As a parent and human I've been watching the "Let None Call it Swine" Flu with vigilant caution, cramming virology and medical anthropology. When Max von Sydow played chess with death in the movie 'The Seventh Seal' (clip above), he might have won if he had consulted the Net.
The media exist in an information marketplace, always trying to take share away from competitors. If things are too quiet, it's in their edgy interests to go blow something up, so when a story comes along which can be used to elicit a strong emotional response, it's conflated and milked until the last drop. For them, a deadly flu should be perfect. When they start telling everyone, i.e. themselves, to remain calm...my gut has me start edging towards the exit sign. What scared them so badly? In short, we've got medical mysteries which together do seem to warrant a strong response by officials. That, and we appear to have a return of the Spanish Flu.
Swine Flu can again be referred to as such because the first case was just confirmed in Canadian pigs, which became infected by a worker returning from a trip to Mexico. Swine Flu is also a misnomer, as was Spanish Flu, since both are and were really forms of an originating avian flu strain, specifically the endemic Influenza A virus subtype H1N1. Two viral proteins, hemagglutinin (H) and neuraminidase (N), are the basis of subtype designations, proteins which all viruses contain. The structure of these proteins differs from version to version due to very rapid genetic mutation in the viral genome, with the relevant H and N digits depending on which numeric forms of each the strain contains. Because of mutation's rapidity and unpredictability, the lethality of even the baseline can vary widely. It is typically not possible to develop appropriate vaccines, though the WHO previously urged the CDC to do so for Spanish Flu. They tried, failed, and they're afraid this is the Big One.
Reports from south of the border, whilst perhaps not very reliable, have all so far indicated a mortality rate higher than the dreaded 1917-1919 influenza A (2.5-5.0%) which broke out near the close of World War One and killed upwards of 70 million people. Coincidentally, the most virulent strain of H1N1 was re-created in international disease study labs five short years ago after exhuming the bodies of well-preserved victims. The blogosphere is, of course, teeming with reports that the flu threat is either a) way overblown, or b) a bio-engineered Great Die-Off. Each extreme or neither or both may be valid.
The Spanish Flu was exceptional in that it killed by using a sort of judo on human immuno-response systems. It tended to kill the healthiest people, particularly healthy adult males, by causing a cytokine storm; the stronger your immune system, the more likely you were to trigger the storm and die, usually from a viral pulmonary consolidation which mimicked pneumonia and could later morph into its bacterial form. As the Mexican version appears to do. The one toddler who died in Texas was from a prominent Mexican family; otherwise the Latino victims have been young, consistent with cytokine storm mechanisms, as with the victims of the 2005 outbreak of H5N1 Bird Flu. So far this outbreak hasn't killed any non-Latinos and the US has been fatality-free so far, with broad-spectrum and mild symptoms.
Mass media have not yet investigated the source of the outbreak. Had they done so, they would've found it started in the small town of La Gloria in Vera Cruz, starting in February:
'Sources characterized the event as a ‘strange’ outbreak of acute respiratory infection, which led to bronchial pneumonia in some pediatric cases. According to a local resident, symptoms included fever, severe cough, and large amounts of phlegm. Health officials recorded 400 cases that sought medical treatment in the last week in La Gloria, which has a population of 3,000; officials indicated that 60% of the town’s population (approximately 1,800 cases) has been affected. No precise timeframe was provided, but sources reported that a local official had been seeking health assistance for the town since February.’February is typically the end of flu season, not the beginning, thus the 'strange' descriptor. Yet the timing is nearly congruent with the North American outbreak of Spanish Flu, the first case observed at Fort Riley, Kansas on March 4th, 1918. La Gloria is the home of Granjas Carroll de Mexico, a factory hog operation owned by Smithfield Farms. It produced a million carcasses last year, along with enough manure lagoons that local residents began demonstrating against it. (Smithfield Farms is a supplier to McDonald's and Subway, and its then US-based operations were fined $12.3 million in 1997 for violating the Clean Water Act. It moved to Mexico after NAFTA's passage.)
Local residents in La Gloria directly attribute the flu outbreak to the pig plant, where the animals are packed into a close muddy proximity similar to trench conditions in France in 1918, where millions of fresh American soldiers were jammed ass by jowl. Oh, and Fort Riley circa 1918 was not just a military base. It was also a high-output pig and chicken farm.
How much to worry? Opinions differ greatly. In a Wednesday article in the LA Times, Wendy Orent, the author of "Plague: The Mysterious Past and Terrifying Future of the World's Most Dangerous Disease" argues that because of past human exposure, rapid viral mutation cycles, and the lack of human proximity this particular version of H1N1 poses little reason for panic:
And we can predict the virus will only spread more easily over time: Natural selection ensures, by definition, that the most transmissible strains will be passed on. Fully adapted human flu is explosive -- no quarantine, no isolation, no Tamiflu can contain it.While that may be true in terms of general virology, Orent's analysis discounts at least three obvious and contradictory possibilities:
Natural selection theory also tells us that whatever we will face, it won't be another 1918. As Ewald has argued for years, only packed conditions allowing deathly sick hosts to pass disease repeatedly to the well can produce highly virulent strains of flu -- for animals or for people. The usual sort of human crowding will not do it. Even massive, densely populated Mexico City, with more than 20 million inhabitants, won't produce the kind of lethal strains that the Western Front did in World War I. People died in Mexico because they were close to the epicenter of the disease, to the probable emergence of lethal strains from crowded pig breeding. But natural selection's corrective action is swift and predictable: The strains spreading across the world are milder.
1) early indications of higher lethality amongst children who have dimmer genetic memories of their forebears surviving other nasty forms of H1N1;Call me a yokel, but it seems viral evolution does not necessarily proceed in one direction towards lesser severity, increased transmission rates are known to augment and encourage mutation, and close-quarters air travel as a percentage of populace now far surpasses that of ship crossings undertaken a century ago. More people fly over the seas in one day than the total number of Allied soldiers who steamed across them throughout all of World War One.
2) artificial introduction of easily transmissible but still deadly genetically-targeted versions which originated in a lab;
3) and natural mutation from mild into deadly strains as previously occurred in H1N1 following its emergence in early 1918.
Spanish Flu's recorded American outbreak in March, 1918 seemed to cause a brief blip in influenza deaths, after which the death rate returned to and remained at or below baseline from March of that year until November, when it suddenly rose to 25 times normal.
The mobility and proximity of doughboys in trenches is not unlike the recycled-air bubbles we hop into for international travel. And the lowest national death rates from Spanish Flu were in those countries which restricted travel (such as American Samoa and Japan) via preventative blockades, warding off ships from other places.
Firmly in the "Mostly Harmless" Camp, the Canadian pig farmer whose herd was infected had this to say:
"The chance that these pigs could transfer virus to a person is remote."Probably true, unless you happen to have been drinking water laced with a 7% solution of pig shit, showered in same, or were bitten by a fly recently born in it. Then the chance seems far less remote. Furthermore, what does this perversely incented dumb-ass know? Orent's article also indicts factory poultry farms in Asia for the outbreak of H5N1 Bird Flu, a corona virus which scientists have derided as something not possible from nature, a force which had previously not seen fit to stuff hens into 10 by 12 inch cages and driven pigs so insane they chew each other's tails off on their crowded lot as antibiotics course through their veins and they root their futter out of common excrement reaching up past their hocks.
Current governmental recourse advises the immediate application of Tamiflu upon notice of flu-like symptoms. Tamiflu is owned by Swiss pharmaceutical giant Hoffman La Roche and is a patented derivative of Chinese star anise, a substance long used as a hallucinogen. Where it has been widely employed, the horrifying side effects profile of Tamiflu gives a pause roughly equal to the possible dangers of Spanish Flu:
Japanese health authorities ordered doctors not to prescribe Tamiflu...to patients aged 10-19 following dozens of deaths and injuries among teenagers over the past six years.Twenty-seven patients taking Tamiflu , "most in their teens" fell to their deaths from buildings in Japan since 2001, and an 8-year old kid committed suicide. The Bush Administration FDA issued a ruling that Tamiflu is safe for children, and it's being pushed as the global influenza solution. Hmm. I'm not a scientist. I'm not a virologist. I'm just a dad who loves his children, and I'm on this like a screaming eagle. I will personally claw the eyes out of the interested dickheads who set this up and use gravity to drop their bloody skulls on shattering rocks.
More than 1,300 people have exhibited neuropsychiatric symptoms since Tamiflu went on sale in Japan in 2001, of whom 71 have died. Twenty-seven, most in their teens, fell from buildings.
Last month the health ministry announced new clinical trials to establish whether the antiviral could cause delirium, delusion and other neuropsychiatric symptoms. The ministry had previously ruled out any link.
We have a box of Tamiflu, four doses. We bought it back when SARS started making its rounds. If history and evolution are any guides in their doubt-ridden complexities, well hopefully they won't be and we're already past the worst. But the viral onslaught might start in November and if it does, Tamiflu, a creation of a cynically profit-driven Pharma, might best be employed as a very last resort.