Pigs ears and the law of unintended consequences

Although a term more commonly associated with social action, we have recently seen “the law of unintended consequences” as made popular by the sociologist Robert Merton1 rear its troubling head in the paediatrics department of a busy district general hospital in the south west of England in the context of the swirling frenzy and ongoing concerns about pandemic influenza (H1N1)2009 or “swine flu”. According to the European Centre for Disease Prevention and Control at the time of writing there have been 143 841 laboratory-confirmed cases of pandemic influenza (H1N1)2009 globally, with 813 deaths. The highest numbers of confirmed cases are currently found in the USA (40 617), Mexico (14 229), Australia (14 037) and Chile (10 926).2 In the UK there have now been 10 649 laboratory-confirmed cases of pandemic (H1N1)2009 since the beginning of the pandemic, with a total of 28 deaths. However, the majority of pandemic influenza cases continues to be mild, and children and young adults remain those predominantly affected. Of 652 inpatients with suspected swine flu in the UK (on 16 July 2009) approximately a third (218) were infants and children up to 15 years of …