Should We Panic?

Swine flu is nothing to sneeze at: the H1N1 strain of the virus wreaked serious havoc in Mexico, killing over 150 people so far. In the United States, however, only 50 people have been diagnosed as having swine influenza (as of April 28), and the majority of them apparently became ill during travels in Mexico. That's just one indication that the U.S. may emerge from this scare in better shape than it's southern neighbor. Consider:

1. We're No. 2. Mexican medical officials had to work backward—identifying the flu only after realizing several unusual deaths in different locations were related. Anyone who comes to an American emergency room with sniffles now will be regarded as a potential swine-flu carrier, which increases the chances of early diagnosis, treatment and containment. Across the country, hospital staff are meeting to discuss everything from how new patients will be tested to how many extra gloves and gowns they need to purchase. "Even if we got nothing more than a few more sporadic cases, it's been a great exercise for our whole hospital staff," says Dr. Thomas Tallman, chairman for emergency preparedness at the Cleveland Clinic. "If this illness goes further in America, we have a big advantage in that we had a heads-up, and we kind of saw it coming."

2. We're Always a Target. The antiterrorism training that resulted after 9/11 has made American hospitals better prepared to handle a pandemic. "The level of preparedness is unprecedented," says Dr. Gregory Gray, director of the center for emerging infectious diseases at the University of Iowa. "We've been drilling for this potential eventuality, not just for influenza but for other biological emergencies." The threat of avian flu over the past five years also gave hospitals specific emergency strategies for influenza epidemics.

3. We're Well Stocked. Mexico did what they could with what they had to keep this disease in check—but America can do a lot more. "We have many more resources: more hospitals, better critical care, more facilities for doctors and nurses, much better diagnostic capabilities," says Dr. David Weber, medical director of hospital epidemiology at the University of North Carolina Medical Center. "They've done an excellent job for a resource-limited country, but we have more resources." Those resources include large quantities of drugs that can treat the influenza virus, like Tamiflu and Relenza, at the ready, as well as antibiotics to treat secondary bacterial infections. (Almost half of those who died in the 1918 flu pandemic died of bacteria-caused pneumonia.)

4. We're Not as Sick. The Centers for Disease Control and Prevention (CDC) made a specific plea not to read too much into the lack of severe illness, but if this trend continues, it may indicate something about the ability of Americans to fight off this illness. "If the illness presents differently in Mexico but the virus is the same, that points to the host being somehow different," says Dr. Richard Wenzel,chairman of the department of internal medicine at the Medical College of Virginia Campus of Virginia Commonwealth University. Maybe Americans are more likely to have protective antibodies from other vaccines or from previous illnesses. Perhaps the high pollution levels in Mexico somehow make those living in the area more susceptible to illness. It's too soon to tell, but in the weeks to come, geographic and sociological factors may prove that Americans are less hospitable hosts.

5. We're Freaking Out.The World Health Organization raised the pandemic alert level to 4 on Monday afternoon (which means a significant risk of a pandemic developing). The U.S. Department of Health and Human Services declared a public-health emergency. It might sound scary, but these measures are all designed to keep the disease in check. "This is in recognition that this is a serious event, and we're taking it seriously and acting aggressively," said CDC Acting Director Richard Besser. "But what it also does is it gives us additional authority. It allows us to move products and dispense drugs in a way that we couldn't before." And what about people worrying that a runny nose is a harbinger of doom? It means they're more likely to wash their hands, get some rest and to get tested and treated—all of which can keep swine flu (or other contagious disease) from spreading.

Update (published April 28, 2009): The first version of this story said officials didn't believe the swine flu was spreading from person to person in the U.S. World health officials now suspect American patients may have transmitted the disease to others.

© 2009