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| Science & Technology | ||
| World Death Toll Of a Flu Pandemic Would Be 62 Million | ||
| 2006-12-22 | ||
| An influenza pandemic of the type that ravaged the globe in 1918 and 1919 would kill about 62 million people today, with 96 percent of the deaths occurring in developing countries. That is the conclusion of a study published yesterday in the Lancet medical journal, which uses mortality records kept by governments during the time of "Spanish flu" to predict the effect of a similarly virulent outbreak in the contemporary world.
If a modern Spanish flu killed all its victims in one year, it would more than double global mortality. About 59 million people now die each year. "It is a huge, huge number," said Christopher J.L. Murray, a physician and biostatistician at the Harvard School of Public Health who headed the study. "This really took us by surprise." One of the World Health Organization's key influenza experts, however, called the main public health implication of the study "no surprise."
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| Posted by:Anonymoose |
| #15 #4 it has now proven that the "cytokine storm" effect exists Th1/Th2 differentiation and cross-regulation |
| Posted by: gromgoru 2006-12-22 23:49 |
| #14 bombay: I am hard pressed to think of pathogens that have anywhere near the potential of influenza. It is pulmonary, it concentrates in the upper respiratory tract, there are 16 H variants (with only H1, H2 and H3 attacking humans up until now, but no saying if H5 is going to go lethal, or any of the other 12), it is loaded with flexible genes which permit both maximum mutation and competition in nature. Only a tiny amount of H5 pathogen is needed for infection, it has a large and growing number of known animal vectors, its mortality rate is high and shows no sign of characteristic decline due to selection. Seriously, I can't think of a natural or artificial pathogen anywhere near as threatening. Only a highly virulent smallpox comes anywhere as close for just sheer numbers of fatalities. |
| Posted by: Anonymoose 2006-12-22 20:19 |
| #13 Anonymoose, Not to nitpick, but there are way worse than H5N1. But you are right, H5N1 is a tinderbox waiting to go off. The other wicked nasties, either kill to quick to spread enough, don't jump species as well, or have fatal flaws to make survival outside a host impossible. For anyone that has studied micro and by extension, pandemics) these are major red flags. Usually an indication of just a matter of time. This thing has the perfect incubation time to spread far and wide before noticed and the killer strain will come from jumping back and forth between animal and human. I take warnings of pandemics from this or that with salt, but I do respect H5N1 greatly. I agree, this one's the real deal. |
| Posted by: bombay 2006-12-22 18:32 |
| #12 Vaccines, even if only partially effective and modestly distributed, will make a huge difference. Population density and hygiene will also make a big difference in mortality. India was hit far harder than the US in 1919 and would be again today. The effects of this virus would be so unequally distributed in favor of the 'developed' world that outcries of genocide would be widespread (though false) - even though mortality in the developed world might well exceed ANY historic precedent. |
| Posted by: Glenmore 2006-12-22 17:24 |
| #11 iow, Can the virulence and/or harm caused flu be attenuated by a partial immunity recieved from exposure to folks who have survived a flu infection? The reverse may be true if Dengue is any guide. With Dengue severe cytokine storm reactions only occur in infected people who have previously been infected with a different dengue strain. Note that high mortality and CS reactions only occured in in the second and subsequent waves of the 1918 pandemic. The first wave was like a normal flu epidemic. |
| Posted by: phil_b 2006-12-22 17:22 |
| #10 whoops, meant H5N1 |
| Posted by: Anguper Hupomosing9418 2006-12-22 15:37 |
| #9 Look on the bright side, guys. After the H5N2 pandemic, there will be many fewer people putting CO2 into the air, a lot less international transportation wasting fuel, much less need to feed farm animals and to till the soil, therefore peak oil will be postponed perhaps indefinitely, and also a big dent will be put in global warming. |
| Posted by: Anguper Hupomosing9418 2006-12-22 15:37 |
| #8 Highly unlikely. This sumbitch is the closest thing to a "Satan bug" imaginable. At the same time it is damned enigmatic. For example, typically, some farmer wakes up and sees a few of his chickens in distress. By nightfall, the whole flock is dead. That quick-and-deadly attack is why downright sluggish Asian governments, even North Korea, are totally responsive, often for the first time ever. Conversely, in one case, an entire large family that lived together was wiped out, everybody who was blood related, but two of their spouses didn't catch the disease. This indicates a genetic factor, maybe. A swine herd was discovered in Vietnam that was actively breeding new strains using single round elimination. That one herd alone was acting like a computer, trying to generate the "best" strain out of hundreds. Now extrapolate that to hundreds of thousands of flocks, herds and other groupings of animals and even fish. |
| Posted by: Anonymoose 2006-12-22 15:17 |
| #7 question Does "Herd" immunity work for humans exposed to human flu out-breaks like it does for cow pox out-breaks in bovines? iow, Can the virulence and/or harm caused flu be attenuated by a partial immunity recieved from exposure to folks who have survived a flu infection? |
| Posted by: RD 2006-12-22 13:29 |
| #6 Doesn't matter, peak oil and global warming will kill us all first. |
| Posted by: Shipman 2006-12-22 13:09 |
| #5 Can we just get this pandemic thing over and done with? I'm already sick of hearing about it and it hasn't even happened yet. |
| Posted by: bigim-ky 2006-12-22 12:52 |
| #4 Several problems: first of all, H5N1 is unlike any flu ever seen before, it is a "perfect flu" among flus. It crosses over animal species with far more ease than is normal, it has mysteriously maintained a sky high (50%) mortality rate, it needs only a fraction of the ordinary amount of contamination to infect, it reproduces in body organs other than the sinuses and it has now proven that the "cytokine storm" effect exists. This latter means that an overreaction of the immune system is just as likely to kill you as the disease itself. Few effective therapies exist for the massive lung damage and resultant oxygen deprivation; doctors have learned they can tell from an ordinary chest x-ray who will live and who will die. To make matters worse, the US has 102k ventilators, of which 100k are needed during a normal flu season. Without adequate ventilators, large numbers of people will die who would have survived. Unlike Spanish flu, which infected about 28% of the US population, no "mild" versions of the avian flu have been found. Either it kills you or it severely damages your lungs. It is also highly likely that it will severely diminish the numbers of farm and domestic animals. While the US has food alternatives to chicken, beef, pork, mutton, and fish (of which some species are now believed to be dual vectors with birds), most countries in the world do not. This means starvation in some areas and malnutrition in others. Extraordinarily, the disease has proven capable of infecting both canines and felines, which is extraordinary. On the plus side, we do have public awareness of hygiene and an excellent communications system; but everybody is going to take some lumps from this thing. |
| Posted by: Anonymoose 2006-12-22 12:06 |
| #3 Traditionally, The Lancet has been a reputable medical journal. They were justly slammed for their Survey of Imaginary Deaths in Iraq for using an inappropriate methodology and essentially pulling the numbers out of their scientific asses. The Spanish flue epidemic was nearly a century ago. Since then, we have learned a great deal about treating the flu and associated complications and more importantly, how it spreads. Limiting the spread of the disease will be the key. Sixty million some deaths sounds like a reasonable guestimate. And yes, most of the deaths will be in the developing world for all the usual reasons. I would expect Islamic countries to be hammered due to their natural resistance to evil Western concepts like vaccines and thinking. But hey, it's the Will of Allan, right? |
| Posted by: SteveS 2006-12-22 11:12 |
| #2 The Lancet in recent years has shown itself to be as reliable in its treatment of numbers and statistics as the AP is in its treatment of photographs. |
| Posted by: RWV 2006-12-22 09:40 |
| #1 ...Question: A pandemic THAT bad - or even betwen the two estimates we had here - what would that do to most Moslem nations? I'm guessing the Saudis, Jordanians and Turks might make it through all right, but seems the rest of the Muzzie world might just flame right out. Mike |
| Posted by: Mike Kozlowski 2006-12-22 09:10 |