or: How to contract Swine Flu and alienate people! :D

swineflu5All of us were shocked when we heard the news about Rupert having caught the swine flu. When the news came up on 4 July 2009, I was on holiday and had just texted Jo about information on the Harry Potter London premiere. Instead of a reply, I got a message saying: “Rupert caught the swine flu! :(” After a panicky back-and-forth of texts (as I was stuck in a hostel without internet), Jo finally told me “His press team says he will be fine :)”.
As the swine flu is still all over the press and Rupert’s name is still associated with it, we thought it would be a good idea to give you some non-hyped-up information, and to explain a few things about the virus and how it might have affected Rupert.

The information about the swine flu has been taken from the websites of the World Health Organisation (www.who.int) and the European Centre for Disease Prevention and Control (www.ecdc.europa.eu). I tried to make this essay as understandable as possible. If you have questions, please ask.
Btw I’m graduating medicine this autumn, so the information is reliable, and you can use it to show off if you want to. *wink*

About the virus:
Swine Flu is caused by the virus called “Influenza A(H1N1)v”.
A virus is a non-living particle consisting of genes (in form of DNA or RNA) and the outer body built. The outer body has specific structures, so-called antigens.
The “H1N1” in the name are actually two antigens specific for this virus. For example, another virus called “H1N2” shares one antigen with the H1N1 (the H1 antigen), but has one different antigen (N2 instead of N1).There are 9 different Hs (H for Haemaglutinine) and 16 different Ns (N for Neuraminidase).
There have been H1N1 viruses in the past, but this new virus contains a combination of genes from influenza viruses seen in birds, pigs and humans. The “older” swine flu viruses did not get transferred from one human to another.

How does the virus get transferred:
The viral particles are transferred from human to human via droplets, when coughing or sneezing, or when the droplets end up on a person’s hand and get transferred to this person’s nose or mouth, even via contaminated surfaces (where they can remain for up to 8 hours).
The time from when a person has “picked up” the viral particle until the first symptoms appear is from one to seven days.
The mostly affected age group are young people. Small children and older people are less exposed to large crowds, hence it is less likely for them to be infected. On the other hand, teens and young adults go to school/work, to discos, bars, they meet friends… All these are opportunities to pick up the virus.
Transmission from animal (pigs) to humans has not been proven.

This means that it is unlikely that Rupert was infected by his recently acquired pigs. Aside from the transmission being unlikely, the United Kingdom has very strict regulations for bringing animals into the country, as they go into quarantine for at least a week. By this time, the pigs would have had symptoms if they had been infected, unless the virus had not caused a reaction.
If Rupert had been infected via his pigs, it is likely that one or more members of his family would have had symptoms as well, which Rupert probably would have mentioned in interviews.

Why does the body react the way it does?
The human’s immune system has the ability to distinguish between “this belongs to me” and “this is dangerous”. Almost all human cells have specific structures on their outside that the immune system recognizes as belonging to the human, and other, foreign structures are likely to be seen as dangerous. swineflu3Over the years (starting during the last months of a pregnancy), the immune system is exposed to various antigens and “gets used” to them. It is a “learning” process for the immune system.
The immune cells (who act like police officers), “operate” on several locations in the body: lymph glands, tonsils, mucosa. So, when exposed to foreign antigens, the immune cells in those areas start a “war” against the “intruder”, which causes most of the symptoms:

  • Sore throat: immune reaction in tonsils and other areas in the throat causes the throat to swell slightly (due to increased blood flow meant to bring those foreign cells into the area where the “police officers” operate!) and become painful (caused by the stretching of the skin due to swelling).
  • Fever: many chemical reactions work better at a higher temperature. While the normal body temperature is perfect for the “normal” processes in the cells, fever helps the immune cells to produce more antibodies in a shorter time. In the case of flu, fever is caused by proteins that are created during the immune reaction.
  • Headache, muscle pain, fatigue: immune cells need a lot of energy to fight the viruses, hence they pick up most of the energy (in the form of glucose). Which, in turn, leaves less energy for the muscles and the brain, so they react with pain or fatigue (that’s why you want to sleep more, because then the brain needs less energy than when you’re awake).
  • Vomiting, diarrhoea: The stomach has an immune system on its own. If it reacts to the infection, the bowels usually react with more movement, hence pushing the food backwards (vomiting) or pushing it too fast forward for the bowels to digest (resulting in diarrhoea).

The time needed for recovery is about 7 to 10 days, and adults are infectious to others for about five days, counting from the first day when the symptoms appear (seven days for children because their immune system is less developed).

Rupert said in recent interviews himself that it “felt like any other flu I had”, and that he suffered from a sore throat. He also mentioned that he had to spend five days in bed (the time he was most likely been infectious); so, by the time he started promoting Harry Potter and the Half-Blood Prince, he was no longer infectious to his fans or media.

Aside from the acute reaction, one part of the immune system works as a memory and will remember the antigens for the future. This is also used in vaccination: the body is exposed to a small number of antigens or to “disabled” (genetically modified) viruses. The immune system recognises the antigens in the case of an infection and is able to cause a reaction much faster (because it already knows the “weapons” to fight), hence it prevents the virus from reproducing much earlier and requires a smaller reaction (also meaning less or no symptoms).
As the new swine flu contains the aforementioned new combination of genes, it is unknown to everyone’s immune system, hence the body’s reaction is noticeable in more people than the symptoms of regular flu.

The good thing: Rupert’s body knows the virus now, so if he is exposed to it again, he will have little or no symptoms.

How do I know I have Swine Flu?
It is impossible to tell the difference between a regular flu and the swine flu without help, as the symptoms are the same.
When you go to the doctor, he will take a nose and throat swab and send it to the laboratory.

Imagine someone taking a long tip and sticking up your nose and into the back of your throat… yes, poor Rupert!

In the lab, the virus RNA can be copied with specific methods if viral particles are found on the swab. If there is evidence of the H1N1 RNA, the result has to be reported to the national health authority, who keep track of the epidemics of certain infectious diseases.

So yes, Rupert has been reported…

How do I get treated if I have swine flu?
The medical treatment varies. Young, healthy people do not necessarily need specific medication. Antivirals might alleviate the symptoms and reduce the time of recovery, but they do not reduce the time of being infectious. Instead, they could also increase the possibility of the virus becoming resistant to the medication, and there is only one type of medication available.
Young, healthy patients can be given painkillers or medication to reduce fever if necessary.
Antivirals should be given if underlying medical problems exist (heart disease, diabetes, asthma, weak immune system), as these people might suffer more from the symptoms and are at an increased risk of complications (like pneumonia).
The antiviral medication that helps against the H1N1 virus (mostly known as Tamiflu®) makes the virus unable to reproduce as quickly as it normally would, thus enabling the immune system to tackle the smaller number of viruses in the circulation.
Aside from antiviral medication, patients with aforementioned medical problems may also receive antibiotics to avoid further complications caused by additional infections with bacteria (e.g. pneumonia). However, antibiotics do not work against swine flu!

swineflu4This is where it gets confusing: Rupert has said he was given antibiotics. As mentioned, antibiotics do not help against swine flu. Since Rupert has said he had regular symptoms of a flu, it is unlikely he had an additional bacterial infection, and as he is otherwise young and healthy, he would not have needed a prophylaxis.
Soooo, either Rupert was given medication he did not need (received no antivirals, but antibiotics), in which case he should consider changing his doctor, or he does not know what kind of medication he took, in which case he ought to read this article.

Aside from this, patients should be isolated (meaning to stay at home and have contact to as few people as possible) and only admitted to hospital if complications arise or are likely to.
Additionally, close contacts (people who live with or are in contact with a patient) should be given antiviral prophylaxis to avoid infection.

So yes, it was okay that Rupert stayed at home, and most likely the entire family got a prescription for antivirals.

Swine flu is actually considered as dangerous as the regular seasonal flu in terms of mortality. Out of 1000 patients, about 40 need hospital treatment, 1 patient dies. The difference is that nobody is immune, so it is more likely to develop symptoms when infected with the H1N1 virus. Hence, more people become patients, and the number of deaths increases accordingly.

How do you avoid swine flu?
By not picking up viral particles. You should avoid huge crowds and people with symptoms, and avoid touching contaminated surfaces. Wash your hands and try not to touch your mouth, nose and eyes. Be physically active, drink fluids and eat healthy food to keep your immune system active.
Infection does not occur by eating infected meat IF (and only if) the meat is cooked properly. Proteins are destroyed when heated, so the viral particles are destroyed when the meat is cooked.
A mask can be used, but it should only be used if the person knows how to use it. Inappropriate use increases the risk of infection. (If a viral particle lands on the outside, and the person wearing it accidentally touches it, the virus lands on the hand and might be transferred to the person’s mouth and cause an infection).
A vaccine against the new swine flu does not exist yet, but is in development. Other vaccinations against seasonal flu do not prevent this infection.

We all know that Rupert’s hands have a tendency to end up in his face ;) so it is very likely he picked up the virus like that.
The media people who wore masks while interviewing him obviously did not research properly, as by the time Rupert was doing HBP promotion he was no longer infectious; besides, the wearing of masks is not recommended anyway.
As for the vaccination: Rupert has already been infected, so his body knows the virus. He doesn’t need the vaccination anymore.
All is well.

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5 Comments

  1. Ivana says:

    Karo I’ve been meaning to say that this is the best article on swine flu I’ve read! A majority of articles tend to either mystify the disease, or talk about some tragic cases to scare people off; but this is great — sensible, accessible and straight to the point. :)
    *off to drink her freshly squeezed sugar free lemonade*

  2. Sabine aka galadriel12 says:

    Thanks, Karo. That was very insightful. And very understandably written.

  3. Caitlin says:

    I think Rupert is gorgeous! I hope he gets better soon

  4. jo says:

    He’s fine!!! That was last year so no worries, he’s recovered by now. :)

  5. we have a sore throat runny nose diarer vomiting headaches

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