By Salma Khalik, Health Correspondent

A RETIRED pharmacist sent me an e-mail recently asking why the hullabaloo over a flu strain that kills fewer people than the seasonal flu.

'It's good that Mexico found the new strain, but 19 deaths in a month is nothing compared to the mortality rate for flu,' she said.

She knows her facts.

Of the more than 150 Mexicans who died from the flu, only 25 have been confirmed to have died from the new strain.

People sick with this strain outside of Mexico seem to recover faster than victims of other flu strains.

Her point is valid - but possibly not the way she meant it.

She decried the waste of public funds and the inconvenience to the public.

While all that might be true, what this exercise has done is to spotlight the morbidity and mortality that the world takes for granted every year from the seasonal flu.

The question we should ask - in the light of all that is being done to prevent a pandemic - is whether we have been too complacent all this time about a disease that does kill and causes severe pain and heavy loss of productivity.

Even Singapore, which like other countries in the tropics has no clear flu season, sees one death from influenza every 15 hours - not a small number by any means.

Worldwide, according to the World Health Organisation (WHO), three million to five million people get severely ill and between 250,000 and 500,000 people die as a result of the flu each year.

In spite of such alarming figures, there doesn't appear to be much concern, largely because the bulk of those who die are elderly or suffer from some chronic ailments.

Deaths among the old and the ill are expected, so there is little fuss.

It has become almost routine for the WHO to send out this warning annually in its attempt to get more people vaccinated: 'Influenza can cause serious public health and economic problems.

'In developed countries, epidemics can result in high levels of worker absenteeism and productivity losses.'

Developed countries are the ones that can afford these vaccines, but even there, a large proportion of the population does not get vaccinated.

The head of Singapore's Communicable Disease Centre, Associate Professor Leo Yee Sin, said recently that she hoped the current concern would lead to greater respect for the flu bug.

'I hope that from this point on, we truly understand that the flu has never spared Singapore,' she said, adding: 'It is time for us to change our mindset.'

Would 600 people die of the flu here each year if people were more considerate about not spreading the virus when they are ill?

Would better hand and environmental hygiene lower the number of cases here?

Logic says that the incidence of flu would be much lower if such precautions were taken.

While vaccines are a major tool in fighting the spread of the flu, they are expensive and do not work as well in the elderly and the ill - the group at the highest risk of severe illness and death.

Even in healthy people, a good vaccine match will afford only about 70 to 80 per cent protection. In the elderly, the protection is much lower.

However, if people travelling to countries in winter were to get vaccinated, the chances of their bringing the bug back and affecting others go down.

And if they were to get ill, staying away from family and friends would reduce the risk of them passing the illness on.

Perhaps it is also time for companies and general practitioners to take a more pro-active approach towards people down with the flu or even the common cold.

In the past, it was considered noble to soldier on in spite of being ill.

Red eyes and a runny nose, heaps of wet, germ-ridden tissues lying in an open bin, earned a worker kudos for being conscientious.

But this attitude is fast changing. A sneeze in the office now draws critical stares and calls for the culprit to go home and not spread his germs to others.

Perhaps Singapore has not reached the level of the Japanese in terms of social etiquette, where people who are ill would wear a mask when in public.

But there is hope, given that pharmacies here have had a run on masks the past week.

There are also medicines that can reduce the replication of the virus, and others that stop runny noses - reducing risk of transmission - so people should take them.

And with modern technology, working from home is now an option for some, should they not be too ill.

Furthermore, companies that are reluctant to give their employees time off for a 'minor' illness might want to relook the real cost to them.

One employee away for a few days is probably better than a dozen slogging away with bleary eyes and woolly heads.

A term which is surfacing more frequently is 'presenteeism' - a state where the employee is at work, but not working to the best of his ability. This often leads not just to lower levels of productivity, but also to costly mistakes.

On the positive side, the current scare has thrown up some enlightened companies too.

These corporations realise that prevention is useful, and have already armed their employees with antiviral medicine to take should a pandemic occur.

Some also provide employees who travel often with annual vaccination. Singapore needs more such enlightened behaviour.

So even if all this hullabaloo proves unnecessary in the long run, as long as it leads to continuing practice of good hygiene habits, its benefit is not to be sneezed at.

salma@sph.com.sg

This article was first published in The Straits Times.