Why we shouldn’t underestimate the flu virus
At the moment, there is so much hype surrounding Influenza A(H1N1), dubbed by the media as swine flu, that it is hard to gauge how concerned we should all be.
Many people could be overreacting about the possibility of it causing deadly havoc throughout the world. But there is also a serious cause for concern considering the number of deaths inflicted so far.
The fact that it can kill normally healthy people so quickly and easily is of course a major worry. But we need to put it into context. Whenever a major scare like this happens, it is very easy to soak the media hype and believe that we are all going to die, when there is just as much chance that scientists and doctors are fully prepared to control the problem until it fades away.
The Spanish Flu
Let’s a take a look of the facts through history, to put it into context and give us some idea of how this particular flu fits in with pandemics of the past.
The 1918 flu pandemic, also known as the Spanish flu, spread to every part of the world. It also claimed young and healthy people as its victims, just like the current flu (which WHO no longer wants to be called Swine Flu because of the potentially damaging repercussions on the pork industry).
It lasted from March 1918 until June 1920 and between 20 million to 100 million people were killed – double the number of people killed in World War 1.
In total, about one billion people were infected by the virus, which was more than half the world’s population at the time. Ironically, it was people with strong immune systems who suffered the most, just like H1N1.
In regards to the origins of this particular flu, one theory is that it started in Fort Riley, Kansas, where poultry and swine that had viruses were bred for food. Soldiers who came into contact with the virus here where then sent around the world, where they spread the flu
However, other research shows that the virus jumped straight from birds to humans without going through swine first.
The Spanish Flu reached level 5 on the Pandemic Severity Index – the same level that H1N1 is currently on. Since then, the Asian Flu of 1957 reached Level 2 and claimed the lives of 1-1.5 million people. After that, the Hong Kong flu claimed 0.75-1 million lives and was also reached Level 2.
Are vaccines effective?
Normal flu infects 10s of millions of people every year and kills 100s of thousands of people. But when there is a pandemic, it can kill millions.
In regards to this current strain of flu, there is a vaccine available that can treat it. It is called the trivalent influenza vaccine, which contains purified and inactivated material from three viral strains.
However, a vaccine formulated for one year may be ineffective during the following year because the virus evolves rapidly and other strains become dominant.
The first big step towards finding a prevention for the flu started in 1944. Thomas Francis Jr. built on work started by Australian Frank Macfarlane Burnet, who found that the virus lost its virulence when it was cultured in fertilised hen’s eggs. The US Army helped Francis to develop this theory into practice.
It is also thought that stronger immunity to past viruses and vaccines have helped to prevent a pandemic from happening on the same scale of the Spanish Flu.
But any kind of flu is not to be underestimated because of the way it can mutate. Mutations cause an increasing variety of strains to be created until one achieves higher fitness, becomes dominant and then sweeps through humans. When new variations are created, everybody can potentially be at risk of catching flu, which is when a pandemic is caused.
Thankfully, the WHO predicts which strains of the virus are most likely to exist in the next year, allowing pharmaceutical companies to develop new vaccines that can protect people against these strains. Some other vaccines are currently available and are recommended to prevent and treat this one - Tamiflu and Relenza. In the meantime, pharmaceutical company Baxter International is working with WHO to create a new vaccine for the current outbreak.
Vaccines are also available to protect poultry from catching it, as a precautionary measure. Every flu season, the vaccines are reformulated, but they cannot include all of the strains affecting people in the world at one time.
There is always the risk that a dominant strain will not be able to be controlled by the vaccine. However, there is plenty of research going on right now into analysing how these viruses mutate and become dominant; how to make more effective and powerful vaccines; and how to understand the immune system to make it even more resistant to the flu.
Hopefully one day, through this research, stronger vaccines will be developed to better protect us from killer flus and help to alleviate fears, like the ones that are currently circling the globe every day.
Are we winning the battle?
Many people are now saying that this current outbreak of flu will die out soon, but could come back stronger later in the year when the next season for flu takes place. This is what seems to have happened with the 1918 virus, a Spanish news agency noted during that spring that they had observed “a strange form of disease”. It was not until the autumn of that year that it really became a problem.
Dr. Schuchat from the Centers for Disease Control and Prevention, said: “I think we do see some encouraging signs, but we are remaining cautious. We have a new infectious disease, a novel H1N1 virus. It’s too soon for us to know exactly how this will involve or play out. We need to be ready for the seasonal flu next fall as well as what this new H1N1 virus is going to do in the fall, and we’re really working actively and aggressively to be one step ahead, both currently and then preparing for the fall.
“The extent of spread of this virus in the U.S. and around the world is widespread, and it’s possible that the W.H.O., the world health organisation, will be continuing to re–evaluate the phasing. Currently we’re at phase five, but it’s important to know that that issue is still being looked at. The phases the W.H.O. talks about relates how widespread infection is. Not how severe it is.”
He went on to say that the organisation is seeing several encouraging signs. “We’ve heard reports that the H1N1 activity might be levelling off in Mexico. It’s too soon to be certain that’s the case, but the patterns may vary at different states. Some of the initial lab tests you’ve heard about are encouraging. The absence of the virulent marker from the 1918 H1N1 pandemic and differences between this particular strain and the H5N1 influenza strain, but we don’t know everything we need to know about how virulent this strain will be.”
He adds researchers are looking at isolettes, which will allow them to really take off on research on this particular virus. “There’s been a lot said about how is this particular virus different from seasonal influenza? A big difference is that this is a virus that’s totally new.
“Another big difference is that this virus is increasing after the period where seasonal flu is usually decreasing, so we can’t predict with certainty what the weeks and months ahead will look like. We are planning to remain aggressive with this new virus and this new infectious disease, because it continues to be a rapidly evolving situation.
“I don’t think we’re out of the woods yet, but I do think that people are co-operating and working together in really effective ways to try to limit the impact this virus has on health and to slow its spread. We don’t know if the virus will come back in the fall harder than it is right now, and, of course, that’s one of the big concerns we have.”
Keeping a cool head in a crisis
One of the advantages of the age we are living in is that there is plenty of information around to keep us up to date on the latest information to help us protect ourselves.
There are regular updates from Government and health organisations around the world. The Honourable Nicola Roxon, the Australian Minister for Health and Ageing, is also providing regular updates. This information will help to prevent us from overreacting and believing some of the sensational coverage of the media. In her latest press conference, she said:
“An important issue is emerging. I’ve been informed by my department that due to an increased demand of Tamiflu and Relenza, that we are seeing the stocks running quite low of those supplies.
“As you would all know, the antiviral drugs are held in large numbers; 8.7 million courses in our stockpile. That stockpile isn’t yet released because we’re not in a pandemic situation, and these antiviral drugs do treat seasonal influenza, but they’ve also been shown to be effective in treating H1N1.
“So I want to reassure people and remind them that there currently are no confirmed cases of H1n1 in Australia, and we need people to be respecting the importance of using those antivirals when they’re needed, and not unnecessarily hoarding them if they are not needed.”
Some people are saying WHO is likely to raise the flu alert to level 6, which means the virus has spread to different regions and a pandemic is underway. But this does not mean that every country will be affected and there will be many more deaths. It just encourages Governments to take appropriate measures.
So it seems that the world is fully prepared and equipped to deal with this problem. But the unpredictable history of the virus mutating and finding new ways to bypass our immune systems still means that the future is very uncertain, although there is nothing to be too scared about at this stage. We need to put our confidence in the experts. They certainly know what they’re doing and their plan of action and current research will be our best hope of prevention and protection.
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