Attention poker players: Flu season is here again



Readers of this column may remember I was pretty concerned about swine flu a year ago, and that I believed poker players had a greater risk than most. I advised them, especially touring pros, to get the vaccine. As the 2010-11 flu season approaches, this is the perfect time to review what happened last year and remind you to get a flu vaccine every year.

So, what happened last year? The media hype made it seem like the streets would be littered with bodies, yet by springtime the flu seemed to have fizzled out. Does that mean the dire warnings were way overblown? I don’t think so. Swine flu, a member of the H1N1 family, killed about 13,000 Americans, less than the average flu death rate of about 23,000, but still a significant number. Two factors kept swine flu in check. First, very large numbers of people got the vaccine, far more than usual. And second, luck would have it that a very close virus relative of swine flu caused a serious pandemic in 1957. Today’s 60-year-olds were just old enough then to be in elementary school and so they probably got exposed. They, and nearly anyone older, developed antibodies in 1957 that protected them from last year’s swine flu.

In a normal year, 90 percent of flu deaths occur in the population older than 65. That means typically for every person younger than 65 who dies from flu, nine in the older age group also die. Last year, almost all of the 13,000 deaths were in the younger group. If the older population didn’t enjoy leftover immunity from 1957, there could easily have been another 100,000 deaths.

So, in my opinion, the warnings weren’t overblown. We were just really lucky.
OK, now what do we have to look forward to this year, the return of swine flu? Or a whole new virus? And what should you do about it?

Well, swine flu isn’t likely to come back. This summer a few isolated cases were reported, but pretty much H1N1 has gone into hibernation for a long time.

Virus strains tend to ebb and flow like imaginary armies marching across a Risk board: mostly blue one turn, mostly yellow the next. Each year one strain tends to win the “world domination war” and all other virus strains retreat to their hideouts in seagull nostrils, turkey spit or pig lungs. That’s why last year’s vaccine won’t work for this year’s virus.

New on the scene this year is likely to be Perth H3N2. This year, 12 states have reported small influenza outbreaks that appear to be similar to a 2009 Australian virus named Perth. Perth never really made it to America in 2009, so unless your name happens to be Hachem or Lisandro, you probably have no immunity to this one. It’s time to roll up your sleeve and get a new shot.

So, let’s focus on three questions:
• Why are poker players at greater risk than the general population?
• What are the risks from the vaccine?
• What should you do if you think you’ve caught the flu?

If your poker career consists mainly of staying at home staring at multiple computer monitors and occasionally ordering pizza or Chinese delivery, then maybe your risk of exposure isn’t so terrible. But if you like to shuffle your chips and squeeze out your hole cards in a real cardroom with real people sitting across from you, you need a shot.

Influenza can live on hard surfaces such as poker chips or playing cards for 24-48 hours. Imagine there’s one sick guy among 300 or so poker players in, say, a Borgata DeepStack event. The 300 players pass around chips and cards for a few days and then, the next week some of them fly to various cities such as Vegas, Macau, Biloxi or New Orleans to play more poker. You can see how one sick fellow in Jersey could infect hundreds or thousands of players all over the world in just a few weeks. If you’re still not convinced, consider H3N2 viruses tend to kill almost three times as many people as H1N1 viruses.

“What about the dangers of the vaccine?” you may ask. Don’t fret. You can’t get the flu from the vaccine because they kill the virus when they make the vaccine. It’s dead! Last year in the United States exactly ZERO people died from the vaccine. None! Nada. Compared to the number of people who died from the flu last year, the vaccine is a more than a bazillion times safer than going bare. Take my advice; get the shot. The CDC is recommending that every poker player in America should get vaccinated. (Actually, this year they’re recommending EVERYONE in America get vaccinated.) As soon as it’s out, I’m getting my shot, and you should, too.

The final question, what should you do if you get exposed, or even, horrors, get the flu? Don’t panic. I’ll cover that next month. For now, just get the shot already.

— An avid poker player, Frank Toscano, M.D. is a board-certified emergency physician with more than 28 years of front-line experience. He’s medical director for Red Bamboo Medi Spa in Clearwater, Fla. Email your poker-health questions to

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