Influenza in Japan

While the H1N1 flu has been written off by the average American as a plot by Democrats to scare the public into accepting a totalitarian socialist state, the Japanese have turned their influenza fighting amps to 12. Everywhere you go, there are masks. There were always masks, but now they come in science fiction flavors, with specially designed models that minimize the possibility of particles entering the oral cavity all the while placating you with strawberry or herbal scents. Some go so far as to act as a substitute for a burqa, covering the entire face save enough space to allow the wearer to see where she is going. Note that “she” was no accident. I hardly saw any men under the age of 90 wearing masks. The fact that it’s largely women wearing these masks leads me to suspect that, rather than being used in a large scale public health intervention, the masks are merely an excuse to not have to wear makeup.

Most people I spoke with believed that the hysteria over H1N1 has largely been overblown by the media and that the frantic mask wearing is not only likely useless in preventing the spread of H1N1, but also borders on the pathological. Granted, as in America, the people I associate with in Japan tend to verge on the jaded and cynical. During the height of the scare, people who did not wear masks were looked at with suspicion. A person seen coughing on a train without a mask could quickly see several seats open up around him/her.

When I entered Osaka, I was immediately asked what countries I had visited in the past 6 months. When I offered that I was coming from Malawi, the attendant immediately passed me a health questionnaire where I had to write what symptoms I might have, my name, address in Japan and phone number, in addition to having the attendant take my temperature. I wouldn’t be at all surprised to find out that my in-laws get a phone call asking if I exhibited any symptoms of flu or ebola during my stay.

I managed to purchase a set of “wet masks”, which obliterate germs by passing air through and antiseptic filter before they can reach the mouth. To please the user they introduce a nice smelling herbal aroma. The box claims that through the use of the mask, 99% of all pollen and virus particles can be obliterated. I’m not sure what pollen and flu viruses have to do with each other, but I’m sure there’s some truth in advertising numbers game going on here given that pollen is not only bigger than viruses, but also likely more numerous since viral infections only hit as certain times of the year, unlike pollen and dust, which can be ubiquitous.

Opening the package, one is given a set of three masks and three wet packets and the user has to assemble them before venturing out in the dangerous world. Personally, I find the whole thing too much work to prevent flu, but since the wet packets only last a day, this whole system has to be boon to Kobayashi Pharmaceuticals. At seven bucks for three masks, you can do the math.

Drug stores all have a section out front displaying anti-viral goods, including a variety of masks, from the traditional gauze to the expensive and complicated ones mentioned above, along with a number of throat disinfectants and Lysol type bathroom and house cleaners. Anti-bacterial soaps (uhh flu is a virus?) are also exceedingly popular and people appear to obsessively hand wash.

The most impressive measure I saw was the closure of the schools and intense monitoring of children. All children in schools must take their temperature every morning and write it in their home room notebook. They must then present the notebook to the school every single day and children who report high temperatures are immediately sent to the school nurse and she reports the child’s information directly to the local health department. If the child is found to be positive for flu, the school is closed and children sit out for a week. I simply can’t imagine this kind of strategy working in the US. Parents would never want to report their child’s temperature to the school for privacy reason, and many parents would probably lie if they knew the school would be closed. The Japanese are incredibly cooperative people.

However, for all of these expensive, product based counter-virus measures, one still has to share handles on the train with numerous other possibly infected people. Smokers abound everywhere, coughing and hacking God knows what straight into their hands, which they then use to touch just about everything you touch.

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About Pete Larson

Assistant Professor of Epidemiology at the Nagasaki University Institute for Tropical Medicine

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