By Lubna Abdel-Aziz Swifter than a shooting arrow, flying on the wings of the wind, the flu virus, known as H1N1, comes our way. This agile virus, hastily hurries to cooler weather, chasing its victims over the highest mountains and across the seven seas. With autumn upon us and winter at our doors, a bird of ill omen soars up above, overcasting the clear blue skies. Children heading back to their classrooms may find an unwelcome visitor in their midst. This H1N1 pandemic is the second wave of this flu that has been hovering around the globe since the spring. The hot summer months normally kill any strain of the flu, but this newly emergent 2009 H1N1 influenza is a novel virus with pandemic potential. Since the first case was reported in Mexico last March, H1N1 has lingered on, resisting the heat, hopping from the Northern hemisphere to the Southern hemisphere, leaving its traces behind. By June the World Health Organization (WHO) found it necessary to declare this pernicious pest, a veritable pandemic. Mexican health officials who thought they had seen the end of H1N1, were disturbed to see a sharp increase in late July. Britain also saw a rise in H1N1 cases during the summer, but not other European countries. That is why this virus is befuddling and bewildering. Its behaviour is confounding scientists because of its unpredictability: "The only thing certain is uncertainty" says Thomas Frieden, director of the US Center for Disease Control (CDC). WHO has instructed governments, especially those of underdeveloped countries to take all the necessary precautions, and to prepare their health systems to care for severe cases. It is estimated that 2 billion people will be infected worldwide over the next few years, nearly one third of the world's population. The most vulnerable groups find pregnant women on top of every list, followed by with chronic disease such as asthma, diabetes, hypertension, cardiovascular diseases, autoimmune disorders. Data shows that 230 million among the obese suffer from asthma, and more than 220 million suffer from diabetes. Those are linked to obesity, which itself is now considered an epidemic. Although those are not killer diseases, when combined with the H1N1virus it adds another dimension to their virulence. Is there any good news in this murky picture of winter's onslaught? We must not overlook the regular seasonal flu that usually kills an average of 500,000 annually. The combination of both flus foretell of a cruel winter ahead. The only good news is the vaccine. Governments are rushing to produce and procure enough vaccines for the population, but it is doubtful that production will be rapid enough to immunize the world population. Priority will go to those most at risk. The CDC list includes pregnant women, caregivers of infants, health care givers, children and youths 6 months and to 24 years, those with medical conditions between the ages of 25 and 64.Those above 65 should be wary of the regular seasonal flu which is particularly deadly for the elderly and those with chronic illnesses. For the millions of us left without the benefit of vaccination, we can only adhere to a list of vigorous precautionary measures. These measures are nothing new but warrant repeating over and over - washing our hands between fingers, under nails, more like scrubbing, with warm or hot water. Avoid touching eyes, nose or mouth. Scrub clean all surfaces you touch in kitchen, office, bedroom, etc. "remember cleanliness is next to godliness.' Viruses survive outside the body for 48 hours, so wash regularly. Hardy and crafty, the influenza vaccine for this virus has proved to be a challenge to scientists. This is due to its ability to change its genetic structure which has been a curse for the human race. Virologists chase the virus, following its every modification and transformation, but it always stays one step ahead of us, "while we try to catch up." The medical community, in fact the world at large is greatly indebted to vaccination. Vaccines are safe and dependable. While millions will benefit from the vaccine, many are still skeptical and fear it side-effects. Vaccination is the process of protecting the body by injecting it with the organism of the disease, thus providing it with immunity against it. The story of the vaccine began with the ancient Chinese in 600BC when small pox material was inoculated through the nostrils, but was never practiced elsewhere or by modern man, until British physician Edward Jenner (1749 -- 1823) rendered humanity this great service. During his time and for centuries before, small pox was a deadly disease that had killed hundreds of millions, maimed and blinded many more. Jenner heard that in his hometown of Berkeley, Gloucestershire, dairy maids who had caught cow-pox did not catch small-pox. In 1796 Jenner collected matter from the cow-pox sores of one Sarah Nelmes a local dairymaid. He made two cuts on the arms of James Phipps, a healthy 8 year old boy and inserted the material extracted from Sarah. The boy caught cow-pox, a minor disease that threatens no disfigurement or death like small-pox. Forty eight days later, Jenner introduced small pox matter into the boy's arms. Risking his reputation, Jenner was determined to attempt this experiment. Ordinarily fatal, the small-pox matter had no effect on Phipps. That was the first vaccine ever given, and small-pox became the first disease conquered by human beings. Since then, this miraculous discovery has come to the rescue of the human race, time and time again. Effective vaccines have saved us from the bubonic plague, cholera, diphtheria, measles, mumps, rubella, polio, rabies, tetanus, whooping cough, yellow fever, the list goes on. Still not all of us will be able to receive a vaccine against H1N1, made by growing the live virus in millions of chicken eggs. The opening of schools has been further delayed in Egypt as a precautionary measure to avoid the predicted October peak. With the heat lingering through October, our peak may not occur till late in November. At the risk of being alarmists, some physicians are expecting the worst. "Better be called an alarmist, than be called a fool." Meanwhile we wait , and we behave. We avoid hugging, kissing, holding hands, as well as trains, planes, and other crowded places. We do our bit to protect ourselves and our families, and as most physicians are saying "expect the worst and hope for the best." What else can we do? Che sera, sera! The patient must combat the disease, along with the physician -- Hippocrates (460 -- 377 BC)
