| Submit your comments on this article |
| Science & Technology |
| Avian Flu: New Information, Scariest Yet |
| 2006-03-24 |
| ...They looked at 2,169 distinct avian virus genes. There were two viruses that showed a protein tag at the end of one of the nonstructural genes that actually looks to help cause the cytokine storm that makes this a unique illness.* And guess which two viruses they were: 1918 H1N1, and the current H5N1... *Cytokines are a class of proteins produced by white blood cells whenever the body finds itself responding to an infection. They vary in function—some cytokines attack invading microbes directly, others relay chemical messages from cell to cell, still others bind with cells in the hypothalamus region of the brain to produce fevers. Cytokines are toxic not only to infectious agents in the body but to the body itself: Much of the pain and discomfort that accompany illnesses like the common flu, for example, are in effect hangover symptoms from the toxic effects of the body's own immune response. The term "cytokine storm" refers to the immune response that occurs when the body is confronted with an infectious agent that reproduces at great speed and in huge volume. This "viral storm" generates an equally huge immune response—the cytokine storm—that can take such a toll on lung tissue (the main battleground where the virus and the immune system face off) that it deprives vital organs of enough oxygen to function, and sets off cascading organ failure. ...This virus is quite different from what we see with the standard annual flu, and what we saw in 1957 and 1968, because of the cytokine storm it causes. In 1918, the vast majority of the people who died were healthy young people, 20 to 40 years of age. And that was in large part because they had the strongest immune systems... ...If you put 1918 H1N1 into animal models at very, very low doses, it basically kills all of them in 24 hours. The lab science people had never seen that. At 16 to 24 hours, that virus was different from anything they'd ever seen in killing these animals. The only virus that was similar was H5N1, and it was fatal at much lower doses. H5N1 is the most powerful influenza virus we've seen in modern human history. What makes them so similar is that they both cause this cytokine storm phenomenon. Which essentially results in a person's drowning in his or her own blood as it fills the lungs, right? It's even worse than that. You get that kind of leakage, yes, but it also goes in and begins to shut down all your vital organs. It's a domino effect. Your kidneys go down, then your liver goes down, you have all this destruction through necrosis of your lungs and your internal organs. Everything goes. ...There are not a lot of mild, asymptomatic infections out there [with H5N1]. We're now aware of six studies involving over 5,000 close contacts of H5N1-infected people, in Indonesia, Vietnam, and Hong Kong, in which less than one person per thousand contacts had evidence of an H5N1 infection that was missed—that is, a mild infection. This [virus] is not causing a lot of asymptomatic infections right now. Some people are saying there's a lot of mild [H5N1-related] illness all over out there, but it's just not true. That means we're not artificially inflating the mortality rate by missing a lot of infections. I'm actually pretty confident that the real mortality is almost that high. So for that number to drop all the way down to a couple percent is a pretty big drop. Which says to me that when people talk about 1918 as a worst-case scenario, well, maybe that isn't the worst-case scenario. That's hard for people to hear, because then they think you're really trying to scare the hell out of people. But you know what? It's just the data. If this virus were to ultimately go human-to-human, none of us know what the human mortality would be... ...Right now, given the amount of virus needed to make vaccines for H5N1—it needs a lot more antigen [than typical flu strains]— our total worldwide capacity right now, in one year's time, is only enough vaccine to protect 100-200 million people worldwide. That's in one year after a pandemic starts. And that's it. You can't make any more, given the limited capacity we have... ...Eighty percent of all the drugs we use in this country—all the childhood vaccines, everything—come from offshore. Your cardio drugs, your cancer drugs, your diabetes drugs, 80 percent of the raw ingredients come from offshore. I could go through a whole laundry list of other critical and essential products and services that come from offshore. If the rest of the world experiences a pandemic, we're still screwed. That's what people don't understand. Somehow they have this attitude that we can wall ourselves off in the Eighth District of Minneapolis and be okay... ...With the H5N1 virus, the virus storm that precedes the cytokine storm is so remarkable in those first 24 hours that if you don't have the (antiviral) drug onboard in those first 24 hours, it may only have limited impact... ...We have anecdotal data on people who got the drug early and appeared to do better, but then, after the typical five-day course was stopped, they died on day ten... ...For example, I talked [in that article] about the 105,000 mechanical ventilators (in the United States)? On any given day, 70,000-80,000 of them are in use, and in a normal flu season we butt up against the 100,000 mark. We have no excess capacity there whatsoever... ...We'll run out of masks and respirators overnight, because it's a global just-in-time supply chain. There are two manufacturers who have the largest share of the market there, but with virtually no surge capacity. We'll run out of IV needles. We'll run out of IV bags. We'll run out of drugs very quickly... ...So the whole medical system will collapse, at a time when we still need drugs for heart attacks, cancer, and everything else. We'll be in freefall. That may sound scary, but it's a reality. And unlike Katrina, where the hurricane did some of the destruction and separated people from health care through evacuation or otherwise, the same thing's going to happen here in every city, town, and village in this country as well. We're all going to need things at the same time, and there won't be any products... ...Right after Katrina, when FEMA was trying to rescue itself, they put out a call for anyone who had a refrigerated truck unit to come and sit in one of several parking lots in the Gulf states down there, in case they had 10,000 bodies, etc. A contingent of them went. Not all of them, by any stretch of the imagination. Within 72 hours, major food manufacturers throughout the United States reported that they couldn't ship their goods. They had no trucks. We have a razor-thin capacity in this country right now on virtually everything. They had to get FEMA to release the trucks. Cities like Seattle have already come to the conclusion they won't be able to have refrigerated trucks, because of that issue. For their work with corpse management, for example, they've already mapped out where every one of the ice arenas in Seattle is... |
| Posted by:Anonymoose |
| #9 CoasttoCoastAM had a recent episode where Noory's guest commented that what is being [wilfully] under-reported or nono-reported in the Medias is how stocks in poor countries are born, raised, eat, and processed in hyper-polluted, unsanitary industrial conditions, and that left alone, these viruses can easily mutate over time to threaten mankind. IOW, the world doesn't need exploding Commie Biowar factories or research complexes - all thats needed is for enviro wastelands/dumps to stay polluted AND HUMAN-OCCUPIED for periods of time. |
| Posted by: JosephMendiola 2006-03-24 22:07 |
| #8 The big jump from bird to human B2H to H2H may not be as difficult as all that. Right now, it is believed that H2H hasn't erupted en masse solely because the virus only takes hold in cells deep in the alveoli of the lungs, unlike typical flu that enters in the cells of the sinuses, eyes and throat. So, how different are the cells in the lungs from those higher up? As far as mutation goes, it is much like a computational problem. Individual animals that do not immediately die from the disease, like swine, may have several mutations of the same disease in their bodies, in a darwinian race to establish supremacy and efficiency. In a herd, each animal is doing the same, but with different mutations. The "winners" of the individual animal viruses are exchanged around the herd, in a "semi-finals", until the best mutation is the sole survivor. Herd after herd and flock after flock produce increasingly efficient mutations, even though many good possibles are eliminated through death. But when you add up all of those individual and group efforts, an awful lot of possibilities are generated. Now, consider human interaction at many stages of this process. Swine, in particular can catch both human and avian influenza, and within their bodies the two different types of viruses can and do exchange RNA. This means that humans are not needed to produce a virus that will transmit easily H2H. Remember that *most* typical flus are uptaken in the upper respiratory system. It is a common mutation that allows them to do this, so there is a very good chance that a common influenza will give that mutated gene to H5N1. In addition to its virulence, H5N1 is also believed to have an optimal incubation period, anywhere from 10-17 days, with an extended period of communicability. This bastard seems to be tailor made to kill humans. |
| Posted by: Anonymoose 2006-03-24 21:43 |
| #7 I'd be interested in knowing how many human deaths there have been in Western countries. Among people who are not from 3rd-world countries with 3rd-world ideas about sanitation. Though I understand it's nothing to sneeze at, I suspect this flu (presuming it jumps to human-to-human transmission) is going to be less of a problem in Western cultures where there is at least a modicum of sanitation. (I'd be concerned about nursing homes, though.) |
| Posted by: Barbara Skolaut 2006-03-24 21:40 |
| #6 The only thing on the good news front is the timeline. 24-48 hour kill rate is too fast for massive, massive destruction. Its well documented that in 1918 many people were killed in 24 hours or less, yet the flu spread just fine. In fact, I would argue exactly the opposite. A person becomes highly infectious very quickly which makes containment a lot more difficult. Hence spread is much more rapid than 'normal' flu. |
| Posted by: phil_b 2006-03-24 21:30 |
| #5 Zhang Fei.. Ebola got its start in Africa, where hygiene is indifferent /hhuummm this mean i'll have to bathe more.. |
| Posted by: RD 2006-03-24 21:19 |
| #4 Diminishing returns, although a delimiter :) |
| Posted by: bombay 2006-03-24 21:06 |
| #3 Zhang Fei, You have some good points, but, we just can't predict what happens when human to human. The only thing on the good news front is the timeline. 24-48 hour kill rate is too fast for massive, massive destruction ... well, given today's populations. 1918, or before and global, problem of a different scope. The problem is, and we can't stop it no matter what, the bugs will adapt. We adjust our health care and technology to a certain level, and they will out do us. It is pure math. We divide once or twice every 50 years or so. They do it every 30 minutes or so. We offset by technology, but there is the law of delimiting returns. It is an iteresting race. At some point we have to come up short, and massive corrections in population are the result. |
| Posted by: bombay 2006-03-24 21:04 |
| #2 Color me blase. When this disease shows signs of being infectious, I'll start to get worried. Remember Ebola and the mad cow disease? Both are fatal. But neither showed signs of being very infectious. Ebola got its start in Africa, where hygiene is indifferent and presents an ideal environment for spreading disease. Same with bird flu and SARS. If they can't spread in China, India, Pakistan and Indonesia (where the natives use their left hands in place of toilet paper), all of which are hygienically-challenged, you're not going to see any serious problems in the West. |
| Posted by: Zhang Fei 2006-03-24 20:23 |
| #1 Yawn. |
| Posted by: Iblis 2006-03-24 20:09 |