Thu, Mar 17, 2016 - Page 8 News List

Influenza: The deadly elephant in the room

By Mayo Kuo 郭明裕

Why has this year’s outbreak of influenza been so destructive? There are several possible reasons.

The anomalous weather patterns. On Jan 24, the northern parts of Taiwan saw snowfall in the plains close to mountain areas for the first time in history. The Lunar New Year holiday period saw low temperatures extended for longer than normally expected. This cold weather exacerbated the spread of influenza.

The Lunar New Year holiday was longer this year and the outbreak occurred later than usual. Instead of breaking out during the Christmas season as in the past, influenza slowly, but steadily, began to spread in late January and continued last month.

Third, for the past two years, the Centers for Disease Control (CDC) has been trying to empty its remaining stock of the antiviral Relenza, but quite a large proportion of patients find the inhalable powder hard to use.

The outbreak also coincided with a government transition. Lin Tzou-yien (林奏延), who is an expert on influenza, resigned from his post as deputy minister of Health and Welfare. The current minister, Chiang Been-huang (蔣丙煌), lacks medical expertise. In addition, the Feb. 6 earthquake that wreaked havoc in Tainan grabbed media attention and the public was less aware of the threat influenza posed.

In 2009, the CDC abolished a system requiring doctors to report to the government when they observed flu-like symptoms in patients. In absence of this system, there is no mechanism to detect early signs of an epidemic. The result is that the total number of patients with influenza and severe complications is not known until at least 10 days into an outbreak — meanwhile, general practitioners and emergency room doctors fighting the epidemic were left without assistance.

It was only after patients filled every bed in intensive care units that the discussion turned to the issue of closing down schools, and this was too late. Hospitals are using all extracorporeal membrane oxygenation (ECMO) machines available and the only thing left to do is wait it out and deal with the consequences.

Influenza is more deadly than the Zika virus. The 1918 flu pandemic that killed 40 million people has been a reminder for the past 100 years that influenza should always be feared.Although nowadays we have flu vaccines, antivirals, intensive care units, medical ventilators and ECMO machines, and a much lower fatality rate, influenza remains a threat to human life.

Medical science has made great progress in preventing and treating epidemics. Yet people should still be cautious of influenza, which is highly capricious and mutable. If the global climate were to suddenly change, the entire disease control system on which we rely could become vulnerable. The incoming government should be more vigilant and never count on good luck.

Mayo Kuo is a Taiwan-based pediatrician.

Translated by Yu-an Tu

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