Health Features

2009 YEARENDER: World held its breath as swine flu grew into pandemic

Dec 31, 2009, 15:45 GMT

Berlin - Latin cultures have made physical proximity one of their trademarks: people regularly kiss each other hello and goodbye.

For a time in 2009, however, both kissing and handshakes became taboo. Disinfectant hand gel was everywhere. Some drug stores even ran out.

The World Health Organization (WHO) first reported the outbreak of an 'influenza-like illness in the United States and Mexico' on April 24. It wasn't long before swine flu - what public health officials later called 2009 Influenza A(H1N1) - was dominating headlines around the globe.

While individuals questioned whether the disease, spread through human contact or by coughing and sneezing, or its vaccine was the greater danger, A(H1N1) proved a powerful societal phenomenon.

In May, Egypt ordered the slaughter of its 250,000 pigs. Early laboratory tests had shown the new virus shared many genes with influenza viruses normally found in swine in North America.

However, later tests revealed that the term 'swine flu' was a misnomer. The US Centers for Disease Control and Prevention (CDC) said A(H1N1) was a 'quadruple reassortant' virus since it contained genes from flu viruses normally found in pigs in Europe and Asia, as well as bird and human genes.

Mexico briefly became a global pariah when the new flu was first detected. Even healthy Mexicans were regarded with suspicion abroad, and some were detained in China even though they showed no symptoms of the virus.

The A(H1N1) virus brought tensions even at the diplomatic level, with Mexico complaining that Argentina and Cuba, for example, temporarily suspended flights.

Social life came to an abrupt halt as restaurants in Mexico City were banned from serving food for a week. Bars remained nearly empty for much longer than that.

Museums, libraries, cinemas and theatres were shuttered. Even churches called off services.

In Argentina, children got a month-long mid-year break. School was cancelled for two weeks due to the swine flu outbreak, followed by the regular two-week winter vacation.

Half of the global tourism industry's losses in 2009 were due to the swine flu panic, said the UN World Tourism Organization. In Mexico alone, the organization quantified these losses at almost 4.5 billion dollars.

Swine flu hit Ukraine hard and, as is frequently the case in the former Soviet republic, with plenty of political recriminations and evidence of official incompetence.

Ukrainian media gave the first hints of increased flu infections in mid-October.

Health officials initially downplayed the reports, saying flu infections were rising, but no faster than in previous flu seasons, and that of the few registered deaths, not a single case of swine flu infection had been confirmed.

But in late October, Prime Minister Yulia Tymoshenko told the nation in a television address that it was in the grips of a 'flu epidemic.'

The government was taking steps to fight the flu, she said, including a blitz programme to manufacture protective gauze masks. She later took the dramatic step of meeting a cargo plane carrying swine flu vaccine arriving from Switzerland at the Kiev airport.

Tymoshenko's critics immediately accused her of fanning panic and creating a false emergency in order to win a presidential election.

In Ukraine, as elsewhere, there was a sense that the panic over swine flu was much inflated. Despite its being the first influenza pandemic since 1968, with the WHO confirming at least 8,768 deaths worldwide by the end of November, public interest in the vaccine was often muted.

Saudi Arabia this year recommended that all Muslim pilgrims get vaccinated for A(H1N1) before going on the hajj, an annual pilgrimage in the Muslim faith. Egypt, meanwhile, banned those under 25 or over 60 from making the pilgrimage to Mecca, and required its citizens intending to go to get a jab.

But, in reality, vaccination certificates were handed out in some cases even if people did not get the jab. It appears some health officials were willing to waive the rules in consideration of some people's concerns that the vaccine itself was unsafe - despite the fact that international medical authorities said they were sound.

This prompted the Egyptian minister of health to get vaccinated on national television, along with the grand sheikh of Al-Azhar mosque, in order to allay fears.

By the end of 2009, swine flu pandemic had peaked in most parts of the world and public interest was generally on the wane. Looking ahead to 2010, WHO Director General Margaret Chan wrote that the pattern seen in the second half of 2009 would continue.

'The overwhelming majority of cases will experience mild symptoms followed by rapid and full recovery.'

But Chan, writing in The Economist's World in 2010 magazine, also said that for those needing a vaccine, supplies will in many areas be 'woefully inadequate.'



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