• A very detailed article came out last week in the New England Journal of Medicine outlining the origins of the swine flu.  They have found that the swine flu is a 4th generation virus from the 1918 strain.  We are in a 90 year pandemic era all originating from 1918 strain, and finally,  “it appears that successive pandemics and pandemic-like events generally appear to be decreasing in severity over time. They say this is probably due to medical and public health advances.”
• Another article points out that Tamiflu is not all that great and that rushing to be seen at the doctor’s office has contributed to the spread of this virus:

“The most puzzling, and most consistent, point of information in these algorithms was a recommendation to treat virtually everyone with antiviral medicines. The departments of health recommended that patients with even mild URI symptoms and virtually any history of any medical problem, or common contact with anyone who has a medical problem, be prescribed anti-influenza drugs.

On what evidence did the NYC DOH recommend prescription-only antiviral medications for all? Cochrane and other large-scale reviews show that oseltamivir and zanamivir reduce influenza symptoms by roughly one half day to a day compared to placebo, though only when given <48 hours after the illness begins. Unfortunately, the medicines frequently seem to add nausea, vomiting, or diarrhea, and cost roughly $100 per prescription. They also only work for those with test-confirmed influenza. The simple use of NSAIDs, it would seem, could rival these agents for symptom control, and without the side effects or cost.

With such a tepid, selective, symptom-only impact, and at such considerable expense, why use them? I asked my local infectious disease specialists this question. Treatment, they said, may reduce complications such as death, pneumonia, or hospitalization.

I looked further. Interestingly, despite the fact that 10,000-20,000 people typically die each year in the U.S. from influenza, antivirals have never been shown to decrease either mortality or critical illness. As for other complications, one meta-analysis of ten trials suggested small reductions in pneumonia and a 1% reduction in hospitalization. But the meta-analysis was retrospective, it used only cherry-picked secondary outcomes, and the studies were hand-selected from a Roche database. And yet this remains the only combined data ever to report any significant benefit on complications. Two much larger reviews have since concluded that the drugs have no appreciable effect on the use of relief medications or subsequent need for antibiotics. “