Discuss the Possibility of Global Pandemic in Modern Times

Discuss the Possibility of Global Pandemic in Modern Times When we are talking of the possibility of a global pandemic it is not so hard to imagine as it is a current reality, the risk and rate of infection seems to be steadily on the increase. A pandemic is a worldwide epidemic that, according to the World Health Organisation, (WHO) has to meet three conditions; the infectious microbe infects and causes serious illness to humans and humans don’t have immunity against the Virus. This virus can also be spread from person to person and survives within humans[1].

Pandemics are not new, the world has been suffering the nasty bugs for almost as long as people have been walking the earth. Influenza for example was recorded as far back as 412 B. C. , when a man named Hippocrates wrote of an uncontrollable outbreak of disease that had very similar symptoms as influenza . [2] This pandemic devastated an entire Athenian army, and has occurred every hundred years since. Influenza has been responsible for many deaths over the years. In the 1300s we discovered the Black Death, this disease, (believed to originate in China) was responsible for killing a quarter of Europe’s population[3].

Perhaps the worst of all influenza outbreaks was the 1918-1919 ‘Spanish flu’ pandemic. “The ‘Spanish flu’ killed more people in a single year than the Black Death caused in Europe over 4 years”[4] Early in 1957 an Asian influenza virus was discovered, science and technological advances meant that the world was quickly able to respond to this threat, thus making the impact less severe than it might have been otherwise. Hong Kong was the next region to be attacked with a pandemic. In 1968-1972 the ‘Hong Kong flu’ was responsible for a significant number of deaths.

Luckily the flu was often treatable and controlled with antibiotics. In 2003 Hong Kong came under siege yet again and had to fight against severe acute respiratory syndrome, (SARS) Yet another flu scare rocked the world in 1997 when avian influenza killed millions of poultry in Asia, Africa and Europe. When it was first discovered, as many as one and a half million chickens had to be slaughtered in China. A growing number of human beings have been infected. There have been two hundred and forty-eight deaths in twelve countries to date [5].

The most recent pandemic we have been faced with is A(H1N1) influenza (swine flu). It is the most virulent outbreak since the same (h1n1) strain devastated Europe in 1918. There are many theories as to the source of “the mother of all pandemics”[6]but most, like David Goulding, writer of Big Issue thinks, “conditions at the end of World War One may have contributed to the spread of the virus and hence the scale of this pandemic”. [6]The virus became known as the Spanish flu because of the attention the Spanish press gave it.

Although flu has always been a risk to infants, elderly and the weak/already sick, Spanish flu was different, it also killed off the healthy in the prime of life. By the end of the reign of Spanish flu it had taken the lives of approximately one hundred million people, an exceptionally severe pandemic. Writers for the occupational health magazine have said, “swine flu was officially declared a pandemic by the World Health Organisation in June, with nearly thirty thousand cases world wide, including more than one thousand in the United Kingdom. ” [7] The virus behind the pandemic may be known as swine flu, but it did not only come from pigs.

Wild birds and humans also played a role in its creation. Scientists are still trying to unravel how it wound up infecting humans and spreading rapidly around the globe. Swine flu is a triple reassortant that is actually a combination of classical swine flu, a North American avian flu, and a strain of human flu. Somehow a single pig became simultaneously infected with that virus and a pure swine flu strain that had been found in pigs in Europe and Asia. The two strains swapped genetic material to produce the new H1N1 strain, which then began to infect humans.

Swine flu is a respiratory disease; the symptoms are fever, tiredness, cough and sore throat. More serious cases can have symptoms that include aching muscles, sneezing, loss of appetite, vomiting and diarrhoea. Swine flu spreads just like seasonal flu, as little as breathing the same air could mean contamination, a sneeze generates millions of air-borne droplets that are propelled up to one metre, a single cough or sneeze could mean transmission of infection from human to human. Flu transmits better during cold weather, when people are huddled together in buses or trains.

Touching a contaminated surface then touching your mouth or nose can also make you ill [9]. As with most influenza viruses, you would expect the very young and very old to be affected the worst but in our current situation the highest number of people infected are found in the fifteen to twenty-four age group. Pregnant mothers seem to be particularly susceptible. Surprisingly, the least effected are the elderly, “only one case has been reported in people over sixty-five and it seems those born before 1957 have a higher resistance to the virus”. 10] One reason for this is that these people are more likely to have been exposed to an older cousin of the virus strain; therefore they have antibodies that react to the virus. [10] With the number of cases rising and the uncertainty of when it will affect certain regions it is very hard for employers and healthcare services to cater for swine flu. Nic Patton reports, “research by Birmingham University has suggested that, in the event of a serious flu pandemic, the National Health Service could be faced with absence rates as high as eighty-five percent. [11] Our current situation with sickness levels is quite mild but in the event that swine flu would become more common there could be devastating effects to the economy of our country. Just look what it did to Mexico! A report from the Oxford Economics think tank wrote, “Pandemic to cost Britain forty-two billion pounds sterling… as a result of a three percent fall in gross domestic product, (GDP). [12] If people are at home sick, they are not attending work. Employers are going to have to plan and cater for absences. Absence management firm FirstCare has suggested there has already been an 8. % rise in the number of staff calling in sick because of cough, cold, or flu like symptoms. ”[12] In certain places of work absences are pointed through a disciplinary system. People who are unfortunate enough to contract swine flu could end up with no jobs! If this pandemic reaches a high infection level it could have a devastating effect on the NHS. Sick people go to the hospital to get better, nurses and doctors who are key individuals in keeping the population healthy are likely to be infected. We however do not have a never ending supply of health care rofessionals so it is vital that these key people are inoculated. Prevention is the key to beating the virus, it is important that people do everything in their power to avoid spreading. The best way to do so is to keep good respiratory and hand hygiene. In other words, sneeze and cough into a tissue and dispose of it in the nearest bin. The NHS has come up with a series of advertisement campaigns to get this message across with the catchphrase; catch it, bin it, kill it! There are a few ways to combat swine flu; mild cases can be treated with paracetamol to reduce temperature and relieve symptoms.

Antiviral medications oseltamavir (Tamiflu) and zanamivir (Relenza) [13] are also being used. Antivirals are not a cure for swine flu but will help to reduce the amount of time you are ill, relieve symptoms, and reduce the potential for serious complications such as pneumonia. Antibiotics are another important medication we will need as they are used to treat patients who develop complications such as bacterial infections. The best protection lies in the swine flu vaccination. There is currently an amount of vaccine available.

There are two different brands- Pandemrix and Celvapan. The vaccine is only presently available to selected groups, people who are most likely to become seriously ill if they catch swine flu. Included in these groups are people with underlying health problems, pregnant women, and health and social care staff who may be in close contact with infected people. Individuals who do not fit into any of the groups may be offered the vaccine at a later stage. The government has ordered enough for everyone in the country if the situation requires it [14].

The government are in a sticky situation in cases like this, vaccines don’t come for free and they are buying enough to cater for most of the population. Nothing is set in stone when it comes down to how many people will be affected. Could this be wasted money in the long run? Too many vaccines are definitely more beneficial than too few, although money spent on vaccines means cuts in other areas of the NHS budget. To date there are one hundred and fifty-four deaths related to swine flu in the UK. With 848 hospitalised and 172 of them in critical care wards this week we have seen a slight increase of new cases.

Sir Liam Donaldson, chief medical officer said that, “this upward trend was a cause for concern but stressed there was no indication that the virus had mutated or changed” [15]. Margaret Chan, the World Health Organisation’s director general, was confident, however, “the disease is only a moderately severe risk, out of 30,000 cases worldwide, only 145 deaths have been reported. ” [16]. The fact that the virus could mutate into a more deadly strain is a possibility, this is what happened in the deadly 1918 outbreak. All we can do is hope that we do not experience this level of infection again.