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The potential risks of a kiss and a handshake The potential risks of a kiss and a handshake
(about 9 hours later)
VIEWPOINT By Professor John Oxford Virologist at Queen Mary, University of LondonVIEWPOINT By Professor John Oxford Virologist at Queen Mary, University of London
Researchers will be studying the relative risks of a kissResearchers will be studying the relative risks of a kiss
Public fears of a flu pandemic appears to have passed, but experts say the threat still exists. Public fears of a flu pandemic appear to have passed, but experts say the threat still exists.
In this week's Scrubbing Up, John Oxford says we need to know more about how people pass the flu virus to each other.In this week's Scrubbing Up, John Oxford says we need to know more about how people pass the flu virus to each other.
What's worse for catching influenza - shaking hands, a kiss, an overnight stay or a sneeze?What's worse for catching influenza - shaking hands, a kiss, an overnight stay or a sneeze?
We are sitting pretty in the UK on stockpiles of antivirals, a pre-pandemic vaccine and, most important of all a very detailed plan of who will do what.We are sitting pretty in the UK on stockpiles of antivirals, a pre-pandemic vaccine and, most important of all a very detailed plan of who will do what.
I am talking, of course, about our plans to counter an outbreak of avian influenza H5N1.I am talking, of course, about our plans to counter an outbreak of avian influenza H5N1.
I expect your reaction is one of dis- or suspended belief. Hasn't bird flu died a death?I expect your reaction is one of dis- or suspended belief. Hasn't bird flu died a death?
Well it may be finished on talk shows, but out in the real world, a new case of a one-and-a-half year old boy was announced by the ministry of health in Egypt while there have been weekly deaths in Indonesia, China and Vietnam during and since the Chinese New Year.Well it may be finished on talk shows, but out in the real world, a new case of a one-and-a-half year old boy was announced by the ministry of health in Egypt while there have been weekly deaths in Indonesia, China and Vietnam during and since the Chinese New Year.
When this virus takes off and arrives on our doorstep, what precautions can we take ourselves to avoid infection? name="middle"> When this virus takes off and arrives on our doorstep, what precautions can we take ourselves to avoid infection?
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These recent victims all caught the virus from sick chickens or ducks. So far the virus has not mutated to allow it to easily move from person to person.These recent victims all caught the virus from sick chickens or ducks. So far the virus has not mutated to allow it to easily move from person to person.
But the question in all our minds will be, when this virus takes off and arrives on our doorstep, what precautions can we take ourselves to avoid infection?But the question in all our minds will be, when this virus takes off and arrives on our doorstep, what precautions can we take ourselves to avoid infection?
Lurking droplets?Lurking droplets?
Here's the rub. Gather all the influenza experts from around the world and let them argue it out, and the answer is hidden in the smokescreen.Here's the rub. Gather all the influenza experts from around the world and let them argue it out, and the answer is hidden in the smokescreen.
And argue we will, but none of us have the very precise knowledge about person-to-person spread of flu that the mathematical modellers need to feed into their gigantean computers.And argue we will, but none of us have the very precise knowledge about person-to-person spread of flu that the mathematical modellers need to feed into their gigantean computers.
We all need this data to plan. Should schools be closed or even airports? What is safe and what is risky behaviour?We all need this data to plan. Should schools be closed or even airports? What is safe and what is risky behaviour?
We are a little like the hapless and adrift politicians - It's not what you know, its not knowing what you don't know.People are still catching flu from birds.We are a little like the hapless and adrift politicians - It's not what you know, its not knowing what you don't know.People are still catching flu from birds.
We know that a cough or a sneeze can carry a virus, probably enough virus to infect 100 others. But do the droplets containing virus actually settle on nearby surfaces and there lurk for a few hours awaiting a new victim?We know that a cough or a sneeze can carry a virus, probably enough virus to infect 100 others. But do the droplets containing virus actually settle on nearby surfaces and there lurk for a few hours awaiting a new victim?
Or does some virus become truly airborne like perfume scent or tobacco smoke, and thereby pose a danger to someone walking into the room perhaps hours after the flu cougher has left?Or does some virus become truly airborne like perfume scent or tobacco smoke, and thereby pose a danger to someone walking into the room perhaps hours after the flu cougher has left?
All this is very practical because common-or-garden paper face masks could block the droplets - but not the truly airborne virus - and so can hand and surface hygiene and disinfectants.All this is very practical because common-or-garden paper face masks could block the droplets - but not the truly airborne virus - and so can hand and surface hygiene and disinfectants.
Also if we can be sure that most spread is droplet, then social distancing comes seriously into play.Also if we can be sure that most spread is droplet, then social distancing comes seriously into play.
Basically, keep 1.5 metres from an influenza person.Basically, keep 1.5 metres from an influenza person.
We can all certainly agree that extreme closeness is to be avoided, especially real kissing.We can all certainly agree that extreme closeness is to be avoided, especially real kissing.
Even the social kiss can be put off for a few weeks.Even the social kiss can be put off for a few weeks.
The delicate matter of the sleeping arrangements also needs to be confronted. In short, better a few nights apart from a flu person than both being ill together.The delicate matter of the sleeping arrangements also needs to be confronted. In short, better a few nights apart from a flu person than both being ill together.
No kissing allowedNo kissing allowed
Best of all we can now move to answer these imponderables. My research group has permission to infect healthy volunteers with influenza.Best of all we can now move to answer these imponderables. My research group has permission to infect healthy volunteers with influenza.
Just before Christmas a couple of dozen such healthy young people gathered at an hotel, not without some trepidation it must be said.Just before Christmas a couple of dozen such healthy young people gathered at an hotel, not without some trepidation it must be said.
It will be like England of the 1970'sIt will be like England of the 1970's
Our doctors quarantined the volunteers and themselves, for eight days.Our doctors quarantined the volunteers and themselves, for eight days.
No one left and no one came in, and day by day we washed noses and recorded symptoms. Bingo! We now have a lovely influenza virus from a victim in Wisconsin frozen safely at -80C.No one left and no one came in, and day by day we washed noses and recorded symptoms. Bingo! We now have a lovely influenza virus from a victim in Wisconsin frozen safely at -80C.
A single vial of 0.5ml has enough virus to infect 100 volunteers.A single vial of 0.5ml has enough virus to infect 100 volunteers.
But soon we want to move a step forward. We want to infect only a small proportion of the volunteers and then allow them to socialise with their yet-to-be infected friends.But soon we want to move a step forward. We want to infect only a small proportion of the volunteers and then allow them to socialise with their yet-to-be infected friends.
No kissing will be allowed and certainly no cohabitation.No kissing will be allowed and certainly no cohabitation.
In our isolated and, it must be said, very moral and strict world we will allow the volunteer to play cards, watch films or read to each other. It will be like England of the 1970's. In our isolated and, it must be said, very moral and strict world we will allow the volunteer to play cards, watch films or read to each other. It will be like England of the 1970s.
We expect the virus to spread.We expect the virus to spread.
Once it has we only need to recruit 1,500 more volunteers for 24 months and split them into sub-groups - some protected by masks, others held apart, some allowed to sneeze and cough into faces.Once it has we only need to recruit 1,500 more volunteers for 24 months and split them into sub-groups - some protected by masks, others held apart, some allowed to sneeze and cough into faces.
And yes we may even allow (married) couples to spend the night together.And yes we may even allow (married) couples to spend the night together.
Is enough being done to prepare for a flu pandemic? What more could be done? name="bottom">
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Would you stop kissing and cuddling to avoid catching a cold? What lengths do you go to to avoid germs? Is enough being done to prepare for a flu pandemic?
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