Apr 29 2009

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swine flu

Bill, how bad do you think it will get?

I note that the first US death from swine flu was reported this morning in Texas. How widespread do you think this will get and with what toll?

John Page


The most honest answer is this – we need more data .

My hunch is that this isn’t “the big one.”

Just to put this in perspective… Typically around 35,000 people die in this country every year from influenza. We now have one (1) death from a new strain – from a 23-month-old child.

The worst case scenario is the H1N1 virus that killed about 50 million people worldwide during and after World War I. That’s a bigger human slaughter than that caused by the bubonic plague. That virus (either from swine or avian origin from a farm in Kansas) jumped species and subsequently took a few years to wreak its toll. The fact that we had a World War going on with people tightly packed in barracks and individuals under great stress traveling the globe to fight aided in the spread. But it’s more than that.

Typically influenza is most likely to kill the very young and the very old. It is in fact one of the ways Nature culls the elderly in our population. Influenza leads to pneumonia which leads to death from respiratory failure. Epidemiologists often refer to the U-shaped risk curve by age, with the very young and the very old having the highest probability of death from infection.

World War I’s H1N1 was different. For reasons that we’re still trying to understand now, it caused immune systems to overreact. Thus the very healthiest ended up having their strong immune systems attack their lungs. Within 24 to 48 hours of the onset of symptoms, some of our very healthiest ended up turning so cyanotic from poor ventilation that it was said you couldn’t tell what race they were. Thus for this virus, the risk of death by age was characterized by a W-shaped curve. The very young, the very old, and the very healthiest were most likely to succumb from the disease. The results were frightening to say the least.

Why are people so concerned about this virus? Here are the following reasons.

* The virus is also an H1N1, although its precise behavior is still being monitored and documented.

* Some of the deaths in Mexico were from seemingly healthy young people.

* The virus is part swine, part avian, and part human in origin.

* It has just jumped species, AND has now shown easily to be passed from human to human.

* It is new, and it is spreading outside the typcial flu season.

However… For whatever reason, the cases in the U.S. have been relatively mild in comparison. Why is that? We don’t know yet. It could be that the virus has mutated as it developed its ability to pass from human to human, and became less virulent in the process. Or it could be that there are many, many more undocumented cases of influenza in Mexico, that their Public Health system is incapable of detecting (hence a bigger denominator when computing risk of death).

Right now its spreading in this country, albeit at the tail end of flu season. We may escape a major outbreak before a vaccine is developed by fall. But its going to run its course in a manner that we have yet to be able to predict at this point.

My suggestion is to make sure you wash your hands, stay away from closed, unventilated spaces where you are exposed to cough and sneeze spray, and encourage your friends to stay home when they get sick. And EVERYONE needs to learn how to cough and sneeze. View the following video.

Why Don’t We Do It In Our Sleeves?

Send a copy of this link to everyone you know.

Also… Make sure you have a family doctor. This virus appears to respond well to anti-viral medication (Tamiflu and Relenza). It’s expensive and it shouldn’t be taken prophylactically because you don’t want the virus to develop an immunity. But if you get the medicine within a few days of the onset of symptoms, then you can significantly blunt the course of the illness.

No need to panic yet. Stay tuned.

- Bill Glasheen
Topic being discussed on the Uechi forums.


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