Much ado about swine flu

Migrant workers rights and racial segregation a concern in government reaction to swine flu; “novel” flu strain still poses threats

Candice Kung

Hand sanitizers and N95 masks were flying off shelves in the wake of a possible global pandemic. The recent H1N1 outbreak in Mexico –also known as swine flu—caused a global frenzy last month, leaving health officials scrambling to find a vaccine as the number of confirmed cases rose around the world.

With the virus now at a standstill, some say the situation was overblown. But even as the hysteria dies down, health experts still worry that the H1N1 virus might return from a crawl to full speed ahead this coming fall.

“The uncertainty is usually what creates the hype,” said Dr. Yvonne Yau, a microbiologist at Sick Kids Hospital where some cases of swine flu have been reported. “Right now, with respect to public health, this is something that is still being monitored and we’re not letting our guard down.” Health officials are worried about the virus mutating and a second wave hitting hard in the fall when the regular flu season starts.

“There isn’t any reason for panic or mass hysteria,” said Dr. Ashley Roberts, the medical director of infectious diseases at Rouge Valley Health System. “But certainly when information was sketchy at the beginning and before we had a better understanding as to what kind severity of illness it caused, I think there was reason for everyone to be put on increased caution and for there to be some level of concern.” 

“It certainly does have the potential to be pandemic influenza but we’re not there yet,” said Roberts, referring to the World Health Organization’s (WHO) decision to raise the swine flu pandemic alert to level five.  Though the H1N1 outbreak has not yet reached the level of a full-blown pandemic, governments around the world took it as a sign to step up precautions against the spread. Countries placed stronger restrictions on travel to Mexico and thermal scanners were installed in airports around the world.

But the hysteria inspired by swine flu extended beyond travel and border control. Restaurants, cafes, businesses and even schools were shut down in Mexico City as Mexican officials tried to control the swine flu outbreak. Millions preferred to stay home rather than risk contamination. 

Still reeling from the recent avian flu outbreak, concerns over swine flu left China and Mexico in a diplomatic row after Chinese authorities clad in biohazard suits forced dozens of Mexican travelers into quarantine. Egypt slaughtered 300,000 pigs despite the fact that there wasn’t a single case of the flu in the country and Iraqi officials killed three wild boars in a Baghdad zoo to ward off the virus. Russia and Ukraine have banned pork products imported from Mexico and the United States, and many countries are stocking up on large doses of Tamiflu.

“It’s like a return to SARS when there were attacks of stereotyping,” said Chris Ramsaroop of Justicia for Migrant Workers, an advocacy group that works with migrant workers across Canada. “We have to be sensitive to these issues,” he said, fearing of a double standard and potential backlash that Mexican migrant workers may face as a result of the swine flu epidemic. It is now mandatory for seasonal and temporary workers from Mexico to undergo a physical examination before entering Canada.

“Migrant workers are being forced to undergo a second test and we see that as a form of racial segregation. Tourists don’t have to. There is a continuing link between swine flu and Mexicans. So far in Canada, all of those who have been diagnosed with swine flu have been Canadians or tourists—not Mexican workers,” said Ramsaroop.

Most confirmed cases of H1N1 outside of Mexico have so far been described as “mild” with symptoms resembling seasonal influenza including headache, fever, chills and coughing. On average, about 4,000 Canadians die of seasonal influenza each year. But what makes H1N1 a concern is that it’s a never-before-seen version of influenza type A and it’s uncertain how severe the outbreak will get. It was originally referred to as “swine flu” because it contains genes from flu viruses that normally circulate in pigs in addition to having avian and human genes. 

“The fact that it is new or novel makes it more concerning for health professionals because the majority of the population wouldn’t have immunity to it and therefore all of us are vulnerable,” said Roberts. “That doesn’t necessarily reflect severity of illness. [The concern] is more about it being a novel strain that the human population has never seen before.”

Cases have now been confirmed in 42 countries around the world with a total of 86 confirmed deaths. Ontario now has a total of 352 confirmed cases and on May 23, a 44-year-old Toronto man marked the second death of a Canadian with the swine flu virus.  Health experts are warning that though most reported cases are mild, the disease combined with other underlying conditions can have fatal consequences. 

But with the H1N1 virus moving slower than expected, doctors worry that people will stop being vigilant. Yau said influenza cases in Toronto are still higher than expected for the end of the season, which could pose a problem if the H1N1 virus reappears in the fall. “Right now we still have intense precautions. As we progress further and know more about the clinical history and clinical spectrum that it causes, then it might change,” said Dr. Yau. “But don’t let your guard down.”