Should we stop shaking hands during this flu season? If yes, why not every flu season? The implication in the title is clear. Is the H1N1 strain of the flu A virus so dangerous that we should desist from personal contact?
The problem is that medical experts and virologists seem unable to agree on the level of danger from the virus. Ever since the initial outbreak was reported from Mexico, H1N1 has been treated as something special and particularly deadly. However, as in all considerations of complex subjects, the facts have to be made as clear as possible and everything needs to be seen in perspective.
According to figures quoted by CNN, between 250,000 and 500,000 people die every year from a seasonal flu virus, and 90% of them are over 65. This is the age group which is considered to be particularly at risk, and deaths often occur as a result of flu affecting someone with an existing pulmonary condition.
Vaccines are offered every year in countries which can afford them, supposedly to reduce the risk of catching flu in the coming winter. Yet at any given time there is a host of different flu viruses circulating throughout the world, and no-one can be sure if the particular strain they are being vaccinated against is the same strain they are going to come across. So it is perfectly possible to be vaccinated and still catch the flu.
People do not, as a matter of course every year, wear face masks, or suggest that we stop shaking hands, or refrain from kissing. The risk of catching a seasonal strain of flu is ever with us and we need to be ever vigilant, keeping our bodies as healthy as possible to maintain natural levels of resistance. Washing our hands regularly is part of this process and it is interesting how much this is being stressed in 2009, with a lot of antiseptic hand wash gels suddenly appearing on the shelves.
In reality the need to wash our hands is a constant, so why are people treating H1N1 as something so special?
First of all it relates to the Spanish flu outbreak after WW!. This was also a flu A virus H1N1 and it killed 1.6 billion people world-wide in 28 months - that is 3% of the world's population. To put that into perspective, Spanish flu killed more people in 28 months than the Black Death did in four years. This sounds really scary.
However, the number of deaths so far has been relatively small, and most of them have been of children (the part of the population at highest risk in this case) who had other serious health conditions as well. Very few people have died from just contracting H1N1 this year, but some have and the Ukraine seems to be particularly badly hit. No-one seems to know why, and there is still general disagreement amongst the experts as to the level of risk to the world of H1N1.
In France, H1N1 has been taken very seriously. Here is a country in which friends and acquaintances always shake hands when they meet, and close friends of both sexes and family members always greet each other with a kiss, often two and sometimes four, depending how close they are. If H1N1 should cause us to stop shaking hands, it should certainly stop us kissing.
The French authorities decided that whenever three children in a school class contract H1N1, the class should be sent home, and should remain there until it is considered safe to return. Everyone else in the school is issued with face masks, and parents have been encouraged to make provision for home schooling if their children are affected.
Primary age children have been encouraged not to greet each other with a kiss, something they would normally do quite naturally. The result of these measures appears to have been successful, inasmuch as there have been no cases of H1N1 running rampant through any schools.
But still the debate rages. Vaccines have been prepared in France against H1N1 and seasonal flu, and all those who work in the health sector have been asked to be vaccinated against H1N1 because of their regular contact with members of the public. However, many are declining to do this on the grounds that H1N1 is no more dangerous than seasonal flu, despite the fact that some experts are suggesting a sudden rise in cases of H1N1 as winter grows colder and as the virus mutates further.
So we are faced with questions which are impossible to answer. Should we be vaccinated? If so, against seasonal flu or H1N1 or both? Is H1N1 more serious than seasonal flu? If so, should we take extra precautions like not shaking hands and not kissing? Only we ourselves can decide what we think is right for us.
There are so many flu viruses out there, probably the best thing we can do is continue to keep ourselves healthy by drinking lots of fluids, exercising regularly and maintaining a sensible diet. But it would be sensible to carry a hand wash gel in our pockets or bags, so that if we do shake someone's hands, we can unobtrusively wash soon afterwards.
When it comes down to it, if we are going to catch flu, there is little we can do about it except try to ensure that our strong body can withstand it and shake it off in a relatively short time. But stop shaking hands? I don't think so.