My newest podcast is up on iTunes (go here for the web-based version).  It's the first of a two (maybe more) part series on influenza - covering flu in general.  We have been seeing a significant number of cases of the flu over the past week, which is extremely unusual for this time of year.  Epidemic flu goes around between November and Late April, with sporadic cases appearing at other times.  What we have seen so far is not sporadic, so it probably represents pandemic flu (H1N1).

I did a poll on Facebook, asking what people thought of the H1N1 situation.  The overwhelming majority responded that they felt the press and the government were hyping it way too much.  This really surprised me - not that people would think that, but that a majority of people felt this was the case.  It may have related to how the question was phrased or what the other choices were, but still this number betrays a lack of worry about the H1N1 virus.

This worries me.

I don't think the fear of the H1N1 is misplaced.  The normal flu kills over 30,000 people per year, and the H1N1 is expected to infect 3 times more people than the usual flu (for reasons I will go into in the next podcast).  The implication of this is that even if this flu is "nothing special" it will kill over 90,000.  Put in perspective, prostate cancer killed 27,000 men and breast cancer killed 41,000 women in 2008.  A "normal" potency H1N1 virus could then kill more than both of these combined.

Thankfully, the cases we've seen so far have not been severe, but still there have been 522 deaths already from the H1N1 in the US.  But in 1918, the virus mutated around this time of year and became significantly more deadly.  I think those who get it now are actually probably fortunate.

The warnings about pandemic influenza are not hype.  But the cynicism about the government and the press are widespread.  Some of the more "unconventional" thought (read into that word generously) espouse conspiracies by the government.  Here's one example of this:

It's man-made. It can be used as a biological weapon. It was developed as an AIDS vaccine-related organism. It was extracted from AIDS patients. It is responsible for virtually all of the symptoms which AIDS patients suffer from. The AIDS virus is at best a co-factor, and not even such a strong co-factor as to bring on all of the symptoms of AIDS. This particular organism, the micoplasma, is associated with this upper respiratory flu-like illness. And it's also associated in its pathogenic process with a whole variety of other symptoms that mimic AIDS.

This guy is totally nuts extreme, but the theories on the Internet of this flavor abound.

Unfortunately, the religious right Obama-haters have seized on this as anything from a means to push universal health to a weapon to sterilize the US populace.  I can assure you that this has nothing to do with Biblical thought and everything to do with the vulnerability of some people to fear-mongering.  I even had one patient ask me what I thought about the sterilization theory.  I reassured her that I had just gotten mine - although sterilization is no longer an issue for me as it has already been done with my consent.  She laughed and went ahead with the vaccine.

But less extreme people still feel this is far too much hype for the severity of the disease.  This scrutiny puts the CDC in a bad situation.  The only thing that would vindicate their dire warnings is the exact thing they are trying to prevent: a deadly pandemic.  Conversely, the more they succeed in preventing this problem, the more people will cast aspersions on them.

Take it seriously, folks.  It's like a massive storm forming in the tropics - it could be deadly and it could be a dud.  Either way, we need to do whatever it takes to minimize the damage.