Here’s Part 2 of our conversation with Kenneth Alexander, M.D., chief of pediatric infectious diseases. In this second and last installment, we discuss what ordinary people can do to avoid getting or spreading swine flu, some steps that medical professionals can take, and what would constitute a flu pandemic.

Here’s a video we shot yesterday of Kenneth Alexander, M.D., chief of pediatric infectious diseases, answering common questions about swine flu.

The news of unusual swine flu cases in Mexico and the American southwest has raised concerns that the outbreaks could herald a new flu pandemic - though the anxiety level in this AP story on today’s news seems just a bit too high at this stage. Something about the tone smacks of that movie “The Andromeda Strain” - “it’s something we’ve never seen before…”

It’s important to be vigilant, but overreaction also can have costs. In 1976, the CDC instituted an emergency immunization program in response to an outbreak of swine flu. The vaccine they used may or may not have been the cause of an uptick that year in cases of Guillain-Barre Syndrome (see this for an account of the 1976 experience by the former directors of the CDC and the immunization program).

President Obama has a history of interest in flu pandemic preparedness. He co-wrote a 2005 op-ed in the New York Times on pandemic measures, and later that year I interviewed him on that subject for the Chicago Tribune. You can see the transcript here. Two passages from that interview may offer clues about how Obama’s administration will handle the latest outbreak: 

Even when the SARS scare struck, the losses were in multiple billions of dollars. And that proved to be a false alarm essentially. If something like this genuinely occurred, you’d see global trade come to a standstill. And in addition to obviously the loss of life, the breakdown of our health systems, the economic consequences would be huge.

…you hate to be Chicken Little on this thing - no pun intended. But this is actually one of those situations where getting people a little scared, and certainly getting our government a little scared is probably a useful thing. And as I said, whatever investments we make are not going to be wasted, because the likelihood of pandemic is so high, even if it isn’t this particular pandemic. 

Perhaps Obama will see the issue differently as president than he did as a senator. But his instincts seem similar to those of the people who ran the 1976 immunization program - “When lives are at stake, it is better to err on the side of overreaction than underreaction.” If this outbreak continues, we may see another test of that idea.