OP/ED: All About The Next Deadly Flu Pandemic.

We are bombarded by dire warnings of impending threats.They fall into two main catagories.The first is the natural disaster. We are warned that statistically we are overdue to have another Yellowstone eruption, Ice Age, or giant Asteroid impact. The second is a manmade terrorist threat. Sarin, Anthrax, Smallpox, Plague, any or all in danger of being imminently spread by Islamic extremists.

The threat I'm going to dedicate this Op/Ed to has an omninous track record having killed up to 50 million people worldwide in the last century alone. I'm going to talk about influenza (flu), specifically H5N1. The World Health Organisation has now advised governments that they should now consider stockpiling vaccines in preparation of another global pandemic, this new advice is the opposite of the traditional advice of wait and see and some countries already have including the U.S.A, France, and Italy but don't think you're safe just because your country is buying vaccine as you'll find out by reading this there won't be enough to go around and it's doubtful it will work anyway.

Why Call It H5N1 ?

Let's start at the beginning and look at influenza itself. Influenza is a virus. There are three types of Influenza known as Type A, Type B, and Type C, of the three only Type A is of real deadly concern.

The Type A virus can be classified into further subtypes by two proteins that appear on the surface of the viral particles. The two proteins are Haeagglutinin and Neuramidase. There are 15 varieties of Haeagglutinin and 9 varieties of Neuramidase meaning that there are 135 possible combinations of the two proteins, and therefore of Type A influenza. The worrying and deadly variety of avian flu now circulating in Asia is classified as H5N1.

Pandemics occur at irregular intervals, ranging from between 11 and 42 years. The last pandemic was atleast 35 years ago.

Pandemics Of The Last Century

1918-19

Known as Spanish flu, it was classified H1N1. More died in the pandemic than in World War One. Estimates range between 20 and 40 million worldwide. In the UK almost 200,000 died, 50% healthy young adults. For many the disease killed within just a few days.

1957-58

Asian flu, classified as H2N2. Is thought to have killed around one million worldwide. The virus spread from China to Europe and the US. In the UK 30,000 died.

1968-69

Known as Hong Kong flu, classified as H3N2. Again is thought to have killed around one million worldwide, the elderly being most susceptable. 78,000 died in the UK.

How Does H5N1 Compare ?

In the US in 2002 and 2003 there were 2 recorded cases of H7N2 there were no deaths indicating that this variety of Type A influenza is quite benign.

In the Netherlands in 2003 there were 89 recorded cases of H7N7 and one recorded death.

H5N1 is in a different league.In Hong Kong in 1997 18 people were infected, 6 of whom died. In Vietnam and Thailand in 2004 there were 45 cases of which 33 died, so far in 2005 there have been 9 recorded cases in Vietnam and Thailand and 8 deaths.

Luckily, all of these cases appear to have been passed from birds to humans. It does not appear to have yet mutated into a new strain of human flu.

The big pandemics always occur when the deadly avian flu combines with the highly infectious human flu.


The problem with flu vaccines

There are problems which would mean that you vaccines might not be as effective as you might think.

1/ As has been noted above there are 135 combinations of Type A Influenza and a vaccine for one combination will not necessarily work for another. The current deadly strain is called H5N1 but what is known as an antigenic shift always occurs before a major pandemic when the avian flu combines with the human flu. It is no good stockpiling vaccine for H5N1 because when the pandemic occurs, as it surely will, it almost certainly won't be H5N1.

2/ For an Influenza vaccine to be effective a person normally needs 2 vaccinations before they are immune.

Because of this there are two approaches now being taken by governments in the light of the World Health Organisations latest advise. Some governments are stockpiling a generic H5 vaccination which would act as a primer while the exact vaccine is being produced once the pandemic has started. This idea that an H5 vaccine would work as a primer is untested and it may simply not work at all.

The U.S.A have ordered 4 million doses, France and Italy have ordered 2 million doses each. Make absolutely no mistake about this, not everyone will get a vaccine and this option is only for the wealthy nations.

The UK and many other nations are following the traditional approach of producing vaccine only when the pandemic strain has become apparent and identified. This plan is being now re-evaluated and may change.

Some will also remember that Chiron, one of the leading flu vaccine manufacturers, based in Liverpool can't start production until their contamination problems have been solved.

The latest data published by British scientist suggest that there could be far, far more cases of deaths due to this strain of flu than had been previously thought and that some victims might show symptoms closer to meningitis than typical flu.

That an influenza pandemic is imminent is not in doubt. Not only is it statistically due but governments are already spending good money on precautions. Consider also how much international travel has developed since the previous pandemics and ask yourself how much time would it take to spread, how much time between you first hearing about it and it being in your neighbourhood ??

[edit on 24-2-2005 by John bull 1]

Great synopsis John bull.

By all accounts, it will be difficult to deal with this plague. Here are a few old threads that addressed the issue last fall.


Flu Vaccine Technology: Who's Blocking its Use?

Bush Pushes Wrong Flu Vaccine to American People

WHO Plans Flu Pandemic Summit

Russian Expert Fears Flu Epidemic May Kill Over A Billion People This Year

Threat Analysis: Genetically Engineered Stealth Bio-weapons



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Ok just by looking at your timeline there of the last Pandemics you should really not be worrying about anything. For instance the second pandemic occured after commercial air travel had been started yet there were slightly less deaths. Then the third there were a fraction of the deaths and this was like right at the beginning of the Vietnam war. Fast forward to today where communications technology makes it possible to immediatley report any suspected cases to proper Authorities where suspected individuals can be isolated and treated. You know I could have sworn weve been talking aobut this for years now, I don't really feel like anything is going to happen. The warm weather is already coming back here in the south so I dont think there is anything to fear.

Originally posted by DYepes
Ok just by looking at your timeline there of the last Pandemics you should really not be worrying about anything. ... Fast forward to today where communications technology makes it possible to immediatley report any suspected cases to proper Authorities where suspected individuals can be isolated and treated. You know I could have sworn weve been talking aobut this for years now, I don't really feel like anything is going to happen.

It's not about commercial air travel at all - birds carry this flu and they get around just fine without planes. ...The real danger is in the genetic structure and molecular form of the H5N1 strain - and it jumps species too.

Scientists have been warning about it for years - and it is coming. Sooner or later.


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Of note, a new strain was classified in California and the article is found below. Note: this years flue shot does not cover this new strain and from my personal experience transporting kids its a nasty one.

According to Norma Arceo at the California Department of Health Services, next year's flu vaccine may protect against a new strain of flu found in Santa Clara County this year. "A/California" is much like the Asian A/Fujian that currently makes people cough, sneeze and ache across the state.
www.theunion.com...

Its also interesting to note that according to a recent UN estimate 50% of the worlds populations will live in cities in 2 years. Alot of those cities will be in the third world and you can bet any epidemic will catch like wildfire in those areas let alone ones with a modern healthcare system in place.

BBC: Bird flu 'has pandemic potential'

We could have a relatively severe pandemic as occurred in 1918 or perhaps even worse.

Although H5N1 has only killed 42 people so far in comparison, its death to infection rate is 76%.

And it could be spread quickly by birds (flying all over the place as noted by soficrow) or via airports.
NEWS: Plane Passengers In Bird Flu Scare

I think it's a good thing that diseases are evolving and mutating. They continue to challenge the human immune system in new ways, and as Flaw says, "Only the Strong Survive."

If the bacteria and viruses around us stopped evolving for a period of time, our immune system would become complacent and incapable of stopping future attacks. The giant fad of antibacterial everything is having real consequences, unfortunately most people are too shortsighted to see.

I grew up around farm animals most of my childhood, and like others with similar upbringings I have an extraordinary immune system. I get sick once every couple of years, usually for a week or so, and then I get better. I don't take pills or medications of any kind, I don't use antibiotics and never get infections. I spend nothing on health care, and am healthier than the pill junkies I converse with every day. Obviously there is a trick being played on us.

Children who grow up in cities and subdivisions are at a high risk for asthma, food alergies, and various debilitating immune system disorders. When you were growing up, playing in the dirt, and your mother said, "Stop that, that's dirty, you'll get sick", if only you had this knoweldge then ya'know? It appears that with all our advances, we are still at the whim of nature. I like it that way. If all the diseases went away, that would be one less evolutionary advantage I have over the rest of the 'civilized world.'

John bull 1,

I think it's also important to mention that H5N1 creates problems with regard to vaccine production. It can't be grown in egg (It kills them), which flu vaccine is traditionally grown in. They have to use a new method, a reverse genetics process where genes from different viruses are cloned and reassembled into an inactivated vaccine virus

Very good posts on this subject I too have read quite a bit on this subject and find it facinating to say the least. Does anyone think their would be quarintene of large or small areas if this thing gets started ? Does anyone know how diet and hygene come in to play as a contributory factor for the 1918 flu compared to one that might take hold today.

I've been wondering about those government administered flu vaccines for a while now.

All of you have made great posts, it looks like a lot of research has gone into them, so I have been hesitant to post my own concern, which is probably (hopefully) unfounded.

I have heard on the news (not lately though), and more so on the Internet stories such as the fact that aids could have been caused by the government's experimentations on developing a vaccine for Hepatitis A (or maybe B), but the vaccine wasn't quite right, and is a theory as to how the aids virus possibly developed.

I have also heard on the news, but also read on the Internet, mostly from threads stemming from ATS, www.abovetopsecret.com/forum/viewthread.php?tid=21676 and www.abovetopsecret.com/forum/thread6954/pg1
just to name a couple, that perhaps not all of the vaccines given by the government are exactly what they say they are.

Remember, this is just a theory of mine, I have no proof, but am hesitant anyway to accept any sort of vaccine from them.

I suppose that this sounds really far fetched, but, what about the flu shots earlier this year becomming contaminated, so that only the very young, very weak and very elderly could take them.

What if they were trying to weed out the weakest, and keep only the strongest?

I doubt it, but apparently not enough to see if anyone else thinks so, too, or if I can be reassured that we aren't really up against anything like that. At least not at the present time.

The current deadly strain is called H5N1 but what is known as an antigenic shift always occurs before a major pandemic when the avian flu combines with the human flu. It is no good stockpiling vaccine for H5N1 because when the pandemic occurs, as it surely will, it almost certainly won't be H5N1.

Interesting that Soficrow glossed over this important detail last fall when he accused the Bush administration of deliberately witholding a vaccine from the American public.

JohnBull1, thanks for the excellent op/ed. It's always good to read opinions AND learn something new.
And, sofi and others, thanks for including linke to previous threads and other links.

A question: at the end of the day, will the flu shot help IF it is for the right strain? Would those healthy young people in Britain have all lived if the proper vaccine was available?
Can you survive a flu like this without vaccine?

Originally posted by MrOtis

The current deadly strain is called H5N1 but what is known as an antigenic shift always occurs before a major pandemic when the avian flu combines with the human flu. It is no good stockpiling vaccine for H5N1 because when the pandemic occurs, as it surely will, it almost certainly won't be H5N1.

Interesting that Soficrow glossed over this important detail last fall when he accused the Bush administration of deliberately witholding a vaccine from the American public.

H5N1 is the strain predicted to go pandemic - and was predicted last fall. Current vaccines do not immunize against H5N1 and last I heard, none had been ordered. Bush ordered H7N1 from Chiron's plant in Italy, after H5N1 was identified as the pandemic strain.


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I am so tired of people spreading fear for the sake of fear (bmj.com) Article found in 2002 issue, 5.01 deaths per million, and 29.9 per million or 2.4% of winter related deaths (1265). This statistic says means that right now a influenza pandemic the size of 1918 is unlikely. When you include significant local health department efforts. I realize that about every 1-3 years there is a epidemic of influenza, but it certainly no going to be the end of the world, such as shown in Steven King's "The Stand".

For those that want more info on antigenic shifts please visit this site which shows how/why H5N1 would change to H5N2 (in this example) step by step. All pandemic strains go through this antigenic shift from avian flu to human flu.

www.colorado.edu...

The editorial here discusses vaccines, as do leaders at WHO and CDC. But my company, GenoMed, has been pursuing another approach altogether to avian influenza, and, indeed, most viruses. It involves toning down the patient's immune response to the virus which we believe is what kills people, not the virus itself.

This may seem like heresy to classical virologists, but there are other virologists who are willing to explore this approach. In a small study, we're running 11-3 for West Nile virus encephalitis; the first 8 patients were published in a small case series last July.

What's neat about our approach is that it uses already existing drugs which are known to be extremely safe. They're already available from every corner drug store around the globe. The only thing we need is more patient outcomes results to see if we're right. So far, the trend has been positive.

So if you know of anybody with a bad viral disease, who's not taking Prednisone or Cyclosporin or is otherwise immunosuppressed because of cancer chemotherapy or because of HIV, we might be able to help them. This goes for regular influenza, avian influenza, SARS, Ebola, Dengue, West Nile virus, polio, perhaps even rabies, etc.--basically every virus except the herpes viruses and CMV.

Originally posted by John bull 1
For those that want more info on antigenic shifts please visit this site which shows how/why H5N1 would change to H5N2 (in this example) step by step. All pandemic strains go through this antigenic shift from avian flu to human flu.

www.colorado.edu...

I thought H5N1 is dangerous because it's directly transmissible from birds to humans.


"The 1997 outbreak of influenza A (H5N1) in Hong Kong established that highly pathogenic avian influenza viruses can infect humans directly, with resulting illness that was fatal in six (33%) of 18 patients.

...Direct infection of humans with H5N1 viruses has been confirmed in Thailand and Vietnam."

CDC


...I don't understand why you're focusing on antigenic drift. Usually, antigenic drift is about how a virus mutates to a form that can infect humans - but H5N1 already does infect humans. Is this concern with antigenic drift because the H5N1 virus might become more easily transmissible from human to human?




Also, FYI anyone interested in symptoms:

"Despite the antigenic and genetic differences in the H5N1 viruses causing the current Asian outbreaks, certain clinical features of the five human cases described in this report are similar to those of severely affected patients from the 1997 outbreak in Hong Kong (3). In all five cases, disease was severe, with pneumonia progressing to respiratory failure and death. Early distinguishing features included fever, sore throat, cough, and lymphopenia. Other organ involvement included mild-to-moderate hepatitis and later cardiac and renal impairment. In contrast with the cases reported from Hong Kong, gastrointestinal symptoms were not prominent features."


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Face it people we are not on top of the food chain here on Earth. Bacteria's that can mutate and change form (disease types) to kill or infect thier prey are a hell of alot smarter than we are. Its pretty scary to know something so small, that cannot be seen through the human eye can actually wipe more of us out then any conventional or nuclear weapon. I guess good old mother Earth is just trying to clean herself of the disease called "Humans".

I don't understand why you're focusing on antigenic drift. Usually, antigenic drift is about how a virus mutates to a form that can infect humans - but H5N1 already does infect humans. Is this concern with antigenic drift because the H5N1 virus might become more easily transmissible from human to human?

The current H5N1 is avian flu and you are correct it can be transmitted from birds to humans but it can not then be transmitted from human to human.

Though deadly to humans H5N1 in it's present form will not cause a deadly global* pandemic. For it to do so and thus emulate other flu pandemics named above it must go through a antigenic shift. It must basically infect from a bird to a person who already has human flu, combine with it, and mutate into a flu virus that will be as deadly as H5N1 but as infectious as normal flu.

When ,not if , this happens a deadly form of flu will be unleashed on the world. The current warnings from amoung others the W.H.O are based upon the fact that H5N1 seems ever more likely to make this switch.

This then ceases to be a problem for southern asia where foul are kept near humans and becomes a fast spreading pandemic.



* I added global only for emphasis.



[edit on 24-2-2005 by John bull 1]