Thursday, June 4, 2009

Ready to Launch? Swine Flu phase 2?

When will swine flu reappear in the Northern Hemisphere? Next September of October is the most likely time.

Most pandemics go through a well described series of three peaks of infection rate. There is an initial outbreak, that we have just had, followed by several months of relatively little activity as the flu literally travels south to the traditional flu season in the Southern Hemisphere. The flu then returns with its largest peak of activity with the next Northern Hemisphere flu season, traditionally around September and October, before dropping away again. There is usually then a final relatively small outbreak the following flu season during the next spring.

Pandemic flu literally spreads around the world, from north to south, and currently continues to be a threat south of the equator, where countries are entering the winter months and their traditional flu season, according to Dr Christian Sandrock, a UC Davis infectious diseases expert on the effect of this virus.

According to the CDC South America has had more than 600 cases, including one death in Chile, while Australia has reported more than 500.

Overall swine flu has hit more than 60 countries, with the United States reporting the most cases — more than 11,400, including at least 19 deaths, according to the CDC, compared with just over 5,700 in Mexico.

The good news is that the swine flu does not seem to be particularly dangerous to humans, although it spreads easily, it kills in relatively small numbers and is not a very potent form of flu. This does not mean that it can be ignored because with the likely impending outbreak next autumn many patients with chronic diseases, and young children, will be at increased risk of infection and potentially fatal consequences.

What should we be doing? Apart from all the obvious things like good hygiene, avoiding contamination and reducing infection spread by self-isolation of those who are infected, this is a classic example of how we can use health informatics and information technology for the greater public good.

If we had universal electronic records, and good public health reporting systems, we would be able to both identify outbreaks earlier, and treat those with infections more rapidly, as well as possibly follow up clusters of outbreaks to prevent further spread. Have a look at the CDC home page and study their swine flu influenza surveillance systems and see the large amount of data that is able to be collected now, without universal electronic records. The data is already impressive but to collect it is difficult because it involves amalgamating so many different data sources, few of which are complete, so the data itself is still not as good as it could be. And it is not available in real time.

The Obama administration is planning a comprehensive implementation of electronic medical records nationwide within the next five years. A very positive added value effect of this important initiative will be the production of more data, much of it in real time, to combat major pandemics such as swine flu, as well as a number of other substantial public health threats such as bioterrorism. The secondary use of electronic health record data for these sorts of purposes should greatly encourage all doctors and health systems to implement electronic health records, and to make sure that they are able to exchange key health information with important national bodies like the CDC.

This article is based on excerpts from the recently published book "Your Health in the Information Age - how you and your doctor can use the Internet to work together," by Peter Yellowlees MD. Available at and most online bookstores. An e-Book called "4 simple steps to better health - an insiders look" is available at Smashwords at

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