Germ Warfare

My husband and I have three boys under the age of five, which is another way of saying we’re sick a lot. School-age kids average between eight and twelve colds a year, as do the siblings with whom our kindergartner competes in twice-a-day long-distance spitting contests known around our house as “brushing your teeth.” Adults, who tend to be more particular about toothbrush ownership, average between two and four colds annually.
If you figure it takes about a week to work through the effects of the average rhinovirus, this means that forty-four weeks out of the year, or almost ten months out of twelve, someone in my family is sick. That’s in a bad year. In a good year—well, we’ve never had a good year. Given our highly infectious history, it’s easy to imagine the viruses likely to visit us in the near future, hitching a ride home from preschool or lurking on the sticky fish tank at the pediatrician’s office that my two-year-old can’t resist licking.

Two years ago, when public health officials convened in St. Paul for a pandemic influenza summit, I read every newspaper report, studied the state’s published emergency plan, followed the movement of birds infected with avian flu from Turkey to Ukraine, quizzed my pediatrician about the effectiveness of Tamiflu, even stocked up on canned tuna fish after someone in the federal government said I should. In the midst of this activity, one of our kids complained that his eyelids were stuck together. By the time he passed his pink eye to every member of the family, the buds were back on the trees and I forgot all about the flu—until the following year’s flu season, when my fretfulness resumed.

This is not the most productive approach to the flu—or to any health threat—but public health experts say it’s typical. According to Buddy Ferguson, the Minnesota Department of Health’s risk communications specialist, most of us have a short attention span when it comes to what he calls the “disease du jour” that dominates the day’s headlines. Whether it’s seasonal flu or the pandemic influenza that health officials have been warning us about during the past few years, our risk is often more enduring than our interest in doing anything about it. “That’s why when there’s a window open—an educable moment when the public will listen to our message—we try to make the most of it,” Ferguson says.

That window opened wide in 2005, when a shortage of seasonal flu vaccine forced people waiting for a shot to stand in long lines (the line I stood in reached into a frozen parking lot). Reports of human deaths caused by the H5N1 avian flu virus had made headlines and President Bush announced plans to use the National Guard to enforce quarantines in the event of a pandemic. Then Minnesota epidemiologist Michael Osterholm, now director of the state’s Center for Infectious Disease Research and Policy, sent chills up the public’s back when he was asked what would happen if a pandemic were to strike that year and he answered, “We’re screwed.” 

In response to the pandemic concern, the legislature appropriated $500,000 for the health department to begin an awareness campaign to help Minnesotans prevent and prepare for such an event. But by the time the session concluded and the check was cut, says Ferguson, “it was already clear that people were turning their attention elsewhere. The educable moment had passed.”

The moment passed, but the threat did not. “Influenza experts assume a pandemic is in our future—it’s part of the natural history of the influenza virus,” says Elizabeth McClure, medical director of the Academic Health Center Office of Emergency Response at the University of Minnesota and an associate at CIDRAP. What experts can’t predict is whether the next pandemic will be as widespread as the one was in 1918, when influenza killed an estimated 40 million men, women, and children worldwide, or whether it will be less severe, more like the pandemics of 1957 and 1968.