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A Flu Pandemic? 830

Posted by ScuttleMonkey
from the run-for-the-hills dept.
Pedrito writes "Scientific American is running a story in this month's issue about preparing for a flu pandemic. What this article tries to convey is that a pandemic is definitely coming. Whether it's from the H5N1 strain (which would likely cause hundreds of millions of deaths) or another strain a few years down the road. There have been 3 other flu pandemics in the past 100 years. The 1918 strain being the worst, with 40 million killed. The reason H5N1 is being followed so closely is because it's already spread to people and because it's incredibly lethal (a roughly 50% fatality rate at th moment). Even if the fatality rate dropped to 5% when and if it mutates into an easily communicable form, it would be twice as deadly as the 1918 virus."
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A Flu Pandemic?

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  • by DurendalMac (736637) on Sunday November 13, 2005 @05:30PM (#14022234)
    Randall Flagg is cackling with glee right now. His plan as almost borne fruit. I'm stocking up on Nozz-a-la and heading for the hills. Who's with me?
  • by external400kdiskette (930221) on Sunday November 13, 2005 @05:31PM (#14022242)
    Whilst this sort of thing has happened before saying it's definitely going to mutate is an overstatement. The same kind of sensationalist journalism not to long ago likened mad cow disease to a new sort of plague with predictions of obscene death rates when in reality it was statistically low. It could end up the same for this with a few hundred people dieing over several years ... nothing huge is definitely going to happen.
    • by stevelinton (4044) <sal@dcs.st-and.ac.uk> on Sunday November 13, 2005 @05:40PM (#14022305) Homepage
      Certainly H5N1 could go that way, but the flu virus is incredibly flexible, and there is
      absolutely no reason why it won't come up with another variant as communicable and as lethal as the 1918 variant. If it does, the experts tell us that nothing modern medicine has come up with will help a whole lot. Basically it will infect everyone and kill a proportion and then the rest of us will be immune. Unless we can find a treatment that blocks, or ameliorates all varants of the influenza virus at once, or a way to mass produce a new vaccine in weeks rather than years, then we are still wide open to whatever mutation comes along.
      • by DrYak (748999) on Sunday November 13, 2005 @06:38PM (#14022688) Homepage
        There's a reason that would limit the lethality of new mutant :
        - The point of a virus is not killing its host, but making copies of it self.
        - The lethality of H5N1 is a bad secondary effect.
        - If a new mutant kills its host to quickly, it'll run out of hosts and wont replicate anymore.

        Example :
        - If one catch a new über-mortal flu
        - brings it home
        - infect familiy member
        - the über-mortal flu kills very quickly and the whole family drops dead the same evening
        - The virus will be "stuck" and won't be able to infect anyone else.

        -> That's one of the reason we didn't see a Ebola pandemia

        But, if it is a slower virus,
        and the people survive at least a few couple of weeks (or don't die at all),
        they will have plenty of time to go to work the next days, and transmit the flu to all co-workers, etc...

        The kind of pandemia you see in movies, when some (hibernating/comating patient wakes up / austronaute lands / whatever else) and see everyone dead is not very likely.

        The danger will be if a flu virus like H5N1 can both cross infect birds, but is almost harmless to them, and humans, and is highly lethal, then there's some chance of such a "everyone drops suddenly dead" scenario. ...

        To put it in more Slashdot-friendly terms :
        Imagine an internet worm.
        If the worm crashes Windows immediatly after infecting the PC, even before having time to replicate and send copies to the whole Outlook addresse book,there's no way it could become widespread.
        A few PC will crashes and that's the whole story.
        But if the virus, silently installs backdoors/trojans/spywares and silently begins replicating, THEN you'll have a lot of infected boxen.
        • by brit74 (831798) on Sunday November 13, 2005 @10:06PM (#14023588)
          > That's one of the reason we didn't see a Ebola pandemia

          Actually, the reason we don't see an Ebola epidemic is because ebola is spread by contact with blood and/or secretions of an infected person. I'm sure you're aware that flus spread easier than that. The one thing ebola had going for it was the fact it caused people to bleed. Other than that, it's not much more virulent than AIDS.

          I'd also point-out something else: the Black Death killed very quickly - most people died four to seven days after infection, which is about the same amount of time that H5N1 takes to kill a person. Your "whole family drops dead the same evening" scenario is not realistic given what we already know about H5N1.

          The Black Death is believed to be carried by fleas on rats. The rats (along with lots of other mammals) were dying from the Black Death as well. So, your "if a flu virus like H5N1 can both cross infect birds, but is almost harmless to them, and humans, and is highly lethal," scenario doesn't need to be true in order for H5N1 to be a big problem.

          So, the Black Death was killing its hosts and doing it quickly, but that didn't stop it from wiping out a third of europe's population within a few years. In many cities, it wiped out 50-60% of the population. So, the Black Death had the attributes (according to you) would've caused it to burn itself out too quickly to be a real problem. Yet, it killed 1/3rd of europe's population.

          The danger will be if a flu virus like H5N1 can both cross infect birds, but is almost harmless to them, and humans, and is highly lethal, then there's some chance of such a "everyone drops suddenly dead" scenario. ...

          I don't think this is the danger. We're talking about the possibility of millions of deaths, which is less severe that your "everyone drops suddenly dead scenario", but also more likely to happen.
          • by DrYak (748999) on Sunday November 13, 2005 @11:32PM (#14023900) Homepage
            > That's one of the reason we didn't see a Ebola pandemia
            Actually, the reason we don't see an Ebola...

            Yeah that's right, that's also why I said "*one* of the reason"

            I'm not speaking about current H5N1.
            The parent was speaking about capability/limitation and killing possibility of a *new* mutant.
            The whole point of my post was saying that there's a upper limit of how fast *a new virus* can kill its host and still manage to survive to natural selection.
            None of us was saying that current virus is fast flash-killing.

            BTW: Concerning the plague, a factor that contribute to the widespread of the disease is that the intermediate host is the flea.
            And flea can survive a certain amount of time while being infectiouse because :
            - they only start to starve when the stomach is full of bacteria. Before they can infect but aren't affected by bacteria
            - they are cold blooded, therefor they have lower metabolism requirement and they don't starve to death very quickly.
            - In fact, they can stay dormant a whole winter with bacteria inside and re-start the plague next spring.
            - A dead rat/human, can still be bitten by a flea.
            ---> the transmitting agent (the flea) dies slowly enough to be able to bite and transmit disease to a lot of people.

            Also: Plague is caused by bacteria.
            Bacteria are able to survive longer outside of host.
            Some bacteria can even from spores, and be able to become living again, after a long time and surviving awfull conditions.
            Most of the viruses, on the other hand have a shorter life-span. It's either infect or die-once-you're-out solution. They must have good condition to survive longer (some viruses use capside to survive better. You may also keep virion in a special medium)

            And about "burning itself out too quickly", there are other parameters coming into account :
            - travelling speed accross towns
            - population densities inside towns
            So one amonst the factors that helped the advent of plague into europe was that travelling (and trading route) were fast enough to bring still living bacteria to europe (dead rat bodies and infectious fleas). A less evoluted civilisation, one with less trading yould less likely be able to import plague.
            But because inter-town travelling wasn't *that fast* either (fleas alone can't travel quickly and cover all european towns), and because plague quickly depopulates towns (once enough people are dead and density drops beyond a certain level, some disease can't easily be transmitted), and also because europeans managed to make a quarantine to some level, part of the reasons plague stoped before whipping 100% of human population (à la Horror movies) may be attributed to its tendency to kill everyone.

            This is also interesting to compare with modern situation where mosquitoes are able to get trapped in aircraft and travel and bring tropical disease in european towns, and where ultra-high population densities may help transmit disease between human hosts.
            On the other hand, modern societies are better able to monitor new disease and have more means to combat new viruses and new bacteria.

            the possibility of millions of deaths [...] likely to happen.


            Yup. As you said. Could happen, but depends on a lot of parameters some of which are unknown (what's next mutation ?) or not yet tested in real cases (are we able to react quickly enough ? do we have enough means to combat a new virus).
      • Absolutely sensationalist, just like SARS.
        The common cold/flu kills around 40,000 americans (that's the stat I saw, don't know about world-wide) each year, but SARS with a handful of deaths globally got BIG press. Now this practically non-existant bird flu gets everyone all worked up.
        I'll worry when there's a few thousand deaths. Until then, eat healthy food, exercise and keep that immune system running. If you're not one of the typical flu victims (elderly, very young or compromised immune system from othe
        • by temcat (873475) on Sunday November 13, 2005 @07:43PM (#14023011)
          I'll worry when there's a few thousand deaths. Until then, eat healthy food, exercise and keep that immune system running. If you're not one of the typical flu victims (elderly, very young or compromised immune system from other causes), you'll have an excellent chance to shrug it off, even if it does spread.

          While I'm not in a position to judge whether it's true or not, but just yesterday I read in a newspaper that H5N1 has especially high lethal rate among healthy young people, and that this is caused not by the virus itself, but by the extremely strong immune response of the organism to this virus. Basically, our immune system kills ourselves! Therefore, the stronger your immune system (above a certain threshold), the more likely that you'll die from this disease.
        • by Saven Marek (739395) on Sunday November 13, 2005 @07:49PM (#14023034)
          If you're not one of the typical flu victims (elderly, very young or compromised immune system from other causes), you'll have an excellent chance to shrug it off, even if it does spread. Same thing said by all the other ignorant people who are blissfully unaware that the immune system reacts so hard and fast it causes extreme rates of inflammation in the lungs, and you die. The better your immune system, the harder that response and inflammation. The elderly, young and those with compromised immune systems are going to be better off than you.
        • by hqm (49964) on Sunday November 13, 2005 @08:49PM (#14023274)
          The Spanish Flu (1918) killed young healthy people very quickly, it turned their lungs into sponge rubber. It was not at all like the "flu" that we are used to. People who blithely confuse the yearly 'achy go to bed for a few days' flu with the killer flu should read the books written during that period about what it was like. People were dying all over the place, sometimes within 24 hours of contracting the disease.
           

        • Agreed. Ditto for West Nile. Media made a huge to-do about it a few years back, but for the most part, the only people it ever claimed were the very young and very old: in other words, those that pnumonia probably would have gotten as well. It was usually in the web news or newspapers where the victims' ages would be listed, the TV and radio hardly ever mentioned the ages of the victims because they wanted to generate a stir, causing everyone to think, "wow, that could have been me!"

          Case in point: my sister
        • by surfdaddy (930829) on Sunday November 13, 2005 @09:39PM (#14023465)
          Go try to find the book: "A Dancing Matrix: How Science Confronts Emerging Viruses". I read this book in the mid 90's, and it described the already overdue flu pandemic. I guarantee that if you read this you won't take influenza so lightly again.

          The upshot is that flu undergoes cyclic major mutations about every 40 years. There are six mutations in the cycle. The last two major mutations were relatively benign (remember Hong Kong flu in the 70's?). The 1918 pandemic was quite lethal, and being a virus rather than a bacteria, influenza is not going to be quickly cured with antibiotics.

          The bird flu virus we see today is about 50% lethal, and has even killed a high percentage of otherwise healthy individuals. I for one find this a pretty frightening scenario, let's hope that when it mutates to an easily-propagatable-between-humans form that its lethality has declined substantially. Imaging the economic effects of a spreading flu that was lethal - people would quit going to work, you could see much commerce grinding to a halt. The CDC has said we should be preparing ourselves for seeing children die, etc., at a numbers that are pretty frightening.
          • Imaging the economic effects of a spreading flu that was lethal - people would quit going to work, you could see much commerce grinding to a halt.

            Then again it might induce a virtual society in which everyone works from home and interacts through only through the internet.

            Kind of depressing though... Oh wait...
    • by kenrick (888343) on Sunday November 13, 2005 @05:40PM (#14022306) Homepage

      Whilst this sort of thing has happened before saying it's definitely going to mutate is an overstatement.

      Hardly - influenza viruses display both antigenic shift and drift: they are gentically one of the more unstable family of viruses. It is inevitable that H5N1 will mutate. What is debatable is whether it will mutate to a form where it is more infectious to a human host, or maybe some other (e.g. porcine).

      Whilst sensationalist journalism is never good, it is important not to sideline flu - there will be a pandemic sometime in the near future, maybe not with H5N1, but we are 'due for one'.

    • by smallpaul (65919) <paul.prescod@net> on Sunday November 13, 2005 @05:53PM (#14022414)

      Did you RTFA? It says: "Scientists cannot predict which influenza strain will cause a pandemic or when the next one will break out. They can warn only that another is bound to come and that the conditions now seem ripe."

      Maybe the bird flu is "the big one". Maybe it isn't. Even if it isn't, we should use the opportunity of its media ubiquity to figure out what we will done when the next big flu does hit. When, not if (unless there is a surprising development in medicine!).

    • Greedy opportunists are trying to cash in, like the author of this story [sciscoop.com] that somehow got onto Sciscoop. At the bottom is a url to his website [avoidbirdflu.com], which is nothing more than a giant ad for some extremely over-priced PowerPoint presentations and a respirator.
    • I can't call myself an expert in the field, but I am definitely on my way there. And I can tell you that H5N1 is coming... and all we can do is prepare to manage the disaster whenever it comes.

      However, there are a few hope-instilling facts:

      1. Most bird-derived influenza strains that infect humans were more lethal when they were xenobiotic infections than when they were once they gained the capability to transmit human-to-human.

      2. We do have drugs (oseltamivir, amantadine and rimantidine) that can fight infl
    • Mad cow/scrappies/Chronic Wasting Disease-CWD/curu-CJD (all prions) is/are such that it takes years for it to show up, with no test for it. What many have missed here, is that it has been showing up in Colorado,Idaho and Montana in humans. [umn.edu]

      Keep in mind that CDC knew about AIDS in 1980/1981, and was trying to get money to slow it down. Reagan turned them down when they requested funding in 81,82,and 83. Keep in mind, that in 1981 when reagan turned down CDC request for 50 million to be spent on it, there w
  • Causing Panic (Score:5, Insightful)

    by AndyFewt (694753) * on Sunday November 13, 2005 @05:32PM (#14022246)
    Yep, this is definitely the way to keep the public feeling safe. Tell them something is definitely coming to kill 40 million or more, only 50% of people infected will survive and that there is no cure yet.

    I can see the same panic buying of the drugs that can help just like the panic buying of gas masks which happened when someone said that terrorists would use bio/chem weaps.
  • by Ctrl+Alt+De1337 (837964) on Sunday November 13, 2005 @05:34PM (#14022259) Homepage
    Here [sciam.com] is a one-page, ad-free version of the article. Seriously, when articles are formatted like this, submitters should use the "printer friendly" version of the article as the submission.
  • by Anonymous Coward on Sunday November 13, 2005 @05:34PM (#14022262)
    As I've been living in a cave with a sneezing chicken. Thanks for bringing it to my attention, Slashdot.
  • Discovery Channel (Score:5, Informative)

    by Dreoth (544253) on Sunday November 13, 2005 @05:35PM (#14022268)
    The Discovery Channel will be having a special on about this at 10:00pm EST, it was on last night and I believe it was nearly a 60% fatality rate. In Holland they had to slaughter nearly 30 million birds (mostly chickens) because the disease spread there. The most cases and deaths have been reported in Vietnam, 41 deaths out of the total of 62. You might want to watch this special, it even talks about how they found out the 1918 flu was originally a complete avian strain, much like how this new one is.
  • still waiting (Score:5, Insightful)

    by BushCheney08 (917605) on Sunday November 13, 2005 @05:36PM (#14022272)
    I'm still waiting for SARS to get me, cos that's what I was told was going to kill me before. And then there was West Nile Virus. And we can't forget those killer bees that'll be here any day now. Shouldn't we all be dead from ebola by now, too? Or how about monkey pox?
  • This Boston Globe [boston.com] article is interesting... it's essentially a summary of a new book by Mike Davis.

    It puts pandemics into their political and social context. The article says that if flu does develop into a planetwide scourge, it "will be a largely man-made disaster" caused by "overseas tourism, wetland destruction, a corporate 'Livestock Revolution,' and Third World urbanization.
  • Latest fad (Score:3, Insightful)

    by ch-chuck (9622) on Sunday November 13, 2005 @05:37PM (#14022282) Homepage
    Sounds like in "Things to Worry About", Asteroid Impact and Global Warming is OUT, and Flu Pandemic is IN. You have to know what the latest popular intellectual fashion is!

  • by Michael Ross (599789) on Sunday November 13, 2005 @05:39PM (#14022299) Homepage
    Here [pristineplanet.com] is an article on "Bird Flu's Environmental Components", for those interested in the ecological side of it.
  • concern? (Score:5, Interesting)

    by Rinisari (521266) on Sunday November 13, 2005 @05:39PM (#14022303) Homepage Journal
    One thing that bothers me about all this sudden talk of pandemics, how much cause for concern is there for the average American citizen? This flu strain is apparently more dangerous than SARS, yet it has recieved nowhere near the amount of press that SARS did, and SARS primarily affected the elderly and people with poor immune systems (there were exceptions, though, back off).

    In my case, I haven't been sick enough to need antibiotics in more than a year and a half. I'm a full time college student living in a thirty year old dorm in western Pennsylvania. I regularly have contact with over 1000 people on any given weekday. At any given moment, there is at least 5 people in my hall who are sick.

    Is this pandemic something that American college students at small schools should worry about? Obviously, there is a much higher chance at a university or much larger school (like Penn State with ~45,000 students from all over the world).
    • Re:concern? (Score:4, Insightful)

      by ctid (449118) on Sunday November 13, 2005 @05:50PM (#14022389) Homepage
      Is this pandemic something that American college students at small schools should worry about? Obviously, there is a much higher chance at a university or much larger school (like Penn State with ~45,000 students from all over the world).

      It's impossible to answer this because as yet there is no pandemic. All of these stories boil down to speculation that the earth is due another flu pandemic because: (a) they have happened several times before; and (b) we haven't had one for a long time. People are fixating on bird flu simply because it has made the jump from birds to humans. And of course it seems to be coming from the far east and that is where SARS seems to have originated. In broad terms, the press is lazy and uninformed - sickness stories that have far east angle have more currency at the moment, so you hear more about them.

      The seriousness of any pandemic will depend on how deadly the strain is and how readily it can jump from human to human. At the moment, H5N1 can't be transmitted from human to human. In order to be able to, it will have to mutate - what we don't know is how dangerous the mutation will be and how easily/quickly we can manufacture a vaccine. I would suggest that there is not much you can do about it, so don't worry too much. One thing that is fairly certain is that the healthier you are in general, the less vulnerable you are likely to be. Of course that's true of any illness, not just flu!

      • Re:concern? (Score:3, Insightful)

        by benjamindees (441808)
        One thing that is fairly certain is that the healthier you are in general, the less vulnerable you are likely to be. Of course that's true of any illness, not just flu!

        That is absolutely wrong. People who know will tell you that bird flu kills those with healthy immune systems far easier than those with weak immune systems.
      • Re:concern? (Score:3, Informative)

        by rkww (675767)
        The press may be lazy and uninformed, but the UK department of health has issued a number of guides and leaflets on pandemic influenza [dh.gov.uk]. These give hard information, for instance:

        "There are 16 haemagglutinin subtypes of Influenza A (designated 1-16), and 9 neuraminidase subtypes (1-9). While relatively few infect humans, all have been detected in free-flying birds which can harbour the viruses without their causing symptoms. Since 1959, rare, but serious, outbreaks of highly pathogenic avian influenza in p

      • Re:concern? (Score:3, Informative)

        by lbya (880645)
        I Am Not An Expert, but aren't there other reasons why people are fixating on H5N1, besides the quantity of human deaths so far (which certainly is a red herring). For instance:

        - It is spreading unusually widely among birds; which means a lot of birds with the virus inevitably coming in contact with humans and human DNA; which does create increased opportunities for either a genetic shift or random mutation in the virus that would make it human-to-human communicable.. at which point humans everywhere would
    • Re:concern? (Score:4, Interesting)

      by squoozer (730327) on Sunday November 13, 2005 @06:21PM (#14022587)

      I am sure that you realize this but it's worth saying (again) for those that don't. Anitbiotics won't directly anything to stop flu. Flu is a virus and therefore not harmed by anitbiotics which stop bacteria. Broad spectrum antibiotics are sometimes given to people that are very ill with a viral infection in order to combact secondary infections that come about due to the patient having a weakend immune system. As a general rule, however, taking antibiotics for a viral infection is just plain stupid. Worse though, it weakens the effectiveness of antibiotics for people that really do need them by introducing bacteria to the antibiotic and risking the development of a resistant strain. Many of our best antibiotics are losing their effectiveness due to over prescription by doctors who want to hand out what are essentially placebos to people with a cold.

    • Re:concern? (Score:3, Insightful)

      by hanwen (8589)
      In my case, I haven't been sick enough to need antibiotics in more than a year and a half.

      That merely highlights how much american doctors over-prescribe anti-biotics. A lot of disease is viral (meaning that antibiotics don't help), and your body can take care of most diseases by itself anyway

    • Re:concern? (Score:3, Insightful)

      by Malor (3658)
      I saw an interesting analysis by someone who purported to know what he was talking about.

      The way he put it was this: viruses don't evolve suddenly. They evolve over time. It won't abruptly be the mega-super-lethal virus from hell. It has to get there in stages. First it has to get into humans. Then it has to learn to move from human to human. Then it has to learn to do that WELL.

      It is, apparently, very unusual for a highly lethal virus to become widespread. This happened in WW1, but that was largely
  • Human Death Fetish (Score:5, Insightful)

    by Tim (686) <timr@a[ ]ni.wash ... u ['lum' in gap]> on Sunday November 13, 2005 @05:40PM (#14022307) Homepage
    "The reason H5N1 is being followed so closely is because it's already spread to people and because it's incredibly lethal (a roughly 50% fatality rate at th moment)." ...maybe.

    So far, fewer than 150 people worldwide have been infected with HN51. Many of those people were old and poor, and didn't have regular access to modern medical treatment. Estimating a human mortality rate from these cases is virtually impossible.

    It's one thing to say that a flu pandemic is inevitable. But then, so are earthquakes, volcano eruptions, giant asteroids, and the heat death of the universe....
    • by Hektor_Troy (262592) on Sunday November 13, 2005 @06:59PM (#14022792)
      Old and poor. Hrmm. Let's see.

      Poor people? 40% of the population in Africa (south of sahara) and southern Asia lives below the poverty line. (that's 1 dollar a day).

      Care to wager how many people that is in all? Hint - Asia has 4 billion people alone.

      What kind of impact would that have do you think? And people don't just die from the flu - if 50% of an area dies from a disease, who's going to clean up the area? In poor regions? That'll lead to massive outbreaks of other diseases, breakdown of all kinds of other stuff (like say - food production). That in turn will lead to even MORE people dying.

      Southern asia is probably one of the main providers of cheap labor for western companies ... but with a complete upheaval of their countries and entire region, who's going to worry about working for those companies? People will be one of a few things:
        * running for the hills (ie neighbouring countries)
        * giving up in dispair
        * trying to get their local areas self sufficient in food (as the ones that'd be bringing in stuff died)

      Running for the hills could easily lead to border skirmishes and full fledged wars, as could the need for resources that the neighbouring countries won't supply.

      Etc, etc, etc.

      Just cause it's only poor people doesn't mean it won't affect you or anyone else.
    • by justins (80659) on Sunday November 13, 2005 @07:47PM (#14023026) Homepage Journal
      Many of those people were old and poor, and didn't have regular access to modern medical treatment.

      Uh... no. Ones with access to modern medical treatment are the only ones accounted for in the WHO statistics. If they never made it to a hospital they won't be accounted for at all.
  • by Ari1413 (872981) on Sunday November 13, 2005 @05:40PM (#14022313)
    I keep seeing these 50+% mortality figures being thrown around, which seems slightly misleading to me. Imagine if 100 people get a disease. 30 might get it asymptomatically. 60 might get the disease to such an extent that they're "sick" (feeling flu-ish, missing work, etc). 10 might get it to the extent that they wind up in the hospital. If 5 of those 10 die, what's the mortality of the disease? It might seem like 50% to a doctor treating these patients, but the actual number would be 5 percent.

    Because we can only report mortality of cases which we actually see, health officials are already biased towards observing the most severe forms of the disease. With something like, say, HIV, or ebola, it might be safe to say that all reported cases = ALL cases. But with something like a strain of the flu, which people suffer to varying degrees, I'd guess there's some much larger number of cases that are simply never seen in hospitals.
  • Death rate -- 50%? (Score:4, Interesting)

    by jdludlow (316515) on Sunday November 13, 2005 @05:41PM (#14022317)
    50% of what? Of people who got sick enough to go to a doctor. Where do the people who never showed up at a hospital fit into this statistic?
  • by thogard (43403) on Sunday November 13, 2005 @05:42PM (#14022328) Homepage
    Right now the US pharmaceutical industry makes most of its money with drugs the reduce symptoms and doesn't cure anything. Right now the flu symptom fixing drugs is about a 10 billion dollar a year industry. The common cold industry has a number of of drugs that make you feel much better but you end up being more contagious for longer so you can spread your cold to even more coworkers.

    This is in sharp contrast to the pharmaceutical research done in other countries that are more interested in finding real cures.
    • This is in sharp contrast to the pharmaceutical research done in other countries that are more interested in finding real cures.


      OK, I'll bite. How about providing three examples of pharamaceutical research into cures being done in other countries for which there is no equivalent effort in the US?
      • by thogard (43403) on Sunday November 13, 2005 @07:03PM (#14022812) Homepage
        How about the budget for Viagra marketing budget being more than the entire R&D budget of the company that makes nearly all of the existing flu vaccines. Then there is the stomach ulcer research in the US that brought out billions of dollars every year in anti-acids while a few guys doing real research fond the culprit and that wiped billions off the ulcer business. Check the drugs that are given in the 3rd world where the doctors may have one chance to immunize a kid for everything for their entire life. Most of those drugs aren't made by the US drug industry even though it spends many times more than every one else. If you want to find your own examples, look at the annual report of the different companies.
  • by sane? (179855) on Sunday November 13, 2005 @05:43PM (#14022335)
    If you're not frightened by a flu pandemic, you haven't understood what it is or what it means. If the average case happens we could likely lose 150m worldwide, most probably from the wage earning, productive heart of each community. The speed and breadth of the disease will run it around the world in a matter of a few weeks with air travel and no medical system will have the chance to do much more than count the corpses. Governments are playing down the numbers, predicting from the basis of mild pandemics and allowing years to act.

    Its no exaggeration to say this is the most significant threat we have faced in decade - orders of magnitude more important than a few terrorists. Yet there still is a sleepwalking feel to people's reaction.

    So how are you prepared?

  • by dindi (78034) on Sunday November 13, 2005 @05:44PM (#14022348) Homepage
    Being somwhat affiliated with a few online pharmacies, I know, that Tamiflu (possibly a cure, or at least a good suport medicine to avoid getting any flu) has been withdrawn form public pharmacies and are stocked by the government.

    Why is that happening ?
    Is this flu propaganda for the drug companies, and fear mongerin ?

    These questions came up almost every day looking at searches for that medication, and many claim that this flue, when getting ins a country with decent medical practices/health services has a very small fatality rate. Most people get it in developing countries, and get it in agricultural professions (e.g. farmers being exposed to chickens)....

    Before you start trolling on online pharmacies, I never send spam, or sell dangerous meds such as hydrocodone, so don't bother. .....

    Anyway I am exposed to medication news because it became part of my revenue, and dunno what to think anymore about that flu panic....

    Most people I know say, that it is just a panic by the drug mob to boost sales, but the stocking of flu meds by governments send me a different message....

    • by keen (86192) on Sunday November 13, 2005 @09:01PM (#14023327)
      You raise some very interesting questions. Fortunately, I do not have to worry so much about the government restricting sales of Tamiflu, as I acquired a personal stockpile well over a year ago now. It does pay to be a geek and read the medical journals. Bird flu is quite a serious pathogen.. H5N1 may not be the exact strain which jumps the species barrier, but if we are to learn anything from history, there *will* be another pandemic. This is guaranteed unless of course you don't believe in evolution. Sadly, a Hegel quote comes to mind: "We learn from history that we learn nothing from history."

      I'm quite surprised at some of the posters here laughing about a flu pandemic. I know it's popular to go for the +5 Funny moderation, but the knee jerk reaction of a scaremongering media isn't always correct. It would be wise to recheck some of your basic assumptions. Many posters have expressed their lack of concern, believing that their "strong immune systems" will save them. This is precisely the problem with H5N1 - it turns your own immune system against you (re: cytokine storm).

      If you believe that the government program to stockpile Tamiflu will save you, think again. From what I have read, Bush plans to distribute supplies of vaccine and antiviral drugs to the elderly as a priority. I guess they must be a strong voting block. ;) Yet the flu disproportionately kills off young people thanks to our robust immune systems. So I feel it pays to have a personal supply for yourself and loved ones (hey, I really love all of you out there and would like it if we could have infinite Tamiflu but that just isn't possible) - current murine models (H. Yen et al. Virulence may determine the necessary duration and dosage of oseltamivir treatment for highly pathogenic A/Vietnam/1203/04 (H5N1) influenza virus in mice. Journal of Infectious Diseases DOI:10.1086/432008 (2005).) show that Tamiflu is most efficacious when taken for 10 days rather than 5.

      A few weeks ago I was visiting Canada, and had a chance to watch one of their national television interview shows. I forget the name but it was approximately "One to one" - where a (famous?) reporter interviews an expert on a currently hot topic in the news. The topic happened to be bird flu, and the expert interviewed was, IIRC, a top MD working at high levels of the government within the health care bureaus. Of course he was also really a PR guy and seemed famous also for giving 10,000 interviews a year. Anyways.. he said he personally had a supply of Tamiflu for himself and his family! When asked, "Is that because you are a medical professional and will be dealing with people who are sick and doing research on the virus... or because you think it is just common sense for anyone to do this to be careful?" - he replied, "A bit of both." Not the exact quotes of course and I am writing this while very tired... but if anyone wants me to dig out a transcript or the exact name and air date of the show I can easily do so. To make matters more interesting, the next day on the news I saw that Canada was totally restricting the sale of Tamiflu!

      Now before anyone jumps on me for being a totally insane, dogmatic, selfish troll - I agree the government has a huge role to play, and it is important that people who are really sick do manage to get Tamiflu. If everyone were to stockpile it beforehand, there would be quite a shortage. But... it is very nice to be forward thinking and preparing for these events on the individual basis. After all, what is best for the entire society during an outbreak might not be best for you individually. As for resistance - yes - please don't abuse the drug and take it unless it is certain that you have no other options. We are already beginning to lose the war with antibiotics as they have been so overprescribed, let's not do the same with our new antivirals.

      All in all - play it smart, educate yourself, and learn the true risks. I'm much more worried about influenza compared to terrorist attack. There is always the group that will follow the crowd in hysterics, and go overboard to protect themselves. But that doesn't mean they are *always* wrong. There is also the group which seeks to protect itself because it is the right course of action.
  • by JohnsonWax (195390) on Sunday November 13, 2005 @05:45PM (#14022349)
    Highly lethal viruses tend to not spread terribly far if they incubate quickly for the simple reason that those who are infected die before they can infect many others. This is one of the reasons why Ebola tends to be limited to individual communities - nobody lives long enough to get it to the next community.

    A 5% fatal virus will leave 95% of those infected to act as carriers - and because of the low fatality rate, some percentage of those won't realize that they're sick and will take it on planes, etc. without being diagnosed.
  • by TheSHAD0W (258774) on Sunday November 13, 2005 @05:50PM (#14022385) Homepage
    Please remember that this is 50% mortality among REPORTED cases. There may be plenty of people out there who get sick with mild or moderate symptoms and treat it like the regular flu, stay home, take lots of liquids, etc. The mortality rate is among people who are admitted to the hospital, and this is probably only people already showing severe symptoms.
  • by eric76 (679787) on Sunday November 13, 2005 @05:50PM (#14022386)
    The influenza virus in the 1957 influenza epidemic may have actually been considerably worse than that in the 1918 epidemic.

    What made a difference was the incredible advances in medicine between the epidemics.

    As for the avian influenza, there is little indication that the virus is being spread between humans and no indication that it spreads easily between humans. If and when the virus mutates and that becomes possible, the mutation may also change the severity of the resulting illness.

    Prepare for the worst and be thankful for the best.
    • The influenza virus in the 1957 influenza epidemic may have actually been considerably worse than that in the 1918 epidemic.

      This doesn't jibe with the little I know about the 1918 epidemic. The 1957 epidemic was more typical of flu epidemics in that it mostly killed the very young and the very old. The 1918 epidemic killed a lot of young adults in otherwise good health, in some cases in a matter of hours. Do you have some evidence behind your statement or is it just your opinion? I highly recommend The Gr

  • Factors in our favor (Score:5, Interesting)

    by StefanJ (88986) on Sunday November 13, 2005 @05:50PM (#14022388) Homepage Journal
    We all know that the news cycle runs on hype, and that there are always charlatans, snake-oil salesmen, and fear mongers waiting to pounce when danger threatens.

    However, immediately dismissing pandemic warnings is foolish. It makes sense to develop a vaccine and work on contingency plans.

    That said:

    There are a lot of differences between 1918 and 2005, and 1963 and 2005.
    Diabetes and obesity epidemic aside, people are a lot healthier:

    * Vitamin deficiences and plain malnutrition are rareities.

    * Lice, bedbugs, intestinal worms and such, while not unknown and on the rise in certain populations, are very, very rare on the whole.

    * The vast majority of people sleep in their own beds, in warm bedrooms.

    * Simple palliative medicines like aspirin, decongestants, anti-diarrheals, and re-hydration drinks can turn what in 1918 were deadly menaces into something merely serious.

    * Most people take hot soapy showers every day; soap and hot running water are available in restaurants and workplaces.

    A pandemic would certainly be bad news for people on the margins, especially the very poor, very old, and recent illegal immigrants crammed into shared housing. But on the whole, the factors listed above will work together to turn a life-threatening menace into something serious -- possibly temporarily debilitating -- but survivable for most people.

    Stefan

    P.S. Hey! You! Wash your goddamn hands after you use the bathroom and cover you mouth when you sneeze. Yeah, you!
    • by captainktainer (588167) <captainktainer AT yahoo DOT com> on Sunday November 13, 2005 @06:45PM (#14022716)
      Factors working against us:

      * As a whole, people do not get as sick as in previous generations. The constant fuss over cleanliness reduces the general health of the immune system because of its lack of exposure to many diseases.

      * Vitamin deficiencies are not as rare as one might think; while scurvy is no longer common, most people in the civilized world consume processed foods, which generally lack vital nutrients. As such, their body mass is maintained or expanded, but the gains made in nutritional science have not, as a whole, trickled down very far into the general population.

      * Palliative diseases are of little use against a virus that causes tissue death in the lungs, encephalitis, and destruction of tissue membranes due to necrosis and apoptosis. H5N1 appears to cause a broad-spectrum attack on the human body in ways that aren't helped by rehydration or salt balance.

      * The vast majority of people may live in their own bedrooms, but are more likely to congregate in large, relatively cramped areas for work, school (especially school!), and purchasing. The rise of mass transit means that especially in urban areas, people are crammed together for long periods of time sharing the same air. For instance, in Tokyo, one person could infect sixty to a hundred people on the ride to the Akihabara district with one sneeze. Same in New York on the A, 4/5/6, 1/2, or 7 lines.

      Furthermore, many more people live in apartments with central ventilation. One infectious person can thus infect dozens, even hundreds, of people with whom he has no direct contact.

      * International and cross-continental travel is much more common, leading to the possibility of faster spread. If the virus has a long presymptomatic infectious period, one overnight flight from China could lead to an infection that spreads through half of San Francisco and hopscotches to New York within a matter of days, catching public health authorities off guard.

      * A virus that spreads via aerosolized particles isn't as susceptible to sanitary conditions as many other diseases. It helps, but isn't as useful in preventative care as you suggest.
  • by steelfood (895457) on Sunday November 13, 2005 @05:54PM (#14022422)
    What really gets me is that even if there's some pandemic that could potentially wipe out half of the human race, at the same time, there's also a company that's charging $100 per dose for the treatment of the disease because they hold the patent to the medication or technique and they can milk it for all its worth.

    I wholeheartedly applaud governments that step in and invalidate such patents under these circumstances so that they can procure and administer the treatment to their people as they see fit. However, I still find it unfortunate that only the wealthier governments can do this (look at AIDS and Africa). The poorer governments still need to rely on complying with the treaties to the letter or risk becoming even poorer. Even then, not all governments, regardless of wealth, will do this.

    I am, of course, specifically talking about the good ol' US of A. When this killer flu arrives in the US, we all know the government isn't going to step in like some of the Asian governments. So what'll end up happening is that the poor and needy who have no health care are completely devastated because they can't afford the treatment or the insurance to pay for the treatment, while the wealthy survive unscathed because they can afford to. And that's really what's most sad--that the wealthiest nation in the world isn't charitable enough to care for its own people. Public welfare be damned, so long as the pharmaceuticals can make back their research money.

    As for those screaming that the patent holder will likely license the patent for making generics in such an event, I have two things to say:

    1) Licensing takes care of supply, but still doesn't address the cost issue for low-income, medically uninsured people.
    2) The way diseases can so quickly spread, by the time anyone recognizes the gravity of the situation, it'll be likely to be too little, too late. Again, supply will go up moderately, but demand will skyrocket.
    • by Otter (3800) on Sunday November 13, 2005 @07:10PM (#14022843) Journal
      Public welfare be damned, so long as the pharmaceuticals can make back their research money.

      As one of those researchers, I've got to ask -- given that Taiwan is already breaking the Tamiflu patent, what makes you think my bosses are insane enough to invest that research money when the product is going to be confiscated?

      Geniuses like you have already brought the development of new AIDS treatments to a near halt. Personally, I think this flu hysteria is nonsense anyway, but stopping the drug pipeline to grab the not-very-good drugs on the market right now seems counterproductive to me. Anyway, we'll go make our money elsewhere, and you'd better hope any future treatments can be produced out of Creative Commons drum 'n' bass tracks...

      • I see only two problems with moving research of this type into non-profit organizations (e.g. the government, since they're the ones funding the majority of research into obscure and rare diseases anyway, as no company would do it, since they can't make money on the treatments). The first is the usual inefficiency and waste associated with a lack of profit. But that is countered by the life-saving purpose of the research, which is more of a drive for the majority of the researchers than any monetary return.
      • what makes you think my bosses are insane enough to invest that research money when the product is going to be confiscated?

        When large numbers of people start dying, and your bosses face the possibility of contracting the disease and facing death themselves, I think you'll find that they'll suddenly develop a motivation to invest research money into cures.
      • Okay, fine. How about pharmaceutical companies that benefit from government funded research (at Universities, etc.) start paying for the value they get from that?
  • by 0xC0FFEE (763100) on Sunday November 13, 2005 @05:56PM (#14022434)
    I had a little bird,
    Its name was Enza.
    I opened the window
    And in-flu-enza.

    Stolen from: http://www.stanford.edu/group/virus/uda/ [stanford.edu]

  • by Gothmolly (148874) on Sunday November 13, 2005 @06:13PM (#14022534)
    From wikipedia:

            * 1918-20 - Spanish Flu, 500 million ill, 50 to 100 million died (pandemic)
            * 1957-58 - Asian Flu, 1 to 1.5 million died (epidemic)
            * 1969-69 - Hong Kong Flu, 3/4 to 1 million died (epidemic)

    If you do the math, its almost a purely exponential decay. Why? Either random,mutant flus are getting weaker, or medicing is getting better. Yes, its a tragedy when people die from this. Yes, its a tragedy, most of all, if I die from this. Will it sweep the planet, leaving Randall Flagg owning the world? No.
    (Yes, I know the 2 later flus were not pandemics, but the point illustrates medicine's ability to react to the virus)
  • by alpha1125 (54938) on Sunday November 13, 2005 @06:32PM (#14022651)
    Before people jump on my back saying I'm an evil heartless person... I'm just putting things in to perspective. I don't want a pandemic to break out, but I'm just looking at this with an objective eye.

    I'm assuming that 'twice as deadly', as meaning killing twice the number of people.

    Yes, the new flu virus may will kill twice as many people as the 1918 pandemic did, however our population has more than tripled since the beginning of last century.

    Lets say that the numbers are true. 40 million people died in the 1918, with a world population of, say, 2 billion people. This would mean that there was a 2% death rate.

    Now, say in 2005, 80 million people die, with a world population of say 6.45 billion [wikipedia.org]. The death rate would be 1.2% of the total world population.

    That's 0.8% lower, than it was in the past. Actual numbers will most likely be less, with better technology, better sanitation in many parts of the world, and an understanding of genetics.

    The numbers are here to scare people, and sell headlines.
    • Even at 1% it looks like someone you know will die from it if not yourself.
    • They are saying a possible death rate of 5% (assuming it drops from the current 50%), so that'd be 320M dead, not 80M.

      But in fact if you read the article they're suggesting that only 25% of the population would become ill, so it's only 5% of that. In the US that's be 5% x 25% x 250M = 3.1M dead.

      To get a handle on that number, consider the 100 largest cities in the US all EACH having not one but ten 9-11 type disasters.. 100 * 10 * 3000 = 3M.
  • by sanermind (512885) on Sunday November 13, 2005 @08:27PM (#14023181)
    Ah chicken little... so convinient to completely ignore obvious scientific demonstration that it's fatality is FAR less in the actuality.
    Some experts like Peter Palese of the Mount Sinai School of Medicine in New York said the H5N1 viruses are a false alarm. He notes that studies of serum collected in 1992 from people in rural China indicated that millions there had antibodies to the H5N1 strain. That means they had been infected with an H5N1 bird virus and recovered, apparently without incident.
    ...From this article on the international herald tribune. [iht.com]
  • Amantadine (Score:5, Interesting)

    by Ranger (1783) on Sunday November 13, 2005 @11:02PM (#14023812) Homepage
    I remember back in the 90's taking some Amantadine [wikipedia.org] to help fight the flu. And I wondered why the news keeps going on and on about Tamiflu. So I did a quick check and yes Amantadine is an antiviral drug, but thanks to the fucking Chinese they have made it useless to fight H5N1 [washingtonpost.com] because they'd been abusing it the way our ranchers abuse antibiotics. Amantadine costs a lot less but it doesn't matter. Now we have to use the much more expensive Tamiflu.

    It gets better. One of the primary ingredients for making Tamiflu [wikipedia.org] is something called Shikimic acid which is difficult to produce and is extracted from star anise that is only grown in four provinces in China. And their is a global shortage of star anise so that's why their's a global shortage of Tamiflu. Anyway it probably won't matter since H5N1 will probably develop a resistance to Tamiflu because of overuse. Anyway, we'll just have to wait and how the next pandemic evolves.
  • by btg (99991) on Monday November 14, 2005 @02:27AM (#14024329)
    There is a lot of speculation in this thread, and very little of it seems to be from public health practitioners. Every major health organisation in the world has actually thought about this problem, so you could go and google their FAQs and advice pages if you want, but let me summarise.

    1. H5N1 is not a pandemic virus. The scary thing is a mutation of H5N1. Forget about the statistical wrangling over 50%. The morbidity (deatharifficness) of the human cases is based on small numbers, and a human-to-human strain could have different characteristics in any case. Just accept that the current concern is real and that random computer programmers do not "know better".

    2. PLEASE don't try and buy up Tamiflu. You don't know what to do with it, you don't know how to diagnose flu properly and it's needed elsewhere. If you think you, or someone else has something which you think should be treated with Tamiflu GET TO A FRICKING HOSPITAL. If it's the correct treatment they will have it.

    3. IMPORTANT: If you are "at risk" of initial infection of H5N1 (professional chicken-kisser etc etc) or you are a high-risk flu group (old, asthma, child etc) then GET A FLU JAB for seasonal influenza.

    Note: This will not do anything to stop you getting H5N1 (sorry), although it may (unproven) help you survive. The idea is that if you don't get "normal" flu in the first place then there is less chance of you getting H5N1 _at the same time_, which could result in in-cell reassortment (genetic mutation) of the virus. In other words, H5N1 could cross with whatever flu you got to make a new flu. That could then result in you being patient zero for the killer-flu we're all scared of. (which would suck)

    4. If you want to be ultra-paranoid, you could postpone non-essential travel to, eg, SE Asia or put off your "All Eastern Europe Cockfighting" tour. Your call.

    5. Frankly, for the majority here I doubt that there is anything in particular you should be doing differently right now. BUT just keep a weather eye on the news - if ever the pandemic hits then these recommendations will instantly be out the window and people will be talking about masks, quarantine and emergency plans.

    The sky is NOT currently falling. It is fair odds that unless you happen to indulge in "the love that dare not speak its name" with poultry or enjoy fresh duck's blood soup then there's not much you can do - the sky will fall or it won't. However, the reason health agencies are making a lot of noise is that _were_ the sky to fall, right now, global preparedness is not as good as it could be.

    Thanks.

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