It would be tempting to allege that the West has been more proactive on what is rather misleadingly termed 'swine flu', or more appropriately A (H1N1), because it has originated in its own backyard, somewhat like HIV/AIDS. As has often been pointed out in fatal diseases such as malaria and TB, which affect poor countries alone, the West has been indifferent to literally millions of deaths throughout the world. In this instance, the disease has originated in Mexico, which is worst affected, and spread to its northern neighbour, the United States.
According to the World Heath Organisation, the number of laboratory-confirmed cases of swine flu has increased to 8500 and also claimed 79 lives around the world. Mexico and the US have topped the list of 39 countries where human cases of the virus have been reported. Mexico has 1626 cases, including 48 deaths, while the US has 4714 cases and four deaths.
"WHO's pandemic alert level remains at Phase 5 - on a six-point warning scale - as it has for the past several days," Dr Keiji Fukuda, WHO's Acting Assistant Director-General for Health Security and Environment said. "Community-level sustained human-to-human transmission has been documented in North America, in Mexico and in the United States most clearly. We do not see clear evidence of sustained community-level transmission going on in other countries yet." He noted that it is possible that the alert level will go up to Phase 6, which would mean that the spread of the virus has become established in another region outside of North America and is spreading at the community level.
India has one confirmed case - a 23-year-old who is an IT student in the US and has come on a visit to Hyderabad. Another student and his mother, who also are visiting from the US, have reported flu symptoms and are quarantined in Coimbatore. It is shocking that the US airport authorities, who leave no stone unturned when it comes to security even when passengers are flying out of that country (often asking them to remove shoes and belts), have allowed these persons to proceed without any checks or alerts. One can only surmise that with these travellers being persons who are leaving rather than entering the country, the US authorities have not been as alert as they customarily are, which is self-serving.
Swine flu, also called hog or pig flu, originates from infections in domesticated pigs. The current virus is a hybrid which combines features of human, pig and avian (bird) flu and its origin is not exactly known. It is correct for the WHO to issue this warning, and keep the global community abreast of current developments, because flu can spread with lightning speed and cause havoc.
In 1918, the disastrous "Spanish" flu pandemic spread to nearly every country in the world and killed between 50 and 100 million, even in remote Arctic and Pacific islands, during an era when jet flights and mass tourism had not developed yet. The deaths worldwide amounted to a third of the entire population of Europe and twice the number killed in the second World War. It infected 500 million people, one-third of the world's population. It took a toll of around 17 million people, or a full 5 per cent of India's population. It was an unusually virulent virus subtype also of H1N1, hence the worrying resemblance.
In this context, the precautions being taken at Indian airports, however well-meaning, appear to miss the point altogether. If one relies on incoming passengers declaring on a form whether they have any flu-like symptoms, that will probably be the last thing they intend to do, for fear that they will be quarantined. Anyone who has the slightest experience of being quarantined at Indian airports - for failing to possess a yellow fever inoculation certificate, for example - will testify that it is quite a harrowing experience. In Mumbai for example, the clinic is unkempt and, during the monsoons, its environs are overrun with weeds and snakes, leading anybody incarcerated there for five days to fear falling seriously ill!
Whatever the exact causes of this epidemic, knee-jerk reactions, such as culling pigs in Cairo and even in certain Indian cities, is never called for. If one take a holistic view, it is clear that so-called modern methods of rearing animals for human consumption are largely to blame for the spread of such diseases. Severe Acute Respiratory Syndrome (SARS) reared its head in China's Guangdong province to infect individuals in 37 countries between 2002 and 2003. While the spread had been contained due to initiatives of WHO by 2006, experts believe that it has not been eradicated, like smallpox, but may return to haunt humans because it may be present in its "natural host reservoirs" which are domesticated animals. The media was full of gory descriptions at the time at the insanitary methods of keeping a wide range of animals, including snakes, for consumption.
Avian flu, which is too close for comfort to swine flu, has from time to time originated, among other hosts like pigs, in domesticated poultry like chickens and turkeys. It can mutate to kill almost an entire farm of such birds, which have to be killed and disposed off safely to avoid further infection from spreading. Robert Webster, a leading expert on avian flu, has published an article titled "The world is teetering on the edge of a pandemic that could kill a large fraction of the human population" in American Scientist. He called for adequate resources to fight what he sees as a major world threat to possibly billions of lives. Since the article was written, the world community has spent billions of dollars fighting this threat with limited success.
Unhealthy rearing practices
A (H1N1) Virus
Influenza A strains are categorized according to two proteins found on the surface of the virus: hemagglutinin (H) and neuraminidase (N). All influenza A viruses contain hemagglutinin and neuraminidase, but the structure of these proteins differs from strain to strain due to rapid genetic mutation in the viral genome.
Influenza A virus strains are assigned an H number and an N number based on which forms of these two proteins the strain contains. There are 16 H and 9 N subtypes known in birds, but only H 1, 2 and 3, and N 1 and 2 are commonly found in humans.
One of the worst cases of disease arising from unhealthy animal rearing is Bovine Spongiform Encephalopathy (BSE), popularly known as Mad Cow Disease, which has sprang up within the last decade. As of this February, it has killed 164 people in the UK and 42 in other countries. UK is the worst affected: 180,000 cattle had been infected and a colossal 4.4 million killed during the eradication drive, which gives a glimpse of the enormous financial toll this disease has taken, not to mention human health. It has been contracted by cattle, which are grass-eating but have been fed in "modern" farms with meat and bone meal of other cattle in order, highly erroneously, to boost their protein intake. In turn, humans who consumed the brain or spinal cord of infected carcasses could contract this enormously mentally debilitating, and possibly fatal disease.
Closer home, the spread of what was wrongly believed to be plague in Surat some years ago was actually a deadly strain of virus which had plague-like qualities. The rampant and often illegal construction that took place in the commercial city of Surat, without any thought to drainage, led to the spread of this contagious disease. Stagnant pools of water and clogged drains proved fertile breeding ground for vectors like flies, mosquitoes, rats and pigs.
More than the toll, it was the panic that it spread - connotations of plague strike deep in the Western consciousness to this day as something that part of the world has rid itself of forever - and cost India millions of crores in business and tourism. The WHO in fact some years later castigated the medical establishment as well as the media for rumour-mongering, terming it "media-induced plague".
While hopefully swine flu will not affect too many countries, it serves as a wake-up call to all countries to take a second, hard look at farming practices as well as urban growth and return to more ecological ways in both sectors.