Nathalie Thibault's bachelor's degree in Microbiology and master's degree in Immunology make her a germ and immune system specialist. Since the birth of her two daughters, she has been particularly interested in the infections which affect children who attend daycare. She is a teacher, speaker, and author. The specialized documents and courses she conceives help those involved in early childhood outsmart germs. She writes for a magazine called La Culbute and the mamanpourlavie.com website.

Infect-Aid Column

Note: This column may be photocopied. It must be contagious... Of course, remember to mention the source of contamination.

Flu pandemic: actual risk and perceived risk

Take a look around and you will see extreme differences when it comes to people's reactions towards the A/H1N1 flu. Some are completely panic-stricken while others are stating that it's a scam to sell vaccines. Between the two, there are all kinds of different reactions. These reactions vary from one country to another. Each person analyzes the situation according to their own references and their own reality. For this reason, there is a big difference between the actual risk and the risk which is perceived.

Here is an image which explains the different reactions:

Actual risk
Suppose that this germ represents the actual risk. Therefore, this is the situation in YOUR country. Once again, we must remind you, the actual risk will not be the same from one country to another and from one subgroup of the population to another.

Perceived risk
This germ represents the risk YOU perceive. The flu therefore seems much more dangerous and you have a tendency to panic more than the average person. You are anxious and you take extreme action. You think with your emotions (fear, anxiety). The measures you use are "questionable". Only an objective vision of the situation and deep breaths will help you.

Example: The mayor of Coulaines (Sarthe) banned spitting on public streets in his town and demanded football chiefs prohibit spitting on football fields during games. (AFP 25.08.09)

If your perception of the risk is smaller than the actual risk, you will tend to wash your hands of it and label everyone else as panicky. You even feel those who are reacting normally are extremists. Several compare the risk to all other causes of infectious mortality on the planet. This is one way of seeing things, but it mustn't serve as an excuse for your failure to act.

If your perception of the risk is similar to the actual risk, you will be able to balance your actions. You will be able to analyze the situation logically and objectively. You will be able to prevent and use basic hygiene actions without panicking. Finally, everyone should be in this zone, but this is far from being the case.

Several will say: "Yes, but what are the REAL risks?"

Here are the facts (actual risk) concerning the A/H1N1 flu (27-08-2009)

• It is a new flu.
• Everyone is likely to get it.
• It works like all other flu viruses: transmission through nasal secretions and saliva, cough, and sneezing.
• Symptoms are similar to seasonal flu: fever, cough, fatigue, loss of appetite, headaches, and muscular pain.
• Mortality rate: much like the seasonal flu for Quebec, less in France, and higher in certain countries (this rate is very difficult to evaluate and is constantly evolving).

The difference between contagiousness (morbidity) and virulence (mortality)

Contagiousness is the proportion of contaminated people. It is the proportion of people who could be sick. The Quebec plan foresees 35% of the population for the entire pandemic.

Virulence is the proportion of people who will die. It is very difficult to estimate and will vary from one country to another. For now, in Quebec, it seems that this number is not higher than for the seasonal flu. The flu can be highly contagious, and therefore infect a large number of people, yet cause very few deaths. This does not mean we may wash our hands of it! We must always take any flu strain seriously, not just the A/H1N1 flu, and adopt measures to protect ourselves.

Since contagiousness and virulence are evolutional for any given virus, it is important that we remain adequately informed. Refer to official and regional sources such as

http://www.pandemiequebec.gouv.qc.ca/en/news/news.shtml. Official: information has been filtered by health experts. Regional: if you consider the information from all other countries to represent your actual risk, you will be submerged with information which does not correspond to your immediate reality.

Do you wish to be well-informed on a Canadian level? See all reported cases and graphs: http://www.phac-aspc.gc.ca/fluwatch/08-09/.

Good news: for the week of August 9th to August 15th, 2009, the number of cases decreased.

Take the situation seriously, without panicking

Nathalie Thibault 

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