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Swine flu: Is this really the big one?

The virus might be a global killer, or might fizzle

ATLANTA – As reports of a unique form of swine flu erupt around the world, the inevitable question arises: Is this the next killer global flu epidemic?

Is this the novel virus that will kill millions around the world, as pandemics did in 1918, 1957 and 1968?

The short answer is it’s too soon to tell.

“What makes this so difficult is we may be somewhere between an important but yet still uneventful public health occurrence here – with something that could literally die out over the next couple of weeks and never show up again – or this could be the opening act of a full-fledged influenza pandemic,” said Michael Osterholm, a prominent expert on global flu outbreaks with the University of Minnesota.

“We have no clue right now where we are between those two extremes. That’s the problem,” he said.

Health officials want to take every step to prevent an outbreak from spiraling into mass casualties. Predicting influenza is a dicey endeavor, with the U.S. government famously guessing wrong in 1976 about a swine flu pandemic that never materialized.

“The first lesson is anyone who tries to predict influenza often goes down in flames,” said Dr. Richard Wenzel, the immediate past president of the International Society for Infectious Diseases.

But health officials are being asked to make such predictions, as panic began to set in over the weekend.

Dr. Richard Besser, the CDC’s acting director, said at a Sunday news conference that comparison to past pandemics are difficult.

“Every outbreak is unique,” Besser said.

The new virus is called a swine flu, though it contains genetic segments from humans and birds viruses as well as from pigs from North America, Europe and Asia. Health officials had seen combinations of bird, pig and human virus before – but never such an intercontinental mix, including more than one pig virus.

More disturbing, this virus seems to spread among people more easily than past swine flus that have sometimes jumped from pigs to people.

There’s a historical cause for people to worry.

Flu pandemics have been occurring with some regularity since at least the 1500s, but the frame of reference for health officials is the catastrophe of 1918-1919. That one killed an estimated 20 million to 50 million people worldwide.

Pigs are considered particularly susceptible to both bird and human viruses and a likely place where the kind of genetic reassortment can take place that might lead to a new form of deadly, easily spread flu, scientists believe.

Such concern triggered public health alarms in 1976, when soldiers at Fort Dix, N.J., became sick with an unusual form of swine flu.

Federal officials vaccinated 40 million Americans. The pandemic never materialized.

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