FLU NEWS: The don't-call-it-swine-flu flu in Canada

As of Friday afternoon the Public Health Agency of Canada's official count listed 51 confirmed cases of the H1N1 flu (more on the nomenclature later).


All the cases have so far been mild and everyone who's been infected in Canada has recovered. The number of confirmed cases, however, has been rising every day.

Update: As of May 5, there were 165 confirmed cases across the country, with most in BC, Alberta, Nova Scotia and Ontario.

WHAT YOU SHOULD KNOW
Physicians trying to stay abreast of all the information about the virus may have read Canadian Medicine's summary earlier this week, "What Canadian doctors need to know about swine flu".

Last night, the Public Health Agency of Canada released several sets of interim guidelines, including a document to help direct clinicians in ambulatory care settings. The guidelines include advice for doctors on screening, triage, infection control precautions, and safety guidelines for doctors on how to protect themselves while examining patients.

More information for physicians and other healthcare professionals -- including infection control measures for hospitals and acute-care facilities, case reports, public health response guidance, and more -- is available on the PHAC's H1N1 page.

VACCINE NEWS
Dr Marie-Paule Kieny, the director of the WHO's Initiative for Vaccine Research, estimates that it will be four to six months before an effective vaccine can be developed and delivered, according to the Toronto Star. She said the seasonal flu vaccine does not appear to protect against the H1N1 virus.

THE POLITICAL FLU
Just as physicians and nurses have kept busy of late examining and assuaging sniffling patients, so too have our representatives in the provinces and in Ottawa busied themselves with monitoring the disease, preparing an appropriate response, and politicking.

Federal Health Minister Leona Aglukkaq, who was seen as an inexperienced selection for the cabinet seat because her previous experience was as health minister of a territory with just one hospital, has largely escaped criticism and has even earned some praise. She consulted opposition health critics Dr Carolyn Bennett, of the Liberals, and Judy Wasylycia-Leis, of the NDP, about her decisions, and she's deftly deferred to her in-house medical experts like chief public health officer Dr David Butler-Jones on technical questions. The Globe and Mail commented that she "gracefully survive[d] her first day in the eye of the storm" earlier this week and quoted Jan Kasperski, CEO of the Ontario College of Family Physicians, lauding Ms Aglukkaq. "Her calm vigilance now strikes us as exactly the right approach," a Montreal Gazette editorial said. Ms Aglukkaq brushed off criticisms of her as being inexperienced. "I was at the territorial-provincial-federal table when we put the pandemic plan together for the country... That plan that we developed in partnership with the provinces and the territories is now in effect and working quite well in my opinion."

Ms Aglukkaq told The Globe and Mail, "In situations like this, it's very important to put aside party politics and be talking with my opposition critics, updating and briefing them on matters of this nature." That sentiment reminded me of the comments Dr Aaron Johnston, a BC family doctor who worked in Nunavut, emailed me when Ms Aglukkaq was first appointed health minister last October. "[A]lthough Leona is a Conservative MP her background is as an MLA in a consensus parliament rather than a partisan parliament," he wrote, "and perhaps that will be of some use to her in this minority government situation."

Not everyone was quite so impressed, however. Maclean's reporter Aaron Wherry called Ms Aglukkaq's performance this week "a minor revelation" but tempered that by adding "[i]f only, it seems, because she would seem for now to understand how poorly prepared to manage a worldwide health crisis she —- or anyone —- may be." Mostly, Mr Wherry was struck by her openness to working with the opposition and willingness to admit a mistake given how infrequent it is to "see someone behaving like something other than a self-aggrandizing outlet for utter nonsense, let alone freely admitting one’s own limitations." Her answer to one question seemed lacking to him. "But if it lacked in substance, it lacked equally in ill intent."

Meanwhile, Rick Mercer irreverently twittered, "The real tragedy? If the swine flu becomes a pandemic Canadians may have no choice but to find out who Canada's Health Minister is."

THE VIRUS'S NAME
A closing note on terminology, for those of you who were wondering about my "don't-call-it-swine-flu flu" coinage in the headline. Swine flu is out, thanks to lobbying efforts by Big Pork and thanks to trade and business worries from government officials.

The World Health Organization is now calling the disease influenza A(H1NI), which, though it doesn't have quite the same visceral ring to it as did swine, is certainly more accurate considering no pigs are sick with the virus and it cannot be spread by eating pork. (The name change may also help save some pigs from being exterminated, as has happened in Egypt.)

The virus has been described in some journalists' shorthand and elsewhere as the Mexican flu. Even Prime Minister Stephen Harper was caught using the phrasing. The Mexican flu usage, however, has been assailed on multiple fronts. One free-trade critic told the Toronto Star that Mexico is not alone in the blame for the hazardous conditions at pig farms that are suspected by some of spreading the virus. "You might call this the 'NAFTA flu,'" said Common Frontiers coordinator Rick Arnold, alleging that multinational corporations took advantage of lax regulatory conditions in Mexico. Others -- with a rationale less political than realistic -- have similarly suggested calling it the North American flu.

Craig MacFarlane, a lecturer in the Carleton University department of law and sociology PhD candidate, made a different argument for not calling it the Mexican flu. "Those of us who study animals know that there is a strong connection between the treatment and representation of animals and other forms of human discrimination," he wrote on his blog Theoria yesterday. Calling the disease the Mexican flu amounts to a slur on Mexicans, he argued. "Carol Adams (The Sexual Politics of Meat) has profitably explored the relationship between sexism and animal use; Charles Patterson (Eternal Treblinka) and Boria Sax (Animals in the Third Reich) have pointed out the connection between industrial agriculture and the Holocaust; and Marjorie Spiegel (The Dreaded Comparison: Human and Animal Slavery) has looked at the connection between racism and animal use. And, of course, Upton Sinclair’s The Jungle should not be forgotten."

Of course, plenty of people haven't been able to resist making light of the serious situation, suggesting names like "Fox News Fever", "Bacon Lung", or, along the same lines as Mr MacFarlane's analysis, "The Xenophobic Flu".

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