Crying Wolf on swine Flu: Prof. Bragg answers questions on Pandemic Flu

1) Do you believe, since the virus hasn't been as deadly as people have expected (so far) that complacency is setting in?

This could be. If you look at the speed and urgency in the response to this outbreak by the CDC and the WHO, one can get an idea of the seriousness the scientific community places on this virus. Influenza virus remains one of the viruses with the highest potential to cause a very serious pandemic.
At this stage it is still too early to make sweeping statements about this virus and this outbreak, but it appears that the virus is not spreading as quickly as feared (although it is already confirmed on 5 continents - so I am not sure how it could spread more rapidly!).
The virus appears not to be spreading rapidly from human to human. It also appears that the virulence of this virus is not as high as first feared. Normally, when a virus crosses the species barrier it is highly virulent. Fortunately this appears not to be true in this case at this stage.
So to get back to your question - yes I do think that a measure of complacency is setting in. This could also be a problem if the virus decides to change a bit and we start seeing a more virulent form of the virus. This could lead to a "cry-wolf" situation, where during the next outbreak - people don't pay as much attention to it.

2) What measures does South Africa need to implement? Do we have enough anti-virals?

I cannot comment on the supply of anti-virals in South Africa. I also think that your protection is pretty much up to the individual at this stage. Monitoring people with a fever at airports will not work in this case. This worked with SARS - but this was a very different virus with a very different epidemiology. SARS was only infectious when people were showing clinical signs - so monitoring of temperatures could be used.
With Influenza, people are infectious before they show clinical signs. Having said this anything which can limit the spread of the virus will help and should be allied.

3) Is a vaccine worth pursuing given how quickly these influenza's mutate?

This is a very difficult question. Influenza is a very complex virus and one needs the correct combination of heamagglutin and neuraminidase for a vaccine to work. So the vaccine manufacturers need to know exactly what virus is causing the problem. So they cannot start with the vaccine production too soon. Another problem with vaccines against this virus is that it takes time to develop and produce a vaccine. If this virus was really virulent, it would be causing serious problems before a vaccine can be produced.

Currently the vaccines are made in embryonated chicken eggs. These are very special eggs which cost a lot. They are specific pathogen free eggs. These eggs come from chickens which are house in "germ free" facilities and have no antibodies in the eggs. It is a very difficult process to keep these chickens and there is a limited supply of chickens laying these eggs. It is impossible to suddenly get a lot more eggs - the chicken will only lay one egg a day!

4) Isn't the danger that even if this strain isn't 'a worse case scenario', we are moving closer and closer to it (if we're not there already).

The world is expecting a serious Influenza pandemic. Based on the past history of Influenza, a pandemic was expected about 5 years ago. This virus, not necessarily this particular strain - but influenza viruses in general, remain one of the viruses which has the potential to cause a very serious pandemic. Hence the very rapid and urgent response by WHO and CDC.

5) What is your information on the virulence of H1N1?

I do not have any specific scientific information on the virulence of this virus at this stage, but based on the spread and the clinical picture reported on, my feeling is that this is not a highly virulent strain.

6) What is the level of infection currently in SA?

I cannot comment on this. As far as I know there were two suspect cases - one of which tested negative.

7) I am concerned because I read reports that government officials say swine flu (in pigs) never occurred in South Africa, they say it occurred in Kenya in the 1950's. When I interviewed you in 2005 I drove through many border checks for swine flu. There were similar checks at the Free State border in December 2007. So do you have confidence that South Africa can deal with this problem spreading to human beings? And secondly, what source of information should ordinary people follow - ie where can we get reliable, trustworthy information from?

I think that you are confusing Swine influenza with Swine fever. This is a different virus in total. There have been outbreaks of swine fever in South Africa, and I am sure that you are taking about this.