Why & How Swine flu is a major threat?

Swine flu was first identified in 1930 as a

common and sometimes fatal respiratory
disease in pigs caused by type A influenza
virus (H1N1). Human are said to have
infected the pigs and now the virus has
returned to infect humans. Influenza A (H1N1) virus resistance to oseltamivir
was reported by WHO in July 2008 and has spread all over the world. These
antiviral treatment is expensive and does not kill the virus but reduce viral
sheading and spreading. Some beleive the treatment may reduce infection if
taken as prophylaxis. The treatment must be given as soon as the symptoms
occur but it is very difficult to diagnose clinically. Indiscriminate use will also
make the virus develop resistance.

The European Centre for Disease Prevention and Control said that the infection of
humans with influenza 'A' virus of animal origins is a concern "because of the risk
that this could represent the appearance of viruses with pandemic potential."

Swine and human H1N1 viruses are

not the same, which means that
seasonal flu vaccines for humans
will not work against the animal
variant. The impact of a new
influenza pandemic has grossly been
estimated at 1-2 billion cases of flu,
5-12 million cases of severe illness,
and 1.5-3.5 million deaths
worldwide. It could result in 1
million to 2.3 million hospitalizations
and 250 000 to 650 000 deaths in
industrialized nations alone.

Patients with Swine flu will have poor immune response to prevent bacterial
infections. This will help entry of CA-MRSA (colonised in our nostrils) through the
mucus membrane and spread rapidly to lung producing pneumonia. In hospitals,
very sick patients will be subjected to practical procedures like IV drips and
catheter insertion. These devices will help MRSA enter circulation resulting in
invasive MRSA (severe septicaemia and death).

HIV was taken seriously and not MRSA

as a major threat in 1980s. In UK, MRSA
was rapidly spreading in neonatal units.
Infected babies were not even isolated
and the callus attitude of nurses and
doctors helped these bacteria multiply
and spread. The first report of invasive
CA-MRSA was reported in USA was
reported in JAMA (2007 highlighted in
CNN. Since then various countries have
come forward to accept they have a
problem. This bacteria has been
spreading their plasmid and educating
other bacteria to resist antibiotics. Now
we have almost ten different bacteria
and fungus that are resistant to
treatment.
 In 1980s, I noticed babies who
were subjected to various practical
procedures (inserting IV cannula,
intubation or inserting catheters)
were getting MRSA. I could not get
any funding to organise studies to
prove my hypothesis nor a device
to compare. JAMA published
information sheet in 2007, which
include invasive procedure as the
risk factor.

To help me prove my hypothesis, I developed two devices, tested my technique

and proved we could reduce invasive practical procedures. I hoped the
manufacturers would help develop new devices to help us perform practical
procedures and reduce contaminated hospital waste that breed bacteria. The
results of my study were published in medical journals but the cannula
manufacturers did not bring in changes because they felt my technique would de-
skill doctors. Unfortunately, this simple mistake has now escalated to catastrophic
proportion, and difficult to manage.

When I heard NHS was planning to spend billions (£) cleaning the hospitals in
2004, I wrote to CMO, Prime Minister and the health secretary this will be a
wistful expense. We must clean our act and take meticulous care when we
perform practical procedures. Studies published by Dept of Health, state, “They
are puzzled by the findings” and now pointing their fingers at IV access & urinary
catheters.
CA-MRSA is said to be colonised in sewers, rivers and soil and is said to infect
healthy adults and children. One in three of us carry these bacteria in our hands
and nostril. This bacteria is also said to be resistant to antiseptic lotions used to
clean skin before performing blood tests, inserting needle or cannula. More than
50% of nurses who wash hands more than 10 times were found to develop
dermatitis and are colonized with MRSA. Our stethoscope, swipe cards and mobile
phones are colonized with CA-MRSA. White blood cells in our body cannot kill
them because the bacteria is said to carry an enzyme that destroy
immunoglobulins.

I feel ethically uncomfortable to subject patients to practical procedures knowing

this could potentially introduce bacteria that kill the very patient we try to revive
or treat. I also feel very sad to when I read about these spreading infections in
our community because these major corporations could have averted this
problem long time ago. Over enthusiastic protection of their medical devices and
preventing advances in developing new technique has made people loose faith in
doctors and is likely to end of our medical profession.

Dr Kadiyali M Srivatsa