Not over yet

"Influenza viruses are extremely unpredictable," said Rear Admiral Anne Schuchat, interim deputy director for science and public health at the Centers for Disease Control and Prevention (CDC). She was speaking at a hearing before a House Foreign Affairs subcommittee May 6 called to assess the lingering swine flu threat.

Even as some Americans are concluding that swine flu warnings may have been more hype than help, the first U.S. citizen, a 33-year-old Texan teacher, was reported to have died of the powerful H1N1 virus. Health officials like Schuchat are signaling that the threat of pandemic may not be over, but sounding the international alarm might also be one reason the flu has not so far been as deadly as feared.

Clearly, Americans took note as over two dozen deaths were reported in Mexico in recent weeks. A subway rider in New York City sat down in a vacant seat in a crowded subway, only to suddenly recall himself, gasp, "Swine flu!," and sprint to a side of the car where human contact was minimal. A student at the Empire State Building wore plastic gloves for her last day of class. In one public restroom of the Hartsfield-Jackson Atlanta International Airport, a woman led people in singing "Happy Birthday"-since her tour guide said a proper handwashing should last the length of the song.

But many of the nation's schools reopened after being closed due to the swine flu scare. Classes began again at St. Francis Preparatory School, the New York school where the first Americans fell ill.

School principal Leonard Conway said that of the 56 confirmed cases from the school, as far as he knew no one was hospitalized, symptoms were mild, and affected students were well enough to come back to school a little over a week later.

Of the 286 U.S. swine flu cases the CDC reported on May 4, only 35 had required hospitalization. (Ordinary seasonal flu sees over 30 million cases in the United States, 200,000 hospitalizations, and an average of 36,000 deaths.)

Brooke Fisher Liu, assistant professor of public health relations at DePaul University, said officials can overdramatize to avoid looking unprepared: "You want to make sure you are protecting your public. . . . But also, your career could be at stake here." And there is a difference between taking reasonable precautions-and needless ones.

Sen. Susan Collins, R-Maine, suggested using $50,000 infrared cameras to detect international travelers who have fevers. The cameras are useless if virus carries haven't developed fevers yet.

Chinese officials banned pork imports from Canada and some U.S. states, while Egypt began slaughtering thousands of pigs-also a misguided campaign since the virus is airborne. Such actions can be harmful, especially in tough economic times. The pork industry is taking a needless hit, and schools that closed without signs of outbreak forced parents to take time off work.

"There's a difference between caution and panic," Liu noted. She said she believes the WHO and CDC struck a good balance by confirming cases before counting them, urging caution while deflecting hype.

Overreaction may have the greatest effect on low-income workers and the world's poor. Stephanie and Wes Vander Lugt, missionaries with Mexican NGO Armonía, said one of their teams went to Mexico City to help and reported that the city is "eerily empty" because restaurants and factories have closed until the epidemic passes. "For some families, the little income that they usually bring in is just enough to put some food on the table, and little more," they said, so while shutting down the city has slowed the virus, it has hurt the poor.

The good news is that the virus seems to be waning rather than spreading to poor countries. Vincent Truglia, managing director for Global Economic Research, said further that influenza usually declines in the summer. Researchers must keep a watchful eye into next autumn, though, since the virus can stick around, mutate, and "resurrect itself in a different form." In a May 5 briefing for the CDC, Dr. Richard Besser said researchers would be watching the Southern Hemisphere, where winter-and flu season-is just beginning.

-with reporting by Mindy Belz, Daniel James Devine, and AWR Hawkins