With concern over the spread of the H1N1flu, questions are being raised about its possible implications. For example,are people infected with HIV, the AIDS virus, or TB more susceptible to the fluthan others?

Dr.Thomas Quinn, head of the Johns Hopkins Global Health Center, considers thepotential threat from the flu outbreak.

       Dr. Thomas Quinn
"Ithink you use the right word: potential. We really don't know whether this willexpand into a global pandemic. And WHO (World Health Organization) is preparingfor that eventuality because you would not want to be unprepared should itoccur. We really will have to monitor this on a day by day, hour by hour basisto see if it's going to expand rapidly to all countries of the world," he says.

Currently,he says H1N1 is "limited to a small number of countries. The actual number ofcases is very small relative to what we ordinarily see with seasonal flu."

Seasonalflu is most prominent in the winter months, tailing off by April. However, H1N1is a new virus for humans. It's unknown whether previous flu seasons provideany immunological protection against the new strain, but the typical fluvaccinations offered each year are not expected to offer any.

"Becauseof that uncertainty, we really have to gear up as if this could be a major,serious disease," he says.

Asked how many people on average die during anoutbreak of seasonal flu, Quinn says, "In the United States, we usually see upto 30,000…deaths from a bad flu year. The people that are most susceptible toseasonal flu are the very young and the very elderly. Where new viruses come inis where we get concerned that it might hit the other age groups of thepopulation."

Hesays that most of the cases of H1N1 have also been of the young and old "andit's those who had delayed, especially in Mexico, access to care till they werepractically moribund."

TheJohns Hopkins official says many in developing countries have poor access tohealth care. But so far, the developing world has been apparently been sparedof any large number of cases. However, this could also be a result of thequality of surveillance systems, so time will tell.

Sub-SaharanAfrican nations have high numbers of cases of HIV/AIDS, TB malaria and cancer,which weaken the immune system. Steroid drugs, given to treat some illnesses,can also weaken the immune system.

Quinnsays, "The individuals who have HIV that are in more advanced stages of thedisease are more susceptible. They are immune compromised and if unvaccinatedare susceptible to any of the common Influenza A viruses. Obviously a lot ofpeople in Africa are not vaccinated. The current vaccine we've been using inthe US -- we do not believe that it is cross-protective against this new strainof the virus, anyway."

Healthofficials say everyone is believed susceptible to H1N1, and if infected, mostcould recover within a week.

"Thosepeople with tuberculosis, especially XDR-TB (Extremely Drug Resistant TB),those people with HIV and…malaria...if they get flu…they will have more severecomplications. And it could result in much more fatalities than we wouldnormally have expected," he says.

Should H1N1 strike many developingcountries, the same guidelines apply as they do in developed nations. Dr. Quinnsays, "If you cough cover your mouth. If you sneeze cover your mouth. Wash yourhands as often as you possibly can. Avoid close, intimate contact with peoplewho are already sick from a respiratory infection. They may not know whetherit's flu or not. They should make the assumption this could be flu and theyshould avoid direct contact, other than the healthcare providers, who should bewearing masks and gloves when they care for those people."  

.E2AfeedbackTitlebg{ background-color:##f5f5f5; width:100%; padding-left:8px; padding-top:2px; padding-bottom:2px; border-bottom: 1px ##cccccc dotted; border-top: 1px ##cccccc dotted;}.E2AfeedbackContent{ background-color:##ffffff; width:100%; margin:0; padding:8px; border-bottom: 1px ##cccccc dotted;}.E2AfeedbackTitlefg { font-size: 14px; font-weight: bold; color: ##666666; font-family: Arial, Helvetica, sans-serif; text-align:left;}.E2AfeedbackBody { font-size: 12px; font-weight: normal; font-family: Verdana, Arial, Helvetica, sans-serif; color: ##666666; text-align:left;}

Feedback