ANALYSTS' VIEW: How serious is swine flu? Should we worry?

HONG KONG Thu Apr 30, 2009 3:08am EDT

HONG KONG (Reuters) - The World Health Organization said a swine flu pandemic was imminent after the new virus showed signs it was spreading efficiently among people.

This is the third infectious disease that experts regard as having pandemic potential in the past 10 years. The others were SARS in 2003 and H5N1 bird flu, which was first discovered in people in Hong Kong in 1997 and continues to infect humans sporadically.

Below are comments on swine flu from leading scientists in Asia who have experience in the fight against SARS and avian flu.

GUAN YI, MICROBIOLOGIST, UNIVERSITY OF HONG KONG

"Obviously the virus is already endemic in some countries. The virus is very mild, but this is just one option. In the 1918 (Spanish flu) pandemic, the first wave was mild, but by fall, the second wave killed many people. So whichever way this virus swings, we can't possibly know.

At this point, chances are it will be mild, but we can't rule out it will turn virulent. And even if it turns milder, it can still kill, depending on the kind of person it infects.

And who is to say it will not reassort with H5N1? In a pandemic, infection rates will be much higher than seasonal flu and chances of this virus meeting and mixing with H5N1 are far higher. If it goes to Egypt, Indonesia, these H5N1 endemic regions, it could turn into a very powerful H5N1 that is very transmissible among people. Then we will be in trouble, it will be a tragedy.

For now we need to limit transmission and treat patients, isolate them and quarantine them. We are much better able to handle this after SARS and so many H5N1 episodes, this is for certain, and we have antivirals that work."

LO WING LOK, INFECTIOUS DISEASE EXPERT IN HONG KONG

"This first wave could be contained by weather. When summer arrives, the flu season will be over in North America, so the initial effect will be moderated.

But come winter this year, November and December, there could be a real big wave coming and fatalities can occur then. The season is a factor here.

It is more likely to have a major impact (now) in the southern hemisphere because it is entering winter now. New Zealand, Australia may be getting more clusters. They would be more subject (vulnerable) to the first wave. The focus on measures now is most important. Cases are growing rapidly, there are secondary infections in New York ... it has the ability to establish in another country."

JULIAN TANG, CONSULTANT VIROLOGIST, NATIONAL UNIVERSITY

HOSPITAL, SINGAPORE

"Apart from Mexico, the other cases reported from other countries are generally mild. This is in keeping with a human-adapted pandemic influenza virus.

As we are seeing, there will be more and more cases reported worldwide, with, unfortunately more deaths, but I think that the overall mortality may not be different from the previous influenza pandemics (1-5 percent of infections). Unlike the avian H5N1 influenza virus, the much lower mortality we are seeing with this swine virus is more in keeping with the behavior of a human pandemic virus strain.

I would say (the world is) quite well prepared due to the experience of SARS and avian influenza (although this will vary between countries due to resources).

The virus so far has not shown any unusual virulence -- though we are still awaiting confirmation of the actual numbers of deaths caused in Mexico."

MASATO TASHIRO, JAPAN'S NATIONAL INSTITUTE OF INFECTIOUS DISEASE AND A MEMBER THE WHO EMERGENCY COMMITTEE, speaking to Japanese business daily Nikkei:

"The virus is relatively weak and about the same as regular influenza viruses passed on via human-to-human contact. I don't believe it will become virulent. But I believe it is a new flu strain that is different from the regular H1N1. Individuals who have contracted the (seasonal) H1N1 virus do not have immunity to the new virus, so it will be susceptible to spreading.

The societal impact of health issues resulting from the new flu strain are clearly much smaller than the more virulent H5N1 avian influenza. There's no need to adopt the same measures. Instead of adopting rigid definitions of the phases, we should be flexible.

The threat to health from the avian influenza and its fatality rate is much greater than the new flu. I am very worried that we will use up the stockpile of anti-flu medicine and be unarmed before we need to fight against the avian influenza. The greatest threat to mankind remains the H5N1 avian influenza.

Travel restrictions and measures that cut off transportation systems can have a negative economic impact. If the health risks are the same as typical influenza viruses, there's no need for strict restrictions on travel. Balance is what's most important. And the virus is already spreading, so containment is not possible.

Economic losses resulting from health issues will not be very significant. Rather, overreacting to the outbreak is a scarier prospect. Excessive curbing of corporate activity will be a problem. The best course of action is to adopt rational measures."

(Reporting by Tan Ee Lyn in Hong Kong and Yoko Nishikawa in Tokyo, Editing by Dean Yates)

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