Via BMJ Blogs, a wonderful article: Tracey Koehlmoos on fear and swine flu in Bangladesh. Excerpt:
They were waiting for me when I returned to Dhaka in late July. My office is not easily found, so the small group of older gentlemen must have been determined in their efforts.
Without an appointment but bearing chocolate, the request was clear: surely I had access to the H1N1 vaccine and they wanted it for themselves. In July the vaccine was available only in trials in North America, Europe and Australia—not in South Asia.
My attempts to provide the best information available on preventing illness through good respiratory hygiene and hand washing fell flat on these accomplished men. As one said, “I have COPD. If I get this disease, I will die.”
The fear of H1N1 is real in Bangladesh, as we look across the border to India where schools have been closed and re-opened, the situation is viewed as a true public health emergency.
Within Bangladesh, enterprising yet nefarious agents were reportedly selling “swine flu vaccine” in the informal market. I wonder what they were shooting into people? Saline? Another real vaccine like Hib or measles? Something potentially dangerous? Fortunately, there were no reported deaths from the fake vaccines.
From June to September 2009, the number of identified H1N1 cases in Bangladesh was 604, and there were only three reported deaths. Further, most people without other risk factors will contract a mild form of the disease, and recover fully without the help of anti-viral treatment or medical care.
In a country where more than 1000 children a day die of diarrheal disease and 83 children per day die of injuries, the panic itself seems disproportionate to the burden and risk of H1N1.
