[M.K. THOMPSON] The swine flu blues and hopes of healthier world

The 2009 H1N1 flu has been grabbing headlines for months. In April, Mexico City came to a standstill as schools and businesses were shut down and transportation hubs were put under quarantine to prevent the spread of infection. In May, hundreds of people were detained in Japan, China and Hong Kong after sick travelers were identified on airplanes and in hotels. On June11, the World Health Organization officially declared H1N1 to be a global pandemic.

This is the third global flu pandemic of the century, following the 1918-19 Spanish flu and the 1968-69 Hong Kong flu. Timing and technology have made all of the difference.

The Spanish flu got its name because at the time it was possible to obtain extensive and reliable media coverage of the outbreak in Spain. Many other countries intentionally limited public distribution of information about the pandemic to prevent panic and maintain morale for the World War I. In comparison, information today is increasingly difficult to control. The internet, satellite technology, cell phones and international journalism keep the world updated with startling speed. Perhaps we are updated a little too fast. So far, the H1N1 swine flu has infected far fewer people and caused far fewer fatalities than either of the previous pandemics. But it has almost certainly frightened more.



Medical technology has had a huge impact on the treatment of the flu. Antiviral drugs can provide a tremendous benefit to high risk and severely ill patients, but the two antiviral medicines that are most commonly recommended to combat H1N1 weren`t developed until the 1990s. Advances in antibiotics have been helpful as well. In 1918, many of the deaths were the result of bacterial pneumonia infections that took advantage of their victims` weakened states. Today, we are much better at treating pneumonia and other complications, which has certainly helped to keep the fatalities this year in the thousands instead of the millions.

Technology to detect and prevent the spread of disease has improved substantially over the past 50 years. Dermal contact digital thermometers allow diligent airport quarantine officials to take the temperature of each arriving passenger quickly and accurately. Infrared cameras are being used to ensnare wily pathogens that get past the initial screeners. And neat little ultraviolet spray hand sanitizer machines have appeared everywhere that people are likely to be (cafeterias, tourist attractions, etc.) to minimize person-to-person transmission. Of course, travel in general has also increased substantially, which increases the need for such measures.

In many schools, students who are suspected of having the H1N1 virus or who are confirmed carriers are being immediately quarantined and sent home until they recover. In some cases, their roommates or classmates are also being quarantined as an extra precaution. The news that someone has been quarantined can be delivered in seconds via cell phone, text message, instant message or e-mail without the need to expose anyone else to the pathogen. In less than an hour, the same students can be home and emailing their teachers or professors to notify them of their absence. News travels fast.

The U.S. Center for Disease Control has said that most infections were mild and that recovery was fairly quick. And clearly some of the individuals who have endured quarantine over the past six months haven`t been sick. For them, the internet has been a blessing.

Most colleges and universities today are making prodigious use of the internet and information technology. My students can read lecture notes, submit homework assignments and collaborate with each other via the internet. They are so well connected that they can still participate in team design projects while they are away as long as they are feeling well enough to do so. These students are, of course, excused from all of their course work until they return. But catching up is hard after falling behind and there is no need to lose ground as long as they can get online.

The internet has made self-imposed quarantine easier too. Today, working from home is well understood, socially acceptable and increasingly common. As a result, it is relatively simple for ailing employees to telecommute for a few days if their job does not require their physical presence. This results in relatively little loss of personal productivity while protecting the health and well-being of their colleagues. Supervisors can grant permission for an online commute in minutes.

Humanity is actively engaged in an epidemiological arms race. Humans evolve. Diseases mutate. Technology advances. Time marches on.

It may never be possible to eradicate disease. We may never be able to prevent t it from jumping species or crossing international borders. But we will continue to inform, study, screen, quarantine, track, treat and develop technology - all in the hopes of a healthier world.





Mary Kathryn Thompson, Ph.D., is an assistant professor in the Department of Civil and Environmental Engineering, the Korea Advanced Institute of Science and Technology. She can be reached at mkthompson@an.kaist.ac.kr - Ed.