A Flu Pandemic? 830
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."
It's Captain Tripps! (Score:4, Funny)
Re:It's Captain Tripps! (Score:5, Funny)
Re:It's Captain Tripps! (Score:2, Funny)
Offtopic?!? Hey Mods, B-O-O-K that spells book! (Score:4, Interesting)
Re:Offtopic?!? Hey Mods, B-O-O-K that spells book! (Score:3, Informative)
Yeah, but if they saw the shit movie first I can understand why they wouldn't want to read the book.
Re:Offtopic?!? Hey Mods, B-O-O-K that spells book! (Score:5, Insightful)
Being literate does not assume that one only reads great works. It is just as important to be aware of highly influential works, and as the most eminent horror -and possibly the most popular American - writer of the late-twentieth century, it is important for a literate individual to be aware of King's major works simply so that one is able to comprehend King's influence on other writers, as well as the influence other writers have had on King.
That said, not all of Steven King's books are long-winded, profane, oversexed retellings of campfire stories. Books like Carrie, The Shining, and probably a few other King novels will long be remembered as American classics, and as for all of the crappy books, well, nobody was forced to buy them.
Don't worry (Score:3, Funny)
And do it with a vacant stare, and a line of drool hanging from his chin, and a good 30% of his brain phased into some other reality.
Sensationalist Journalism? (Score:5, Insightful)
Re:Sensationalist Journalism? (Score:5, Insightful)
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.
There's is a reason (Score:5, Insightful)
- 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.
Re:There's is a reason (Score:5, Interesting)
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.
Re:There's is a reason (Score:4, Informative)
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.
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).
Seriously : you *can* eat chicken meat. (Score:4, Interesting)
Unlike the mad cow disease (which is caused by [very rare] self-replicating proteins, not virii),
the flu virus (like other chicken disease, lysteria, and so one) doesn't survive cooking.
So if cook your chicken soup well, or roast correctly your roasted chicken, you're safe, at least from virii and bacteria.
Re:There's is a reason (Score:3, Insightful)
Everyone in the media thought it would be HUGE and nasty, when in fact it was rather mild because of decent controls and quarantines.
The bad thing about the flu though, is that most people are used to it. (I haven't gotten a flu shot since I was a wee lad because it is just the flu, it won't kill you) So they won't react with ugency when reporting symptoms.
Re:Sensationalist Journalism? (Score:3, Insightful)
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
Comment removed (Score:5, Informative)
Re:Sensationalist Journalism? (Score:5, Interesting)
Why is this modded as 'insightful'?? (Score:5, Informative)
Re:Sensationalist Journalism? (Score:3, Insightful)
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
Re:Sensationalist Journalism? (Score:5, Informative)
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.
Re:Sensationalist Journalism? (Score:3, Funny)
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...
Re:Sensationalist Journalism? (Score:5, Insightful)
Also, life has a 100% fatality rate.
Re:Sensationalist Journalism? (Score:5, Insightful)
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'.
Re:Sensationalist Journalism? (Score:5, Funny)
THIS MESSAGE BROUGHT TO YOU BY THE KANSAS EDUCATION SYSTEM
Re:Sensationalist Journalism? (Score:5, Insightful)
Some may look back and say "the odds of going THIS LONG without a hit are incredibly low" which is true, but you are factoring known events that have already happened into your odds, and that's just wrong. If it has already happened (or not happened) then the odds of that past outcome are 100% since we know what occurred. So those results don't have any effect on the odds of something happening tomorrow.
So we are no more "due" for a major outbreak this year than we were last year. OVERdue maybe, but not due.
Re:Sensationalist Journalism? (Score:5, Insightful)
If you're talking about a slot machine then, yes, you have the same odds every time. If you're talking about an event that, by its occurence, affects the odds of its recurrence within a period of time, then talking about being "due" is entirely appropriate. All evidence indicates that flu outbreaks are such events.
It's like looking at the weight on a pressure cooker. If steam hasn't come out in a while, you can say that it's "due" to come out soon.
You can argue that pandemics don't *have* to occur, but until we can go at least a few generations without having one, I'd say you'd be wrong.
Re:Sensationalist Journalism? (Score:3, Insightful)
One reason for cyclical epidemics is that new generations are not immune from the last time. Once the number of immune individuals drops below a certain amount then an epidemic can proceed. This is the reason why not everyone has to be immunised against measles to stop an epidemic.
Re:Sensationalist Journalism? (Score:3, Informative)
It was actually smallpox [www.hon.ch].
Whenever a large population of non-immunes exists, epidemics happen. [maa.org]
The model does not aim to predict the emergence of new strains of influenza, but it does suggest that a short-lived general immunity to the virus might affect the virus's evolution. [hhmi.org]
The model takes into account the effects of specific immunization against viral strains, but also infectivity randomness and the presence of a short lived strai [iop.org]
Re:Sensationalist Journalism? (Score:5, Insightful)
Mutation of the flu virus into something seriously dangerous, like the 1918 variety, certainly qualifies as a Poisson process [wolfram.com]. The time between events in the Poisson distribution [wolfram.com] follows an Exponential distribution [wolfram.com]. The exponential distribution is "memoryless" [wolfram.com], that is, the probability that an event will occur in the first n years of a time interval is the same as the probability that, after any number of years in which an event has not occured, an event will occur in the next n years.
Shortly, the fact that we haven't had a flu epidemic recently has absolutely no bearing on whether or not one is coming soon. Even more shortly, we are not 'due for one'. This is known as the gambler's fallacy.
Re:Sensationalist Journalism? (Score:5, Insightful)
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!).
Re:Sensationalist Journalism? (Score:3, Informative)
Re:Sensationalist Journalism? (Score:3, Interesting)
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
Re:Sensationalist Journalism? (Score:3, Interesting)
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
Re:Sensationalist Journalism? (Score:5, Funny)
Ummm...Not gonna comment on that one... : p
Re:Sensationalist Journalism? (Score:3, Informative)
Re:Sensationalist Journalism? (Score:4, Informative)
Tsk, Tsk. You really must learn to pay attention to the medical literature.
Source: The Writing Committee of the World Health Organization (WHO) Consultation
on Human Influenza A/H5 "Avian Influenza A (H5N1) Infection in Humans" The New England Journal of Medicine 353:1374-1385 You can probably find it online here [nejm.org]
Causing Panic (Score:5, Insightful)
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.
Re:Causing Panic (Score:5, Funny)
Boy Crosses Road Unharmed
Apartment Building Completed On Time And On Budget
A Man Loves His Wife And Tells Her Of That Fact
Ice Cream Is Enjoyed By Many
Zero Asteroids Hit Earth
I hope that makes you feel better about humanity.
Re:Causing Panic (Score:3, Insightful)
There are many valid reasons to be worried about H5N1, but at le
Re:Legitimate concern? (Score:4, Interesting)
I was in the hospital last week for routine blood tests, chatting with my favorite nurse, and she was telling me about all the new plans they have in place for dealing with the coming pandemic. The top health authorities in each country have reviewed the actual hard data on what is coming, and getting ready for various worse case scenarios. They just aren't certain which winter it will hit, probably not this year, but almost certainly one of the next three winters.
The hospital had just reviewed and practiced for a "plan blanc" (white plan) of being overwhelmed with large numbers of highly contagious patients. The plan blanc was mostly aimed at preventing infection of the hospital staff, and how to isolate the sick and keep visitors from circulating and possibly spreading the disease. Next week they are reviewing their "plan noir", to deal with huge numbers of dead, and the disposal of highly contagious bodies and medical waste. The hospital never really had a plan noir tested before, what once was a short couple pages of suggestions is now a whole large book. In my town of 40k population, the hospital was looking for a place to store up to 1000 bodies, with 200-400 deaths per week over a 10 week period, and only being able to dispose of 100 per week. Scary shit, indeed.
The town authorities are preparing for a 50% worst case mortality rate, with all the subsequent recovery problems; no more younger school age children for years, half of the tax revenue generating population dead, food shortages if the borders are closed, longterm drop in tourism, local exports blockaded, and no financial aid from any direction because the devastation may be all around Europe.
All the hospitals in the Benelux, France and Germany are preparing for the worst, and its not in response to some poorly written articles in the mainstream press. They have the experts looking at the data and are getting very, very nervous.
I just got my flu shots, something I've never felt the need before.
the AC
Re:Legitimate concern? (Score:3, Insightful)
Someone asked for a couple of worst-case scenarios, and an "expert" provided them. They handed it to the people who would be first affected. It's an alarming read, as most worst-case scenarios are. So far, what you're telling me is facts about the panic, not about the disease.
The fact that the administrators of a town of 40,0
Re:Legitimate concern? (Score:3, Interesting)
Preparation (Score:3, Informative)
This means that everybody who comes into contact with birds currently needs to be very vigilent about the health of the birds they come into contact with. The Chinese for example are culling all birds in an area where an outbreak occurs in order to reduce the likelyhood of it spreading. This is working fairly well as it is not clear whether transmission is occuring through the wild bird
8 click-through pages?! (Score:5, Informative)
A haven't heard anything about this! (Score:3, Funny)
Discovery Channel (Score:5, Informative)
Re:Discovery Channel (Score:3, Insightful)
Re:Discovery Channel (Score:3, Interesting)
This means an immune system over-response which destroys various membranes in your body, like your lungs, or spinal cord.
Healthier people get hit harder.
still waiting (Score:5, Insightful)
Re: (Score:2)
"Politics of pandemics" (Score:2)
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)
Bird Flu's Environmental Components (Score:3, Informative)
concern? (Score:5, Interesting)
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)
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)
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)
"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)
- 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)
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)
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)
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
Don't forget Africa (seems everyone has) (Score:4, Informative)
24.5 million of them in sub-Saharan Africa.
Nearly 19 million have died from AIDS, 3.8 million of them children under the age 15.
5.4 million new AIDS cases in 1999, 4 million of them in Africa.
2.8 million died of AIDS IN 1999, 2.4 million of them in Africa.
13.2 million children orphaned by AIDS, 12.1 million of them in sub-Saharan Africa.
Reduced life expectancy in sub-Saharan Africa from 59yrs to 45yrs between 2005 and 2010, and in Zimbabwe from 61yrs to 33yrs.
More than 500,000 babies infected in 1999 by their mothers most of them in sub-Saharan Africa.
Human Death Fetish (Score:5, Insightful)
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....
Re:Human Death Fetish (Score:4, Insightful)
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
* 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.
Re:Human Death Fetish (Score:5, Interesting)
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.
About those numbers... (Score:5, Insightful)
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)
it would change the pharmaceutical industry (Score:3, Insightful)
This is in sharp contrast to the pharmaceutical research done in other countries that are more interested in finding real cures.
Re:it would change the pharmaceutical industry (Score:3, Insightful)
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?
Re:it would change the pharmaceutical industry (Score:5, Insightful)
Are you paying attention? (Score:4, Insightful)
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?
So why is Tamiflu withdrawn from customers? (Score:5, Interesting)
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....
Re:So why is Tamiflu withdrawn from customers? (Score:5, Insightful)
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.
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.
Highly lethal viruses (Score:5, Insightful)
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.
50% may be wayyyy too high (Score:5, Insightful)
The 1957 influenza epidemic (Score:5, Insightful)
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.
Re:The 1957 influenza epidemic (Score:3, Informative)
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)
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!
Re:Factors in our favor (Score:5, Insightful)
* 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.
It'll be a sad state of affairs when this happens. (Score:4, Insightful)
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.
Re:It'll be a sad state of affairs when this happe (Score:4, Insightful)
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...
Re:It'll be a sad state of affairs when this happe (Score:3, Interesting)
Re:It'll be a sad state of affairs when this happe (Score:3, Interesting)
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.
Re:It'll be a sad state of affairs when this happe (Score:3, Interesting)
Little bird, little bird (Score:4, Funny)
Its name was Enza.
I opened the window
And in-flu-enza.
Stolen from: http://www.stanford.edu/group/virus/uda/ [stanford.edu]
look at past pandemics though (Score:3, Informative)
* 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)
Yes twice as deadly... but... perspective (Score:4, Interesting)
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.
Re:Yes twice as deadly... but... perspective (Score:3, Insightful)
Re:Yes twice as deadly... but... perspective (Score:3, Informative)
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.
%50 fatal is a complete lie (Score:5, Informative)
Amantadine (Score:5, Interesting)
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.
Flu Pandemic - What To Do (no, really) (Score:4, Insightful)
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.
Re:Pandemic (Score:4, Informative)
A string immune system is not garuntee that you will survive. The 1918 flu killed a lot of healthy people.
The flu was most deadly for people ages 20 to 40. This pattern of morbidity was unusual for influenza which is usually a killer of the elderly and young children.
http://www.stanford.edu/group/virus/uda/ [stanford.edu]
The 1918 virus sometimes killed completely healthy people in killed overnight.
"Some people would go to bed healthy and never wake up."
http://www.cbc.ca/news/background/flu/fluepidemic
This was one of the flus that worked so fast the immune system couldn't keep up.
Re:Pandemic (Score:5, Informative)
Start worrying. Many of the deaths from the 1918 pandemic and from H5N1 have been related to a "cytokine storm [msn.com]," resulting in an overly vigorous immune response. The typical "healthy young adult" is very much at risk.
Re:Pandemic (Score:5, Funny)
In 1918, the young and healthy were dead by night (Score:5, Informative)
The problem? An immune system has to be _reactive_. Your immune system has to develop sensitivity to the new virus and that takes some time. The usual flu strain isn't a problem since it's very similar to the strains we've already seen (in infection or innoculation) and our immune system can quickly respond. There's also a lot of natural selection going on over time -- a virus would rather see us miserable and contagious for a week than dead and non-contagious within a day.
But we have no natural immunity to an entirely new strain, and some can kill before our immune system can develop an effective response.
That's why older people faired better in 1918. They hadn't seen the same strain, but they had seen enough variety that they had a stronger initial response than their younger peers.
Re:In 1918, the young and healthy were dead by nig (Score:5, Informative)
But not too reactive. The suggestion has been made that the problem isn't that our immune systems don't react to H5N1, it's that it reacts too vigorously, as per, for example, this article, Bird Flu Triggers Immune System 'Storm' [www.hon.ch].
Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota School of Public Health is quoted in that article as saying that this might be why the young and healthy get stricken more severely (presumably he's referring to H5N1, but perhaps that happened with the 1918 flu as well):
Re:Pandemic (Score:4, Informative)
Actually, this is to your disadvantage, as a strong immune system is probably what is going to kill you. Your immune system could trigger a Cytokine Storm which will basically dissolve your lungs through severe inflammation.
Re:Surely high lethality makes for SLOWER contagio (Score:3, Informative)
Re:I've been polled twice about the flu (Score:4, Informative)
Polio is a particularly good example because it's been flaring up again in isolated areas on a regular basis due to lack of political will - for instance in Kano province in Nigeria in 2003 after muslim leaders caused the immunisation programs to be suspended over paranoia that Western nations used the polio vaccines to distribute drugs to reduce fertility and spread HIV... Yes, you read that right.
As of this year Polio is still endemic (exists in the wild) in at least 5 countries. The other countries with significant Polio outbreaks have all been cases of it being imported from elsewhere.
The good news is that the Polio vaccine programs in Nigeria were reinstated, though despite that Nigeria alone have had about a third of all Polio outbreaks this year.