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quarta-feira, 2 de setembro de 2009

Dr James Le Fanu: swine flu



Swine flu? Pigs may fly

Dr James Le Fanu on swine flu
Dr James Le Fanu Photo: MARTIN POPE

There is nothing like a fortnight’s holiday for putting things in perspective. I flew to Greece, leaving Britain in the grip of the swine flu epidemic with an estimated 100,000 new cases per week – only to discover on my return that this major threat to the nation’s health seems to have evaporated.

Or perhaps, as the British Medical Journal suggests, there never was an epidemic. After considerable difficulty, Edinburgh doctor Wilfrid Treasure tracked down confirmed cases in his area – just 13 per cent of those in whom it was originally diagnosed. Almost nine out of 10 of those suspected of having swine flu had some other viral illness. It was a similar story at Middlesbrough’s University Hospital, which set aside a special swine flu ward. In July, 28 patients were admitted but the diagnosis was confirmed in just two. It will be interesting to see if a more realistic assessment of the scale of the “epidemic” will influence plans for a mass immunisation campaign this autumn. I doubt it.

There is more than I realised to the controversy over the potential hazards of the widely prescribed bone-strengthening drugs, the biphosphonates. These are the focus of one of the largest ever mass action claims in the United States, involving 800 people who allege the manufacturers Merck failed to properly warn of potentially serious side effects.

Dr Terence O’Neill of the National Osteoporosis Society concedes the biphosphonates may have the paradoxical effect of causing spontaneous fractures and bone destruction of the jaw but says these problems are very uncommon and must be set against the overall benefit the drugs confer. This turns out to be more modest than the widely cited figure of reducing fracture risk by almost a half. Translated, this means halving the chances of having a fracture over a period of five years from two to one per cent.







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