What they're not telling you about Swine Flu

Here's a portion of an email I got from one of our public health officials, just to put things in perspective:

I am getting more than 8 Swine Flu "Updates" per hour.  Good grief.  This is a true epidemic, likely soon to be a global pandemic.  My guess is that we'll be in Phase 6 next week.  But the relatively minor human toll (low morbidity and low mortality) does not yet justify the resource allocation, nor the media attention that we have all seen.

We need to insure that we have a "measured response" that is commensurate with the real, not the perceived, threat.  And responding appropriately, in the face of media hype and patient worry and governmental involvement, is a real art.  I am hoping to hear your opinions on this.

In the past six weeks, Swine Flu has killed between 20 and 80 people.  More than 2000 have had clinically significant infections.  In the same time period, more than 40,000 people have died from routine influenza.  Millions were infected.  More than 40,000 died from TB just last week.  40,000 more died from malaria last week.

Pink Eye Epidemic Quieting Down

It seems like the epidemic that struck Saipan about a month ago is starting to quiet down. We're still seeing a steady trickle of cases, but nothing like the huge numbers we were seeing at first. Here is the worst case I saw. Yes, that stuff on the left side is the conjunctiva (the white tissue on the surface of the eye -- here really really red) actually coming out from between the eyelids. She couldn't close her eye because of the tissue hanging out.

Epidemic Strikes Mariana Islands

You may have seen the article on the front page of the Tribune today. We are in the midst of an ugly epidemic of "pink-eye." This strain appears to be highly infectious, striking members of entire families within ours of one another. It's also one of the "hemorrhagic" strains which causes bleeding on the surface of the eye. I've been seeing about a dozen patients a day with this for the past few days.

Pink eye is caused by one of several viruses. It usually takes a week or two to go away. I tell my patients that it's just like a cold. We can't cure it. You have to wait it out. But we can treat the symptoms -- pain, itching, tearing, irritation --- with a variety of medications. This is the reason people come to see me: to get relief of their symptoms.

The big danger with viral conjunctivitis of this sort is that it can cause permanent corneal scarring and vision loss. Scarring can be prevented if we catch things early enough.

The big effect of epidemic viral conjunctivitis is that it results in huge losses in productivity from the general misery it brings. And, because it's highly infectious, anyone who gets it needs to stay away from work or school for about a week.

Isolation is one of the ways to prevent spread. The virus is spread through indirect contact with tears. Someone has pink-eye, they rub their eye and open a door. You're the next person to open that door, then you touch your eye innoculating it with the virus and you get pink eye. Prevention lies in washing your hands after you touch your eyes, if you have the virus; and in washing your hands before you touch your eyes if you don't have it yet. Don't share towels or pillow cases.

It's not an airborne disease. There is some superstition that if you look at someone with pink-eye, you'll catch it. This isn't true. You have to come into contact with the tears, directly or indirectly.

Be careful. Wash your hands. This is a miserable strain right now.