Swine Flu: Potential Threat to Human Species?

[B. Elliott]

The swine flu finally hit the base I'm stationed on here in the northeastern US. There have been eight confirmed cases so far with no one really becoming 'extremely' ill. Just typical flu-like symptoms.

The command here on base has been in direct contact with the CDC to provide and receive updates. They advised that the problem with swine flu is that it changes quickly which has made it hard to come up with a vaccine specifically for it. It's definitely been spreading from person to person though... at least that's how it's been spreading here.

The real concern is with people who do not have fast available medical care. Swine flu is definitely a concern, but it's still just a strain of the influenza virus. If it can be treated in a timely manner, the person will make a quick recovery with no severe problems. It's the people who try to fight it and put off treatment, thinking that it's just a cold, that really have the problem. And again, mainly the people without readily available treatment.

 

[Moridin]

Ummm... when I checked the CDC website, it indicated there were 27 deaths in the U.S. due to H1N1 virus. I don't see how this compares to 1 million or 50 million or 100 million deaths.

Or is this some sort of "we must be ever vigilant" mentality?

We are just in the first stages on this pandemic, and the virus has the ability to mutate to a much more virulent and dangerous strain and come back in the fall or winter. Viruses, and indeed many microorganisms, are very promiscuous when it comes to sharing genetic material. The question is not when we will get another 1918-style outbreak, but when.

 

[Moridin]

The reason it affects younger people more may be very simple: http://news.yahoo.com/s/ap/20090521/ap_on_he_me/med_swine_flu_older_immunity

This explanation is very probable and it is consistent with the epidemiology of the 1918 pandemic as well.

http://mitworld.mit.edu/video/323

 

[ViewsofMars]

Medline Plus (A service on the U.S. National Library of Medicine and the National Institutes of Health) has a X-Plain Education Tutorial: H1N1 Flu (Swine Flu). It's a very good.

http://www.nlm.nih.gov/medlineplus/tutorials/h1n1flu/htm/_no_50_no_0.htm

 

[ViewsofMars]

I forgot to mention that you have the option of reading the X-Plain Education Tutorial: H1N1 Flu or listening to it if you turn on your computer speakers.

 

[Andy Resnick]

We are just in the first stages on this pandemic, and the virus has the ability to mutate to a much more virulent and dangerous strain and come back in the fall or winter. Viruses, and indeed many microorganisms, are very promiscuous when it comes to sharing genetic material. The question is not when we will get another 1918-style outbreak, but when.

Well, look- if you want to hyperventilate about vague possibilites, that's up to you. Don't expect everyone to agree with you.

 

[russ_watters]

Well, look- if you want to hyperventilate about vague possibilites, that's up to you. Don't expect everyone to agree with you.

Agreed, but it's worse than that: the last sentence says it is all but a certainty, while the first and second are about possibilities. The hype has people holding these contradictory ideas in their heads that it might mutate and become worse (might any virus?) and that it will. Well it also might not get worse*. Why we should be more than just mildly concerned about this escapes me.

*edit: By "worse", I mean more virulent/lethal. Certainly, many more people will get it and die from it next flu season than did this flu season. That certainty alone is not cause for alarm.

 

[russ_watters]

"The Swine Flu? Pah, just Media Hype!"

Does the white board add credibility? There is so much idle speculation and specious logic in there, it's rediculous. Some obvious problems:

1. A normal flu doesn't necessarily just infect one person per generation (how could it, considering how many people are infected every year).
2. A flu that no one has a previous exposure based immunity to will not necessarily affect everyone exposed.
2a. Some people do have a previous exposure based immunity to swine flu.
3. Might mutate into something worse does not equal will mutate into something worse.
4. There was no flu vaccine in 1918.

 

[Moonbear]

We are just in the first stages on this pandemic, and the virus has the ability to mutate to a much more virulent and dangerous strain and come back in the fall or winter.

And that COULD be the case for any strain. So far, there really isn't any indication this particular virus is anything special in terms of severity of illness.

Viruses, and indeed many microorganisms, are very promiscuous when it comes to sharing genetic material. The question is not when we will get another 1918-style outbreak, but when.

The question is not when but when? I don't know. I'd argue that our understanding of hygiene and public health, ability to rapidly inform large percentages of the population about newly emerging viral strains, along with knowledge about the mechanisms of virus actions and the treatments available have changed considerably since 1918. All of these would contribute toward lessening the impact of any particular flu virus on the overall population.

 

[Moonbear]

2a. Some people do have a previous exposure based immunity to swine flu.

Our state has a really low incidence of this strain of swine flu, and only among those who have traveled outside the state to other affected regions so far (I think it was either 2 or 4 cases so far). We also have a lot of agriculture in this state. Perhaps similar to the way those who had been exposed to cowpox in their cattle developed immunity to smallpox before a smallpox vaccine was developed, people who live in areas where other forms of swine flu have been passed around among swine have developed an immunity to the strain that infects humans.

 

[Count Iblis]

Even if the virus stays the way it is, we still have to deal with this fact, see WHO message posted above by ViewsofMars:

Dr. Chan added that the most severe and fatal infections have been in adults between the ages of 30 and 50 years, a significantly different pattern to epidemics of regular seasonal flu which generally claims frail, elderly people.

This looks quite alarming to me. I've also read somewhere that about half of these fatalities were people who had no chronic disease that would be associated with a higher risk of complications due to flu.

Swine flu is spreading slowly, presumably because it isn't the right season for flu. So, not many people have been infected and as a result, the number of people who have died are quite small if you compare that to other ordinary flu epidemics.

But if swine flu goes on to infect a significant fraction of the World's population then, assuming that the fatality rate is similar to ordinary flu, you could have tens of thousands of deaths, but these will be relatively young people. So, unless everyone is vaccinated in time, it would still be a disaster.

 

[Phrak]

I haven't visited this thread, nor the WHO website in a while. What happened the alert levels, oddly redefined as they were? Now we are given phases instead. I feel the WHO is jurking us around with the shell game to justify past statements.

 

[B. Elliott]

Does the white board add credibility? There is so much idle speculation and specious logic in there, it's rediculous. Some obvious problems:

2a. Some people do have a previous exposure based immunity to swine flu.
3. Might mutate into something worse does not equal will mutate into something worse.
4. There was no flu vaccine in 1918.

Those are the points I meant to hit on, Russ. The current overall quality of life, when it comes to vaccinations, is much better when comparing it to 1918.

 

[Moridin]

Well, look- if you want to hyperventilate about vague possibilites, that's up to you. Don't expect everyone to agree with you.

It does not matter if your particular political ideology disallows you to agree with me, since I have the science on my side. It is not a vague possibility, it is something that has been observed repeatedly throughout history.

 

[Moridin]

Agreed, but it's worse than that: the last sentence says it is all but a certainty, while the first and second are about possibilities. The hype has people holding these contradictory ideas in their heads that it might mutate and become worse (might any virus?) and that it will. Well it also might not get worse*. Why we should be more than just mildly concerned about this escapes me.

*edit: By "worse", I mean more virulent/lethal. Certainly, many more people will get it and die from it next flu season than did this flu season. That certainty alone is not cause for alarm.

I expected more from you. Those positions are hardly contradictory. It is a possibility that this particular strain will, but do to the facts of evolution, it is a near certainty that a strain will sooner or later repeat the effects of earlier pandemics. I am obviously not talking exclusively about this strain, but the overall epidemiology of influenza viruses. As you know, viruses like these are very promiscuous, so there is cause for attention when a possible pandemic arises.

I apologize if I expressed myself a bit vague earlier.

 

[Moridin]

Does the white board add credibility?

Again, I expected more from you here, rather than mere irrelevant points.

1. A normal flu doesn't necessarily just infect one person per generation (how could it, considering how many people are infected every year).
2. A flu that no one has a previous exposure based immunity to will not necessarily affect everyone exposed.
2a. Some people do have a previous exposure based immunity to swine flu.
3. Might mutate into something worse does not equal will mutate into something worse.
4. There was no flu vaccine in 1918.

1. The video does not states that a seasonal influenza infects one person per generation, he is merely focusing on one particular lineage, and the lines beside that specific lineage shows that he isn't arguing that only one person is infected per generation.
2. One of the reasons an influenza becomes a pandemic is that there exists little or no natural immunity. Without natural or exposure based immunity, you are hoping for a lot of...asymptomatic carriers? Or what?
2a. Yes, so did people during the 1918 pandemic, yet 50-100 million died.
3. Straw man, see previous post.
4. There is nothing that will guarantee that a readily available flu vaccine will be ready for deployment during a pandemic. Even antiviral drugs like Tamiflu is problematic. In 2005, there was only one factory that produced it in Switzerland. During a pandemic, companies like FedEx will not fly, so the US air force has to land on Switz soil. There was also no global travel in 1918.

 

[Moridin]

The question is not when but when? I don't know. I'd argue that our understanding of hygiene and public health, ability to rapidly inform large percentages of the population about newly emerging viral strains, along with knowledge about the mechanisms of virus actions and the treatments available have changed considerably since 1918. All of these would contribute toward lessening the impact of any particular flu virus on the overall population.

If you look at how the Ebola epidemic in Zaire, the pneumonic plague outbreak in Surat (both in the 90s) or how antibiotic resistant bacteria was actually aided by the sloppy prescriptions and uses of antibiotics in both the US and the USSR one might reach a different conclusion. Garrett (2000) reports that the Zaire outbreak took five to six months from the doctors in Zaire knew about the first cases until either the WHO or CDC got the information. The "not if, but when" is an argument from the nature of the evolutionary arms race between H. sapiens and microorganisms that cannot be easily refuted by a reference to our current tools and methods. Surely, you do not believe that it is just a matter of inventing new drugs?

 

[russ_watters]

Our state has a really low incidence of this strain of swine flu, and only among those who have traveled outside the state to other affected regions so far (I think it was either 2 or 4 cases so far). We also have a lot of agriculture in this state. Perhaps similar to the way those who had been exposed to cowpox in their cattle developed immunity to smallpox before a smallpox vaccine was developed, people who live in areas where other forms of swine flu have been passed around among swine have developed an immunity to the strain that infects humans.

You have no idea how difficult it was for me to suppress the urge to make fun of your state in reply to that...

 

[russ_watters]

It is a possibility that this particular strain will, but do to the facts of evolution, it is a near certainty that a strain will sooner or later repeat the effects of earlier pandemics. I am obviously not talking exclusively about this strain, but the overall epidemiology of influenza viruses.

Oh, ok - you're not saying that the current flu will be the one. Well ok, maybe, but then you're not really adding anything useful to a thread about swine flu by saying that. The question being posed isn't 'will we eventually get hit by another mega flu', it is "is the swine flu a threat". And your previous post was about the hype of this flu not being excessive. In any case, I and others have pointed out differences between today and 1918 that imply that it would be difficult for a repeat performance.

The video does not states that a seasonal influenza infects one person per generation, he is merely focusing on one particular lineage, and the lines beside that specific lineage shows that he isn't arguing that only one person is infected per generation.

When he says "most seasonal flus...if one person with the flu comes into contact with four, maybe only one will actually develop the virus", it's wrong. He adds weasel words like "maybe" to it, but that's what he is saying and that's what he drew it on the board. I am aware that it may start in multiple places simultaneously, but that doesn't make it any more wrong to illustrate the spread as being linear. It isn't.

2. One of the reasons an influenza becomes a pandemic is that there exists little or no natural immunity. Without natural or exposure based immunity, you are hoping for a lot of...asymptomatic carriers? Or what?

A lot or a few, doesn't matter: there are some who don't get sick. But the bigger problem is mostly what constitutes "exposure". As Moonbear pointed out, we know better than they did how to prevent exposure, which will make each generation smaller than in 1918 (assuming equal virulence).

Then, of course, there is the vaccine (that's related to the point)... That also will make each generation smaller than in 1918.

2a. Yes, so did people during the 1918 pandemic, yet 50-100 million died.

That's not the point of the criticism. The point is that he said "in a pandemic, no one has any native immunity to it..." and that's just plain not true for the 1918 2009 case.

3. Straw man, see previous post.

Not a straw man, I just misunderstood your point, because your point doesn't directly address the point of this thread. But as far as the video goes, it isn't a straw man. He's talking specifically about the risk of this flu strain, not some vague 'sometime, eventually, we'll get hit with one' notion.

If you want to argue that the media attention for the swine flu isn't hype, you should be making comments about the swine flu. Heck, to me, even if you're right that eventually we'll have another mega flu, it is still hype, because there is no evidence that this one is it. It's 'every lottery has a winner' type logic. That fact doesn't make it reasonable to play.

4. There is nothing that will guarantee that a readily available flu vaccine will be ready for deployment during a pandemic.

Again, this thread and that video are about the swine flu and there is a vaccine that will be available for next year's flu season.

 

[ViewsofMars]

Again, this thread and that video are about the swine flu and there is a vaccine that will be available for next year's flu season.

Russ, the video that Moridin posted (#213) was on an Avian Flu Pandemic. It was taped on September, 26, 2005. It appears to me that you and Moridin are in a discussion about the Avian Flu not the Swine Flu.

Back on track. Dr. Chun announced to the United Nations health agency in my post #210, “I understand that production of vaccines for seasonal influenza will be completed soon, and that full capacity will be available to ensure the largest possible supply of pandemic vaccine in the months to come.” If I understand her correctly, the current vaccine available that is being used at this time for H1N1 Flu (Swine Flu) are antiviral drugs. There aren’t any medications as of yet, but hopefully according to Dr. Chun there might be a vaccine by Fall or Winter that will treat the infection for for type A -H1N1 which is a new strain. People don’t have the antibodies that protect against it as of now. It might be helpful to review the educational tutorial which explains about the Swine Flu (#214), H1N1 Flu (A,B,& C).

Thanks. Have a great weekend.

 

[Lancelot59]

The swine flu, as said before is going to really only be a problem in densely populated areas.

I really think this latest flu is our own fault. We keep dumping so many antibiotics on things that now many things are is immune to them. The panic and rush to use drugs is what will really cause problems later on down the road.

 

[ViewsofMars]

Lancelot59, addressing strickly your remarks. Dr Margaret Chan, Director-General of the World Health Organization said the following:

We know that the novel H1N1 virus preferentially infects younger people. In nearly all areas with large and sustained outbreaks, the majority of cases have occurred in people under the age of 25 years.

In some of these countries, around 2% of cases have developed severe illness, often with very rapid progression to life-threatening pneumonia.

Most cases of severe and fatal infections have been in adults between the ages of 30 and 50 years.

This pattern is significantly different from that seen during epidemics of seasonal influenza, when most deaths occur in frail elderly people.

Many, though not all, severe cases have occurred in people with underlying chronic conditions. Based on limited, preliminary data, conditions most frequently seen include respiratory diseases, notably asthma, cardiovascular disease, diabetes, autoimmune disorders, and obesity.

At the same time, it is important to note that around one third to half of the severe and fatal infections are occurring in previously healthy young and middle-aged people.

Without question, pregnant women are at increased risk of complications. This heightened risk takes on added importance for a virus, like this one, that preferentially infects younger age groups.

Finally, and perhaps of greatest concern, we do not know how this virus will behave under conditions typically found in the developing world. To date, the vast majority of cases have been detected and investigated in comparatively well-off countries.
http://www.who.int/mediacentre/news/statements/2009/h1n1_pandemic_phase6_20090611/en/index.html

Lancelot59, I take offense to your particular remark, "The panic and rush to use drugs is what will really cause problems later on down the road..." I have asthma. If I didn't take a drug for it then I wouldn't be able to enjoy my outdoor life as much as I do. If I happen to be walking on a windy day when there is oftentimes a high pollen count in spring, summer, or winter whether it be in a city or woodland area out in mountains, and I have forgotten, because I was rushing around too much, to take my medicine then my joy is stolen from me since I have to curtail my fun. I like to have fun. Fortunately, I don't take any other type of prescribed medication. I'm pretty darn heathy though I realize that isn't always the case with other humans whose health depend on pharmaceuticals.

As far as A-H1N1 is concerned, we have to remember that nobody knows yet how this new stain of virus started so there is no blame to be placed on anything.

 

[Lancelot59]

I don't mean to cause offence. For things like asthma drugs are necessary.

I meant for bacterial and viral infections. Lots of these organisms are becoming immune to antibiotics because of how much they are used to combat them. I guess I should have worded that differently. Sorry.

 

[ViewsofMars]

Forgiven. Only a doctor can prescribe medication. I trust my doctor. If I need an antibiotic he will be the one who knows.

 

[Moridin]

Oh, ok - you're not saying that the current flu will be the one. Well ok, maybe, but then you're not really adding anything useful to a thread about swine flu by saying that. The question being posed isn't 'will we eventually get hit by another mega flu', it is "is the swine flu a threat". And your previous post was about the hype of this flu not being excessive.

It is certainly useful to this thread since it outlines the possibilities that exist for it to have similar effects as the other, more lethal, pandemics. Similarly, the "it is all a hype" position outlines the possibilities for it to not have similar effects as the other, more lethal, pandemics. Both positions contribute to the discussion since we cannot in practice predict whether or not (or when) this or a virus will mutate to a more virulent form.

I have no objection to the rest of the content of your post, since it was entirely convincing.

 

[Moridin]

The swine flu, as said before is going to really only be a problem in densely populated areas.

I really think this latest flu is our own fault. We keep dumping so many antibiotics on things that now many things are is immune to them. The panic and rush to use drugs is what will really cause problems later on down the road.

Viruses does not generally respond to antibiotics anyway, but I agree with the overall argument. We have been playing with the devil for quite some time with inconsistent treatments and of course the evolutionary arms race will continue regardless, but we can hinder or contribute to this process.

 

[Count Iblis]

How can this not be alarming:

At the same time, it is important to note that around one third to half of the severe and fatal infections are occurring in previously healthy young and middle-aged people.

So, assuming that swine flu does not cause more casualties than ordinary flu, we can take the statistics of any ordinary flu epidemic and then asumme that a third to a half of the fatalities will be " in previously healthy young and middle-aged people". Sounds quite a horrible scenario to me.

 

[Lancelot59]

Natural selection has to happen somehow. It sounds bad, but that's the unfortunate reality. If the black plague hadn't happened we would have been massively overpopulated around the year 2000.

It's an even more horrible scenario when you really take a look at how many people fall under that one third alone.

 

[ViewsofMars]

How can this not be alarming:

At the same time, it is important to note that around one third to half of the severe and fatal infections are occurring in previously healthy young and middle-aged people.

So, assuming that swine flu does not cause more casualties than ordinary flu, we can take the statistics of any ordinary flu epidemic and then asumme that a third to a half of the fatalities will be " in previously healthy young and middle-aged people". Sounds quite a horrible scenario to me.

Count Iblis, the quote you are referring to is the novel virus [A(H1N1)] that UN health chief Dr. Margaret Chan is speaking about. Please reread my post from the United Nation News Center, (#210). It states, “Dr. Chan added that the most severe and fatal infections have been in adults between the ages of 30 and 50 years, a significantly different pattern to epidemics of regular seasonal flu which generally claims frail, elderly people.” Ok, we know that regular seasonal flu usually affect the elderly whereas this new strain (novel) has been affecting the 'healthy young' and 'middle -aged people'.

If you read the entire article I presented in post #210 and not only the snippet that I presented then you would know that it also states:

The upgrade to Phase 6 means that sustained human-to-human transmission of the virus has spread beyond North America, where it was concentrated, with WHO reporting 28,774 verified cases of the infection in 74 countries, including 144 deaths, as of this morning. [June, 11, 2009]

The good news is that 28,630 have survived the novel virus A(H1N1). With teary eyes, the sad news is 144 people did die.

I'm a positive thinking individual, always hoping for the best, and most definitely a firm supporter of the scientific community and technology. Here's an article that brings a big smile to my face. It's from Los Alamos National Laboratory! Go Alamos! Hometown of innovative brains! (Love you guys.)Fast Pandemic Detection Tool Ready to Fight Flu
http://www.lanl.gov/news/index.php/fuseaction/home.story/story_id/16785

 

[B. Elliott]

The good news is that 28,630 have survived the novel virus A(H1N1). With teary eyes, the sad news is 144 people did die.

And to think, on a yearly basis the typical seasonal flu ends up killing over 30,000 people in the US alone.

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.

http://www.cnn.com/2009/HEALTH/04/28/regular.flu/index.html

 

[hypatia]

Just to note that mutations have been confirmed, but that the mutations at this point, do not seem to make H1N1 more virulent. Also, no confirmed cases outside of the Netherlands are found. http://www.promedmail.org/pls/otn/f?p=2400:1001:50943::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1010,79432

 

[Mattara]

And to think, on a yearly basis the typical seasonal flu ends up killing over 30,000 people in the US alone.

As many others, you fail to grasp the difference between a pandemic influenza and a seasonal influenza. It is not primarily about fatalities.

 

[Count Iblis]

I've read that about 10% of the people who die from Swine flu were healthy young people. So, even if the Swine flu pandemic turns out to be less deadly overall than ordinary flu, it will have far more devastating consequences.