Whatever The Name Prevention Is The Game 5-8-09

5-8-09 Whatever The Name Prevention Is The Game

It’s been interesting being a fly on the wall as I go about my business and hear people talking about the so-called Swine Flu. In supermarkets and libraries people chat about this and that. At first there was curiosity. Something was happening over there in another country. Then the alarm set in as the USA map lit up in various cities representing confirmed cases of a novel influenza virus spreading throughout the US upon visitors return from Mexico. At first it was hoped these cases represented some kind of direct contact in Mexico and this would be the end of it now that they were at home. Isn’t home a safe place?
By mid week last week, word was out and traveling through those gossip lines. So-and-so’s family went to Mexico last week and the children are at school! Can you believe it? Don’t you think something should be done about it? Don’t you think they should stay at home and be tested? As those families continued to attend school and go to work, if they displayed no symptoms of flu, there was panic and anger from some, as the virus was clearly spreading from human to human and did not have anything to do with swine anymore.
As public health nurses and health agents and first responders participated in numerous conference calls we had the opportunity to hear again and again that the influenza virus spreads in droplets. It is not an environmental disease, per se. The droplets from an infected person’s cough, if not interrupted by something such as a sleeved elbow, will fly out a few feet into the air and, being relatively large and heavy, those droplets fall to the floor. Stop the spread by learning the rules of particular germs. For this “germ”, cough etiquette is the first line of defense.
As the days went by and we heard consistently about the Big Four: hand washing, cough etiquette, staying at home when sick with any flu-like illnesses (isolation and quarantine) and keeping our distance from others who are coughing, aka, social distancing, I felt relieved at the consistency and thought, “Finally, the message is out loud and clear! This is what we do to prevent the spread of any type of influenza.”
My relief did not last long as I saw people make fun of the situation. Talk about “going through all of this before for bird flu” quickly led to jokes about when pigs fly and I saw giggling and guffawing adults convince me that the BWCW phenomenon had arrived: the Boy Who Cried Wolf.
I know with certainty that this is not the case. There was no panic on the part of public health. There was no knee jerk response of widespread inoculation or an antiviral prophylactic campaign, as happened in 1976. Many lessons have been learned since then. Public health is driven by science and as the scientists observe, track and arrive at scientific conclusions, the advice is appropriately adjusted.
Those adjustments are still occurring and at a faster rate all the time. Massachusetts’s State Lab has been approved to conduct confirmatory tests for the H1N1 influenza virus. That means that a suspect case can be confirmed in about twenty-four hours instead of several days to send the specimens to CDC. We are fortunate, indeed in Massachusetts.
Our Director of the Communicable Disease Division of DPH, Dr. Al DeMaria, was explaining recently that so much has been learned about this virus that we can say, with confidence, that this new virus appears to be a relatively mild one and, so, we can respond with what should be routine actions for the seasonal flu. Should be’s don’t make it so, though.
Many of us think of seasonal flu as an inconvenience, nothing more. Consider this: Every year about 35,000 people die in the US from seasonal flu. Did those people; the young, the old and the ones with chronic conditions have to die though? Did they have to catch it in the first place?
I know it is temping to want the shot, the pill, the vaccine, the silver bullet. It may take a lot of listening but only a little more time and a little effort with awareness to wash hands after blowing the nose and before eating, to cough into the elbow area, to wash doorknobs and railings and to stay at home when sick with respiratory illnesses. It is within our power to have a great impact on preventing the spread of communicable diseases.
Those methods of prevention require actions based on knowledge. The Norovirus is very hardy and can live on surfaces for up to a couple weeks. In that case, meticulous sanitizing of surfaces, in addition to personal hygiene is necessary. The influenza virus, though, requires hand-washing and droplet precautions. That’s actually a lot easier than eradicating Nasty Noro!
Our State’s Department of Public Health is urging everyone to exercise scrupulous self-monitoring if they have had contact with a confirmed case of this flu by practicing the Big Four. We can have a really big impact on any kind of flu. When the big bad pandemic comes along and the DPH and CDC really do yell, “Wolf Flu!” we’ll know what to do because we started doing the right thing way back in 2009.

Cathleen Drinan is the health agent for the Town of Halifax. For more information on influenza look at MA DPH and CDC online. To talk to a person, call 211 or call your local health department. She can be reached at 781 293 6768 or cdrinan@town.halifax.ma.us