Thanksgiving and Swine Flu

  1. The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.

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    Thanksgiving festivities produce two things of epidemiological import. There are increased close contacts between different age groups (for example elementary, highschool and college age and the over 65 age group); and close personal contacts between people from widely separated geographic areas. It's a heady mix. December is the time when seasonal flu starts, slowly at first, then picking up steam in January and February. But this year we've already had a whole flu season (and more), although the usual victims (old folks like me) have so far been spared the worst. Will it now be our turn, falling prey as we usually do to seasonal flu? Or has the new kid on the block, swine flu, in some way we don't quite understand, "crowded out" the usual residents? We don't know yet.

    There's also a new and completely different mix of the susceptible and immune in the population, a vaccination campaign targeting younger populations just starting to get underway, weather turning colder (which increases flu in ways we don't understand) and a major economic recession that is affecting habits, living patterns and perhaps susceptibilities in unknown ways. The dynamics of seasonal flu -- how the disease unfolds in space in time -- still isn't understood and now we have a completely novel situation: not only the aforementioned factors, but possibly four flu viruses (swine flu, two seasonal influenza A subtypes and influenza B) all circulating -- maybe -- along with the usual other respiratory viruses (respiratory syncytial and rhinoviruses chief among them).

    What will be the result? We're going to find out soon.
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