How to prevent the world's next swine flu

The latest outbreak proves that ecologists have as big a role in fighting flu as doctors.

By Philip Alcabes

Influenza is always a major worry for public health officials. But that doesn't mean the best response to it will emerge from chemistry labs or pharmaceutical companies. On the contrary, the news from California and Texas about flu cases produced by a virus that seems to represent the mixing of genetic material from human and animal viruses should remind us of a lesson we neglect: A good public health approach to flu has to be ecological. If the many cases in Mexico arose in a similar way, that adds urgency to the need to take this lesson to heart.

What we ought to have learned from avian flu, and indeed from the flu pandemic of 1918, which killed at least 40 million people, is that it isn't enough to prepare vaccines, to stockpile Tamiflu, or to prep emergency rooms. Flu virus, with its facile molecular rearrangements, slips relatively easily across species lines. That means that it can take advantage of all sorts of contacts between humans and animals -- which, in turn, means that a sound approach to flu must take account of a wide array of factors.

As the "One World, One Health" movement has pointed out, many factors matter: livestock raising; industrialized food production; economic straits that force some people to live closely with the animals they raise, slaughter, and sell; the reliance on wild animals for food; the mixing of wild and domesticated animals; globalized commerce in animals, feed, and food; and of course human travel and migration patterns. Such determinants of flu are dynamic, which makes fighting the virus more daunting but no less worth taking on.

When these sorts of epidemics break out in poor countries, hundreds, sometimes thousands, of animals get slaughtered. The terrible financial costs to farmers in places like Vietnam or Mexico of losing flocks or stocks are the avoidable result of incomplete public health planning -- a byproduct of worrying only about simple preventives against human flu. By now, it should be clear that such a narrow approach is shortsighted, given the more than 400 human cases of avian flu that have been documented and, presently, the thousands of people at risk from what seems to be recombinant human-swine flu.

Vaccines might help, especially if they are implemented for animal as well as human populations. But we have to stop our narrow-minded campaigns of "preparedness" for a return of the 1918 flu and instead substitute more broad-minded and long-term planning that recognizes the linkages of many aspects of our environment -- natural, political, and economic. Flu virus after all, recognizes those links; we should, too.

Philip Alcabes is the author of Dread: How Fear and Fantasy Have Fueled Epidemics from the Black Death to Avian Flu. He is associate professor of urban public health at Hunter College of the City University of New York.

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