under increased risk

Unlike with the seasonal flu when children and older people are under more risk, the swine flu affects individuals 20-40 years old more – this is where the analogy with the 1918 Spanish flu came. The deadliest flu in recorded history, the 1918 Spanish flu was notorious for targeting young healthy people. The 1918 Spanish flu killed more people than the number of people who died in WW1.


Myth #8: It is best to go to a hospital immediately if you have flu-like symptoms

Not true, unless you are experiencing severe symptoms, such as severe shortness of breath, chest pain and very high fever. In general, there is very little your doctor can do about a respiratory virus. Viruses do not need antibiotics, so there is nothing your doctor can prescribe to cure you of virus, except for Tamiflu, which can be prescribed at the very early stage of infection (see above). Of course, your doctor can also prescribe medications that will keep your symptoms in check and reduce your fever and congestion so that you can go back to work or school and function normally. But, in reality, alleviating symptoms is not helping you much, and can actually work against you. The typical flu-like symptoms you get are the side effects of an immune response being mounted. Subduing these symptoms means interfering with the immune response and ultimately prolonging your illness. Finally, going to the hospital while sick puts other people around you in danger. You can spend hours in the ER or at your family physician office for nothing, but will end up infecting other people in the waiting room.


Myth #9: The fact that this flu season has been named a “pandemic,” means a lot of people are likely to die

The term "pandemic" does not have anything to do with the potential of the virus strain to kill. It is an epidemiologic term used to describe the distribution of the virus. When WHO declared swine flu outbreak a pandemic, it was because according to WHO’s nomenclature phase 6 pandemic is global in nature, i.e: it is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5, which specifies human-to-human spread of the virus into at least two countries in one WHO region. So, essentially recording human-to-human transmission of a virus in at least three countries in two different WHO regions is sufficient to call an outbreak a pandemic. But, nowhere in the WHO’s definition of the swine flu pandemic does it say that swine flu is expected to kill many people.


Myth #10: Masks help prevent the infection

Could be true, but the effectiveness of masks is a highly debatable topic in the medical community. It really just depends on how you use them. The masks have to wrap around one's face extremely tight to make sure no viral particles make it through. Unfortunately, by design, some masks are not as tight-gripping and still let viral particles through. Also, some people wear masks while on errands or public transport, but once they start talking to someone, they pull their masks down. While it definitely is not convenient to talk to people while wearing masks, pulling your mask down to chat just defeats the purpose of having one on. In any case, hand washing and vaccination seem to be the two proven ways of protecting against the flu. But, wearing a mask for extra protection can't hurt.