Pandemic Expert Sets Record Straight on Swine Flu for CSO Roundtable

By Matthew Harwood

In a conference call this morning with ASIS International's CSO Roundtable, a disaster epidemiologist gave listeners accurate, expert information on the swine flu scare while advising organizations how they can ready themselves if infections strike their employees.

K.C. Rondello, M.D., a pandemic-planning expert and assistant professor at Adelphi University, said people should expect the swine flu problem "to get worse before it gets better." Overnight, the number of infected people in the United States climbed from 91 to 109, he said.

The World Health Organization (WHO) raised its pandemic level to phase five, meaning a pandemic is imminent. According to Rondello, the best way to think of a pandemic is multiple epidemics occurring simultaneously across different geographic regions.

Rondello’s teleconference was open to members of the CSO Roundtable, an invitation-only group of the senior security executives from the world’s largest companies. Rondello stressed to Roundtable members from around the world  that no one should panic.

While the infection spreading globally is a more virulent strain of swine flu—known as Swine Influenza A/H1N1—that has mutated and jumped the species divide, it is still a disease marked by "high morbidity and low mortality."

The bad news is that many people will get sick, while the good news is few will die. Many of those who contract the flu will recover without the need for medication or hospitalization, he said.

The swine flu outbreak will be a "gentle pandemic," according to Rondello.

What makes this particular strain of swine flu hard to fight is that it takes a while before symptoms arise in the infected. This means infected people will spread the disease at work, school, and other public places because they don't know they're sick. In addition, many flu carriers will not get sick or show symptoms at all, perhaps making them modern-day versions of Typhoid Marys. Although no one knows for sure, Rondello said a good estimate of the time a person's contagious is a day prior to the onset of symptoms to seven days after symptoms manifest.

Symptoms include the following: febrile respiratory illness, cough, sore throat, body aches, headache, chills, fatigue, and diarrhea or vomiting, although the last two are less common. People with chronic medical conditions, like asthma, will suffer more from the infection. In some cases, pneumonia could result, and in rare cases, prove fatal.

Rondello told the CSO Roundtable members that swine flu will take months, not weeks, to contain.

There are two reasons for this. First, this strain of swine flu has a tendency to mutate fast, which makes it difficult for health organizations like the Centers for Disease Control and Prevention and the WHO to create a vaccine that works. And even if an effective vaccine is produced, it will take months to manufacture and distribute it worldwide.

It's also difficult to contain this type of flu because it's spread from host-to-host rather than arising from a common source. In a common-source epidemic, something becomes contaminated, like food and water, and illness quickly spreads throughout a community. While infections occur quickly, it's also easy to stop the infection's spread by eliminating the source of the contamination.

During host-to-host epidemics, one person infects another and the sequence is repeated down the line. While its growth is slow, its demise is also slow.

There is, however, a silver lining for the United States, Rondello said. Because the outbreak of swine flu is occurring outside of traditional flu season, it will be easier for medical professions to identity the infected and get them speedy medical attention.

Rondello speculated that the disproportionate number of Mexicans killed by swine flu has two interdependent causes. First, the infected waited too long before seeking medical treatment. Second, when the infected did eventually seek medical treatment, the disease was too far advanced for Mexico's healthcare system to handle.

The most important thing for organizations to remember now, he said, is to arm their employees with good information. Employees should know to follow standard cold and flu precautions such as covering their nose and mouth with a tissue when they cough or sneeze; throwing out used tissues immediately; washing hands with soap and water regularly, especially after coughing or sneezing; and avoiding the temptation to touch their eyes, nose, and mouth. Other good practices include refraining from contact with sick people, staying home if they feel sick, and monitoring good sources of information such as the CDC's "Swine Flu" Web page as well as the WHO's Web site.

Organizations should also ask themselves whether they can operate if 30 percent of their employees turn up sick and consider whether or not they want to screen employees for illness or acquire N95 masks or antivirals, Rondello said.

Organizations that prepared pandemic plans during the SARs and avian flu scares between 2005-2007 should also rest assured that their plans will effectively meet the swine flu challenge.



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