By Alex Repp
Recently, there has been much ado over the all-new and improved flu. As anyone who has failed to stifle that cough or sneeze in a crowded area knows by the sharp glares immediately thrown in his or her direction, people seem to be taking this super-bug more seriously than several other diseases recently come and gone from the media spotlight. Catching the flu is a real blower, everyone knows that, but is this one really that special? Common knowledge is that the flu is only dangerous to the young and old, does this hold true, is there any real cause for concern? Who is saying what? Who is to be trusted? Mostly importantly, what does yours truly think?? All this and more is here for your enjoyment; I like feedback and animated debate but please don’t be a bonehead.
Background
Officially monikered Swine Influenza Virus (SIV), the new pestilence has been identified as several different strains of the influenza A virus, and has been found to carry “genetic components of the H5N1 avian influenza virus,” reports Official Wire, the significance of which will be discussed later. Currently, the strain receiving the most hype (which is the only way to describe the publicity these quasi-celebrity diseases receive, remember MRSA and Bird Flu) is H1N1 (flu tests do not identify a certain strain, they only differentiate between influenzas A & B, so a positive influenza A test means that you have a strain that is at least “swinish”). H1N1 has been identified from corpses frozen for medical research as the particular strain of flu whose infectious spree reached its climax in the 1918 “Spanish Flu” pandemic, which, incubating in soldiers returning from their victory in WW1, wreaked havoc in the United States and the rest of the world.
The Spanish Flu possessed such virulence that it afflicted at least one-third of the world’s population, and it was no glorified cough either. The mortality rate, which was never truly documented, has been placed between 10% and 20%; and given the extent of infection, experts have concluded that 50 to 100 million people died around the globe (compared to 25-75 million during the infamous 14th century Black Plague, arguably making the Spanish Flu the deadliest pandemic in recorded history); this figure encompassing a full 3 to 6 percent of the world’s population. Now certainly, health care has improved since then, but the global situation has become much more conducive to pandemics, especially from a particularly virulent, airborne pathogen (the bubonic plague responsible for the Black Plague was mainly transmitted through insect bites such as fleas and contact with infectious tissue, making person to person contact extremely rare). Therefore it can be argued that it was not the pathogen (which has been responsible for numerous plagues of lesser impact on humanity) to which credit for the Black Plague is due, but the sanitation conditions at that time that can only be aptly described as abysmal. Influenza is an entirely different ball game; included with no assembly required is a completely autonomous and highly effective dispersal capability. With one un-covered cough at an airport, the infection could be spread to every country in the world within 72 hours (in 1918, it took 6 months). Certainly, the global scene has developed a highly efficient medium for infection to all havens of civilization in our advanced transportation network, which despite their best efforts is still susceptible to hijacking by antagonists the size of you or me, not to mention something a few nanometers across and hiding inside someone. In addition, urban conditions have become much more crowded, adding further obstacles to the success of a potential quarantine operation should the need arise. However, technology is not to be our bane but is a double-bladed sword, capable of being a potent weapon in the fight against pandemics. For every development that could lead to our downfall, technology has given us a parallel rise in sanitation and health care in highly developed countries, but many of the world’s densest cities such as Delhi and Mumbai in India (#1 & #2), Seoul in S. Korea, and Jakarta in Indonesia (#3 & #5) do not have the public health systems of cities such as Tokyo (#4) and New York (#6).
The virus has different methods of dealing death, which create strange trends in the death rate. Obviously, the weaker immune systems of young children and the elderly result in deaths from pneumonia and fever; however, the death rate spikes between ages 15 and 35, when the immune system is the strongest. During the Spanish Flu pandemic, this trend was also observed. The only explanation that scientists can attribute to this mystery is that the virus can induce a “cytokine storm,” (Official Wire). Cytokines are proteins and other substances in the blood that act as directors for the immune system, in addition to signaling the site of infection to immune system cells such as T-cells and macrophages, the cytokines activate them, stimulating them to produce more cytokines as well as attack foreign bodies. However, some afflictions such as smallpox and the H5N1 avian flu mentioned earlier, and theoretically the Spanish flu or H1N1 appear to cause these so called cytokine storms. Scientists have postulated that this particular effect H1N1 may have on the body hitch-hiked its way into the Swine Flu arsenal through its shared genes with H5N1, which was positively linked to cytokine storms. In a cytokine storm, certain ailments such as those described previously, through a process not entirely understood, cause an explosion in the chain reaction regeneration of the proteins. These cytokines result in an exaggerated immune system reaction in afflicted areas of the body, and valuable organs and tissues are caught in the crossfire. When infection spreads to areas such as the lungs, heart, brain, and other vital organs, potentially life threatening organ damage can occur. Consequently, when an individual whose immune system is in the prime of effectiveness, the body’s own potent immune system can serve as a death warrant; like the bodyguard who senses danger and smothers their charge to death under their protection.
Who is Saying What?
Information in italics is cited from one of several websites hyperlinked in this article. My responses will be indicated by bullet point.
Will it get you?
“Almost all of the influenza viruses identified were the new 2009 H1N1 influenza A viruses. These 2009 H1N1 viruses remain similar to the viruses chosen for the 2009 H1N1 vaccine and remain susceptible to antiviral drugs (oseltamivir and zanamivir) with rare exception.” (
- Several things stand out in this tidbit. Waving most warning flags in my mind is the confirmation that “almost all the influenza…[was] the new 2009 H1N1”. No one will be catching the same old flu this season; it will be the real deal. In a WHO (World Health Organization) report (this organization is international and not affiliated with any country) released on March 18, 2009, WHO scientists released their opinion on the virus and treatment options. The report confirms H1N1’s high resistance to anti-viral drugs, in direct contrast to the official CDC statement above. In the United States, 237 of 241 samples of H1N1 tested were found to be resistant to oseltamivir. To me, this is deeply worrying, because it shows that the CDC is underplaying an obvious area of concern, recalling to my mind FEMA’s behavior before Hurricane Katrina, when director Brown and his staff were caught with their pants down by a disaster whose proportions were accurately predicted by many organizations in the weeks prior.
Some facts and figures:
“From April 15, 2009 to July 24, 2009, states reported a total of 43,771 confirmed and probable cases of novel influenza A (H1N1) infection. Of these cases reported, 5,011 people were hospitalized and 302 people died. On July 24, 2009, confirmed and probable case counts were discontinued.”
- In a period of two months (April-June), swine flu killed 6% of everyone that was hospitalized before records stopped. This is actually encouraging; this represents a drop from the 10% to 20% mortality rate of the 1918 pandemic. However, data gathered from the Branch-Hillsdale-St. Joseph Health Department shows that the flu mortality rate during the first few years of the 21st century was a paltry ~30 deaths per 100,000, or .003% death rate. In addition, the CDC reported that, during the week of August 30-September 5, 196 deaths were reported amongst 1380 influenza related hospitalizations, representing a 14% death rate. This confirms that H1N1 is, as feared, far more deadly then its seasonal predecessors. In addition, the CDC reported that, during the week of August 30-September 5, 196 deaths were reported amongst 1380 influenza related hospitalizations, representing a 14% death rate.
The Vaccine:
“Together with scientists in the public and private sector, CDC has isolated the new H1N1 virus and modified the virus so that it can be used to make hundreds of millions of doses of vaccine. Vaccine manufacturers are now using these materials to begin vaccine production. Making vaccine is a multi-step process which takes several months to complete. Candidate vaccines will be tested in clinical trials over the few months.”
- This factorial, labeled What are the plans for developing 2009 H1N1 vaccine was published along with other vaccine related information on September 15 on the CDC’s H1N1 site, promised a vaccine in a few months. The next such factorial, labeled When is it expected that the 2009 H1N1 vaccine will be available? states that the vaccine is expected to be available in the fall. Pardon me for being a stickler, but a few months is not this fall. Certainly, the flu shot should be administered to persons at high risk of developing dangerous health complications to a flu infection, such as the elderly and infirm, or the young and sensitive, as well as persons whose occupation implies a situation where they could spread an infection to others whom the flu poses a danger, such as health and daycare workers. For the rest of us, it appears the best we can do is wait.
The Most Important Part
The stark reality as I see it is that we can talk all we want, pass out awareness brochures, adopt stereotypical obsessive-compulsive hygiene habits, but there is not much we can do to obstruct the viral onslaught. In all my years, I have never heard anyone attribute their evasion of influenza during any given winter to obsessive hand washing. When you get on the elevator to the 17th floor and breathing down your neck is an average Joe busying himself with “rapidly expelling air from the lungs typically in order to clear the lung airways,” (coughing as defined by medterms.com if the vernacular went over your head) no amount of Purell is going to prevent the inevitable. However, the proper message to carry away from this is not one of despair, hysteria and panic. My advice to my readers is to use a bit of common sense and be conscientious of the public at large—if you don’t feel well, stay the hell at home—your boss will understand. The last thing you should do is attribute it to a cold, pop an Advil, and be on your merry (sickly, but hey it’s just a cold after all, right?) way. Just because you have the world’s greatest immune system and consume your daily dose of vegetables and remember your Flintstone’s vitamins and floss your teeth every night doesn’t mean the same applies to newborn Tiny Tim or Old Lady Gertrude (yes I am reading Hamlet in class). So do yourself a favor; keep yourself at home at the slightest inclination (heck, look at it as the one winter when your boss won’t chew you out for taking one too many lazy days in bed) and advise your friends and family and Average Joe to do the same. Also, on a final note, can someone explain to me why in god’s name does pending FDA approval of the H1N1 vaccine for expecting mothers keep the REST of us from getting our bloody vaccines??
