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mattbrowne's avatar

Superbug or super-influenza: Is our world prepared for the next Spanish-flu-like pandemic?

Asked by mattbrowne (31563points) April 26th, 2009

From Wikipedia: Avian influenza, sometimes Avian flu, and commonly Bird flu refers to “influenza caused by viruses adapted to birds. Influenza A virus H5N1 is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. In 2003, world-renowned virologist Robert Webster published an article titled “The world is teetering on the edge of a pandemic that could kill a large fraction of the human population.

http://en.wikipedia.org/wiki/Avian_flu

The outbreak of a new strain of influenza virus in March and April of 2009 is infecting many people in Mexico City, other regions of Mexico and parts of the United States. There have been over 1,000 suspected cases. Because it is not possible to confirm every one of such cases as being caused by an influenza virus, the World Health Organization (WHO) refers to them collectively as influenza-like illnesses (ILI). The cases are characterized by severe influenza-like symptoms, followed by pneumonia, which has, in some Mexican cases, resulted in death. The new strain is derived in part from human influenzavirus A (subtype H1N1), and in part from several strains of influenza virus usually found only in swine. In April both the WHO and the U.S. Centers for Disease Control (CDC) expressed serious concerns about this novel strain, because it apparently transmits from human to human, has had a relatively high mortality rate in Mexico, and because it has the potential to become a flu pandemic.

http://en.wikipedia.org/wiki/2009_swine_flu_outbreak

Is Mexico and a few US states just the beginning? What would happen if this influenza virus starts spreading around the world on a large scale? Can we contain it if we simply stop public life with everyone but a few critical people staying at home?

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15 Answers

avalmez's avatar

based on the news here in the usa, oficials are baffled by the current outbreak. there have been several deaths in mexico, but none in the usa. and there is one case of the disease in CA involving a woman whose contact with the disease is unknown (i.e. hasn’t traveled or been in contact with people who have).

i guess the scariest part is it’s not known the extent to which current vaccines are affective against the disease. experience in the us indicates current treatments may be effective. but, in developed countries fatalities can be expected mostly amongst the very young and elderly, while in less developed countries more widespread.

and yes, may be just the beginning. students from New Zealand who recently traveled to Mexico are reportedly affected. and the last time i went to mexico (2007) it seemed there were more europeans there than americans – power of the euro vs usd.

mattbrowne's avatar

Influenza is a very well-known disease. What’s going on right now is related to the most severe forms of influenza (not to be confused with the seasonal flu i.e. seasonal influenza which is still serious and often deadly). The Spanish flu is a colloquial term for the 1918 influenza pandemic. The virus belongs to the very same category as the present viruses for avian influenza and the swine influenza virus now detected in Mexico. The subtypes are named NxHy for example H1N1. We have to take this very, very seriously.

kenmc's avatar

Epidemics/pandemics have been hyped like crazy. Anyone remember bird flu? What happened there?

I’d bet it’s more media sensationalism than actual threat.

mattbrowne's avatar

@boots – Sorry, but I couldn’t disagree more. It’s like all the money wasted on fixing Y2K bugs. Why has so little happened in terms of the bird flu? Because scientists and doctors know about the true potential and politicians did an excellent job by imposing strict rules about the handling of domestic and wild birds.

Hype? Media sensationalism? On the contrary. It’s great to have media like that. This was very different in 1918. Plus the influenza A virus strain of subtype H1N1 wasn’t even known to be the cause. No powerful microscopes. Even DNA wasn’t discovered.

Sorry to be so direct, but what’s happening right now has nothing to do with media sensationalism. I’m not saying the media isn’t prone to engage in this from time to time. But in this case, they are not.

I’ll give you an example:

http://news.bbc.co.uk/1/hi/sci/tech/3553368.stm

Look at the date: August 10, 2004

I remember the discussion. Huge tsunamis? They are so rare. Then came December 26, 2004 just a few months later. And almost 300,000 people died.

Even if there’s only a say 2% chance this influenza turns into another pandemic we should demand that everything gets done to minimize the risk.

Blondesjon's avatar

At this point, if it is spread through human contact, it’s already too late to do anything effective. A vaccine would be the only exception to this and we all know how likely that is.

I sometimes wonder if these viruses aren’t the Earth’s way of thinning out the herd. It happens to the coyote, deer, and rabbit populations around here every few years. Perhaps we should expect this when we pack 22 million people into such a small area.

kenmc's avatar

@mattbrowne You’re more likely to be right than I am. That was just my observation.

mattbrowne's avatar

@Blondesjon – From what I’ve heard unlike the avian influenza virus this one can spread from human to human. Too late? We can slow down the deadly spreading. And governments can eventually impose drastic measures. We don’t know how long it’ll take to create a vaccine.

@boots – No problem at all. But I feel strongly about this and I’m aware that many people are surprised by the media reports. In this case there’s a good scientific and medical reason. I just wanted to stress this.

avalmez's avatar

@mattbrowne the “experts” (public health officials) i’ve been hearing this morning all say the cat is out of the bag and we have to wait and see how things turn out. one likened the current situation to a hurricane warning – you know it’s out there, you know it may hit, but you just have to wait and see what it eventually does.

BookReader's avatar

…one day at a time Matt…the opportunity to be a part of such mind boggling changes is just so energizing- what a rush!!!

oratio's avatar

Yes, it is serious. There is going to be a pandemic sooner or later and most likely it will be another flu.
It’s a fascinating and potent virus type, fast mutating.

I hardly think this is the one. For one it is easily treated with Tamiflu.

oratio's avatar

But no, I don’t think the world can ever be really prepared for the next plague.

mattbrowne's avatar

The media are handling this very well. Awareness is there, but no panic, which is exactly what we need.

Hurricanes and influenza viruses are different: the first is a local phenomenon (if we discount abrupt climate change a la Roland Emmerich) while the latter is potentially a global phenomenon. A severe pandemic in the year 2009 could potentially kill hundreds of millions of people (in a similar way the Spanish flu did when there were less than 2 billion people on our Earth), especially in the poorer regions of the world.

@oratio – The strange part is virus DNA from birds, swines and humans strangely merged into a new form. Yes, so far the Tamiflu treatment seems very effective. But the situation is still more severe than 3 years ago and this is the reason the WHO has raised the level to “Phase 4” one level higher, see

http://en.wikipedia.org/wiki/Influenza_pandemic

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.

Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.

oratio's avatar

@mattbrowne Very interesting. Allthough, antigenic shift is not uncommon when it comes to viruses. Several flu outbreaks have been reassorted viruses. Not so strange but uncommon. What’s interesting with this one is that it’s merged all three types of flu. There will be a super-flu. I just don’t see how this would be the one.

mattbrowne's avatar

@oratio – This one might not be the super-influenza, but there’s still a chance depending how the mutations will progress. Let’s hope for the best. It looks okay right now. In any case it’s a very valuable exercise and test for the real thing bound to happen some time. Asia is ahead of Europe and North America, because of SARS and the bird flu.

oratio's avatar

@mattbrowne I see your point.

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