The H1N1 influenza virus first occupied center stage in the years following World War I, when it was called "The Spanish Flu."  That particular strain of H1N1 went on to kill between 50 and 100 million people (3 - 6% of the global population), compared to 15 million killed in WWI.  The Spanish Flu was particularly virulent and killed young and middle-aged people disproportionately because it caused the body's own immune system to attack the body: those with stronger immune systems faced stronger symptoms and died at higher rates.  In contrast, seasonal flu outbreaks (sometimes H1N1), which kill 250,000 to 500,000 people every year, tend to disproportionately affect young children, the elderly, and those with weakened immune systems.  The recent strain of H1N1/09 influenza shares more in common with the latter, but, due to the possibility for sudden mutation, its high rate of infection, and conflicting media reports in the early days of the epidemic, it's important to separate myth from fact as we head into the winter flu season. 

MYTH: Because H1N1/09 originated in pigs, pork products are unsafe for consumption. 

FACT: Although the pandemic H1N1 influenza virus originated in pigs, the current mutation is a human to human virus.  The WHO, CDC, FAO, and OIE confirm that pork is safe to eat.  In the initial stage of the outbreak, media reports referred to pandemic H1N1/09 as "swine flu", despite the fact that humans, turkeys, and pigs collaborated in making the current incarnation the first documented triple-hybrid, meaning it is genetically composed of elements from each species's endemic strains of influenza.  The WTO suggests most bans of pork products are disguised protectionist measures for local pork industries facing public relations nightmares in the years ahead.  Despite the fact that H1N1 cannot be contracted from eating pork, China has banned pork imports in its ongoing trade war with the Obama Administration, along with Ghana, North Korea, Russia, and Ukraine.  Many other countries have outlawed the importation of live pigs.  In Egypt last spring, the Islamic government slaughtered all 300,000 pigs in the country, which were owned predominantly by Coptic Christians, ignoring the FAOand causing clashes between police and pig-herders- all despite the fact that pigs cannot spread the disease.

MYTH: The best way to prevent contraction of pandemic H1N1/09 influenza is to regularly wash your hands with warm water and antibacterial soap.

FACT: H1N1 is a virus, so antibacterial soaps are useless.  Nevertheless, the best way to avoid contraction is to regularly wash your hands with warm, soapy water or with alcohol, as this usually removes or kills the virus.  Also, avoid touching your mouth or nose.  In many countries, it is recommended that citizens wear surgical masks, however studies have found no evidence that surgical masks help to prevent contraction of the virus.  Surgical masks do, however, prevent the virus from spreading by catching mucus and saliva.  If you have symptoms, it is best to wear a mask.  Or just cough into your T-shirt.         

MYTH: Everyone should get the H1N1/09 vaccine and everyone with symptoms should take antivirals.

FACT: Since there is a shortage of pandemic H1N1/09 vaccines in many places and many health-care professionals are still unvaccinated, it is unnecessary and counterproductive for young, healthy people to get the pandemic H1N1/09 vaccination.  While the 1918 H1N1 strand affected young, healthy people disproportionately, seasonal flu outbreaks, as well as pandemic H1N1/09 influenza are generally fatal only to the very young and elderly, as well as those with asthma, diabetes, obesity, and immune deficiencies.  These people should receive vaccines first.  The same principal holds for antivirals.  Furthermore, unlike with influenza vaccination, overconsumption of antiviral medication creates resistant strains.  Therefore, it is also recommended that only the very young, elderly, asthmatics, diabetics, obese people, and the immune-compromised take antivirals such as oseltamivir (Tamiflu) or zanamivir (Relenza).  The antiviral peramivir is being stored in case oseltamivir-resistant and zanamivir-resistant strains develop.    

MYTH: Pandemic H1N1/09 is more dangerous than seasonal flu strains.

FACT: H1N1 has lower rates of mortality than seasonal flu strains.  Nevertheless, it is very contagious, and because it is a new strain, immunities do not exist in the general population.  Studies have shown H1N1 can survive for up to eight hours without a host.  This makes washing your hands regularly and avoiding contact with your nose or mouth all the more important.  H1N1 is a pandemic, which only means that it is new and beyond containment; this description says nothing about the virulence of this particular strain. 

MYTH: Pandemic H1N1/09 is likely to mutate into a more-virulent form this winter.

FACT: Pandemic H1N1/09 is likely to peak sometime this winter.  Typical influenza epidemics last two seasons and peak in winter.  The 1918 Spanish Flu was unique in that it rose to prominence in summer and peaked in fall, but the vectors of the Spanish Flu were complicated by World War I, and so far it seems pandemic H1N1/09 follows the same pattern as seasonal flu outbreaks.  Viruses are most likely to mutate once they've been controlled, or after they enter another species, like pigs.  Widespread vaccination and widespread consumption of antivirals allow the influenza virus time to rest and regroup.  It is far more likely that a more virulent form of H1N1 emerges next year, or ten years from now, once the pandemic has subsided.  H1N1/09 is particularly dangerous because of its easy transmission and the fact that it combines attributes of human, swine, and avian influenzas.  It's possible that sometime in the future H1N1/09 could mutate into a more-virulent form while remaining just as contagious, but for now, there is little reason to worry or take more than the usual precautions.