Some information about the lethality of the 1918 pandemic for certain regions have me wondering about the estimated lethality for a possible H5N1 derived pandemic.
“The death rate was especially high in indigenous peoples where some entire villages perished in Alaska and southern Africa. Fourteen percent of the population of the Fiji Islands died in a period of only two weeks while 22% of the population of Western Samoa died.” Wikipedia
This raises a few questions. Why the difference in death rate? As far as I can understand it, the pandemic was caused by a then new virus (to humans), but that doesn’t fit easily with the very different death rates. Had some populations been exposed earlier to a sufficiently similar virus and thereby been partially protected, or was there a genetic protection or other mechanism in place? All the high “death-rate” places are in “isolated areas”, which could point to a previous exposure of some kind. Or that the high death rate was a compound effect of several factors, one of which was the flu virus.
“The current projected worst case scenario for a H5N1 pandemic is somewhere around 150 million human deaths directly due to H5N1 infection (or two to three percent of the world’s human population). No one knows what the chances are for this worst case scenario.” Wikipedia
If a previous exposure “saved” the wast majority of people, then the next question naturally is: Do we have a similar protective exposure now, and if not, are the current estimates based upon the wrong numbers? If so, what should the real numbers be?
If the high death-rate in these areas wasn’t caused by a lack of previous exposure, but by a compound effect, then what was the compounding effect besides the flu virus?
there is one obvious previous exposure and that is the first wave of the 1918-pandemic itself. That wave was mild, even milder than normal flu and few people died, but most/many who caught it were protected in the 2nd much more lethal wave. I don’t know whether Samoa,Alaska,Southern Africa were hit by the first wave, maybe someone else does ?
Maybe genetic, such as blacks being more susceptible to sickle cell anemia.
I would think it is isolation. The more isolated a society the fewer chances they have to gain immunity through prior exposure. There is a chance that our globalized society will actually diminish our death rate due to broad exposure over time. Then again, I suppose there is a chance that the virus will not in fact “dummy down” and it could be an unprecedented high mortality rate event. Certainly the case for that exists in prior incandesces where illness met a lack of immunity such as the Samoan, Alaskan events in 1918 and when white man first made contact with indigenous populations through the world.
“I would think it is isolation. The more isolated a society the fewer chances they have to gain immunity through prior exposure. There is a chance that our globalized society will actually diminish our death rate due to broad exposure over time.”
That’s an interesting point. If there is a mild first wave, it might actually make sense to deliberately seek exposure, so as to obtain the aquired immunity which would (almost certainly) provide protection against infection during a subseqent, more virulent wave. I can see “infection centers” set up in major cities, with people waiting in line to get their “dose” (but I have to sorta close one eye and squint).
There is no guarantee that the first wave of any pandemic will be any less lethal than subsequent waves.
Would people who lived through the last great pandemic (1918) and are still surving today possess antibodies that would be effective against H5N1?
Chrys,
The Spanish Flu Pandemic, also known as La Gripe Espagnole, or La Pesadilla, was an unusually severe and deadly strain of avian influenza, a viral infectious disease, that killed some 50 million to 100 million people worldwide over about a year in 1918 and 1919 [1]. It is thought to have been one of the most deadly pandemics so far in human history. It was caused by the H1N1 type of influenza virus, which is similar to bird flu of today, mainly H5N1 and H5N2.
Not the same virus type. That was H1 not H5, that’s part of the problem.
And first wave does not guarantee immunity; there were people who got sick in more than one wave. That’s why last year’s seasonal flu shots get thrown away; it mutates so much you need new strain vaccines.
Oh, and isolated populations may have had genetic factors (haplogroups?) sort of “the un/luck of the genetic draw”; “how many and what kind of tools in your inherited immune toolbox, and how do they interact with that new virus”?
Now we have the compounding effects of many being reliant on modern medicine/care to survive, someone else growing and delivering our food, imported fuel, ect. More drug addicts and weapons than in 1918, too. Climate change and weather patterns affecting crops and storms may be a problem the next couple of years. (Arg.)
I don’t mean to be flippant but is there actually a 2006 human pandemic flu yet? I know what you are getting at but please don’t wish it on us!
I too spend a lot of time wondering who/if anyone is genetically better off when it comes to flu. WHo are the people who live round it but don’t get it? Those doctors who wrote all those letters you see on thos 1918 website - why weren’t they sick too?
Ms J “I don’t mean to be flippant but is there actually a 2006 human pandemic flu yet? I know what you are getting at but please don’t wish it on us!”
I agree. Please don’t jinx us. :-)
The 1918 death rate was apparently quite variable, very high in India and low in Japan, for example. We just don’t know how much of this was genetics, the virulence of the subtype, environmental factors etc. It makes it much harder (as if it wasn’t hard enough already) to say what the CFR will be per location in a (hopefully very distant) future pandemic.
So much for curcumin helping if it was high in India and low in Japan. Maybe wasabi boosted the Japanese curtive abilities?
Maybe their bathing, eating, or other hygiene practices were different, and they probably had a more one-standard culture (and similar, perhaps lucky that time, genetics?) than did/does India? Also to get to Japan one needed a boat back then; more chances to drag viruses through India’s borders?
I think that bathing in the Ganges would have doomed many. the cultural practice of burning the bodies and then did they throw the ashes and unburnt bits into the Ganges. People still regard it as sacred, or did that practice fall by the wayside in the 1918 pandemic.
Also much must have been different in Japan in 1918. Women strictly in the home. Commercial enterprises different. Certainly not the crowding you get in Tokyo now. I still think its in the food, wasabi, daikon radishes. What was the mainstay of the Japanese diet then. Only a Japanese historian would know.
The title should actually have been “Questions About the 1918 and the 2006 (?) Pandemic”, but the question mark got swallowed :-(
The title should actually have been “Questions About the 1918 and the 2006 (?) Pandemic”, but the question mark got swallowed :-(
Ha! I got exactly the same problem when I posted a thread (pandemic after chinese new year) that was more a possibility than fact, and got into trouble for that!
Seems like it doesn’t like punctuation.
I wonder if the religious views in some areas of India would allow them to kill millions of birds to slow the problem.
It won’t slow the problem; too many birds and environmental (insect) problems next year if we did) - no nation can even keep farmers (from ignorance and dire economic reasons) from getting their poultry indoors, nor culling safely, and can’t stop smuggling, fighting roosters, ect.
Lily, never stopped: http://en.wikipedia.org/wiki/Ganges
“And first wave does not guarantee immunity; there were people who got sick in more than one wave. That’s why last year’s seasonal flu shots get thrown away; it mutates so much you need new strain vaccines.”
I wish I had a nickel for every time I’ve heard this. It’s always bothered me, though. The whole deal is that the global human population has no previous exposure to an H5 subtype; the difference between a new subtype and a seasonal strain is much greater than that between a seasonal strain and a previous seasonal strain. Right? A person having previously recovered from infection with a strain of the same subtype would no longer be immunologically naive to that subtype, and would therefore be expected to have at least as much immunity as against any other seasonal strain. Claims that the same people fell ill in successive waves seems to contradict this.
This causes me to wonder how numerous those alleged cases of re-infection were, and how well documented.
Well, my grandfather survived the 1918 flu pandemic, but he passed away many years ago from other causes. I doubt there are many people alive today who were around in 1918, unless they were young children at the time (?)
My grandfather was in the Navy in WWI — went in very young (16 or 17). He was on a ship near England & France when he became ill. He did not do anything special to survive except — and John Barry mentions this — he went to bed and stayed there until he was well again. So who knows if it was genetics or just luck of the draw?
Some people might be immune to a future pandemic as well, right? But there is know way to know who, I guess.
Is the possible cytokine storm and the multiorgan vulnerability the result of having no previous exposure to a H1N1 or a H5N1 virus? Or in other words, are such exposure risks still present even after one has been sick with the virus, say in the first wave? And if that is the case, is it just that recently formed h2h avian flu viruses require a few years of circulation before they act more like the flu viruses that we are familiar with?
Another question that raises its ugly head is: How many of the currently known survivors would have survived without medical attention? A pandemic would probably overflow the capacity of even the best medically equipped and prepared societies.
I know that one year’s flu shot is not good for the next flu season,…. but I also understand that it does give some (small percent) protection for the next season. So if you have been exposed to some “similar” flu strain it might give some protection to a “similar” strain. The question is how similar do they have to be to be useful. As I understand it, (big gap here…) this H5N1 is really different from the ones that went before.
I know that they are waiting for the H2H mutations to occur before they start massive production, but I would thank that even shots based on the current strains might offer a some (very small) benifit. Even a few fractions of a percent could translate into many lives. But I guess I will just have to trust the experts.
[quote]Oremus – at 11:25 Maybe genetic, such as blacks being more susceptible to sickle cell anemia.
[/quote]
Actually, blacks are not more susceptible to getting sickle cell due to their genetics, as sickle cell is not an acquired disease but an inherited one. A person with the disease has inherited the recessive gene from both parents and it is not transmissible in any other way than through a roll of the dice when conception occurs.
If you meant ‘more likely’ when you said blacks are more susceptible, then you were correct. However, it doesn’t apply in this case since the 2 diseases are not in anyway similar.
As far as genetics go though, I wish I had my husband’s constitution. He seems to fight off even the worst flu in a matter of days, where any ordinary person would take 3 times as long. :(
“Birdflu survivors may not be all that safe-experts” http://www.maconareaonline.com/news.asp?id=12605
(look at this article from July 2005 -Officials have wasted so much time- http://tinyurl.com/f57lo )
Someone, somewhere mentioned by name a man know to have contracted flu in 3 Spanish flu waves, but of course, I can’t recall where I saw that!) There were supposed to be other cases of two bouts of Spanish Flu(hope I don’t suddenly recall where I saw these when I’m trying to sleep).
“Grandpa Anonymous – at 16:39″ wasn’t “immune” (that would mean he didn’t get sick) he just (fortunately) didn’t die.
I think so much about H5N1 and the way it has gotten out of their “containment zone” idea, (play “whack-a-mole” over 3 continents, maybe 4 and 5 soon; if any of those strains can go pandemic?) well, no one really knew about cytokine regulation, nor preventing/treating ARDS now, nor how H5N1 would be as a pandemic strain, though it is bad enough now we can’t hope for it acting just like seasonal flu for at least a few years after pandemic.
( http://en.wikipedia.org/wiki/Sickle-cell_disease …”The malaria parasite has a complex life cycle and spends part of it in red blood cells. In a carrier, the presence of the malaria parasite causes the red blood cell to rupture, making the plasmodium unable to reproduce. Further, the polymerization of Hb affects the ability of the parasite to digest Hb in the first place. Therefore, in areas where malaria is a problem, peoples’ chances of survival actually increase if they carry sickle cell anemia.
Due to the above phenomenon, the illness is still prevalent, especially among
people with recent ancestry in malaria-striken areas, such as Africa, the Mediterranean, India and the Middle East.
In fact, sickle-cell anemia is the most common genetic disorder among African Americans; about 1 in every 12 is a carrier.”…)
Back to the topic, sorry.
…”are the current estimates based upon the wrong numbers? If so, what should the real numbers be? “…
If they are based on things like 25% attack rates and 1% mortality, yeah; worng numners. If they don’t take into account the effects of disrupting our “modern” life, the ammount of people in care, all our “compounding effects”, should have been enough for them to risk telling the public this was worth improving our and world’s health infrastructures and farming practices to prevent.
That current average 50% mortality rate (way scarier if you just look at recent Indonesian rates) is with hospitals still functioning, and, international medical advice, and antivirals! We would be back to 1918 levels of medicine, and nowadays modern societies aren’t used to nursing their own ill, nor burying their own dead.
European, we would lose many now if we just kept everyone home from work for a month. Back in 1918, “medical” care was very simple (many “remedies” tried were dangerous) sometimes just the fact someone was there trying to get fluid or food (fresh orange juice in one case) into a person, to keep them fromfreezing to death in winter, or keep them away from other sick people helped them live. (Just as sending the healthy away from the sick helped.)
I would have thought that only a few cases of subsequent reinfection by spanish flu proves nothing - these could have been misdiagnosed or been the result of compromised immunity. There is always someone who claims they had measles twice etc - doesnt mean its true, or even if it is, that it is relevant to greater part of community with normal immune systems.
Medical Maven:
“Is the possible cytokine storm and the multiorgan vulnerability the result of having no previous exposure to a H1N1 or a H5N1 virus?”
I think this is really two separate questions.
Mulitorgan vulnerability seems to have more to do with receptor binding specificities than with immunological naivete. Cells in different types of tissues have different glycoproteins on their outer surfaces, and nuances of those structures are what determines the ease with which a specific virus will be able to “dock” to them (the first step in infecting the cell). H5N1 seems to have rather more flexibility in this regard than does the typical influenza virus, but nobody knows why, nor whether this property will be preserved in a pandemic strain.
Cytokine storm, remember, is still largely hypothetical at this stage. It isn’t the only thing that could kill a patient. If the immune system fails to produce an antibody within a certain period of time, cell destruction as a direct result of the activities of the virus will do the job nicely even if cytokine dysregulation does not occur. Unlike typical seasonal flu, in which pneumonia is usually the result of secondary bacterial infection, H5N1 is capable of causing primary viral pneumonia.
Let’s look at this quote from the (first) news article crfullmoon linked:
“The virus, which has infected 130 people in Asia and killed 67 of them since late 2003 [ok, it’s a bit dated - the current numbers are 174 and 94], is changing constantly and repeat infections by new strains could still leave a birdflu survivor in peril, just as people can catch a new form of the flu every year.”
People can indeed catch a new form of the flu every year, and about 36,000 of them die from it in a typical season — but those who are “in peril” are primarily those with pre-existing underlying conditions; for the average person, a case of the flu means nothing but a few days of misery and a week off work.
and another quote from the same article:
“If the person is infected by the same strain, he should have immunity, but nobody knows for how long.”
This statement also has a distinct excrementitious quality. We don’t know everything about immunity, but it’s a slam dunk that it would last at least for the duration of a pandemic.
Racter: So if H5N1 retains it current configuration (with minor modifications) as it progresses to panflu, then a reinfection in a second wave with a slightly different H5N1 could still result in ARDS and multiorgan vulnerability?
So if that is “the beast that comes out of the box”, how does it get tamed as it recirculates globally? Or will we have a long period of dealing with a particularly deadly flu even though we may have partial immunity?
This may be a little off, but, the subject made me think. It is possible older folks aren’t catching this because of immunity due to a prior flu strain from years ago?
deborah— thanks for the info
“So if H5N1 retains it current configuration (with minor modifications) as it progresses to panflu, then a reinfection in a second wave with a slightly different H5N1 could still result in ARDS and multiorgan vulnerability? ”
Anything’s possible. But if we saw frequent cases of ARDS on reinfection, with H5N1 confirmed as the causative agent both times, I think we’d be challenged to come up with good explanations. As for multiorgan vulnerability, we need to be careful to note that multiple organ dysfunction does not necessarily indicate virus dissemination across a wide range of tissue types. Though experimental models have indicated this as a possibility, autopsies have so far failed to show evidence of viral replication beyond the respiratory tract. Take any good news we can get, I say.
“It is possible older folks aren’t catching this because of immunity due to a prior flu strain from years ago?”
Anything’s possible. But as far as we know, this is the first time that an H5 subtype influenza has caused infection in humans.
crfullmoon: the man was Edward House, president Wilson’s closest confidant,
it’s mentioned in Barry’s book on page 381
Racter: I can’t believe it’s the first time in history that H5 emerges.
That would be a strange coincidence. It’s just longer than a lifetime ago
when it last appeared, so noone is still immune ?!
Lurking contentedly underneath, there seems to be considerable comfort in dwelling on the 1918 pandemic. It’s QUITE bad enough and so we resist imagining a worse.
Remember the lesson of Billy-Goats-Gruff? The monster was tricked by the smallest goat, and the next, but the last goat was huger than the predator imagined.
What if the second goat was the 1918 case, the 2006–7 attack the third? Huger than we can face imagining?
There is no reason, even after trillions of small meteors striking, that a single object very much larger cannot come in… As all know, they have and well may again.
Horse flu and 1918 pandemic?
1918: Pete Hesser’s Children, la Gourme, and New Information on the Flu Pandemic
I think that the Black Death of 1347 could have been H1N1 bird flu. 300 years of that would have given populations exposed a large degree of immunity. In 1918, naive populations, like Inuits and Western Samoans suffered Case Fatality Rates similar to those suffered by the English in 1348 and 1349.
It pisses me off the way the CFR of indiginous peoples in 1918 has been totally discounted in any “think tank” discussions of worst case scenarios for 2006. Put simply, I think the western world could be in the same situation as Native Americans when encountering measles for the first time. H5N1 is a new virus for most populations (?). This virus doesn’t watch the academy awards, and doesn’t even know we exist. ie, it is not going to adjust it’s virulence to fit in with our preconceptions. It will go its own way.
If you read the following thread on curevents, there are the references to scholarly articles and the whole line of reasoning.
Clark,
Most of the historical authorities I know think that 1347 could have been pneumoniac plague, rather than flu. This is such ancient history that we’ll never get much beyond conjecture.
All this, above, a chilling reminder just how BAD-BAD bad can get to be! And as I have just read the new thread ‘Isolated Islands’I am acutely aware of the practical limitations imposed on almost every one of us in seeking to survive. We can do only so much and, at that level of preparation, to then imagine a 1347 hitting!!!
I want my Mum! And my bottle! (Yes, thanks Mum! Straight bourbon, please!)
racter-
Immunity can only be provided by a properly functioning immune system at the time of first infection and at each subsequent challenge.
If PF51 hits w/ social disruption, will anyone have consistent immune function?
Think malnourishment.
I think whether someone has immunity from previous exposure is a matter of degree. Most of us would have immunity if we were exposed to a particular virus, and if re-exposed to a modified version, the immunity might be enough to prevent sickness, or it may not. It is unlikely that on second exposure to a virus that has not altered a great deal that one’s reaction will be just as bad as first exposure, assuming a healthy immune system. So these stories from 1918 of re-infection could be wrong diagnosis, mutated strain, immune dysfunction, etc. We don’t know for sure but current evidence points to some level of protection after infection generally, so I wouldn’t worry too much about re-infection if we ever have a pandemic.
I’m at work and my co-workers are telling me that for this flu to get into the cough mode (being able to be spread through mucus, human to human) that it would almost be impossible. This is something they heard on a news show this weekend. Please someone inform them on this site and I will show them the posting. thanks
Everyone is laughing at me…please someone explain how dangerous this flu could be.
We do not know how bad a possible future pandemic will be. I believe that scientists are basing their predictions on current fatality rates in birds plus fatality rates for previous pandemics. As far as I understand it they come up with fatality numbers based on an estimated percentage of the population that will be infected and the number of those that will die. The numbers vary quite significantly; from about a low number of 2–7.4 million extra dead ( low rate Wikipedia to 1 billion extra dead (one Russian virologist). Most seem to be somewhere in the 10s or very low 100s of million extra dead. Either way it’s a big number.
In truth I do not believe the low number estimates, as the current version of H5N1 is extremely deadly. Just have a look at the current number of dead ( Wikipedia ). I find the assertions that it will “lose punch” or become less deadly far from convincing. In addition to that, there will be a lot of extra dead caused by lack of ordinary medical facilities.
I believe the answer to “how bad it will be” depends on how draconian measures the authorities will impose on the population. The authorities will have to take the bull by the horns, face the future and make the right decisions, even though it will make them extremely unpopular. Pandering to economic and other factors will not help them.
Sharon, the Flu Wiki is one big explanation of how dangerous this virus could be, but your co-workers obviously have attention spans fine-tuned for the ten-second sound bite, and it’s hard to fit a synopsis of the virology of influenza into such a small package. I would consider it wonderful news to learn that some fundamental constraint prevents H5N1 from aquiring efficient H2H transmissibility. Unfortunately, the science doesn’t support that. The virus has already demonstrated an affinity for human receptors, so we’re only talking about a minor tweak that would increase that affinity. That some influenza virus (if not H5N1, then some other) will at some point aquire the ability to be easily transmitted between humans is an event virologists regard not only as not impossible, but inevitable. The only sort of “news show” I can think of where one might encounter such a claim is one produced by certain religious fundamentalists who reject the concept of evolution altogether.
Impossible to go to cough mode? Not sure what that means, but you have some mis-informed people there!
Check out the 1918 flu first, to become informed about what could (and did) happen:
Then check out:
fun. folks simply believe that no new information is created during genetic change, that the gene pool is not growing.
European at 9:17: “face the future and make the right decisions”--You are on the mark there. Let us hope to God that there are a few visionaries who will “take the bull by the horns” and incur public wrath. The way out and forward will be an excruciating process. This mill will grind exceedingly fine, and we are all grist for the mill.
NS1 at 7:29: You have nailed it. “Properly functioning immune systems” will be rare indeed. Aside from “malnourishment” you will have depressed immune systems due to the death of loved ones, the stress of uncertain futures and everyday living, a lack of sleep because of security concerns and caring for the sick, etc. etc.
The industrialized countries have generations of what I would call “coddled” DNA pools, and it doesn’t just include the obviously infirm and debilitated. This virus, if it goes pandemic, will purge the gene pool of those who can not effectively cope, regardless of their level of preparation. It will pluck those individuals from the gene pool. Hopefully some of your family will have the “right stuff” (DNA and coping abilities) and will benefit from your preparations, if you don’t make the grade.
Sharon (well, your co-workers, Hello!)
it is Very possible for H5N1 to become as contagious as regular influenza, (and now it is running “casinos” on 3 continents, soon to be 4 and 5, each animal or person sick with H5N1 another chance (risk, from our viewpoint) to hit the “pandemic jackpot”,
that is why the World Health Organization, national governments and militaries, Fortune 500 companies, and all sorts of people in the know have been laying awake at night, and, committing millions of dollars to face a pandemic (in such a crummy way we aren’t at all ready yet, but,)
and the only reason your co-workers have been unable to connect the dots themselves yet, is a huge ammmount of effort being put into keeping the public calm, “to prevent panic”
(I don’t know if that means “Premature Stock Market/GDP Disruptions” or what -since keeping the public ignorant until pandemic occurring is about the best recipe for panic I can think of; ignorant, unprepared people, suddenly under weeks or montha of quarantine, people getting sick and dying and hospitals collapsed within the first week, local contingencty planning undone and/or undiscussed with the public.)
Seems the officials or federal employees most in the know as to possible worst cases have been told they are not allowed to inform the public. (And they have chosen not to risk their jobs and go along with that. The public will be told later by the higher-ups, they don’t think it’s the right time to make this too public.) (Gambling that this could mutate next week. and get on a plane and come to your region.)
Governement can say “They told you” because of websites in the public view (that most people have not looked at yet).
Have them look at http://www.who.int/csr/disease/influenza/pandemic10things/en/ (the first 9 are still true, the alert level seems to have gotten unplugged last Nov.) and the US gov, and state gov; the public is on their own: http://pandemicflu.gov/plan/tab3.html
(Clark, and Nikolai, I’ll be back in a few minutes.)
mm-
we’re the ones w/ mutations, aren’t we?
(darn, I’m no typist)
Clark said, “I think the western world could be in the same situation as Native Americans when encountering measles for the first time. H5N1 is a new virus for most populations “ -Unfortunately I agree. Why do they want to take a “more recent” or “happens more often” as their influenza event scenario?
Only building for, say, Cat.2 hurricanes because they are more likely, seems like the less likely but more catastrophic consequences are sure to do people in, that way. (And after the hurricane season last year; right off into the Greek alphabet because they’d run out of names for storms, and, projections of weather sytems saying, We’re entering a “bad storm cycle”, why not build for something we haven’t seen, Cat “6″, or at least Cat.5 ? Because some people think the chances aren’t very likely this year, and if it happens, then, they will do something about it? Won’t work, and won’t work for pandemic.
“Nikolai—Sydney – at 01:12 Lurking contentedly underneath, there seems to be considerable comfort in dwelling on the 1918 pandemic. It’s QUITE bad enough and so we resist imagining a worse”
this is I fear what’s going on with the local authorities; (they seem to even forget the reasons we are in worse shape than 1918 though) do they think if it really bad, they can’t do “anything” and don’t want to tell the public; let pandemic sort us out?
I know there’s no top-down solution for everybody; that’s why the public needs to get each household aware and prepared. Our priorities have been turned away from what really important and we are going to find out how hard it is to meet our survival needs. People who think everyone should keep going to work; many of those jobs or products are not worth risking one’s life or one’s family for. Only the things that are needed to keep people and their communities functioning are essential. I don’t now how the fatality rate can come down so many percentage points; airtravel is still capable of spreading the virus; it does not have to mutate its way across a continent person by person anymore. Air and car travel can sow it broadcast, and tracking strains is going to be probably impossible during the pandemic year or so. Maybe, if samples are preserved, they can try and figure it all out later, but they too, may have other things to do.
Sharon’s co-workers, have you seen the current fatalities were 90% age 39 and under, and 70% age 25 and under? Wish they had never used the words “flu/influenza”; I don’t think you understand how dangerous viruses in populations that have zero experience with them can be.) Have you seen the chart here with the countries’ % fatality rates so far? http://en.wikipedia.org/wiki/H5N1
(Who’s ready to have their community locked down for even 6weeks of quarantine, schools closed, truck deliveries stopped, pharmacies closed, even if no one was contagious or sick??)
CBO macroeconomic report to US congress Dec 2005, expects each pandemic wave to be in a region for 3 to 5 months, but haven’t seen fit to put this out in mailings and public service announcements, yet.
They can’t even get the public to wash their hands after they use the toilet, nor quit smoking, drink in moderation, nor wear their seatbelts; some public health jobbers or other officials have perhaps given up on trying to reason with the public.
Telling people what to do in a State of Emergency seems simpler, but lives would be saved if the public economized and prioritized and made sure they and their communities could do without federal or state assistance after a disaster. Governments have warned us we need to be able to do that; they can’t help entire populations. And when pandemic occurs there will not be vaccines and antivirals; we will be going through the first wave with only social distancing measures, if we use them.
NS1 at 10:43: In our dreams, in our dreams………
http://tinyurl.com/mzmnj This is the story that my co-workers saw on NOVA. It states: “But since we don’t know the recipe for coughing and sneezing, when you read stories that seem to know the odds, that say the bird flu “is coming,” or the worldwide pandemic is “inevitable,” or it’s “overdue,” or “around the corner,” be skeptical. We know this flu is dangerous to birds. We don’t know if it’ll be dangerous to humans tomorrow, or next year, or decades from now. We just don’t know”. Now because of this story on NOVA my co-workers are telling me that the virus does not have the ability to create “Cough” so there is no need to worry. I’ve been told to stop talking about it.
Sharon. Most think that evolution occurs in small ordered steps. Sometimes it occurs in leaps. If you follow the steady mutation progress of H5N1 you will see that it has made leaps already, the most significant of which was Quangyi (sp) Lake (China) in Mar to May 2005. It is one leap away from full pndemic potential and this could have already occured and not been reported due to totalitarian states and countries not reporting to avoid political and economic consequences (it is in no countries interest including developed countries to be honest at the momemt).
Sharon- welcome to the club. It’s easier and faster to make fun of something than to really learn about it before forming an opinion. That’s all some people are interested in. Short bits for them to take a look at. These are all articles from today
“WHO: Bird flu poses greater challenge to world than any previous infectious disease”
http://www.newspress.com/Top/Article/article.jsp?Section=WORLD&ID=564695123456558664
“40 Countries Have Had Bird Flu H5N1, See The List”
http://www.medicalnewstoday.com/healthnews.php?newsid=38946
I hope this helps
Tom, Why would NOVA broadcast such a program at this time??? I almost can’t believe it. I have been working so hard to explain the cause for concern to everyone and with one show they completely make me look like a fool. Sigh : {
Sharon, send your co-workers to Mike Osterholm’s Foreign Affairs article (google it, it’s easy to find). I think its an excellent article, and by a reputable scientist in a well-respected journal. I also think they are right to be skeptical. There is a lot of misinformation out there, and even stuff that is true gets overblown (if I had a nickle for everytime I’ve heard a pandemic is “overdue” I’d be a lot richer). However, skeptical is not the same as uninformed.
From Sharon’s linked NOVA transcript:
“So far, this new bird flu has not acquired the ability to travel on a cough or a sneeze, through the air, from one infected person to another. But what everybody wants to know is, could it learn how? And what are the odds?”
Since coughing and sneezing are an intrinsic part of the body’s response to any intrusion, the virus doesn’t have to “aquire the ability to travel on a cough or sneeze”; what we’re really talking about is the virus’ ability to infect tissues in the lung or upper respiratory tract. H5N1 has already demonstrated the ability to do that, it just hasn’t yet aquired the ability to do so efficiently.
“But if the recipe for coughing and sneezing is 13,000 letters long, in a very precise order, that’s like one monkey accidentally typing the first two acts of Hamlet perfectly.”
The business about the monkeys, the typewriters, and Hamlet is an argument which is standard fare for creationists everywhere, and it is surprising and a bit disturbing to see it presented on a program called “scienceNOW”. After all, if the sequences which govern the receptor binding specificities for an influenza virus are so unlikely to randomly arrive at a given configuration, how much more unlikely are the cases of those which confer abilities on more complex organisms such as flight, or color vision, or web-spinning?
The argument was formulated with a certain target audience in mind, and widespread scientific illiteracy insures that it will often play to a full house. In his book, “The Blind Watchmaker”, Richard Dawkins presented what is probably the argument’s best known refutation.
Microbes continually underscore the point by stubbornly defying “the odds” by evolving antibiotic resistance.
Sharon. My answer is on the physicians thread.
Racter. Is this a load of bull **** or is it just me? I have never read anything like this before on what I assume was supposed to be a scientific program.
They said “they don’t know” because they cannot say with 100 % scientific certainty of the future that H5N1 will go pandemic , nor give the month and year of our next pandemic.
But, if they did not say, No matter how low you think the Risk is, the Consequences, if it occurs are so Devastating that if you don’t Prepare you will wish in vain that you Had, they should have.
No excuse not to prepare against such a bad possible outcome.
Sure, the people in the 9th ward of New Orleans hadn’t read the scientific articles, and the officials hadn’t wanted to spend money on the levees, but, would it have hurt so much to make sure you could get everyone to the attic, and, kept a few tools up there you knew you could break the roof with? (A few lifejackets and a waterproof go-bag wouldn’t have been foolish there, either.)
Obviously not thinking about/knowing about/preparing for an event doesn’t prevent it from occurring.
Preparing for the worst does not make it happen, either.
That program should have told people basic preparations can be used in multiple emergencies; from having the water shut off for reapirs, to storms, or job loss, or pandemic, and told everyone to improve their own preparedness.
I have to say that the NOVA transcript sounded pretty balanced to me. Spiders, flight and color vision had millions of years of mutations in billions of organisms to play with. We’re talking about a few months of mutations. It is a long shot that the virus will mutate in exactly the right way to become a deadly H2H pandemic. But, as NOVA rightly points out, it did happen in 1918, and it could happen again. I think where NOVA fails is in pointing out the reason that some very high-level people and agencies are concerned about this particular long-shot: we have no immunity.
crfullmoon. You have it exactly right. Who said nature is either ordered or predictable. We are not driving the bus. We were never driving the bus. Does H5N1 have the tools to make the leap before I finish this sentence…Yes.
My theory is that the remote villagers who were devastated likely caught and ate sick birds or drank contaminated water while those living in cities had less of a chance of such an exposure as human to human spread was likely less efficient than bird to human transmission. I have read that there were large numbers of poultry that died in the years leading up to the Spanish Flu pandemic, but I have yet to see a comprehensive timeline which might allow us to draw paralells to the current situation.
“Is this a load of bull **** or is it just me? I have never read anything like this before on what I assume was supposed to be a scientific program.”
What bothers me the most is the ease with which this sort of garbage can be foisted off on a scientifically illiterate public. It isn’t just that so many are so ignorant of even the basics, it’s that so many (in the U.S. at least) seem to be proud of it. They don’t want to know any more than the bare minimum needed in order to experience the desired titillating effect of having some little piece of eye candy dangled in front of them. If it ceases for a moment to be entertaining enough for them, they’ll grab the channel changer and pop over to see what the latest developments are in the personal lives of some celebrities they’ve never met in person.
Epidemiologists say: “Thin out sick chickens.”
Virus says: “Thin out stupid people.”
Lost Vegas:
“Spiders, flight and color vision had millions of years of mutations in billions of organisms to play with.”
Yes. In organisms whose genetic replication processes include sophisticated error-correction mechanisms, and with generation times longer than the influenza virus by many orders of magnitude. That was really my point. By contrast, a single day in the life of an influenza-infected patient might represent as many little “genetic experiments” as would take many thousands of years to conduct in continent-wide populations of higher organisms. That’s precisely what all the fuss is about.
I am not “scientifically illiterate,” and it is not necessary to be insulting.
“I am not scientifically illiterate, and it is not necessary to be insulting.”
If you would find it insulting to be called scientifically illiterate, then I wasn’t talking about you.
“Melanie – at 03:54 “Clark, Most of the historical authorities I know think that 1347 could have been pneumoniac plague, rather than flu.”
The theory that the Black Death was caused by Yersin Pestis is a theory from 1895. That was 40 years before the first virus was even seen in an electron microscope. The historical authorities that you are referring to are from early last century. (Could you supply some recent research?) My references are all from the last ten years. Everyone wants the Black Death to be a bacterium- but hope does not make reality.
Do you really imagine that the 1918 flu pandemic was the first flu pandemic in recorded history (the last 5,000 years)??? It is illogical. Viri have been here for billions of years. This is not a new, unprecedented situation that we are in. This is old stuff.
“Since coughing and sneezing are an intrinsic part of the body’s response to any intrusion, the virus doesn’t have to “aquire the ability to travel on a cough or sneeze”; what we’re really talking about is the virus’ ability to infect tissues in the lung or upper respiratory tract.”
“Dr. Terrence Tumpey, a senior microbiologist with the Centers for Disease Control and Prevention in Atlanta….”
…
“For now, the bird flu is a direct-contact-only disease. Tumpey said research at the CDC indicates the virus is unlikely to develop into the “aerosol,” or airborne, stage.
“I don’t know that H5N1 can transmit by aerosol. We haven’t been able to get it to do that,” he said. “Other viruses do. It may be that it will never figure out how to transmit and, if that’s the case, then it’s not going to cause a pandemic because it needs to be airborne to do that.””
If you would find it insulting to be called scientifically illiterate, then I wasn’t talking about you.
I’ll have you know I’m not just any old smarty pants, I’m a professional smarty pants, and I take my smarty pants responsibilities very seriously ; )
And the rest of the cheery article Tram is quoting?
“Even so, the race is on to produce a viable vaccine to attack the avian flu where it lives before it can become any more problematic than it already is. An H5N1 vaccine is undergoing clinical trials.
“It takes about eight months to make,” Tumpey said. “One of the things that we’re doing is trying to develop better vaccines that don’t require so much time to generate.”
The approach being used with H5N1 is to narrow that time even further by skipping the use of eggs, as is typically the case when developing flu vaccine every year. The challenge lies in that you can’t do that with H5N1, Tumpey emphasized, because the virus kills the eggs.
In any case, some of the insights gained by decoding the inner workings of the 1918 virus have helped pave the way toward a better understanding of newer strains such as H5N1.
“By identifying the characteristics that made the 1918 influenza virus so harmful, we have information that will help us develop new vaccines and treatments,” he said. “Influenza viruses are constantly evolving, and that means our science needs to evolve if we want to protect as many people as possible from pandemic influenza.”
I think my distrust of news articles as sources of information began after the first time I was interviewed by a reporter myself, and upon viewing the report, saw a wide discrepancy between what I actually said and what they said I said. Even the reporter who is above outright misquoting can cherry-pick quotes, rearrange them in order, edit out qualifying statements, paraphrase, and generally perform any tweak he wants. The end result often represents the reporter’s opinion more than that of the person being interviewed.
When the statements reflect conclusions based on the results of scientific studies, I’d rather study the results personally, to the best of my ability, and decide for myself if the conclusions seem to be supported by the evidence. Backtracking from news articles often reveals that the conclusions reached by those who performed the studies don’t even agree with the versions of those conclusions that appear in print for a popular audience.
When we have Tumpey saying: “I don’t know that H5N1 can transmit by aerosol. We haven’t been able to get it to do that”, we aren’t invited to look at the studies he’s talking about, but one thing we know for sure is that nobody at the CDC deliberately tried to produce H5N1 infection in humans by exposing them to virus-laden aerosols.
Another thing we can be pretty sure of is that when an H5N1-infected patient coughs or sneezes (and they tend to do that a lot), the droplets produced are laden with virus. In this sense, the virus is already “airborne”. It seems reasonable to hypothesize that the fact that airborne transmission has not been observed has to do with the virus having not yet aquired enough specificity for human receptors (particularly those found on cells in human lung tissue) to allow it to easily overwhelm the human body’s first line of defense: the so-called “mucociliary escalator”, and therefore that infection thus far has probably been through self-innoculation by fomite-contaminated hands (the greater initial viral loads facilitated by this mode of transmission may also play a role). Once infection has been accomplished, however, evolutionary progress toward better affinity for the sialic structures (specifically the galactose linkages) found in human lung tissue is, if not a foregone conclusion, then at least pretty darned likely — especially where co-infection with an ordinary strain of “human” influenza provides the opportunity for reassortment. Influenza is, after all, primarily a disease of the respiratory tract.
Brian, the remote villages which were devastated, often were all of (because of their isolation) racially similar, and may have have an unlucky immune system over-or under-response, that everyone with similar genes would have.
Some places, they knew it was the mail delivery (didn’t seem sick when he left the shop, but was sick by the time the dogsled brought the mailman to the village) or, one ship makes a port of call or comes ashore to get water or food; usually isolated didn’t mean they were able to keep 100% quarantine - they didn’t know enough to aim for that.
Also, some villages that were very isolated, there would be less chance some healthy people to come look; volunteer to help. If people were too sick to heat their dwellings, or too sick to get more water, (or feed their dogs)and not even a chance of city officials sending volunteers round to look in on people or pick up the bodies, being too small and isolated might have been a drawback, once the virus was in.
But it may have more to do with genetics. Have you read “1491″ about how much more populated they now think the Americas were before first contact with Europeans, and their live animals brought over as groceries on ships, and all their viruses ?
Microbes can be carried by water, wind, and animals. Lots of vectors for contamination, however unlikely. The odd occurrence of a susceptible, immune-depressed individual encountering a very small viral load by whatever means could be all that is needed to start the wildfire.
Microbes have been tracked crossing the Atlantic to the Caribbean via Saharan dust storms. Life finds a way, even life that is more dead than living.
Will we all get this thing in time?
Data from previous pandemics suggest that about a third of us can expect to contract the virus.
Does that mean the other 2/3 won’t come in contact with it or does it mean that 2/3 will be immune?
Probably a little of both. We’ve been discussing differential susceptibility in another thread; not much is known about this yet, but it does appear that some folks are less likely to get the flu even if they are exposed.
http://www.nature.com/news/2005/050…0307-15_pf.html NATURE 11 March 2005; | doi:10.1038/news050307–15
Did Black Death boost HIV immunity in Europe? Michael Hopkin Experts argue over whether smallpox or plague should take the credit.
Deaths from plague in the Middle Ages may have left more people with a gene that guards against HIV.
Devastating epidemics that swept Europe during the Middle Ages seem to have had an unexpected benefit - leaving 10% of today’s Europeans resistant to HIV infection.
But epidemics of which disease? Researchers claimed this week that plague helped boost our immunity to HIV, but rival teams are arguing that the credit should go to smallpox.
What is clear is that something has boosted the prevalence of a mutation that helps protect against the virus. The mutation, which affects a protein called CCR5 on the surface of white blood cells, prevents HIV from entering these cells and damaging the immune system.
Around 10% of today’s Europeans carry the mutation, a significantly higher proportion than in other populations. Why is it so common in Europe? One possibility is that it favours carriers by protecting them from disease. But geneticists know that the mutation, called CCR5-Delta32, appeared some 2,500 years ago - long before HIV reared its head.
“You need something that has been around for generation upon generation,” explains Christopher Duncan of the University of Liverpool, UK, who led the latest analysis. Plague fits the bill, he and his colleagues conclude from a mathematical modelling study published in the Journal of Medical Genetics1.
Duncan’s team points out that when the Black Death first struck, killing some 40% of Europeans between 1347 and 1350, only 1 person in 20,000 had the CCR5-Delta32 mutation. As the centuries wore on, repeated outbreaks, culminating in the Great Plague of London in the 1660s, have occurred in tandem with rises in the mutation’s frequency.
Other experts are not convinced, however. A similar study2 published in 2003 suggests that it was smallpox that boosted the mutation’s frequency. “Smallpox would still be my favoured hypothesis,” comments Neil Ferguson, an infectious disease expert at Imperial College in London, who was not involved in the study.
Duncan counters that smallpox has only been a serious threat in Europe since the 1600s, which may not have been enough time to have such a big genetic effect. But Ferguson argues that the influence of smallpox over the centuries may have been underestimated, because it largely affected children.
“Smallpox seems the most parsimonious explanation,” he adds. He points out that one major problem with Duncan’s plague theory is that it requires a rethink of how plague was caused. If those with a virus-blocking mutation were more likely to survive, it follows that plague would have been caused by a virus. But the conventional view is that the plague epidemics of the Middle Ages were caused by a bacterium, Yersinia pestis.
Duncan admits that his theory is difficult to prove. But he argues that the outbreaks are easier to explain if one assumes that plague was passed directly from person to person as a virus, rather than the ‘bubonic plague’ that was caused by bacteria carried by rats and their fleas. “Rats are absolutely in the clear for Europe,” he argues.
If that’s true, then Duncan can explain not only the mutation’s average levels in Europe, but also the fact that people in Finland and Russia have the highest level, around 16%, whereas a mere 4% of Sardinians possess it.
He points out that outbreaks of feverish viral disease continued in Scandinavia and Russia for far longer than in the rest of the continent, reinforcing the mutation’s status as a valuable asset. “It was mouldering on until about 1800 in northern Europe.”
There is a good report on Spanish Flu and Bird Flu with lots of links at http://www.arielco.us/page3.html
Slightly off topic but does anybody know how many of the current H5N1 deaths were treated with Tamiflu? Given the $Billions governments have spent, I would think somebody would want to know if the stuff actually works against Bird Flu.
Pfwag- about the Tamiflu effectiveness. I just found an article a short while ago. Thailand and a few other countries are going to partner a study on treating BF patients. It’s on the news thread.
Closed to speed Forum access
Check dates