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A Flu Pandemic?
Pedrito writes "Scientific American is running a story in this month's issue about preparing for a flu pandemic. What this article tries to convey is that a pandemic is definitely coming. Whether it's from the H5N1 strain (which would likely cause hundreds of millions of deaths) or another strain a few years down the road. There have been 3 other flu pandemics in the past 100 years. The 1918 strain being the worst, with 40 million killed. The reason H5N1 is being followed so closely is because it's already spread to people and because it's incredibly lethal (a roughly 50% fatality rate at th moment). Even if the fatality rate dropped to 5% when and if it mutates into an easily communicable form, it would be twice as deadly as the 1918 virus."
Here is a one-page, ad-free version of the article. Seriously, when articles are formatted like this, submitters should use the "printer friendly" version of the article as the submission.
The Discovery Channel will be having a special on about this at 10:00pm EST, it was on last night and I believe it was nearly a 60% fatality rate. In Holland they had to slaughter nearly 30 million birds (mostly chickens) because the disease spread there. The most cases and deaths have been reported in Vietnam, 41 deaths out of the total of 62. You might want to watch this special, it even talks about how they found out the 1918 flu was originally a complete avian strain, much like how this new one is.
Fear the turtle farming ninja!
Here is an article on "Bird Flu's Environmental Components", for those interested in the ecological side of it.
Am I the only one, having a somewhat strong immune system, that is not in the least bit worried about a pandemic?
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A string immune system is not garuntee that you will survive. The 1918 flu killed a lot of healthy people.
The flu was most deadly for people ages 20 to 40. This pattern of morbidity was unusual for influenza which is usually a killer of the elderly and young children.
http://www.stanford.edu/group/virus/uda/
The 1918 virus sometimes killed completely healthy people in killed overnight.
"Some people would go to bed healthy and never wake up."
http://www.cbc.ca/news/background/flu/fluepidemic
This was one of the flus that worked so fast the immune system couldn't keep up.
Fly me to the moon Let me sing among those stars Let me see what spring is like On jupiter and mars
Am I the only one, having a somewhat strong immune system, that is not in the least bit worried about a pandemic?
Start worrying. Many of the deaths from the 1918 pandemic and from H5N1 have been related to a "cytokine storm," resulting in an overly vigorous immune response. The typical "healthy young adult" is very much at risk.
Short subject line -- in the 1918 pandemic the young and healthy were often fine in the morning and dead by nightfall. Even in the more common situation where it took a few days to kill, it struck the young and healthy disproportionately harder.
The problem? An immune system has to be _reactive_. Your immune system has to develop sensitivity to the new virus and that takes some time. The usual flu strain isn't a problem since it's very similar to the strains we've already seen (in infection or innoculation) and our immune system can quickly respond. There's also a lot of natural selection going on over time -- a virus would rather see us miserable and contagious for a week than dead and non-contagious within a day.
But we have no natural immunity to an entirely new strain, and some can kill before our immune system can develop an effective response.
That's why older people faired better in 1918. They hadn't seen the same strain, but they had seen enough variety that they had a stronger initial response than their younger peers.
For every complex problem there is an answer that is clear, simple, and wrong. -- H L Mencken
Am I the only one, having a somewhat strong immune system, that is not in the least bit worried about a pandemic?
Actually, this is to your disadvantage, as a strong immune system is probably what is going to kill you. Your immune system could trigger a Cytokine Storm which will basically dissolve your lungs through severe inflammation.
But not too reactive. The suggestion has been made that the problem isn't that our immune systems don't react to H5N1, it's that it reacts too vigorously, as per, for example, this article, Bird Flu Triggers Immune System 'Storm'.
Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota School of Public Health is quoted in that article as saying that this might be why the young and healthy get stricken more severely (presumably he's referring to H5N1, but perhaps that happened with the 1918 flu as well):
Your either drunk, high or extremely fucking stupid. Your post makes no sense and even after distilling the point you are trying to get across, it is complete bullshit. You are confusing the overuse of anti-bacterials with vaccinations. Getting vaccinated does not help the virus mutate. In fact, if you get the flu, once you are well you are vaccinated against in naturally and you will most likely never get that strain again for the rest of your life. In addition, getting vaccinated for the flu each year boosts your immune system in general so you will not get a common cold as easily.
People like you who 'tough it out' are vectors who make the rest of the country sick by spreading highly communicable yet easily preventable diseases.
Tsk, Tsk. You really must learn to pay attention to the medical literature.
Source: The Writing Committee of the World Health Organization (WHO) Consultation
on Human Influenza A/H5 "Avian Influenza A (H5N1) Infection in Humans" The New England Journal of Medicine 353:1374-1385 You can probably find it online here
Polio is a particularly good example because it's been flaring up again in isolated areas on a regular basis due to lack of political will - for instance in Kano province in Nigeria in 2003 after muslim leaders caused the immunisation programs to be suspended over paranoia that Western nations used the polio vaccines to distribute drugs to reduce fertility and spread HIV... Yes, you read that right.
As of this year Polio is still endemic (exists in the wild) in at least 5 countries. The other countries with significant Polio outbreaks have all been cases of it being imported from elsewhere.
The good news is that the Polio vaccine programs in Nigeria were reinstated, though despite that Nigeria alone have had about a third of all Polio outbreaks this year.
Yeah, but if they saw the shit movie first I can understand why they wouldn't want to read the book.
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According to the World Health Organization 34.3 million people in the world have the AIDS virus
24.5 million of them in sub-Saharan Africa.
Nearly 19 million have died from AIDS, 3.8 million of them children under the age 15.
5.4 million new AIDS cases in 1999, 4 million of them in Africa.
2.8 million died of AIDS IN 1999, 2.4 million of them in Africa.
13.2 million children orphaned by AIDS, 12.1 million of them in sub-Saharan Africa.
Reduced life expectancy in sub-Saharan Africa from 59yrs to 45yrs between 2005 and 2010, and in Zimbabwe from 61yrs to 33yrs.
More than 500,000 babies infected in 1999 by their mothers most of them in sub-Saharan Africa.
The more you know, the less you understand.
I'll worry when there's a few thousand deaths. Until then, eat healthy food, exercise and keep that immune system running. If you're not one of the typical flu victims (elderly, very young or compromised immune system from other causes), you'll have an excellent chance to shrug it off, even if it does spread.
While I'm not in a position to judge whether it's true or not, but just yesterday I read in a newspaper that H5N1 has especially high lethal rate among healthy young people, and that this is caused not by the virus itself, but by the extremely strong immune response of the organism to this virus. Basically, our immune system kills ourselves! Therefore, the stronger your immune system (above a certain threshold), the more likely that you'll die from this disease.
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the pen is mightier than the sword, the sword is mightier than the court, the court is mightier than the pen.
The Spanish Flu (1918) killed young healthy people very quickly, it turned their lungs into sponge rubber. It was not at all like the "flu" that we are used to. People who blithely confuse the yearly 'achy go to bed for a few days' flu with the killer flu should read the books written during that period about what it was like. People were dying all over the place, sometimes within 24 hours of contracting the disease.
I Am Not An Expert, but aren't there other reasons why people are fixating on H5N1, besides the quantity of human deaths so far (which certainly is a red herring). For instance:
- It is spreading unusually widely among birds; which means a lot of birds with the virus inevitably coming in contact with humans and human DNA; which does create increased opportunities for either a genetic shift or random mutation in the virus that would make it human-to-human communicable.. at which point humans everywhere would in fact get it; and although we don't know the mortality of the virus post-mutation, it's at least even odds that the mortality will be bad.
- It is spreading among birds in places where culls -- the most effective method to prevent mutation -- are not likely to be successful: rural Asia and Africa. That is not just some kind of prejudice of fear, it's an actual public health difference between those places and Europe or North America.
- The flu virus in general, unlike other arbitrary viruses, is known both to mutate in the feared way (going from communicable within one species to communicable within another); and also to be highly communicable among humans.. so unlike "new" diseases like SARS and mad cow, in this case it is not actually speculation but learning from history.
Agreed, buying $99 worth of Tamiful is not necessarily a sane (nor ethical) solution. But I think you're a fool if you don't want your government, as well as pharmaceutical companies and universities, to devote vastly increased resources and competencies to this scenario. Sometimes you actually do need to plan for (or attempt to change) the future.
Go try to find the book: "A Dancing Matrix: How Science Confronts Emerging Viruses". I read this book in the mid 90's, and it described the already overdue flu pandemic. I guarantee that if you read this you won't take influenza so lightly again.
The upshot is that flu undergoes cyclic major mutations about every 40 years. There are six mutations in the cycle. The last two major mutations were relatively benign (remember Hong Kong flu in the 70's?). The 1918 pandemic was quite lethal, and being a virus rather than a bacteria, influenza is not going to be quickly cured with antibiotics.
The bird flu virus we see today is about 50% lethal, and has even killed a high percentage of otherwise healthy individuals. I for one find this a pretty frightening scenario, let's hope that when it mutates to an easily-propagatable-between-humans form that its lethality has declined substantially. Imaging the economic effects of a spreading flu that was lethal - people would quit going to work, you could see much commerce grinding to a halt. The CDC has said we should be preparing ourselves for seeing children die, etc., at a numbers that are pretty frightening.
Yeah that's right, that's also why I said "*one* of the reason"
I'm not speaking about current H5N1.
The parent was speaking about capability/limitation and killing possibility of a *new* mutant.
The whole point of my post was saying that there's a upper limit of how fast *a new virus* can kill its host and still manage to survive to natural selection.
None of us was saying that current virus is fast flash-killing.
BTW: Concerning the plague, a factor that contribute to the widespread of the disease is that the intermediate host is the flea.
And flea can survive a certain amount of time while being infectiouse because :
- they only start to starve when the stomach is full of bacteria. Before they can infect but aren't affected by bacteria
- they are cold blooded, therefor they have lower metabolism requirement and they don't starve to death very quickly.
- In fact, they can stay dormant a whole winter with bacteria inside and re-start the plague next spring.
- A dead rat/human, can still be bitten by a flea.
---> the transmitting agent (the flea) dies slowly enough to be able to bite and transmit disease to a lot of people.
Also: Plague is caused by bacteria.
Bacteria are able to survive longer outside of host.
Some bacteria can even from spores, and be able to become living again, after a long time and surviving awfull conditions.
Most of the viruses, on the other hand have a shorter life-span. It's either infect or die-once-you're-out solution. They must have good condition to survive longer (some viruses use capside to survive better. You may also keep virion in a special medium)
And about "burning itself out too quickly", there are other parameters coming into account :
- travelling speed accross towns
- population densities inside towns
So one amonst the factors that helped the advent of plague into europe was that travelling (and trading route) were fast enough to bring still living bacteria to europe (dead rat bodies and infectious fleas). A less evoluted civilisation, one with less trading yould less likely be able to import plague.
But because inter-town travelling wasn't *that fast* either (fleas alone can't travel quickly and cover all european towns), and because plague quickly depopulates towns (once enough people are dead and density drops beyond a certain level, some disease can't easily be transmitted), and also because europeans managed to make a quarantine to some level, part of the reasons plague stoped before whipping 100% of human population (à la Horror movies) may be attributed to its tendency to kill everyone.
This is also interesting to compare with modern situation where mosquitoes are able to get trapped in aircraft and travel and bring tropical disease in european towns, and where ultra-high population densities may help transmit disease between human hosts.
On the other hand, modern societies are better able to monitor new disease and have more means to combat new viruses and new bacteria.
Yup. As you said. Could happen, but depends on a lot of parameters some of which are unknown (what's next mutation ?) or not yet tested in real cases (are we able to react quickly enough ? do we have enough means to combat a new virus).
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