Saturday, May 02, 2009

Swine flu: Prevention is the only sure cure

Hi everyone,

And now, back to more pressing matters. Remember to wash your hands!

Saturday's column.

Swine flu: Prevention is the only sure cure

The sixth question from the top of the Center for Disease Control’s Key Facts about Swine Flu this week is “Can I get swine influenza from eating or preparing pork?” The answer is “no.” Under normal circumstances this might have raised a smile but these aren’t normal circumstances and this year’s swine flu – or, to give it its full name, the H1N1 flu virus – is serious business.

Public health preparations are under way around the world. The World Health Organization raised its pandemic alert to Level 5, its second-highest level, to bring worldwide preparedness plans online; the Center for Disease Control has reported 109 confirmed cases in the United States; the governor of the Mexican state of Puebla has canceled his trip to celebrate Cinco de Mayo in Milwaukee next week; and the Milwaukee Health Department has started closing schools. In Wisconsin, as of April 30, 144 suspected patients have yielded only three cases classified as probable and none has been confirmed as actually infected with swine flu. Yet.

But as the scary reports begin to come in, remember to maintain some perspective.

People often forget that Wisconsin, and Milwaukee in particular, are historic examples of the best way to cope with a flu pandemic. In 1918 when the “Spanish flu” killed between 50 and 100 million people worldwide, Milwaukee had one of the lowest contagion rates in the world: 30 percent to 50 percent lower than other American cities. Why? A first-rate public health system.

The first six cases of Spanish flu were reported in Milwaukee on Sept. 26, 1918. By Oct. 2, four people had died. By Oct. 7 there were 256 new cases and nine more deaths. The epidemic spread out into the rest of the state, but Wisconsin was ready.

The point man for Wisconsin’s public health system was Dr. Cornelius A. Harper, appointed in 1902 by Gov. Robert M. La Follette, Sr. As state health officer during the epidemic and, like most Progressives of that era, a strong believer in activist state government, his actions made Milwaukee one of the safest cities in the world in which to ride out the pandemic. On Oct. 10, 1918, he closed schools, churches, and nearly every public space other than factories and offices. Wisconsin’s response was the most comprehensive in the nation and Harper kept quarantines in place until the epidemic subsided that December.

You can’t mount a massive response like this single handedly, and Harper didn’t have to.

In 1883 our Legislature required every Wisconsin municipality to appoint a local public health officer and board of health and, by 1918, if you can imagine this, there were 1,685 local boards of health around the state to implement Harper’s orders. Thirty years of work by reformers and Milwaukee’s socialist politicians created a public health system that tallied some of the lowest infection rates in the country.

That public health system is still in place so, if we have to have an epidemic, Wisconsin is one of the best places to live through it. Don’t forget that.

Here’s a factoid to put things into perspective. How many Americans do you think die from the flu, or complications, in a normal year? I was surprised. During the 1990s the CDC estimates that, on average, 36,000 Americans died each year from flu-related causes. During these years, the number of estimated deaths ranged from 17,000 to 52,000. Thirty-six thousand a year. So far this epidemic as produced 109 confirmed cases and one death.

Here’s another factoid: The greatest advances in human health, over the past 200 years, have come not from developing new drugs but from public health measures, like improved sewer systems, clean drinking water and even washing your hands. Simple prevention has produced far greater benefits to public health – and cut off the spread of epidemics – than any other development in medicine.

So much for perspective. Now: What can we do?

The official textbook advice goes like this (and even though it doesn’t sound like much, it works like a charm): Get enough sleep and exercise to stay healthy, chill out to keep your stress levels low, eat right, stay home if you get sick and avoid people who are sick. And, most importantly, wash your hands. Seriously, Mom was right. Wash your hands.

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