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School closures, canceled proms, and emergency rooms flooded with people panicking over run-of-the-mill coughs and sore throats. Have people gone hog wild over the so-called "swine flu," and is the media to blame for fanning the flames of fear?

The media hype, in particular, has drawn heavy criticism from the Los Angeles Times's James Rainey, who recently highlighted headlines like "Bracing for the Worst" (CNN) and other examples of fear mongering. Others, such as the reporters and editors quoted in this piece by Editor & Publisher, say it has been appropriate and measured.

So what do those on the front lines think? "I don't think it's fair at this point to indict people for being too cautious," says Michael Cappello, a pediatrics professor and infectious disease specialist at Yale University School of Medicine in New Haven, Conn. Some reactions may be overblown—for example, closing a school when there is no evidence of the virus passing among students or going to the ER with a sore throat before calling your doctor—but it’s still unclear how this epidemic is going to play out, he says. This fundamental uncertainty is driving both the public’s and the media’s reactions.

There have been some examples of exaggerated media coverage, but many journalists are covering H1N1 responsibly and asking reasonable questions, says Nayer Khazeni, a pulmonary and critical care physician at Stanford University School of Medicine in Palo Alto, Calif.

Among the key questions, Khazeni says, is figuring out who may die from an H1N1 infection, and who will just have a mild case. “It’s very reassuring that that the majority of cases have been mild.”

Anytime a virus pops up that scientists have never seen before, health officials as well as the public and the media have good reason to be concerned, Carolyn Bridges, an epidemiologist at the U.S. Centers for Disease Control and Prevention (CDC) told reporters this week in an interview arranged by the Association of Health Care Journalists. In previous outbreaks, novel viruses have been known to replace the older seasonal flu viruses, Bridges explained. With flu season now coming upon the Southern hemisphere and no vaccine for this new H1N1 strain, the virus is still a threat even if it turns out to cause the same degree of illness as seasonal flu, which kills up to 36,000 people annually just in the U.S.

It may be a year of two before we understand whether reactions to the early phase of the epidemic have been commensurate with the danger, Cappello says. “When you’re in the eye of the hurricane, it’s very difficult to look around and say, ‘oh it’s going to be okay.’”

Mike Licht via Flickr

11 Comments

1. 1. j.quasimodo 09:09 AM 5/9/09

   The (over) reaction to the H1N1 strain is what one would expect from media that are themselves in a state of panic, not about the flu but about declining revenues. Bad news apparently sells papers and advertising, or at least media leaders suppose that they do.
   
   The people who do silly things like canceling a prom or shutting down a school have a different motive: they don't want to get sued if someone gets sick (most likely for a different reason.) Politicians were berating the President for not joining the panic.
   
   Yes, there is harm from being "too cautious" because we get so jaded that we won't react when the real thing comes along.

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2. 2. way2ec 12:55 PM 5/9/09

   Damned if you do, damned if you don't. Here in Mexico we have all paid the price to protect everyone's health. How does one measure the success? The epidemic has not (yet) become a pandemic. I would call that success. To err on the side of caution? Is it ever an error to take precautions when dealing with a potential pandemic? What are the options? Wait and see? If 36,000 people die of influenza every year in the United States, why NOT put the people on high alert to insure greater health protection for all?

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3. 3. jbairddo 10:24 AM 5/10/09

   Can it be that physicians have put themselves out as god for so long, that people now need to run to them for any little thing? My days in family practice were filled with people who couldn't get out of work with out a Dr.'s note or were told by doc's or their mum that they should see a doc for every little thing that comes about. Fills up ER's and removes resources from serious ill. Pt's believe that we doc's have cures for all that ails them and traditional medicine does nothing to stop that belief. Then we have health dept officials, school officials who try to step up and be like doc's and do stupid stuff like close the schools. Face it, rarely does the flu god's ever get the right strain right for flu shots, and the last time swine flu hit, more people were killed by the flu shot than the flu. So if you are a health official, how do you react when you get blindsided? Panic everyone and make it a public health emergency so no ones knows that the "flu" economic machine isn't infallible and most of what they tell everyone is crap and a major guess. Hell three years ago the real flu was so bad, up to 2/3 of the kids in our small town classes were out sick, I am sure most years regular flu kills 1000's (mostly older and way young-don't worry) but no one is shutting down schools for that. You can't quarantine an endemic or pandemic, unless you shut down the country, and mouthy moms who keep their children home because they know more than the health dept officials when they say it is ok to go back, don't help. Look, flu isn't about the bug, it about the host.

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4. 4. Wolfdeck 04:16 AM 5/12/09

   Rather than discuss the overreaction or prudent caution of the news media for hyping the avian-swine-human flu with a bio-engineered heritage at a time when Tamiflu shelf life is coming to an end, let's query why they parroted what they were told rather than questioning the information fed/or not to them and what the ramifications might be for a SPP, Montebello, 2007 beta test.

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5. 5. andreanis 08:14 AM 5/12/09

   Well lets put aside for a moment all sorts of dispute and see what can be
   done constructively in order to come out of this problem with the less possible
   economic loss.
   PROLOGUE
   I think the "CTLS approach" can be useful here (standing for Charateristics of the virus/Targeted organs/Laboratory measures to detect disease/Spread methods of this pathogen),since a thorugh understanding of the "mechanism of action " of the bug will greatly improve the fight aginst it.
   C: enveloped single stranded RNA virus with segmented genome (important for genetic shift & drift,meaning the sly microrganism undergoes frequent mutations so that a killed vaccine may be unsuccesful);pathogenic factors a)hemagglutinin b)neuroaminidase (those are glycoproteins interacting with the host's respiratory epithelia damaging them and leading to the classic pneumonia signs).T; targets respiratory tracts{nose bronchi etc).L:lab is not immediately necessary since flu symptoms are obvious.S:via floating respiratory droplets (basically breathing other infected people's air).
   
   DISCUSSION: the epidemic has the potential of causing lot of problems because a) Influenza viruses strike respiratory organs (Airway a vital anatomic structure,am referring to the ABCD primary survey of emergency medicine) b) Humans are,by nature "social animals" meaning they work & thrive by close activities and interaction((work,family,leisure this refers in particular to big Cities and highly populated areas;all those activities would therfore resent of a pandemia)
   CONCLUSION: even if improbable because of better understanding of the spreading of the bug by the "man in the street" still the danger is there with potential great human and finacial losses.It is therfore advisable to refer to experts in this field ( infectious disease specialist possibly with public health competences or similar).Mass media should increase understanding of basic biology of the virus without creating a panic atmosphere.Situation at risk should be spotted and emergency plans organised .Public debate should be stimulated about prctical ways to dicrease infectious risk (use of masks,use of internet & other "no-contact" human interaction medias,any other useful idea).Optimism should prevail,eventually a vaccine will be available and the threat wil be over.
   
   AndyBess

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6. 6. stan3 06:42 PM 5/12/09

   I think that j.quasimodo came closest to hitting the nail on the head. His(or Hers) analysis of the actions of the media were the most accurate.

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7. 7. andreanis 04:16 AM 5/14/09

   read this guys:
   
   http://www.hs.fi/english/article/Swine+flu+brought+to+Finland+from+Mexico+by+couple+is+milder+than+feared/1135245917993
   
   it seems mexican population is particularly sensitivive to this flu........

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8. 8. quiact 02:48 PM 5/14/09

   Virus is a Latin word, meaning ‘poison’.
   
   A virus is more of a very well organized molecular parasite than an actual life form, such as bacteria.
   
   The virus cannot grow or reproduce without a host cell- another life form. That means it needs a bird or mammal, such as humans, in order to exist and thrive.
   
   And the virus has the potential to completely destroy the host they have acquired in the process in order to exist.
   Presently, influenza is once again a very concerning sub-microscopic infectious agent, and we are their potential hosts in order for these viruses to survive.
   The influenza viruses are of what are called orthomyxoviruses, which is a group or family of RNA viruses that are categorized into A, B, and C.
   
   The Influenza A virus is the one that historically has caused pandemics that have developed in the past.
   
   About eighty percent of flu cases in the U.S. are type A influenza viruses.
   
   Influenza vaccinations are the only available method of prevention at this time from the potentially deadly effects of influenza.
   
   Influenza is the virus responsible for the disease that has its name, and it is spread easily to other humans.
   
   This virus can be deadly to a greater degree when the virus creates a pandemic, which did happen in the United States and other parts of the world less than 100 years ago.
   
   Other influenza pandemics primarily and historically have occurred in countries in Asia.
   
   For an influenza pandemic to occur, which means a global disease existence and presence, the virus must emerge from another species to humans without a strong immune system- as well as the ability to make more humans ill than normal due to the constant mutation of the influenza virus.
   
   Also, the virus must be highly contagious for a pandemic to occur.
   
   That pandemic caused around a half a million deaths in the United States alone.
   
   This event is now known as the Great Influenza Epidemic.
   
   Understandably there was panic among people worldwide, as the influenza virus itself was not identified until the year 1933.
   
   So, the mystery was rather frightening of what was happening at that time.
   
   The etiology for the illness and the deaths that followed at such a rapid rate was a complete mystery to everyone at the time.
   Clearly, at times these influenza strains are more dangerous than others, and this was one of the strains that clearly proved to be much more during that particular epidemic.
   
   The potentially deadly effects of the influenza virus is due to this virus penetrating the host, such as a human being
   
   Once infected and established in the host, the virus replicates within the cell of the host in the cell’s cytoplasm.
   
   To survive, the influenza virus targets an enzyme called polymerase, which is what directs the content of this cell to produce proteins the virus needs to exist.
   
   Unlike coryza, influenza expresses symptoms more severely, and usually lasts two weeks until one recovers who has the flu.
   
   Influenza, however, poses a danger to some with compromised immune systems, such as the chronically ill.
   
   So the risk is greater in such populations, along with women who may be pregnant during the flu season, residents of nursing homes or chronic care facilities.
   
   If unprotected by an effective influenza vaccination given to such patient populations, influenza has a greater ability to penetrate hosts and create complications.
   
   These complications may include deadly diseases, such as bacterial pneumonia or encephalitis.
   
   Symptoms of influenza usually start to express themselves symptomatically about two days or so after being infected with the virus.
   
   Over 10 percent of the population is infected with this virus every year- resulting in about 200,000 hospitalizations and nearly 40,000 deaths, according to the Center For Disease Control (CDC).
   
   Those who do survive an influenza infection allow others to obtain antibodies from them to develop other antibodies for future viral outbreaks.
   
   The antibodies are used to produce vaccines to prevent acquisition of the damaging effects of influenza.
   
   Yet this is only if the antibodies contained in the influenza vaccine are effective against the suspected particular influenza strains that are present during the influenza season.
   
   Specifically, it is usually what is known as strept pneumo bacteria that kill those due to an infection of these microbes due to being invaded by influenza, ultimately.
   
   This is the type of bacteria that typically infect a person suffering from influenza who may have compromised immune systems, as mentioned earlier.
   
   In these cases, the bacteria are allowed to thrive at a higher and more deadly rate.
   
   On average, it takes over a week for one to die after being infected by influenza that has the power to cause death in particular human populations.
   
   Pandemic flu outbreaks, such as the one that happened that was mentioned earlier was an influenza strain so powerful that it overkills the cells of its host.
   
   The influenza virus has this ability on occasion, and its efficacy is dependent on its mutations that have developed over time that make it more powerful than other influenza viruses.
   
   The flu vaccination is trivalent- meaning it contains three viral strains of suspected viruses for flu outbreaks during a particular winter season.
   
   The viral strains are determined by the World Health Organization, as well as the Centers for Disease Control, and other organizations.
   
   Yet one should keep in mind that these three strains of influenza may not even exist in a particular flu season.
   
   The vaccination is a guess, at best, yet is certainly better than the absence of a flu vaccination.
   
   Unfortunately, the influenza vaccine administered last flu season was believed to be largely ineffective due to unsuspected strains of the virus infecting others.
   
   Although about 140 million injections of this vaccine were administered, this proved to be pointless for preventative medicine for influenza during this season.
   
   The most recent flu season was fairly mild, according to the CDC.
   
   After giving the vaccination dose to one, it takes about 10 days for that person to build up the immunity for the disease of influenza.
   
   The months of October to December are recommended to receive this vaccine.
   
   And the vaccine is about 50 percent effective in offering protection from influenza, according to others, if one calculates the previous flu seasons with flu vaccinations.
   
   Vaccines are a catalyst for antibody production in humans, which protect them against the virus, if the influenza virus happens to present itself within them.
   
   The influenza vaccines can be given by injection or nasally.
   
   The flu season that is now occurring was supplied with 150 million vaccines in the United States.
   
   However, some studies have shown that this vaccine is rather ineffective based on incidences of the acquisition of the influenza virus by others, initial reports have indicated.
   
   The influenza season peaks between the months of January and March.
   
   The vaccine for this influenza season is manufactured by 6 different companies in preparation for this timeframe of the influenza season.
   
   Also, it takes manufacturers about 6 months to make and formulate the influenza vaccination.
   
   The influenza vaccine is produced every year according to which type of virus types that may be prevalent during a particular flu season.
   
   The presence of influenza can be widespread in certain states, yet not others. The vaccination is recommended to be administered to those who are at high risk, such as the chronically ill.
   
   Also, it is recommended that those under 18 years of age get the vaccine, as well as those people over the age of 50.
   
   Pregnant women should receive the immunization. Health care personnel are always encouraged to get a flu vaccine as well.
   
   Such populations of those recommended to receive the flu vaccination are those believed to need the protection the vaccine may offer the most.
   
   This is of concern, as influenza can progress rapidly into the more serious illnesses mentioned earlier that can lead to death.
   
   Anti-virals, on the other hand, decrease greatly the ability for viruses to reproduce once established in a human.
   
   That seems like it should be a focus during viral seasons instead of any vaccination that exist today regarding the disease of influenza.
   
   Yet, as with antibiotics, viruses can become resistant to anti-virals as well.
   
   Yet the strains chosen for the influenza vaccine contain what are speculated influenza viruses.
   
   So the vaccine is ineffective if a new and dominant influenza viral strain that possibly could cause a pandemic happens to be present during an influenza season.
   
   With the influenza virus, again it can have the ability to kill mammals, as well as birds, along with humans at times.
   
   The concern that there is an influenza strain that exists that has the ability to mutate.
   
   If this happens, the viruses have the ability to share genetic data between separate life forms as they, multiply within each one of them with ease.
   
   This is the case with what is known as the Avian Flu, as well as the Swine Flu.
   
   The most recent avian influenza virus was identified in China in 1997. Called the H5N1 virus subtype, it has the potential to be the next flu pandemic.
   
   The last Swine Flu outbreak occured in the United States during the mid 1970s.
   
   However, the virus responsible for the pandemic mentioned earlier was an avian influenza, which was called the H1N1 influenza virus.
   
   This virus, unlike the human influenza virus, has a longer incubation period- about 5 days.
   
   Also, H5N1 has the ability to mutate more rapidly, as well as replicate at a similar speed.
   
   Avian influenza viruses are highly pathogenic. No one fully understands the influenza virus and its rapid ability to mutate.
   
   This is because this particularly malicious virus is the result of two separate influenza viruses acquiring the same host at the same time.
   
   As a result of mutual sharing of genetic material between the two viruses, novel attributes are allowed to develop and create a H5N1 that obviously prove to be rather deadly.
   
   The H5N1 Avian influenza virus seems to have become progressively more pathogenic in the past decade, according to others.
   
   The letters H and N, by the way, stand for the antigens HA and NA-and are the letters of proteins that protrude from the viral shell.
   
   It is these proteins that mutate so often with the influenza virus, and which is why we continue to be infected with this virus.
   
   With the Avian Influenza existing with the H5N1 strain, millions of birds have been slaughtered due to the danger and unpredictability of this strain.
   
   The first recorded incidence of human-to-human transmission of the H5N1 virus was believed to be in Thailand in 2004.
   
   There have been outbreaks of Avian flu in about 10 or 20 countries in the world so far- with Indonesia appearing to be the worst.
   
   Migratory birds spread this influenza virus between continents.
   
   The pathogenic strength of the H5N1strain varies due to constant re-assortment or switching of genetic material between the viruses.
   
   This essentially creates hybrid modifications of what it was before this occurs due to this re-assortment that makes this virus much more virulent.
   
   So far, nearly a half a million people worldwide have been infected with this strain.
   
   Also, about half have died from the infection caused by this H5N1 influenza virus.
   
   Vaccinations are being developed and reformulated constantly at this time due to the pandemic threat of the H5N1 Influenza virus, and most recently, the swine flu virus. Of the two, the H5N1 is believed to be more deadly.
   
   www.cdc.org/flu/weekly
   
   Dan Abshear
   

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9. 9. jen10715 05:02 PM 5/14/09

   ImmuneRegens H1N1 studies furthered by renowned scientist
   
   Ted Ross, Ph.D., an assistant professor at the University of Pittsburghs Center for Vaccine Research, will explore the use of ImmuneRegens lead influenza therapeutic product, Viprovex�, as an adjuvant to novel influenza vaccines. In studies of influenza-infected animals performed at other research facilities, ImmuneRegens Viprovex has consistently demonstrated efficacy in reducing symptoms related to seasonal (e.g. H1N1 and H3N2) influenza and highly-pathogenic (e.g. H5N1) influenza strains. The current pandemic Swine Flu (H1N1) has many attributes of typical seasonal influenza strains.
   
   Click below to read full press release:
   http://news.moneycentral.msn.com/ticker/article.aspx?Feed=MW&Date=20090514&ID=9902980&Symbol=IRBS
   
   http://www.CadenceforCancer.org
   

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10. 10. jen10715 05:03 PM 5/14/09

    ImmuneRegen’s H1N1 studies furthered by renowned scientist
    
    Ted Ross, Ph.D., an assistant professor at the University of Pittsburgh’s Center for Vaccine Research, will explore the use of ImmuneRegen’s lead influenza therapeutic product, Viprovex®, as an adjuvant to novel influenza vaccines. In studies of influenza-infected animals performed at other research facilities, ImmuneRegen’s Viprovex has consistently demonstrated efficacy in reducing symptoms related to seasonal (e.g. H1N1 and H3N2) influenza and highly-pathogenic (e.g. H5N1) influenza strains. The current pandemic “Swine Flu” (H1N1) has many attributes of typical seasonal influenza strains.
    
    Click below to read full press release:
    http://news.moneycentral.msn.com/ticker/article.aspx?Feed=MW&Date=20090514&ID=9902980&Symbol=IRBS
    
    http://www.CadenceforCancer.org
    

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11. 11. Karl 03:24 PM 5/15/09

    I rode here (printed version) some time ago, that viruses like living things (not saying they are living, but that they are subject to the same process) are subjects to evolution, hence resistance to antivirals, mutations, species jumping and so on, now, if you throw a virus on a crowded population (where it has lots and lots of chances of infecting new hosts) it tends to evolve to an increased pathogenicity, which is likely to happen in a crowded city, like mexico city.
    Second, a RNA virus can mutate faster (as stated before), so you get better chances of it going really bad.
    Third, H1N1 family was responsible of the 1918-19 pandemics, where about 30 million died, I think caution was in place.

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