THE SWINE FLU SCARE

Fears of a Major Pandemic

When in February 1976 swine flu was first identified as the agent responsible for a small outbreak of respiratory disease among recruits at Fort Dix, New Jersey, there was ample cause for concern. Hsw 1 N 1, the swine flu virus, was the cause of the pandemic of 1918, which killed twenty million people worldwide and five hundred thousand in the United States. Since the late 1920s the strain could be found only in pigs; no human being under age fifty could have built up antibodies to it. This meant that what might (or might not) be a virulent human flu virus had acquired a new outer coat of antigenic proteins that might (or might not) make it very contagious to humans. The federal government's Centers for Disease Control recommended a major effort to produce a vaccine against the new strain.

President Ford's Decision

In March President Gerald Ford announced an unprecedented nationwide campaign to inoculate every American against swine flu. Congress appropriated $135 million to finance the effort, and after a variety of delays and concerns about proper dosages, it got under way on 1 October.

Guillain-Barré Syndrome

In the first ten days of the program, more than one million people were vaccinated. Then, first in Pittsburgh and later elsewhere, came reports of deaths following vaccinations. A final tragedy came in December. A rare paralytic disease called Guillain-Barré syndrome was reported in a few people who had been vaccinated. It was never clear whether the syndrome was related to the swine flu vaccine, but it was clear that the program had to be suspended. The mass-immunization program ended on 16 December and was not resumed. The epidemic never occurred.

"The Swine Flu Fiasco."

In February 1977 Joseph Califano, the new secretary of Health, Education, and Welfare, commissioned a review of what had become known as "the swine flu fiasco." It was clear that a mass epidemic was cause for concern. But hindsight suggested that a better option was not considered soon enough: stockpiling a vaccine and waiting for evidence of a significant spread of the virus before proceeding to mass immunization. Not enough attention had been paid to preparing the public for such foreseeable incidents as the Pittsburgh deaths or reacting to the appearance of a side effect such as the Guillain-Barré syndrome. The authors of the review, Richard E. Neustadt of Harvard University's John F. Kennedy School of Government, and Harvey V. Fineberg, M.D. of the Harvard School of Public Health, examined the administrative and technical difficulties that arise whenever science and public policy come together and concluded, "[in 1976] in the absence of manifest danger, all-out action was a mistake."

Source:

"Swine Flu Affair; Neustadt-Fineberg Report," Scientific American (January 1979): 80+.