Swine Flu in the United States, Essay Example

The Swine Flu has become a highly feared disease that has caused the deaths of thousands of individuals within the United States and abroad.  The Swine Flu has also been medically labeled as H1N1 due to its evolutionary pathogenic coding.  According to the World Health Organization (WHO), as of July 31, 2009, 168 independent countries have reported at least one confirmed case of Swine Flu that has resulted in over 162,380 reported cases and 1,154 associated deaths (Petrosillo 163).  The WHO has declared H1N1 on its pandemic scale-alert, “designating the Influenza H1N1 2009 a potential threat to worldwide health and declared the outbreak as Public Health Emergency of International Concern” (Tandon 161).  Due to the extreme increase of the prevalence of the H1N1 viral strain, many researchers have worked hard to develop a history of the viral strain, a list of characteristics of the disease, and possible vaccinations or treatment methods to reduce the impact that the disease has upon the global community.  These elements are all combined to effectively utilize the medical anthropology methods of environmental/ecological theory and political-economic theory to determine potential causes of outbreaks around the world and various factors that may serve as inhibitors for possible treatment and medical cures.

History and Evolution

The Swine Flu has become a large pandemic that has greatly impacted populations throughout the world.  The most recent epidemic emerged in April 2009 in Latin America.  The city of Veracruz, Mexico, became the first country to declare an increase in patients requiring hospitalization for “pneumonia and an unusual series of deaths,” which are common side-effects of prolonged influenza (Petrosillo 163).  Many medical professionals believed that these effects were caused by a new flu virus.  Officials for the Centers for Disease Control and Prevention (CDC) in Atlanta uncovered two cases in younger children from neighboring California counties that were just across the border from Mexico (Petrosillo 164).  The CDC labeled the new strain the “Swine Flu” and a large epidemic began in the United States.  Cases of the Swine Flu date as far back as 1918 where a worldwide pandemic emerged from the human influenza A (H1N1) virus.  This virus was responsible for over 40 million deaths in regions throughout the world, and around 4.9 million deaths occurred in India alone (Petrosillo 165).  The pandemic subsided shortly after 1918, but sporadic cases of the H1N1 virus continued to appear.  The Swine Flu disappeared from the world in 1957, in which scientists believe was caused by people developing immunity.  The disease emerged again in a confined army base in Fort Dix, New Jersey where 230 individuals were infected including one fatality (Petrosillo 165).  In November 1977, a different H1N1 strain emerged in former Soviet Union and China; whereby, the disease infected young children.  Many professionals have difficulty explaining the cause of different strains, but modern studies found unique genetic characteristics within the H1N1 virus.

Through the RNA transcription coding, the H1N1 strains appear to have mutated into the current 2009 epidemic.  “The new H1N1 virus appears to be a mixture of avian, porcine, and human influenza RNA.  Genomic analysis indicates that it is closely related to common reassortant swine influenza A viruses that have been isolated in North America, Europe, and Asia in the last 20 years” (Petrosillo 171). Due to the genetic mutation, the strain is much different than influenza A strains, and much more difficult to treat.  Current research shows that the RNA coding unveiled point mutations that changed the proteins in H1N1.  Particularly, “the mutations in surface proteins result in antigen drift, which helps the virus to escape the immunity of its host” (Dogra 167).  In other words, the viral strain has evolved and developed genetic immunity to the human immune system and medicinal treatments used for the common flu.

As Image 1 illustrates, the complete evolution of H1N1 stems from separate influenza strains.  Prior to the 1990s, there existed the classic swine H1N1 strain, the Human H3N2 strain, the Avian strain, and the Eurasian swine strains (Dogra 168).  The current strains have evolved to combine the avian, porcine and human strains into one H1N1 virus.  In the early 2000s, the Classic Swine strain mixed with the Avian and Human strains and then also merged with the Eurasian swine virus to create a new H1N1 virus (Dogra 168).  Despite very little research on the 2009 strain, it has been reported that H1N1 is highly infectious and effective in reproducing to impact large populations.  The strains can be spread to others within 6 feet of an infected person, and it lives longer in cold and dry weather if it is outside the body than in any other environmental conditions (Mir et al. 163).  Meanwhile, “human-to-human transmission of swine flu can also occur in the same way as seasonal flu through coughing or sneezing” (Tandon 162).  The symptoms of Swine Flu are similar to human influenza, which are fever, lack of energy and appetite, cough, runny nose, sore throat, nausea and vomiting.  Medical professionals have difficulty in diagnosing Swine Flu cases because of the similar symptoms unless there is a reasonable suspicion for H1N1 (Dogra 168).  Many doctors are uneasy about diagnosing Swine Flu because it often leads to increased panic in local communities, large work loads for local laboratories and hospitals, and can cause an indirect negative affect on the economy (Tandon 163).  Nevertheless, the disease can be fatal to high-risk groups such as the elderly, individuals with chronic health conditions, young children and pregnant women.

Medical Anthropology Implications

This disease clearly illustrates two very important concepts in medical anthropology that can lead to determining the true nature of the pathogen and its potential treatment.  The first concept that can be examined is often called the environmental or ecological model of medical anthropology.  Joralemon states in Exploring Medical Anthropology that under this model the specific nature of the genetic traits for a society as well as the traits of the disease causing agent are studied and analyzed to draw appropriate levels of conclusions (33).  In many cases, these conclusions may suggest a behavioral or environmental factor that is causing the disease to spread and to reduce fitness for the society within the environment.  Perhaps the most apparent theory utilized within medical anthropology, especially for the study of epidemiology regarding the Swine Flu epidemic, is the ecological and environmental framework.  “Epidemiology views disease in ecological terms as the interaction between a pathogen(s) and its host(s), as this interaction is shaped by the conditions of a specific environment(s)” (Joralemon 33).  This theory is very important when analyzing the various evolutionary and environmental trends that have led to the Swine Flu being a monumental epidemic in modern times.

First of all, this theory can be utilized in tandem with the process of H1N1 influenza strain.  The pathogen originally developed as a serious health problem in the early 1900s as previously mentioned.  The environment quickly changed for this pathogen as the human hosts began to develop a minor immunity to the disease.  In other words, as the body began to become immune to allow the pathogen to inflict damage upon the body, the body began to fight off the influenza strains and eliminate their effectiveness altogether.  Essentially, this can be described as the body’s way of killing the strain.  Therefore, this medical anthropology theory would analyze the environmental changes that occurred in order to force pathogenic evolution.  The influenza strains became dormant as a defensive mechanism to the human body’s reaction over time.  Furthermore, the development of alternative influenza strains also changed the biological environment.  The Avian and Human influenza strains continued to impact the environment.  Through the invention of effective medicinal treatments, these strains also became ineffective.  However, each of the strains became introduced as dormant pathogens within the same environments.  Therefore, the ecology and environmental theory would state that his naturally led to a pathogenic and genetic evolution.  In short, this created an influenza super-strain.  Overall, in order for the strains to remain effective in their genetic purpose, they needed to evolve based on the reactions of their environment that forced pathogenic dormancy.

The political-economy theory analyzes the political and economic elements that exist within a country and create potential causal factors for the emergence and spread of an epidemic (Joralemon 61).  Given the extent of the damage to the United States and Latin American nations, it is clear that the H1N1 influenza strain has political considerations.  For instance, the first recent account of the new strain appeared in Mexico.  Shortly afterward, the strain had traveled across the United States border into California.  Obviously, the political considerations of pathogenic delivery should be discussed in determining potential restrictions for bringing foreign pathogens into other countries.  Furthermore, an analysis of the economical factors must also be conducted.  At first glance, the history of this epidemic does not directly show evidence of economic factors that may have caused the outbreak.  Veracruz is a major port city in southeastern Mexico.  The economy is very strong in Veracruz; however, medical anthropologists would be interested in studying exactly how the strain initiated in Veracruz after decades of dormancy and then traveled to California.  There are multiple political-economic considerations that must be analyzed to effectively determine a potential increase and emergence of the Swine Flu epidemic.

Theories in Action

Medical treatment and detection of H1N1 influenza strains are difficult within the medical community.  There are few methods for early detection, and only “Real Time PCR, Viral culture, Four-fold rise in swine influenza A (H1N1) virus specific neutralizing antibodies” are able to provide detection in laboratories (Petrosillo 169).  Unfortunately, these capabilities are not accessible to all doctors, and only a handful of capable centers are available worldwide to perform such tests.  Furthermore, the costs for performing the detection test are very high.  It currently costs between $10,000 and $15,000 to perform the tests, and it causes a potential threat to the economy and poor populations that cannot afford to pay high costs (Dogra 169).  Therefore, it is clear that very few treatment options are available.  A recent national vaccination campaign has been available to limited groups throughout the United States, but the vaccine’s effectiveness is still unknown due to the recent emergence of the methods.  It is believed that Oseltamivir is the only available treatment method for the H1N1 virus, but the viral strains have begun to develop immunity to the treatment methods and appear to mutate yet again (Dogra 169).  This information clearly shows the interrelationship between ecological/environmental and political-economic theories.  Obviously, the economic considerations are great in determining potential H1N1 detection and even greater in providing for essential research to create a cure for this dreaded pathogen.

The limited resources and lack of international knowledge on the genetics of the Swine Flu pathogen have led to an increase in debate and research.  This disease has caused much damage throughout the entire world and effectively impacted all major continents in different ways.  Medical anthropology not only seeks to analyze how the diseases have developed, impact the hosts and various socioeconomic factors, but it also analyzes how these theories can come together to assist an entire international population.  David Fidler from the Indiana University School of Law, suggests that the term “global germ governance” be utilized to explain the significance of shifting the anthropological view from national to supranational when monitoring epidemics (Joralemon 59).  This alternative viewpoint would not only help broaden the scope of cases that are analyzed but assist researchers in analyzing potential socioeconomic and evolutionary factors that could contribute to increased resistance to current treatment methods by the new H1N1 influenza strain.

Conclusion

Due to the limited knowledge and lack of resources for medical professionals, many individuals throughout the world continue to face misdiagnosis and potential fatalities from H1N1.  Much advancement is being made to develop potential treatment methods, yet the genetic mutation of the H1N1 strains make it difficult to show strong results.  Increased funding by the World Health Organization and other global economies must be utilized in order to reduce the negative effects of the Swine Flu throughout the world.  Furthermore, additional research must continue to be performed to analyze the evolutionary traits associated with the H1N1 strains to create a permanent solution.  Current results have shown that the medical community is on the right path, but the world is still far from being free of H1N1 and will continue to impact the world population for quite some time.

References

Dogra, Sandeep “Emergence of Swine Origin Influenza (H1NI Virus).” JK Science 11.4 (2009): 167-169. Academic Search Complete. EBSCO. Web. 20 April 2010.

Joralemon, Donald. Exploring Medical Anthropology. Third ed. Upper Saddle River, NJ: Prentice Hall, 2010.

Mir, Shakil. A., et al. “History of Swine Flu.” JK Science 11.4 (2009): 163-164. Academic Search Complete. EBSCO. Web. 20 April 2010.

Petrosillo, N., et al. “The novel influenza A (H1N1) virus pandemic: An update.” Annals of Thoracic Medicine 4.4 (2009): 163-172. Academic Search Complete. EBSCO. Web. 20 April 2010.

Tandon, Vishal R., et al. “Swine Flu (H1N1) – Pandemic or Bioterrorism.” JK Science Oct. 2009: 161+. Academic Search Complete. EBSCO. Web. 20 April 2010.