Sorry: it is properly called swine flu

The old Atomic Energy Commission (AEC) had a fatal flaw. It's task was both to promote and to regulate nuclear power. That sounds like a bad idea, right? Conflict of interest? But in fact there are a number of government agencies that are in the same awkward position. One of them is the US Department of Agriculture, now run by Obama appointee and former ag state (Iowa) Governor, Tom Vilsack. I'll say one thing for Vilsack. He takes his responsibilities seriously. At least the promoting and protecting the ag industry part. Vilsack has had a mixed record on matters of importance to progressives. He was a timid but definite opponent of the Iraq War and had a fairly good record on energy (except for the inevitable ethanol bias of corn producing states). But generally, Big Agribusiness liked him. For some of the same reasons, organic food advocates didn't. He has a strong bias for industrial farming and livestock operations and the promotion of genetically modified food and seeds developed by the big agribusiness and biotech players. Now comes swine flu. Vilsack is on a crusade to expunge swine flu from all media reports and government agency use. Why? He's upfront about it. Because it hurts the pork producers:

Hog markets are depressed. Farmers struggle to put food on the table. Hard times are seeping into the rural economy, hurting owners of grocery and hardware stores.

Blame the media, said Agriculture Secretary Tom Vilsack, unleashing several lengthy rants about the evils of oversimplification during a 25-minute teleconference with reporters on Thursday.

Vilsack scolded the media for continuing to call the new strain of pandemic H1N1 flu by its more common name: swine flu.

“It is not swine flu,” Vilsack thundered. “Every time that is said, consumers get confused. Schools that are considering purchases for school lunch and school breakfast programs get confused, get worried.”

Vilsack implied that pork consumption is down because people worry they can catch swine flu — whoops, H1N1 — from eating pork. (You can’t.) Instead of stressing safety of pork, or sharing details about how the USDA plans to keep watch for the flu-that-shall-not-be-named in hogs, Vilsack dressed down reporters for harming farmers. (Roberta Rampton, Reuters blog)

Too bad, Mr. Vilsack. This virus came from swine. As far as I am concerned, "swine flu" is the most appropriate and descriptive name for it. There is no "official" scientific name, no matter what Secretary Vilsack may think. It is an influenza virus with eight genetic segments, each one of which came most recently from swine (some had earlier histories in birds and humans). It probably circulated in swine for years without being detected because the USDA doesn't do systematic swine surveillance for a virus known to be endemic in hogs at least since the 1930s. Neither Vilsack nor anyone else knows if the virus is in US pig herds. We know pigs can pick it up from people and people are infected. We are fairly confident that at some point, probably as recently as the end of last year, the virus made the jump from pigs to humans. We don't know when or where, although some recent analyses suggest Mexico as one of the most probable origins. By the time we discovered it infecting humans (April 2009) it had already seeded the US and the US was the main source for sending it around the world. Sealing borders doesn't work for flu, but if any country's borders should have been sealed, it was the US. But of course that wouldn't have done much good and done a lot of harm. But back to pigs.

Vilsack thinks the proper scientific name for swine flu is H1N1. Not correct because that's not specific enough. H1N1 is a subtype of influenza A virus and exists in the form of many strains, including the one that caused the 1918 pandemic (also called Spanish flu, although Spain had nothing to do with it) and the seasonal flu that has been co-circulating with the H3N2 subtype since 1977. These are all H1N1 flu as well. WHO is now using the name pandemic H1N1 2009, but CDC still calls it swine influenza. I'm with CDC on this. And I think they know a bit more than Mr. Vilsack, whose motives are to protect the pork producers.

Ostensibly the argument is that calling is swine flu confuses the public and makes them think that you can get it from eating pork. You can get it from an infected pig, but most people have no contact with infected pigs and none have been identified in the US. Anyway, almost everyone knows you're overwhelmingly more likely to get it from a person than a pig. I know very few people who are under the misapprehension eating pork is a real danger. Instead I think the real motive is to protect the export of live pig and pork products. Pigs can be infected with this virus and no country wants their herds infected. There goes the export market:

But on Tuesday [Vilsack] and others insisted that the economic impact reaches far beyond U.S. borders, telling countries around the world that “there is no basis for restricting imports” of American pork products.

As of Tuesday, more than 10 countries placed restrictions on imported pork products from the United States. The U.S. pork industry exports nearly $5 billion worth of products each year.

“We want to make sure that a handful of our trading partners don’t take advantage of this legitimate concern over public health and engage in behavior that could also damage the world’s economy,” U.S. Trade Representative Ron Kirk said at Tuesday’s briefing with Napolitano and Vilsack. (Mike Levine, FoxNews.com)

Manipulating language in such a transparent way isn't gong to do the trick anyway. It's swine flu. I'm sorry, Secretary Pork Producer. I'm going to keep calling it swine flu. As in: swine flu, swine flu, swine flu.

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Methinks that the good Secretary has been successful in his campaign. "H1N1" is becoming the name that most people and organizations are using. For example:
CDC: http://www.cdc.gov/h1n1flu/
NEJM: http://h1n1.nejm.org/

Anecdotally, I also sense, in my own 10-year-old child (N=1), that it is easier (i.e. less stressful) to talk about "H1N1 flu" than "swine flu"; the latter somehow seems more sinister.

Our neighbor is a swine vet and even he calls it swine flu. H1N1 just doesn't roll off the tongue as easily.
As for kids, if the virus were called pig flu maybe that would be scary. Swine flu not so much since most parents don't call pigs swine.

Bravo for your honesty and integrity!
I could see them getting upset if we called it "pork chop flu brought to you by such and such farms......made in U.S.A!" But we do not.
How many other public health threats have been publicly sanitized? Like blaming the spinach contamination on the wild boars of California, or blaming ALL antibiotic resistant bacteria on physician overprescribing rather than such and such corporate farms' use of broadspectrum multiple antibiotics on the livestock?
But I digress. Many thanks.

By Dr Denise (not verified) on 11 Sep 2009 #permalink

How about swine in '09 flu? Or the nine-swine flu?

By Invigilator (not verified) on 11 Sep 2009 #permalink

In Argentina it's called "A Flu", which is in no way related to swine flu. I'm not sure who was behind the change, since pork is not an important product/

I started a new bulletin board in my high school library called "Think Critically." I'm posting this article there. I'm totally trained to think of it as H1N1, which for some reason trips off *my* tongue. But, as a decades-long vegetarian, I can agree that it's pretty silly to change the name of a virus just to protect a meat product.

Of course this is all about exports and money. Do you know how many years I suffered eating domestic prosciutto because of fears of zoonotic diseases migrating from Italian to domestic pigs? Oh those Italian farmers raised their pigs in primitive conditions! The shoe is on the other foot it seems.

If you feel this is about agribusiness, then it should be called "US Congressional Swine Flu", the true epicenter of this pandemic.

Vilsack is just doing his job and it won't change until Congress stops being a wholly owned subsidiary of Big Food.

Considering that most people think they have "the flu" when they have food poisoning, it seems to me that giving actual influenzas some kind of abstract name is probably a good way to go. As someone who comes at this from the rhetoric and communications side of things, I kind of disagree with you, Revere; I think calling it "swine flu" simply because it appears to have come from pigs is kind of dumb, because a lot of flu comes to humans from infected pigs -- also, what do we call the next flu that's not H1N1 that also comes from pigs. I'm also not exactly in favour of gratuitously doing favours for agribusiness, but the fact that people have been terrified that they're going to get sick from eating pork probably indicates that yes, there's a nomenclature problem. I am personally all in favour of communicative strategies that reduce or eliminate popular panics, moral or otherwise. (Apparently raising the intelligence of people who are dumb enough to think this way is still beyond our tech level and/or administrative competence.)

Yeah, "swine flu" is an easy name to remember and say, but there are entire consulting professions dedicated to inventing new abstract, meaningless names for things, and I don't hear people griping about how difficult it is to remember "Activia," "Corolla," and "Previa," no?

By Interrobang (not verified) on 11 Sep 2009 #permalink

interro: Actually very little flu comes to humans from pigs (i.e., a human catches it from a pig). Nor have previous seasonal flus been thought to have started in pigs (the 1918 virus remains a bit controversial in this regard as to which direction it went or whether in fact pigs and humans both got it from birds). So the "swine-origin" (CDC's preferred term before the naming bouhaha) part is accurate and differentiates it from seasonal H1N1 flu and most other human cases (the recent Kansas H3N2 case is also H3N2 swine flu). There is also little evidence that many people are terrified of pork because of the name, any more than they were terrified of birds because of bird flu. Poultry, perhaps (but it wasn't called poultry flu) but that fear wasn't completely irrational because that's the way most people got it. The gastrointestinal route remains a muddled issue. If you don't cook something enough to kill a flu virus you are also at much higher risk for getting any number of other more common foodborne pathogens and this is where the emphasis should be -- proper food preparation.

I agree it could have been called a lot of things (the Israelis call it Mexican flu) but swine flu is both commonly used and makes sense. The most accurate probably is swine-origin influenza virus (SOIV), which CDC tried to use, but was too cumbersome so it remained in its shorter form, swine flu. Changing the name to protect pork exports won't work and isn't a project that appeals to me as a worthwhile way to spend our messaging capital (no one is protected by it except the pork producers and the message gets confused and muddled). I brought it up more to call attention to the dual role of USDA, but this blog does a lot of flu so it was convenient. And I have a migraine and wasn't able to do heavy lifting.

I don't avoid buying pork because I'm afraid of catching swine flu from it. I avoid buying it, Mr. Vilsack, because of the deplorable and inhumane conditions pigs are kept in before they are slaughtered. If you can fix THAT, then I'll start buying pork (and beef and poultry) again, flu or no flu.

So maybe it's a bit over the top to be calling it Hamthrax?

Should be called Smithfield Flu because it bred in the containment pens of Smithfield pork.

This is one of problems of scientific illiteracy and the very poor reporting of science by main stream media. Selective scientific literacy isn't going to work very well to stop it.

Rebranding isn't goingn to help either.

Well, if he doesn't like the name "swine flu", how about we rename it "Vilsack flu"?

Ah.. its not swine flu. Swine flu doesnt exist because they arent testing. If you dont test then you dont have the swine flu. Nor are you dead from it. Its pneumonia dont you see.

Hells Bells, if we cant get them to test people do you really think they are going to test pork or poultry?

By M. Randolph Kruger (not verified) on 11 Sep 2009 #permalink

Randy: Of course. The reasons and ways of testing are completely different. We test animals for all sorts of diseases we don't or can't test for in humans. What we want to know and why aren't the same. We will have swine influenza surveillance soon on an ongoing basis, even after this pandemic is over. Testing most people during a pandemic is dumb.

But it goes back to the toe tag testing Revere if they dont test at least partially. We find out the hard way that this thing mutates and it might be too late. Or, it might not mutate at all but you have to test to do that too.

By M. Randolph Kruger (not verified) on 11 Sep 2009 #permalink

Randy: But they do test, copiously and systematically in ways that are interpretable and useful. I just did a whole post on it yesterday (End of flu Season). It's the flu surveillance system and it has at least 9 different components and is being continually, but rationally, expanded. It produces FluView each week. You can look at it yourself on the CDC site. Where do you think that info comes from if not testing?

Revere,
Thanks for the link to FluView. I keep forgetting about that nice report from the CDC. CDC seems to be improving its surveillance system to monitor the severe H1N1 cases better:

"Pneumonia and Influenza Hospitalization and Death Tracking:

This is the first week that CDC is reporting data from a new system for monitoring the trend of influenza-related hospitalizations and deaths. This new system replaces the weekly report of laboratory confirmed 2009 H1N1-related hospitalizations and deaths. States and territories can now report to CDC either laboratory confirmed or pneumonia and influenza syndromic hospitalizations and deaths resulting from all types or subtypes of influenza, not just those from 2009 H1N1 influenza virus. To allow jurisdictions to implement the new case definition, counts were reset to zero on August 30, 2009. For week 35 (August 30-September 5, 2009) 1,380 hospitalizations and 196 deaths associated with influenza virus infection, or based on syndromic surveillance for influenza and pneumonia, were reported to CDC. This is the first week of data from this new system and reflects reports by 29 states and territories. CDC will continue to use its traditional surveillance systems to track the progress of the remainder of the 2008-09 season, and the 2009-10 influenza season, which officially begins October 4, 2009. "

Regardless of it's origins, it is H1N1 and is endemic in humans, and has been transmitted H2H, not from swine. Originally it may have been transmitted from swine or avian sources, since it has both avian and swine genes.

We do not even know for sure where seasonal flu resides during the summer before emerging in the flu season to affect local populations, so it will likely become just another seasonal flu after it's novelty status wears off, as did the original H1N1 and H3N2 which changes a bit every year. The effect of the new H1N1 seems the same as seasonal flu, probably because it's just the flu, and a variation of an older H1N1. Nobody dropping dead on the street like 1918 when H1N1 first came on the scene, because we all have some immunity unlike in 1918.

Those preferring the more sinister "swine flu" name are fear promoters, some of whom may have a conflict of interest. Scaring people is profitable, such as promoting vaccines, etc.

In the end, government will use fear to assume more control over peoples lives. Stuff along the lines of disposing your bottled water at airports. Quarantines, forced vaccinations, etc. will be the health care equivalent enforced by some new health care police that will be formed or maybe already has been formed (medical reserve corps?, a rear admiral in charge of CDC program for vaccinations?).

The sheep say "Baaah!!, protect me Uncle, take my hair or whatever you want". Pathetic creatures, our founding fathers must think from their graves what a waste, they would have been better off to let us have a king or emperor who talks to god rule us. Could have taken turns and had more fun. Of course, maybe the sheep were tougher then, not so sheepish as today. Probably could not get away with this crap then.

Thank you very much Reveres to have written Truth as it is... in French we call this Une Vérité de la Palice, (when it is minus 45 outside it is cold, that a Vérité de la Palice)

Snowy

Actually, acccording to CDC/WHO conventions, swine flu is not the appropriate name. Human influenza has traditionally been named after the geographical place it was first identified from (Hong Kong Flu, Asian Flu, Russian Flu, Spanish Flu). Avian flu is a bit of an exception, since it is predominently a disease of birds that only rarely affects people, and only then those who work intimately with birds. The current flu should have been more appropriately called "Mexico City Flu", "Mexican Flu" or "North American Flu". Unfortunately, the media had gotten used to avian flu, and latched onto "swine flu" as the catch-phrase for the new strain of influenza, even when it became apparent that this is not a disease of swine (it has been identified in one Canadian herd as a low-level disease, brought into the herd by a sick human).

The term "swine flu" has absolutely hurt the swine industry. I know. I'm a veterinarian who lost her position last month because of depressed pork sales. Enough people have taken the "better safe than sorry" route of refusing to purchase pork in an effort to protect their health that hundreds of people in farming, packing facilities and the pork industry in general are now unemployed.

I'm sorry to hear that you will continue to promote the use of "swine flu" for common usage. It denies both the economics and the science of the current situation.

Essay: We've discussed this fairly often here. Swine flu is the appropriate name because that's where it came from but more importantly, that's how the public identifies it. The only scientific conventions applicable are for isolates and strains named after seed strains made from specific isolates. Those aren't the names used to identify the strain except in special contexts (like when talking about vaccine strain matching).

Regarding CDC and WHO "conventions," scroll back and yo will see that the conventions keep changing, which tells you what we already knew, there are no real conventions. It has become conventional to call the 1918 strain the Spanish flu, although it had little to do with Spain (except that they forgot to lie about it). As for the pork industry, it has been depressed for at least three years. It has little to do with swine flu and everything to do with over production. I'm sorry to hear you lost your job. But so have many other people and it hasn't been because of swine flu. Other agricultural sectors are also down the drain.

The reason to promote swine flu was aptly encapsulated on NPR the other night. A parent also a doctor related how college students know immediately what you are talking about when you say swine flu and don't have a clue when you call it (ambiguously) H1N1. It's swine flu, just like 1918 flu is Spanish flu. The public establishes the convention since there is no scientific convention for naming. It's not just geography (which caused controversy of its own with Fujian strain), as we know with both classical swine flu and avian flu. The campaign to change the name by agribusiness is about export policy. They know consumers march to a different drum and have for 3 years at least.

Here's CDC's Home Page on the subject: http://www.cdc.gov/h1n1flu/
Note how they identify it.

Yeah, the whole Newspeak/control of thought by control of language thing is exactly as creepy when done by industry groups as when done by governments. Swine flu it is.

By albatross (not verified) on 13 Sep 2009 #permalink