Over the past week, media reports cycled through various names for the 2009 A(H1N1) influenza—swine flu, Mexico flu, North American flu, novel flu—as international health agencies struggled to better understand the global outbreak.
The World Health Organization and the Obama administration eventually settled on “A(H1N1),” which stands for Influenza A, the sugar protein hemagglutinin type 1 responsible for initial cell infection, and sugar protein neuramidinase type 2 responsible for helping the virus spread to other cells. Just as readers were getting used to stumbling over that awkward alphanumeric, however, investigators discovered the virus in 220 Canadian pigs. Newsweek’s cover story this week also uncovered a tangled history of H1N1 infections through pig-human interactions since 2005. Will these findings reinvigorate the name game? We hope not.
The naming of diseases and outbreaks has always been a tricky task that involves balancing socioeconomic sensibilities with scientific understanding. In the case of this flu, however, the confusion and indecision wasted hundreds of reporting hours on a problem that could have been easily solved with an established naming system, similar to the National Hurricane Center’s forename procedure.
It seemed almost effortless in the early stages of outbreak in Mexico to call the virus “swine flu.” During initial genetic studies before April 24, the virus was found to contain mostly North American swine and Eurasian swine segments, with bird and human flu strains making up only a small percentage of the genetic composition. Swine flu seemed like the logical name for a strain scientifically grounded in swine segments.
Then came the hoopla: the meat industry complained the name would hurt businesses (despite nearly ubiquitous disclaimers in the media that humans cannot contract the flu from eating pork) and countries began banning pork imports from those with reported cases of H1N1. The Egyptian government ordered the culling of all pigs within the nation’s borders. And the Israeli health minister objected to the term swine flu because of Jewish and Muslim sensitivities over pork (being as culturally sensitive as possible, they suggested “Mexico flu” instead).
To top it off, hundreds of articles were written debating the pros and cons of the controversial appellation. Stories about the naming controversy was covered by Agence France-Presse, The New York Times , Newsweek (blog post), and USA Today. Reuters even hosted a “Rename the Virus” contest. Unsurprisingly, it inspired such ridiculous submissions as “Flu-oink” or “Floink,” the “Chicken Little Flu Pandemic” (because the sky is falling), “PorkPlague,” “Panchovillasrevenage,” “Mystery Meat Flu,” and “Oinkvirus.” The big winner was “The Freedom Flu.”
Unfortunately, most articles about the naming debate failed to mention an important detail: the genetic composition of the strain has not changed since it was initially studied; it is still mostly comprised of swine segments. One exception was an excellent May 1 article by Associated Press science writer Seth Borenstein, who reported that “six of the eight genetic segments of this virus strain are purely swine flu and the other two segments are bird and human, but have lived in swine for the past decade.”
“Scientifically this is a swine virus,” virologist and influenza expert Richard Webby, a researcher at St. Jude Children’s Research Hospital in Memphis, told Borenstein. While it is still unclear where the strain originated, and some scientists say it should be referred to as “swine-like,” the article argued there is no denying the predominant genetic composition.
Nonetheless, swayed by cultural and economic concerns, the World Health Organization, the U.S. Centers for Disease Control, and several other government health agencies nixed the term “swine flu” on April 30 and began referring to the virus as “2009 A(H1N1) influenza.” Many reporters have now conformed to that standard, but not all. According to a New York Times article headlined, “W.H.O. Gives Virus a Name That’s More Scientific and Less Loaded,” “a hapless reporter who used [‘swine flu’] during a radio interview was roundly scolded by Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.”