Potential Swine Flu Pandemic

rimrocker · Apr 28, 2009

Not a particularly encouraging NYTimes Op-ed from a guy who wrote a well-received history of the 1918 flu...

Where Will the Swine Flu Go Next?
By JOHN M. BARRY
http://www.nytimes.com/2009/04/28/opinion/28barry.html?pagewanted=print

New Orleans

AS the swine flu threatens to become the next pandemic, the biggest questions are whether its transmission from human to human will be sustained and, if so, how virulent it might become. But even if this virus were to peter out soon, there is a strong possibility it would only go underground, quietly continuing to infect some people while becoming better adapted to humans, and then explode around the world.

What happens next is chiefly up to the virus. But it is up to us to create a vaccine as quickly as possible.

Influenza viruses are unpredictable because they are able to mutate so rapidly. That capacity enables them to jump easily from species to species, infecting not only pigs and people but also horses, seals, cats, dogs, tigers and so on. An avian virus responsible for the 1918 pandemic jumped first from birds to humans, then from humans to swine (as well as other animals). Now, and not for the first time, pigs have given a virus back to humans.

Mutability makes even existing, well-known flu viruses unpredictable. A new virus, formed by a combination of several existing ones as this virus is, is even less predictable. After jumping to a new host, influenza can become more or less virulent — in fact, different offshoots could go in opposite directions — before a relatively stable new virus emerges.

Influenza pandemics have occurred as far back in history as we can look, but the four we know about in detail happened in 1889, 1918, 1957 and 1968. The mildest of these, the so-called Hong Kong flu in 1968, killed about 35,000 people in the United States and 700,000 worldwide. Ordinary seasonal influenza, in comparison, now kills 36,000 Americans a year, because the population has a higher proportion of elderly people and others with weak immune systems. (If a virus like the Hong Kong flu hit today, it would probably kill more people for the same reason.)

The worst influenza pandemic, in 1918, killed 675,000 in the United States. And although no one has a reliable worldwide death toll, the lowest reasonable number is about 35 million, and some scientists believe it killed as many as 100 million — at a time when the world’s population was only a quarter of what it is today. The dead included not only the elderly and infants but also robust young adults.

What’s important to keep in mind in assessing the threat of the current outbreak is that all four of the well-known pandemics seem to have come in waves. The 1918 virus surfaced by March and set in motion a spring and summer wave that hit some communities and skipped others. This first wave was extremely mild, more so even than ordinary influenza: of the 10,313 sailors in the British Grand Fleet who became ill, for example, only four died. But autumn brought a second, more lethal wave, which was followed by a less severe third wave in early 1919.

The first wave in 1918 was relatively mild, many experts speculate, because the virus had not fully adapted to humans. And as it did adapt, it also became more lethal. However, there is very good evidence that people who were exposed during the first wave developed immunity — much as people get protection from a modern vaccine.

A similar kind of immune-building process is the most likely explanation for why, in 1918, only 2 percent of those who contracted the flu died. Having been exposed to other influenza viruses, most people had built up some protection. People in isolated regions, including American Indian reservations and Alaskan Inuit villages, had much higher case mortality — presumably because they had less exposure to influenza viruses.

The 1889 pandemic also had a well-defined first wave that was milder than succeeding waves. The 1957 and 1968 pandemics had waves, too, though they were less well defined.

In all four instances, the gap between the time the virus was first recognized and a second, more dangerous wave swelled was about six months. It will take a minimum of four months to produce vaccine in any volume, possibly longer, and much longer than that to produce enough vaccine to protect most Americans. The race has begun.
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aghast · Apr 28, 2009

rimrocker said:

Not a particularly encouraging NYTimes Op-ed from a guy who wrote a well-received history of the 1918 flu...
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His book on the Spanish flu was what scared the bejesus out of me when I first read about this one.

This sounds like good news:

However, there is very good evidence that people who were exposed during the first wave developed immunity — much as people get protection from a modern vaccine.

A similar kind of immune-building process is the most likely explanation for why, in 1918, only 2 percent of those who contracted the flu died. Having been exposed to other influenza viruses, most people had built up some protection. People in isolated regions, including American Indian reservations and Alaskan Inuit villages, had much higher case mortality — presumably because they had less exposure to influenza viruses.
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So, if anybody has a particularly nagging cough they've picked up in the past couple of days, or knows anyone who does, party at my place this weekend! Free booze, plus all Kleenex confiscated at the door! Me hablo espanol! Evacuees welcome!

In all four instances, the gap between the time the virus was first recognized and a second, more dangerous wave swelled was about six months. It will take a minimum of four months to produce vaccine in any volume, possibly longer, and much longer than that to produce enough vaccine to protect most Americans. The race has begun.
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Let's just hope, when the buzz of this news story dies down, that government & pharmaceutical companies are still compelled to run it.

vstexas09 · Apr 28, 2009

there was a big article on it on the yahoo...2 million could die at the worst...

Lady_Di · Apr 28, 2009

vstexas09 said:

there was a big article on it on the yahoo...2 million could die at the worst...
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uh, care to post the link?

rimrocker · Apr 28, 2009

New news and a few quotes...

‘Many hundreds’ of kids may have swine flu
New York Mayor Michael Bloomberg also says two people are hospitalized
msnbc.com news services
updated 12:18 p.m. PT, Tues., April 28, 2009

"Many hundreds" of schoolchildren are sick with suspected cases of swine flu, said New York City Health Commissioner Thomas Frieden.

Also Tuesday New York Mayor Michael Bloomberg said two people are hospitalized with suspected swine flu. He said the hospitalizations are separate from the outbreak at a private school in Queens.

The mayor says the hospitalized are a child in the Bronx and an adult in Brooklyn.

Across the country, the Los Angeles County coroner's office was investigating the recent deaths of two men, 33 and 45 years old, for links to swine flu. Coroner's Capt. John Kades said the bodies were being tested but that there has been no confirmation the disease killed them.

Gov. Arnold Schwarzenegger has declared a state of emergency that will help California agencies coordinate efforts in response to the outbreak of swine flu.

The virus has killed more than 150 people in Mexico, but there haven't been any confirmed swine flu deaths in the United States.

Health officials say the number of confirmed swine flu cases in the United States has jumped to 68.

The new count includes "at least five who had to go into the hospital," said Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention. The hospitalizations include three in California and two in Texas.

The cases are currently in six states. There are 17 new cases in New York City, four more in Texas and three additional cases in California. That brings the total confirmed cases to 45 in New York City, 13 in California, six in Texas, two in Kansas, one in Ohio and one in Indiana.

For days, CDC officials have said they expected to see more confirmed cases — and more severe illnesses. Health officials across the country have stepped up efforts to look for cases, especially among people with flu-like illness who had traveled to Mexico.

CDC is moving forward aggressively with plans to produce a vaccine to protect against the new strain of swine flu, said Dr. Richard Besser, acting director of the CDC, during a Tuesday press conference. Scientists have started growing the "seed stock" of virus that forms the basis of a vaccine.

“Moving forward, vaccine is something we are looking at very intently,” he said.

Test kits are coming to states, so they can perform their own confirmations of swine flu, Besser said. Also, every state has requested their portion of the strategic national stockpile of antiviral drugs, gowns and masks.

“With a new infectious agent, you don’t sit back and wait,” said Besser. “We are in a pre-pandemic period.”

Besser urged people with confirmed cases of swine flu to stay home, and said their family members should stay home, too.

That effectively is a call for voluntary isolation for households in which the virus has been detected. The swine flu appears to be acting like a normal flu virus, which has a fairly high rate of transmission in families, said Besser.

“I fully expect that we will see deaths from this infection,” he said, although he noted that he hadn’t heard of the suspected deaths in California.

A handful of schools around the country have closed over swine flu fears and some people are wearing masks, but it’s mostly business as usual in the U.S., even at border crossings into Mexico.

While Asian countries deployed thermal sensors at airports to screen passengers from North America for signs of fever, there have been no extra screenings at the U.S. border with the country considered ground zero for the outbreak.

No deaths have been reported in the U.S. so far. In contrast, there have been over 150 deaths in neighboring Mexico, ground zero for the illness.

World health officials said they suspect American patients may have transmitted the virus to others in the U.S. Health Organization spokesman Gregory Hartl said WHO was waiting for U.S. authorities to announce that a number of students at a New York high school have passed the virus on to one another after their return from a spring vacation in Mexico. “I think we might have one other instance in the U.S.,” he said.

President Barack Obama on Monday characterized the U.S. cases as a cause for concern but not "a cause for alarm." The federal government said travel warnings for trips to Mexico would remain in place as long as swine flu is detected.

The Obama administration on Tuesday defended its "passive surveillance" policy to deal with the threat, saying that it's measured, cautious border monitoring makes sense.

Homeland Security Secretary Janet Napolitano said Tuesday that more draconian enforcement steps are not yet necessary, even as she acknowledged that officials "anticipate confirmed cases in more states." She reiterated President Obama's stance that people are justifiably concerned but need not be alarmed by it.

"We anticipate that there will be confirmed cases in more states as we go through the coming days," Napolitano said on NBC's "Today" show Tuesday.

Napolitano assured of a "very broad multi-agency federal response" and said that she and a number of Cabinet members had met into the night Monday to discuss strategy. She also said the administration wouldn't wait for a World Health Organization declaration of a pandemic to deliver a pandemic-like response.

Noting that the international health body has elevated its pandemic alert status to Level 4 of a 6-step process, Napolitano said: "We're prepared as if there were a pandemic. We're not waiting."

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, testified before a Senate subcommittee Tuesday that this hybrid flu — with pig, bird and human genetic components — has "pandemic potential."

"This is a brand new virus that we've never seen before," he said. " But what we're focusing on is to contain the spread of this."

While the virus has killed people in Mexico, but so far, not in the U.S., it's too soon to say that it won't, said the CDC's Schuchat.

"I think we're at early days here at what we're seeing in the U.S.," she said. "I don't think we can be confident we won't see severe spectrum of disease here."

In the immediate future, cases may begin to level off and dwindle, but then return during the tradition flu season in the fall and winter, as the 1918 flu did, Schuchat said.

"We might see an improvement just like we do with the seasonal flu but we need to be aware this strain is out there and it might come back in the fall," she said. "We're preparing the country for a period of uncertainty and a commitment that we'll stay with you."

Scattered protective steps
Scattered protective steps were being taken across the U.S. A few schools were closed — in Cibolo and New Braunfels, Texas; Claremont and Mira Mesa, Calif.; and Columbia, S.C. — and residents of Guadalupe County, outside San Antonio, were asked to avoid public gatherings and stay home if they are ill.

Security guards at all entrances of the University of Chicago Medical Center required anyone walking in to use a liquid disinfectant. At Rush University Medical Center, anyone seeking treatment for fever, runny nose and coughs was being tested for flu with nasal swabs.

Elsewhere, there were signs of growing unease among the public, even in places where there was no immediately known cause for alarm.

Pharmacies in Manhattan reported that paper face masks were selling by the box. One pharmacy owner said he had to order more from his wholesale supplier for the first time since the SARS epidemic six years ago.

Students at a Chicago school were instructed not to shake hands with anyone, and Southern Illinois University urged students to wash their hands frequently and cover their mouths when coughing. There were no known swine flu cases in Illinois.

And in New Mexico, which also had no reported cases, health officials were so besieged by calls from concerned citizens that they set up a swine flu hot line.

Richard Besser, the acting director of the Centers for Disease Control and Prevention, said his agency was looking for evidence of the disease spreading and probing for ways to control and prevent it.

The government also issued an advisory warning travelers to cancel any nonessential visits to Mexico. It also took issue with a European Union health official who said the same thing about travel to parts of the U.S.

At the White House, a swine flu update, delivered by White House homeland security adviser John Brennan, was added to the president's daily intelligence briefing.

FDA issues emergency flu drug rules
The Food and Drug Administration issued emergency guidance late Monday that allows certain antiviral drugs to be used in a broader range of the population in case mass dosing is needed to deal with a widespread swine flu outbreak.

The agency originally approved the use of the antiviral drug Tamiflu for the prevention and treatment of influenza in adults and children age 1 and older. Another antiviral drug, Relenza, was originally approved to treat people 7 and older and to help prevent flu in those 5 and older.

The White House also aimed to sidestep a potentially problematic diplomatic headache. Press secretary Robert Gibbs declined to discuss whether Obama officials have any concern about when Mexico notified the U.S. of the outbreak — particularly significant given the president's trip to Mexico on April 16 and 17.

The White House said Monday that its medical unit asked if Mexican health officials and U.S. Embassy medical staff had any concerns about infectious disease and were told they did not. But a White House statement said, "We have no reason to believe they withheld any information they had at the time."

http://www.msnbc.msn.com/id/30453688/
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BmwM3 · Apr 28, 2009

Yes, can you post the link and give me a shout out. I sit behind you in Mrs. Smith's English class.

aghast · Apr 29, 2009

First US casualty reported.

From Reuters: "Texas baby first flu death reported outside Mexico"

By Jason Lange

MEXICO CITY (Reuters) - A baby in Texas became the first confirmed death outside Mexico on Wednesday from the new H1N1 flu strain.

A U.S. government official said a 23-month-old child in the southern state had died from the virus, which Germany said it had found in three cases -- the eighth country to do so.

There were no further details about the death in the United States, most of whose 65 confirmed cases of swine flu have proved mild.

Nearly a week after the threat of a pandemic emerged in Mexico, that country remained the hardest hit, with up to 159 people killed.

France said it would seek on Thursday a European Union ban on all flights to Mexico because of the flu. The EU, like the United States and Canada, has already advised against nonessential travel to the popular tourist destination.

Cases have now been confirmed in the United States, Canada, New Zealand, Israel, Britain, Spain and, on Wednesday, Germany.

Germany's infectious diseases agency found swine flu in a man and a woman in their late 30s in Bavaria, and a 22-year-old woman in Hamburg at the other end of the country, all of whom had recently returned from Mexico.

The World Health Organization said it may raise its pandemic alert level to phase five -- the second highest -- if it was confirmed that infected people in at least two countries were spreading the new disease to other people in a sustained way.

Before the U.S. death was reported, Keiji Fukuda, acting WHO assistant director for health security and environment, said it could be a "very mild pandemic," adding, however, that influenza "moves in ways we cannot predict."

Stock markets in Asia and Europe rose on Wednesday, partly on optimism the world could be spared a major deadly pandemic.
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KingCheetah · Apr 29, 2009

Putting things in perspective...
_____

Regular flu has killed thousands since January

An outbreak of swine flu that is suspected in more than 150 deaths in Mexico and has sickened dozens of people in the United States and elsewhere has grabbed the attention of a nervous public and of medical officials worried the strain will continue to mutate and spread.

Experts are nervous that, as a new strain, the swine flu will be harder to stop because there aren't any vaccines to fight it.

But even if there are swine-flu deaths outside Mexico -- and medical experts say there very well may be -- the virus would have a long way to go to match the roughly 36,000 deaths that seasonal influenza causes in the United States each year.

"That happens on an annual basis," Dr. Brian Currie said Tuesday. Currie is vice president and medical director at Montefiore Medical Center in Bronx, New York.

Since January, more than 13,000 people have died of complications from seasonal flu, according to the Centers for Disease Control and Prevention's weekly report on the causes of death in the nation.

No fewer than 800 flu-related deaths were reported in any week between January 1 and April 18, the most recent week for which figures were available.

The report looks at deaths in the 122 largest cities in the United States.

Worldwide, the annual death toll from the flu is estimated to be between 250,000 and 500,000.

full article

DonnyMost · Apr 29, 2009

KingCheetah said:

Putting things in perspective...
_____

Regular flu has killed thousands since January

An outbreak of swine flu that is suspected in more than 150 deaths in Mexico and has sickened dozens of people in the United States and elsewhere has grabbed the attention of a nervous public and of medical officials worried the strain will continue to mutate and spread.

Experts are nervous that, as a new strain, the swine flu will be harder to stop because there aren't any vaccines to fight it.

But even if there are swine-flu deaths outside Mexico -- and medical experts say there very well may be -- the virus would have a long way to go to match the roughly 36,000 deaths that seasonal influenza causes in the United States each year.

"That happens on an annual basis," Dr. Brian Currie said Tuesday. Currie is vice president and medical director at Montefiore Medical Center in Bronx, New York.

Since January, more than 13,000 people have died of complications from seasonal flu, according to the Centers for Disease Control and Prevention's weekly report on the causes of death in the nation.

No fewer than 800 flu-related deaths were reported in any week between January 1 and April 18, the most recent week for which figures were available.

The report looks at deaths in the 122 largest cities in the United States.

Worldwide, the annual death toll from the flu is estimated to be between 250,000 and 500,000.

full article
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Not very reassuring, since we know what the regular flu does already.

This is more about fear of the unknown and the potential to worsen.

It's like saying that because gang violence in america kills X number of people per year that we shouldn't be worrying about a potential war that is brewing somewhere...

ima_drummer2k · Apr 29, 2009

DonnyMost said:

Not very reassuring,
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How about this from the Sci Guy?

Cautious optimism on swine flu?

Today I spoke with several infectious disease physicians and researchers, and they all expressed cautious optimism that the swine flu outbreak we've been discussing may not reach pandemic proportions.

One of the reasons for their optimism is that despite stepped up surveillance efforts around the world, it does not yet appear as though the disease has begun spreading exponentially. It's far too early to say the swine flu outbreak will burn out, but it's OK at this point to have some optimism.

There's another good reason to believe the disease may begin burning out: Influenza is characterized by seasonal patterns, and it tends to go away in April or May, only to return in the fall and winter. There are lots of theories as to why this happens, but we really don't know why.

The last two virus outbreaks with pandemic potential, the spread of H5N1 avian influenza from 2004 to 2007 and SARS outbreak of 2003, have undergone this kind of fluctuation, which saw a rise of viral activity until mid-May, then declined dramatically through August, only to begin rising again in September.

"I'm cautiously optimistic that we will begin seeing a decline in swine flu cases by mid-May or in a couple of weeks," said C. Ed Hsu, director of Preventive Health Informatics and SpaTial Analysis at the University of Texas Health Science Center.

The Spanish Flu also followed a similar course, with an early wave in the spring of 1918 before striking full force in the fall of 1918.

"That's what happened in 1918, the classic Spanish flu," said Dr. Herbert DuPont, director of the Center for Infectious Diseases at UT-Houston. "There's reason to believe this will happen again this time."

Any similarity to the 1918 pandemic may scare some people, but it actually may provide some reassurance.

That's because scientists and public health officials can now genetically identify the virus in circulation, and if they believe it will be a threat this fall they can incorporate it into the vaccine that will soon be developed for the 2009-2010 flu season. In other words, if this particular swine variant comes back in the winter, the new flu shot may protect against it.

Such biological weapons of mass protection weren't available in 1918, but they might save plenty of of lives this year.

LINK
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Sounds like this thing may be about to calm down. And by the time it starts back up again in the fall, we'll be ready for it.

MadMax · Apr 29, 2009

ima_drummer2k said:

How about this from the Sci Guy?

Sounds like this thing may be about to calm down. And by the time it starts back up again in the fall, we'll be ready for it.
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I read that last night and I thought it was funny that the claim was:
"hey, this is just like what happened with the spanish flu, so i'm optimistic!"

farrisdabis · Apr 29, 2009

First official US swine flu death. 23 month old toddler. IN HOUSTON.

http://news.yahoo.com/s/ap/20090429/ap_on_he_me/med_swine_flu

WASHINGTON – A 23-month-old Texas toddler became the first confirmed swine flu death outside of Mexico as authorities around the world struggled to contain a growing global health menace that has also swept Germany onto the roster of afflicted nations. Officials say the death was in Houston.
Kathy Barton, a spokeswoman for the Houston Health and Human Services Department, said Wednesday that the child had traveled with family from Mexico to Brownsville in South Texas. The child became ill in Brownsville and was taken to a Houston hospital and died Monday night, she said.
"Even though we've been expecting this, it is very, very sad," Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention, said Wednesday of the infant's death. "As a pediatrician and a parent, my heart goes out to the family."
President Barack Obama said this morning that Americans should know the government is doing all it can to control virus. Obama also says schools should consider closing if the spread of the swine flu virus worsens.
Canada, Austria, New Zealand, Israel, Spain, Britain and Germany also have reported cases of swine flu sickness. Deaths reported so far have been limited to Mexico, and now the U.S.
As the United States grappled with this widening health crisis, Besser went from network to network Wednesday morning to give an update on what the Obama administration is doing. He said authorities essentially are still "trying to learn more about this strain of the flu." His appearances as Germany reported its first cases of swine flu infection, with three victims.
"It's very important that people take their concern and channel it into action," Besser said, adding that "it is crucial that people understand what they need to do if symptoms appear.
"I don't think it (the reported death in Texas) indicates any change in the strain," he said. "We see with any flu virus a spectrum of disease symptoms."
Asked why the problem seems so much more severe in Mexico, Besser said U.S. officials "have teams on the ground, a tri-national team in Mexico, working with Canada and Mexico, to try and understand those differences, because they can be helpful as we plan and implement our control strategies."
Sixty-six infections had been reported in the United States before the report of the toddler's death in Texas.
The world has no vaccine to prevent infection but U.S. health officials aim to have a key ingredient for one ready in early May, the big step that vaccine manufacturers are awaiting. But even if the World Health Organization ordered up emergency vaccine supplies — and that decision hasn't been made yet — it would take at least two more months to produce the initial shots needed for human safety testing.
"We're working together at 100 miles an hour to get material that will be useful," Dr. Jesse Goodman, who oversees the Food and Drug Administration's swine flu work, told The Associated Press.
The U.S. is shipping to states not only enough anti-flu medication for 11 million people, but also masks, hospital supplies and flu test kits. President Barack Obama asked Congress for $1.5 billion in emergency funds to help build more drug stockpiles and monitor future cases, as well as help international efforts to avoid a full-fledged pandemic.
"It's a very serious possibility, but it is still too early to say that this is inevitable," the WHO's flu chief, Dr. Keiji Fukuda, told a telephone news conference.
Cuba and Argentina banned flights to Mexico, where swine flu is suspected of killing more than 150 people and sickening well over 2,000. In a bit of good news, Mexico's health secretary, Jose Cordova, late Tuesday called the death toll there "more or less stable."
Mexico City, one of the world's largest cities, has taken drastic steps to curb the virus' spread, starting with shutting down schools and on Tuesday expanding closures to gyms and swimming pools and even telling restaurants to limit service to takeout. People who venture out tend to wear masks in hopes of protection.
The number of confirmed swine flu cases in the United States rose to 66 in six states, with 45 in New York, 11 in California, six in Texas, two in Kansas and one each in Indiana and Ohio, but cities and states suspected more. In New York, the city's health commissioner said "many hundreds" of schoolchildren were ill at a school where some students had confirmed cases.
The WHO argues against closing borders to stem the spread, and the U.S. — although checking arriving travelers for the ill who may need care — agrees it's too late for that tactic.
"Sealing a border as an approach to containment is something that has been discussed and it was our planning assumption should an outbreak of a new strain of influenza occur overseas. We had plans for trying to swoop in and knockout or quench an outbreak if it were occurring far from our borders. That's not the case here," Besser told a telephone briefing of Nevada-based health providers and reporters. "The idea of trying to limit the spread to Mexico is not realistic or at all possible."
"Border controls do not work. Travel restrictions do not work," WHO spokesman Gregory Hartl said in Geneva, recalling the SARS epidemic earlier in the decade that killed 774 people, mostly in Asia, and slowed the global economy.
Authorities sought to keep the crisis in context: Flu deaths are common around the world. In the U.S. alone, the CDC says about 36,000 people a year die of flu-related causes. Still, the CDC calls the new strain a combination of pig, bird and human viruses for which people may have limited natural immunity.
Hence the need for a vaccine. Using samples of the flu taken from people who fell ill in Mexico and the U.S., scientists are engineering a strain that could trigger the immune system without causing illness. The hope is to get that ingredient — called a "reference strain" in vaccine jargon — to manufacturers around the second week of May, so they can begin their own laborious production work, said CDC's Dr. Ruben Donis, who is leading that effort.
Vaccine manufacturers are just beginning production for next winter's regular influenza vaccine, which protects against three human flu strains. The WHO wants them to stay with that course for now — it won't call for mass production of a swine flu vaccine unless the outbreak worsens globally. But sometimes new flu strains pop up briefly at the end of one flu season and go away only to re-emerge the next fall, and at the very least there should be a vaccine in time for next winter's flu season, Dr. Anthony Fauci, the National Institutes of Health's infectious diseases chief, said Tuesday.
"Right now it's moving very rapidly," he said of the vaccine development.
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We're all ****ed.

Falcons Talon · Apr 29, 2009

Baby came from Brownsville...where do I live? Brownsville...right on the border.

Ugh.

aghast · Apr 29, 2009

ima_drummer2k said:

Sounds like this thing may be about to calm down. And by the time it starts back up again in the fall, we'll be ready for it.
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There does seem to be an emerging consensus, that this will percolate until reappearing (in some slightly mutated form) next flu season. That's still not exactly a rosy scenario, however. If the second wave of this stuff is anything like the incredibly lethal second wave of the Spanish Flu (a tremendously big if, if the reports of the deaths in Mexico continue to prove aberrant), we still have a major problem.

I don't believe we've ever manufactured 300 million dosages of vaccine in this country, given only a few months lead time. Already, in the past few flu seasons, there were reports of vaccine shortages, for the smaller percentage of the population who bothers to get them.

Even if the government & pharmaceutical companies were able to produce a vaccine by next flu season, they would still need to band together and synthesize 300 million doses, to cover most or all Americans. We'd need to institute something akin to a mandatory nationwide vaccination program, ignoring those who deny the risk and the Jenny McCarthys who cry vaccine safety (as happened in the 1976 false alarm).

Even if that occured, globally, I don't think there's even a remote possibility of creating 6 billion plus vaccines by winter. So, the industrialized world might be okay, but the rest of the world would be left to suffer?

Without such a national vaccine program, 40,000 US deaths would likely remain the baseline for potential deaths next winter from this thing, assuming it sticks around as a weakened strain. Those forty thousand are the weak, young and elderly, who cannot handle the normal influenza illness. (They are the ones currently instructed to get flu vaccines.) They are the zebras in the nature videos, coltish, or graying with pronounced limps; when the lions catch up to them, it's understood to be part of the natural order.

On top of that, add the people in Mexico City, reported to be healthy adults with sound immune systems, who after contracting one strain of this flu drowned in their own lungs. They were healthy one moment, then a few days later they drowned in their own lungs. If that stuff is real, and it gets out before a vaccine can be mass-produced, or if present antivirals prove ineffective (I believe Napolitano stated the other day that we have 50 million instances of Tamiflu in storage), whether it be tomorrow or next flu season, you still have to worry about the remainder of the zebra herd.

Invisible Fan · Apr 29, 2009

Healthy lungs get targeted?

Time to start chain smoking.

JeopardE · Apr 29, 2009

rocketsjudoka · Apr 29, 2009

aghast said:

On top of that, add the people in Mexico City, reported to be healthy adults with sound immune systems, who after contracting one strain of this flu drowned in their own lungs. They were healthy one moment, then a few days later they drowned in their own lungs. If that stuff is real, and it gets out before a vaccine can be mass-produced, or if present antivirals prove ineffective (I believe Napolitano stated the other day that we have 50 million instances of Tamiflu in storage), whether it be tomorrow or next flu season, you still have to worry about the remainder of the zebra herd.
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I remember hearing that this was the same situation with Avian flu, that seemingly the ones who should be the most healthy suffer more. One explanation that I heard was that the immune system goes into overdrive to fight the infection and its that counter reaction that ends up killing the patient. So someone who has a weaker immune system is oddly safer since it is a more measured response from the body to the infection.

This is just from what I recall but I will see if I can find something about that.

That said its still a good idea to exercise, rest, and eat right to keep your immune system as strong as it can be.

the futants · Apr 29, 2009

from 1976...

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aghast · Apr 29, 2009

rocketsjudoka said:

I remember hearing that this was the same situation with Avian flu, that seemingly the ones who should be the most healthy suffer more. One explanation that I heard was that the immune system goes into overdrive to fight the infection and its that counter reaction that ends up killing the patient. So someone who has a weaker immune system is oddly safer since it is a more measured response from the body to the infection.

This is just from what I recall but I will see if I can find something about that.
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You're right; it's called a cytokine storm. It's what made the Spanish flu so deadly 90 years ago, and the reports of similar deaths in Mexico are what make me pay attention to this one. However, to me, "healthy people drowning inside their own lungs" sounds a lot more terrifying than "immune overreaction" or "cytokine storm." Although, as stated earlier, the latter would make a pretty kick*** band name. But, if things go south, you'd end up having to change your name, like Anthrax did after the postal attacks in 2001.

rocketsjudoka said:

That said its still a good idea to exercise, rest, and eat right to keep your immune system as strong as it can be.
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Invisible Fan said:

Healthy lungs get targeted?

Time to start chain smoking.
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Bah. For my two cents, Invisible Fan has the right idea. We're all playing chess with the Reaper anyway. Eat, drink and be merry. Immune suppression away!

rocketsjudoka · Apr 29, 2009

aghast said:

Bah. For my two cents, Invisible Fan has the right idea. We're all playing chess with the Reaper anyway. Eat, drink and be merry. Immune suppression away!
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Howabout its easier to pick up chicks if you have a healthy immune system since biologically we are more likely to look for mates that are physically healthier.

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