H1N1: Lessons learned

FORT LAUDERDALE, Fla. — Some people view H1N1 flu as a hyped health scare created by the government and the medical industry. Aubrey Opdyke isn't one of them.

One year after the H1N1 virus touched off a world epidemic, the former waitress from West Palm Beach, Fla., is still healing from a bout with the flu that claimed the life of her unborn baby, almost killed her and kept her in the hospital for three months.

"It just seemed like one of those things, it won't happen to me. I figured if I get it ... I'll handle it," said Opdyke, 27. "Now I know better."

Health officials and scientists learned, too, from the epidemic sparked by the new virus identified in late April 2009.

The lessons: The nation's vaccine system is flawed, the health system is not ready for a mass illness, pregnant women have heightened risk that needs more study, and conventional wisdom that has guided epidemic planning was wrong in many ways.

Americans learned as well: They are washing their hands more carefully and coughing into their elbows.

"We were lucky. It could have very easily have been much worse," said Dr. Claude Earl Fox, director of the Florida Public Health Institute in Lake Worth, Fla. "We ought to look at this as a dress rehearsal."

Health officials said the virus, while generally much milder than originally feared, was a serious threat that warranted the worst-case planning and warnings of the past year.

Swine flu killed an estimated 12,000 nationwide. It sent 265,000 in the nation to the hospital. About 60 million Americans got it.

The H1N1 virus also pushed health officials to reassess their thinking on how they deal with, and plan for, epidemics.

Some of those lessons:

—Cover your cough. Tim O'Connor, a spokesman for the Palm Beach County Health Department, said he knew the swine flu education campaign had worked when he saw an "American Idol" contestant sneeze into his elbow two weeks ago: "I was like, yes! Success."

A survey this month found that 80 percent of adults cough and sneeze into their sleeves instead of their hands, where germs can easily spread, and 85 percent wash their hands longer.

—Pandemic expectations. Contrary to expert predictions about epidemics, Fox said the H1N1 virus did not start in Southeast Asia, could not be contained to the origin original country (Mexico), and spread most widely among children and young adults instead of seniors. Those alive in the early 1950s, it appears, may have gained immunity from a past flu.

Disaster experts will have to alter their planning in response, including finding ways to combat the spread of viruses by air travelers, said Dr. Richard A. Stein, a Princeton University molecular biologist.

Scientists did succeed in isolating the new virus within weeks, said Dr. William Schaffner, a vaccine expert at Vanderbilt University Medical Center.

—Vaccination disappointments. The nation's system proved flawed, experts said, and mass inoculation plans remain untested.

The slow technique of growing vaccine in chicken eggs — developed in the 1950s — delayed production, so the first doses did not trickle out until October, when the virus began to wane. Officials had raised hopes with the public but didn't deliver and, as a result, millions didn't get the vaccine, Schaffner said.

Federal officials say about 80 million people received the H1N1 vaccine and as many as 100 million received the seasonal flu vaccine. Still, up to 70 million H1N1 doses were unused.

Schaffner said scientists are ready to try a faster method of growing vaccine in test tubes, at a new U.S. plant.

—Pregnant women. Doctors have long known that women have low immunity and are more vulnerable to infections during pregnancy, but the elevated severity from H1N1 should spark health officials to take even stronger precautions in the future, Stein said.

« Health

Share