Facts, figures, history and cool science
Yeah, we are supposed to be a bunch of old codgers on this site (not!), but I doubt there are too many of our members that were around during the great 1918 flu epidemic. Certainly none that were old enough to remember what happened. I have been reading some fascinating accounts of this pivotal era in our history and I thought I would share my insights with you. You know what they say, you either learn from history or you repeat the same mistakes over and over.
Lessons from history
The great flu pandemic of 1918 killed anywhere from 20- 40 million people world wide. That is more people than got killed in World War I, more people than the “Black Death” (bubonic plague) killed over a 4 year period (1347 – 1351). The impact of the 1918 flu was so stark that for the first time in ‘recent’ history the average life span in the US decreased by 10 years!
Roughly a third of the world population got infected. Back then human population was around 1.5 billion, give or take. We are now at four times that number, at roughly 6 billion. The 1918 flu was spread from country to country by troop movements during WWI. Today we don’t think twice about getting on a plane to go some place. Back then we had few anti-viral medications and sketchy understanding of what was going on. Today we are dealing with a worldwide financial meltdown. Hospitals have been cutting bed capacity for years in order to improve bottom line profits and few can handle a surge in demand. There is chronic nursing shortage and just-in-time manufacture as well as outsourcing means we live on the edge a lot more than we used to. Back then people were more self-reliant, more willing to work together as close knit communities. Today we live from paycheck to paycheck, no resources of money, food or much of anything else set aside for a rainy day. As for close knit communities, most of us now consider ourselves lucky to have cyber friends that we do not have to meet face-to-face.
“One physician writes that patients with seemingly ordinary influenza would rapidly “develop the most viscous type of pneumonia that has ever been seen” and later when cyanosis appeared in the patients, “it is simply a struggle for air until they suffocate,” (Grist, 1979). Another physician recalls that the influenza patients “died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth,” (Starr, 1976). The physicians of the time were helpless against this powerful agent of influenza. In 1918 children would skip rope to the rhyme (Crawford)”
I had a little bird,
Its name was Enza.
I opened the window,
And in-flu-enza.
Who was most at risk?
Looking back, scientists now understand that when the 1918 flu struck very few people had any kind of immunity to this brand new flu virus. As in any “unknown” situation, our immune systems sensed grave danger and struck back will all guns blazing. Below is the citation for one of the most important papers on the subject.
1918 Influenza: the Mother of All Pandemics
Jeffery K. Taubenberger* and David M. Morens†
*Armed Forces Institute of Pathology, Rockville, Maryland, USA; and †National Institutes of Health, Bethesda, Maryland, USA
Younger people in the prime of their lives have stronger immune systems. When their immune systems went into over-drive trying to fight a virus they have never seen before, much of the damage was done by the “cytokine storm” unleashed by the patients’ own immune systems. Their lungs became a bloody pulp as a result of their own immune systems behaving like Keystone Cops on steroids, shooting first and asking questions later.
Does this mean old geezers like us have a get-out-of-jail-free card?
Not on your life!
Below is a diagram I got from the Taubenberger paper. The dotted line is generic annual flu mortality, number of people who died in each age group (death per 100,000 persons). As you can see, the very young and the very old were most at risk of flu related death. We have a “U” shaped graph.
Now let us look at the solid line, the mortality rates observed during the 1918 flu. We have a “W” shaped graph. The very young and the very old still died at the highest rates. The difference is that during the 1918 pandemic there was a clear bump in the graph representing a much higher than normal rate of death in the 14 -45 year age group. The pandemic graph is “W” shaped.
Take home lesson is this for us: the very young, the very old, the sick and the frail are still at risk. And I want to highlight this point: the majority of the deaths were due to overwhelming pneumonia. If you have CLL, COPD, asthma, bronchitis or any other chronic pulmonary health issue, you are automatically in the high risk group. No kidding. As I have written dozens of times, the single biggest vulnerability for CLL patients is pneumonia – viral or bacterial.
Are we done with the “Swine flu”?
Not quite yet, according to the experts.
My crystal ball is no better than yours, I have no idea whether the present behavior of the H1N1 virus (Swine flu) will continue for a while longer and then fade away. It seems to be very communicable, it has no problem with human-to-human transmission, but the fatality rate is reassuringly low. If it stays that way into the future and gradually fades into the background, we can count ourselves lucky and go on with life.
But let us take a look again at history to see what else can happen. Below is another telling picture from the Taubenberger paper. The first wave of the new flu struck in the spring of 1918. It was no big deal, a mere blip in the mortality rates. Through March – August of 1918 it spread unevenly through USA, Europe, and Asia. Many people got infected but death rates were not that different from normal.
But starting in September through November a second (and in some countries a third) wave of flu infections / death struck. This time there was no mercy. Look how high the death rate was in the second wave! So many people died so quickly that all resources were stretched to the breaking point. Historical accounts from those dark days talk about many people who died because there was no food, no help for routine illnesses, general lack of resources that we take granted in a civil society.
You tell me: how well do you think our present day society will do if all of our resources of modern day living dry up quickly? I think we got a taste of it in this country when bad storms devastated much of the coastline of Louisiana and other Gulf Coast states, even though the rest of the country was untouched. How much worse will it be when the whole country, the whole world is involved in the same crisis, when there is no one left to come galloping to our rescue? People stuck in Miami highrise apartments for just a few hours during the hurricane season because electricity went out and elevators did not work complained about lack of food and water. One old lady said all she had to eat in the apartment was a small bag of jelly beans. How many of you fall into the same group of ill-prepared folks?
Know your enemy
Here is some cool science that you can use to dazzle your kids and neighbors.
Influenza is fundamentally a bird disease, spread through out the world because wild birds migrate long distances to distant lands. The “avian flu or H5N1 of a couple of years ago is one such bird flu disease. Fortunately for us, flu viruses that are good at infecting birds are not very good at infecting humans. Reason for this is very simple. Birds have hotter body temperatures than humans, bird flu viruses have a hard time adapting to our colder noses and pulmonary tracts.
Avian flu beaten by cold noses
By Clive Cookson
An important reason why avian flu viruses rarely infect people is that the human nose is too cold, according to an analysis by virologists at Imperial College London and the University of North Carolina. This may explain why the feared H5N1 avian virus has not spread readily between people, unlike the H1N1 pig virus, which recently emerged in Mexico.
The study, published in the journal PLoS Pathogens , shows that normal bird flu viruses do not spread extensively in cells at 32°C, the temperature inside the human nose – probably because they usually infect the guts of birds, which are much warmer at 40°C. The first site of infection in humans is usually the nose, where a virus would not be able to grow and spread between cells.
Pigs are a different matter
Humans and pigs share a lot of genetic traits – one reason why it is possible to use heart valves from pigs in humans with little risk of rejection. But the flip side of that is diseases in pigs also infect humans with relative ease. One of the common features of the 1918 flu and today’s H1N1 swine flu: both viruses seem able to infect pigs and humans with ease.
Many researches believe pigs are the perfect promiscuous mixing vessels since they are infected with ease by human, bird and pig viruses. Pigs represent nature’s own experiments in genetic engineering, mix-and-match of viral bits to see what works. Intensive farming practices with ever closer contact between pig herds, domesticated and wild birds and human populations has made this a much bigger concern.
What’s with the H and N?
Flu strains are named for the H and N proteins, hemagglutinin and neuraminidase, which stick out from the surface of the virus like spikes.
The name hemagglutinin refers to the ability of influenza to clump (“agglutinate”) red blood cells. A typical flu virus is covered with 500 or more hemagglutinin molecules, which together can glue many red blood cells together into a visible clump. But the major role of hemagglutinin spikes is that they allow the flu particle to attache to sialic acid and other receptors on cells of our respiratory tracts where it replicates like crazy and causes havoc. There are three distinct types of haemagglutinin molecules important in human infections designated as H1, H2, and H3.
While the H spikes allow the flu virus to attach itself and penetrate your hapless cells, the N (“neuraminidase”) spikes have a different function. You see, viruses are very simple things, they do not have the machinery to replicate themselves. For that they have to depend on the resources of the cell they infect. Once inside a host cell, the virus takes over the machinery of its victim and uses it to make zillions of copies of itself. Pretty soon the victim cell is completely eaten up from the inside.
Now the virus needs to get out of the bankrupt cell. The neuraminidase spike is used to rupture and escape the infected cell, finishing the job of killing it in the process. Typical flu viruses have 100 or more N spikes on their surfaces. Recorded history has shown human flu types using two types of N spikes, the N1 and N2. But there are many more N and H types out there in nature, especially among birds. Witness the H1N5 bird flu strain that caused a ruckus couple of years ago.
WHO chief warns against false security about flu
Citizen’s Guide to Flu Preparedness
I will end with this quote I read somewhere: Life is not measured by the number of breaths we take, but by the moments that take our breath away.
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27 comments on "Lessons from history"
Chaya,
Once again you make the complex understandable.
God bless you.
Chaya, very interesting information and very relevant. Back in 1959 I started boarding school, a very large school with nearly 1000 pupils. We then had an outbreak of ‘Asian’ flu. The first time round only a few pupils went down with it and were not particularly ill, but it came back a couple of months later and devastated the school. Our dormitories were turned into sick bays as 80% of the pupils and staff were very sick. We had very few people to cook and clean and it was chaos. Two pupils died. Never think flu is on its way out after the first round, its got the worst punch to come!! I have had the anti pneumonia injection as I am only in the first stage of CLL and my doctor thought there was a good chance that it would offer me protection at this stage so I am very grateful for that. Doing my best to stay away from sick grandchildren but it is not always possible. I wish everyone out there with CLL the very best of health and good luck in staying away from all the bugs out to get us!
Chaya asks: You tell me: how well do you think our present day society will do if all of our resources of modern day living dry up quickly?
The answer is we will do very poorly. All of the government pandemic plans focus on what each level of government will do with its limited resources (and those resources are become more limited every day because of the current financial meltdown). It is an easy calculation to show that even a simple 50% increase in the number of deaths from the ‘normal’ annual flu would overwhelm our emergency rooms and hospitals, as well as our morgues.
There is no surge capacity in any of our public institutions because we as citizens have made the decision not to invest in surge capacity. We consider excess capacity in government as waste and a horrible thing rather than as an investment is a safety net to be ready and available when disaster strikes. Just imagine a hundred Hurricane Katrinas striking all over the Nation over a period of 2-3 months and you can begin to grasp how quickly our current institutions will be exhausted.
So what will happen? Each individual and family will literally be on its own and their outcome will depend on a combination of location,luck and personal preparedness. Those who live in densely populated areas and are not well prepared stand a very good chance of both getting the flu and dying from the resulting non-flu infections. People living in less densely populated areas who are sufficiently well prepared with food and medicine that they can distance themselves from others stand a good chance of not becoming infected and of surviving if they do get infected.
The choice regarding individual preparedness is yours but don’t look to any government agency to tell you the brutal facts of what it means to be prepared. Washing your hands is but the first of many steps that you need to take and most of those steps need to be taken well before the pandemic hits. For example, try to buy some N95 masks today.
Peter:
Thank you for your detailed response to my partly rhetorical question.
All of us live in different circumstances with different trigger points. No one game plan will work for all of us. My agenda in writing this article is to get you thinking about your needs, your trigger points, what you need to have in place if this (or some other) pandemic becomes a reality.
Soon after my husband PC’s CLL diagnosis it became clear to me that there is a Murphy’s Law which ensures patients develop fevers and infections late on a Friday evening, after all doctors have gone home for the weekend.
How long will it take you to get hold of a prescription for antibiotics (or the more difficult to get anti-viral medications)? The clear guidance is that Tamiflu works best when given within 1 or at most 2 days of onset of infections. Is your doctor and pharmacist responsive enough to meet that deadline? Will they continue to be available in a crisis situation?
PC carried a valid script for a broadspectrum antibiotic in his wallet at all times, something we could get filled locally at short notice. Not a bad insuracne policy, if you ask me.
One picture (the mortality chart) says it all.
The young, old and ill will suffer mightily even without the hazards of cytokine storm if the right circumstances present themselves.
Preparation, both personal and community oriented, will always be the key to fending off disaster.
We do have time to prepare for things as best we can and will only regret it if we fail to act. Unused preparations are never really wasted, because they teach us and remind us how to prepare for future disasters.
For example, the Superdome likely wouldn’t have been used again had another hurricane struck last summer because we learned from our prior mistakes.
Chaya,
Again, thank you for such valuable information. I really appreciate all your information.
Perhaps because we have a devastating disease or a family member or friend with the disease, we take special interest. But a few weeks ago I sent per email a letter explaining a web site on Preparedness in a Pandemic. I sent many emails to friends and family. I heard from one that received it.
Maybe they were too lazy to email back. I think they were too lazy to read it.
Just my thoughts on this. Most of the time I am upbeat. But every once in a while, I slip.
Take care and Blessings,
Rita
Chaya,
Thanks for keeping all of us current on this and other potential deadly flu bugs. I am early stage and 47 but not assuming anything here.
I remember my Grandfather who was born in 1899 talking about working in a train station in NYC and unloading bodies by the carload who had perished from the 1918 pandemic.
God Bless
David
Comment to Rita – Could you respond with the website on Preparedness in a Pandemic? I would be interested in reading it.
Lillian
Thanks Chaya for this report on the Pandemic flu of 1918.
I have always been informed about flu as both my grandparents on my mother side died within a week of each other during the 1918 flu epidemy, my mother was only two years old when she lost both her parents.
In the UK they are doing a lot to educate people and have printed leaflets instructing people what to do. Yesterday I read on a New paper that the goberment has ordered 90 million of vaccines so they start making them as soon as they got the info from the WHO.
There are 78 people with the flu, all doing well, some schools have closed when a pupil has been tested positive for the flu.
People ghave been advise no to go out if they have syntoms, simply phone the doctor and the neccessary medications would be delivered to their home.
Chonette (UK)
Thank you Chaya. As others have said: you distill what is difficult to grasp for non-scientists and present it in a clear fashion!
We will do poorly I am afraid. Even in the small town where I live, we had to stop going to our favorite breakfast restaurant when the waitress remarked that the kitchen staff was all out sick with the flu last week, and she thinks she is coming down with it! Friends of ours sat with us for breakfast and were coughing and ill! People have lost the ability to protect themselves and others. Well, that is my polite way of saying it….
We not only have to prepare for ourselves, but prepare to stay away from others!
Beth
I am very new to CLL – diagnosed in January. I do have a question in light of the flu and Cll/pneumonia. Should I get a pneumonia innoculation while I am on Watch and wait? I am 56 years old and never had one.
CDMAy56
I strongly urge you to get a flu and pneumonia shot. As a newly diagnosed CLL patient you are still likely to respond to the vaccinations (at later stages CLL patients are not very good at responding to vaccinations). Some protection against flu and pneumonia is better than none.
Even more important, it is essential that people around you also get vaccinated. “Herd immunity” is important in protecting us. If everyone around you is healthy, chances are good that you will stay infection free as well.
Note that the vast majority of older, immune compromised and very young people who die in a flu pandemic die not from the influenza but from pneumonia and other infections which followed their influenza infection.
Healthy young people often die, as Chaya has noted in the original article, from an ‘hyper immune response’ (or cytokine burst) to the influenza infection itself.
Keep yourself and those people with whom you are in contact healthy and you will stand a better chance of surviving a pandemic. Pneumonia vaccine is available NOW and provides protection for 2-3 years. A strain specific flu vaccine may not be available for months after a new mutation appears.
I was dismayed,during the frenzied days of swine flu discovery, by abivalent and misleading statements by CDC representaives regarding the efficacy of wearing masks as a defensive measure. While stating that masks work for those infected, they would then, assert that no evidence exists that wearing a mask confers defensive protection. When pressed they would admit that a flu carrying sneeze or cough from five or six feet away could be transmitted directly through inhalation. Are there some dots that need to be connected here? On the subject of airplanes they seemed to revert to mantra that passengers should not worry because infected people should not get on the plane, so therefore we’ll all be safe because they’ll stay home. CDC insists airplane air is filtered but I understand there is no US requirement for HEPA N95 filtration on US planes. I was appalled by the poor information presented to the public surrounding the use of masks and hope somebody gets on the issue before the next crisis presents itself.
The best use of face masks is for them to be worn by infected people to minimize the amount of virus which they transmit to others. Masks on healthy people are thought to be useful in preventing infection but there is very little definitive data on their effectiveness.
If I were in an environment where I thought others might be infected I would wear a mask – simply to try to reduce the probability of infection.
Hi all, update from the UK, we have had one person die from swine flu now, an Assistant Principal at a school that the flu had broken out in. As far as I now he was a normally healthy person in his fifties. Ok, it might only be one, but as we have only had 78 cases confirmed, thats 1.2% of cases. Multiply that by the number who get it world wide and thats not a good percentage, especially bearing in mind this is the first round so to speak. I always try to look on the bright side, but have found since being diagnosed that I am a little more cautious. By the way, don’t you just love the press! We have had leaflets from the government with recommendations for being careful about not passing flu on etc, which prompted a headline about ‘the amount of people pulling sickies and costing the economy money’ because people with symptoms are staying off work. Personally I have said for years that there would be fewer sick days taken if more people stayed off work when they are coughing and sneezing etc. Better one person stays off than the 10 or more they pass it on to. However, when did common sense ever come into economics.
I was once the chairman of the safety committee at the pharmaceutical company I worked for in my other life before I retired. And, as such, was also involved in specifying latex gloves, masks, protective suits, and other protective equipment (to protect both the product, and the employees).
I’d like to add to a couple of statements I see above regarding N95 masks. Much good information can also be found on 3M’s website … a good place to look, since they make all the masks we are discussing as well as surgical masks.
Basically, masks are made for two different purposes. To keep stuff out, or to keep stuff in. The NIOSH rated N95 masks (and other, non NIOSH rated masks as well) are designed to keep particulate matter in the external environment, and for some designs – viruses and bacteria, from being inhaled by the user. They keep stuff out.
The other type of mask is generally known as surgical quality masks. They, on the other hand, are designed to keep the bacteria and viruses that the wearer may have IN…so they don’t get into the environment (i.e. on the patient). Surgical masks are also designed to protect the wearer from liquids, chemicals or matter that is splashed onto them during procedures. They keep stuff IN.
Of the dozens of N95 masks that 3M makes to keep stuff out of the human respiratory system, only two are approved by the CDC for public use. The 8612f and 8670f. And they sell for about $25 each! And should be discarded after EACH USE.
However…and this may be important. Even they will not do the job completely if proper fitting, wearing and handling procedures are not followed. One has to be trained on how to use them, and how to fit them properly. For example, if a man doesn’t shave before using them, they won’t do their job! These two 3M masks received their CDC approval based on the information included on how to fit them and their proper use…not that they are that much better than other designs.
But, even if they are working at 100% efficiency, there is still a considerable chance that bacteria and viruses will be contracted by contact with the skin, in the eyes, and in the hair, not to mention clothing in general. Places even a properly fitted and worn mask doesn’t protect.
Also when you remove the mask, you are touching the contaminated head bands and the exposed surface with your hands. You are spreading contaminants that way as well.
So, in my opinion (and it is only my opinion), the masks are helpful in keeping the stuff out of your respiratory system while you are wearing them and they help to make you feel like you are doing something to ward off an invisible enemy.
You do not need to purchase the highest quality ones, as our inexperienced and untrained use and handling will negate the benefits of the more expensive masks.
So, use an N95 rated mask, but don’t spend a fortune on them, you probably won’t gain that much benefit from spending the extra money. In the end, even masks are probably not as important as the good old standard of washing and washing and washing. AND WASH EVERYTHING! Even nasal irrigation may help.
For myself, I have some very nice 3M N95 masks here that I use while I am sanding and painting my airplane (just for the fine dust, not the paint solvents). They cost a little more than $1 each in lots of 20 and considering what I mentioned above, I believe they will do me fine if we ever need them to block viruses. Any N95 WILL filter out the bad guys, but I will still have to be careful of other contact with the “contaminated” air.
To really stop the spread of disease, it simply isn’t reasonable to expect all infected people to wear surgical masks to keep the bad fellas in…
Stay home, keep to yourself and stay clean if there is an epidemic.
Just my thoughts on the matter…
Harley
Chaya,
Thank you once again for keeping us up on all the information needed to understand and how to be cautious with all flu. And of course the 1918 flu epidemic charts are very insightful. I did pass on your last report you put out on the Swine Flu to my family and friends. I have a tab on my email that will show when someone reads what I send out. Many have read that last article. I hope to educate them further with this one.
I recently was in a hospital with my daughter(veteran’s hospital) while she had eye surgery done. I managed to find a N95 mask outside a room that are for use with personnel. I took one and put it on. I don’t care what it looks like, I felt better having it on to protect me while I was surrounded by visitors and patients most of the day. Precaution is the key here. Thank you for your very wise counsel.
Anita
Great article Chaya,
It provoked a thought on treatment timing. I am preparing for first tx and it occurred to me that my timing while not planned in conjunction with flu season might be a point of discussion.
While it is not possible to say for certain how the swine flu will evolve, I am more comfortable going into treatment as the current flu season is ending.
Treated patients will certainly be more immune compromised after treatment but with the summer to recover a bit my sense is that timing can be a management tool if possible. Any thoughts Chaya or 11qRick??
WWW
We are dealing with a lot of imponderables here Wayne. Too many what-ifs to come up with a logical decision. We can prognosticate all we want, but there is no clear picture. In the final analysis this has to be a gut call. You need to make choices that feel right to you and your family.
And having met you in person, I know you will make smart choices.
Now that some time has passed perhaps it would be useful to ask where are we.
“What happens next is chiefly up to the virus,” states John Barry, author of The Great Influenza, “What’s important to keep in mind in assessing the threat of the current outbreak is that all four of the well-known pandemics seem to have come in waves,”
The take-away message is that there WILL be a next wave to this particular influenza virus but we don’t KNOW what that next wave will being in terms of transmissability and virulence. The H1N1 virus will mutate – will it become more easily transmissable and/or more virulent/deadly or less? We do not know and cannot accurately predict the answers to these quesions.
What we do know is that the better prepared we are the better are our chances of doing well regardless of what happens. Get your seasonal flu and pneumonia vaccinations, be prepared to distance yourselves from others by having adequate supplies of food and medicines, and practice good personal hygiene. These small steps can dramatically improve your probability of a good outcome IF the next waves is a tidal wave rather than a blip.
Peter’s words are wise, rational and logical. I hope many of our members pay attention to them.
As a society we have gotten so scared of creating a panic that it is no longer socially acceptable to discuss reasonable but nasty scenarios. There is an unspoken rule that citizens can no longer be trusted with scary reality. One aspect of it is the many times we are told CLL is a “good cancer”. Like hell it is.
Well, I think we are a slightly different crowd on this website. We have already faced scary reality; we have already come to grips (more or less) with a life threatening cancer. Perhaps we have a bit more steel in our spines now. Perhaps we can be trusted with real-life risk communication.
This patient group knows all about Watch & Wait. I would like to change that to Watch & Get ready, both for CLL and potential nasty flu season down the road this fall.
CLL patients and others with chronic medical conditions (especially those with immune system or pulmonary problems) are the canaries in the mine. Any community wide disease or disruption of medical services will be felt most acutely by us; we will be the first ones to feel the pain. Some of the issues are beyond our ability to control. But there are some things we can do to weather the storm (if it becomes one) a bit better.
The logic for preparing for a possible flu epidemic is no different than preparing for a CLL fight down the road. It is the same Watch & Get ready. Play it smart, make sure you and your family are reasonably well prepared for what may be ahead of us. The link I have provided in the article to the “Citizen’s Guide” is a good place to start.
Johnny Eagle
WASHINGTON (May 22, 2009) – From parades to somber ceremonies and a
Moment of silence, Americans will recall the sacrifices of military
Members who paid the ultimate price for freedom on Memorial Day, Monday,
May 25.
As veterans, we have a little bit more work to do to knock out and defeat CLL. Times are tough and so is each of our veterans. I ask each of you to come together as a band of Brothers and Sisters to donate “Whatever you Can” to help Chaya continue her critical work in the battle against CLL. Each and every veteran has protected us from enemies within and beyond our borders. One more time you are being asked to sacrifice in tough times and America knows you will respond.
It is easy to donate or send a check this weekend as the web site has all the information. Thank you Brothers and Sisters as I know you will respond.
Chaya is not aware of my request for donations to her web site, but the cost to opperate and do research on a first class web site, such as this one, is very costly.
Thank You.
Just wanted to thank you all for the input on the pnuemonia vaccine. I got mine this past Thursday. I learn soooo much from this website and am so thankful for it.
Below is a snippet from an article today by Madeleine Brindley in the Western Mail. My biggest worry is that in immune compromised patients like us chickens, even a mild case of swine flu can create a window of opportunity that lets bacterial infections take hold. Of particular concern, bacterial pneumonia. One more reason to discuss your risk profile with your doctor as we face the upcoming fall flu season.
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Swine flu ‘could lead to a rise in bacterial infections’
AN OUTBREAK of swine flu could lead to an increase in MRSA and other bacterial infections.
Public health experts said they would expect to see a range of secondary bacterial infections, if swine flu affects large numbers of people in Wales.
They are already braced to see a rise following the current measles outbreak in Mid and West Wales. So far there have been no cases in Wales of the disease, whose most serious recent outbreak was in Mexico.
Dr Jonathan Watkins, a consultant in public health at the National Public Health Service for Wales, said that a virus like flu can unlock the door to other bacterial infections, including the hospital superbug MRSA – methicillin-resistant staphylococcus aureus. There were reports of cases of scarlet fever and other infections caused by streptococcus bacteria during the winter’s flu season, which caused higher than expected numbers of cases.
Dr Watkins said: “Our bodies are covered with bacteria all the time – we will find MRSA, meningococcal and pneumococcal bacteria happily living on people’s skin, up their noses and in their guts.
“The body also has its own defences, including good bacteria. Bacteria only cause problems when they get into part of the body where they shouldn’t be. Flu, along with a whole host of other viral illnesses will smash the body’s surface up and create portals through which the bacteria can enter the body.”
A new pandemic fear: A shortage of surgical masks
May 19, Time and Reuters (National). The surgical face mask has become perhaps the most recognizable symbol of the H1N1 pandemic threat, but if the currently circulating flu virus does in fact reach full- fledged pandemic proportions, U.S. health officials say there will not be enough face masks to go. The Department of Health and Human Services (HHS) says the nation would need more than 30 billion masks — 27 billion of the simple surgical kind, which can be worn safely for only about two hours before needing replacement, and 5 billion of the sturdier respirator variety, which also requires regular replacement — to protect all Americans adequately in the event of a serious epidemic. But the Centers for Disease Control and Prevention (CDC) Strategic National Stockpile currently contains only 119 million masks — 39 million surgical and 80 million respirators. That is less than 1 percent of the goal health officials set in 2007 following the devastation of Hurricane Katrina, which highlighted the country’s shortages of vital medical gear. The U.S. mask gap stands in stark contrast to what other nations have on hand: the U.S. has one mask for every three Americans (masks are not supposed to be shared), while Australia has 2.5 masks per resident and Great Britain boasts six.
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