[eiren]

I'm shocked at the lack of real scientific information that's out there, so much so I went through and found my Virology notes from University from 1999. I studied Genetics and specialised in Viral Genetics. Here's a few facts that I can't find in any of the sensationalised media reports:

1) All human influenzae virus/flu is swine flu -

All human flu comes from the following route as per the findings of the CDC

Birds -> Pigs -> Humans

Bird droppings get into the swill that swine eat, and then in places where humans have very close every day contact to swine (i.e. 3rd world developing countries, usually the far east) it is passed onto humans.

2) It usually takes 5-6 years for someone to be susceptible again to new forms. It's not due to virus mutations (mutation = antigenic drift which is slow) but due to genetic reassortment/antigenic shift (much faster).

3) The whole world is affected by an influenza pandemic every 10-15 years due to the totally new strain. This has been the case for as far back as records go.


So what has been different this time around that's causing so much media sensationalism?

4) Last time there was a media panic about bird flu (actually no such thing, it's always pigs -> human transmission) the pharmaceutical companies produced an enormous amount of the new Tamiflu drug... and created huge stock piles that were never used. They obviously need to sell on these huge stock piles and keep the industry going, so what better way to do that than to create a mass panic about a new influenza strain? Many of the CDC advisory comity and government advisers are also chairmen of these pharmaceutical companies. They have a great deal of self interest in this.

5) Media sensationalism is required to remain competitive to new media such as the internet. There's nothing like a good health scare to sell more newspapers.


What we're seeing is nothing new, and nothing to worry about anymore than other years.

[GasDad]

Originally Posted by eiren

3) The whole world is affected by an influenza pandemic every 10-15 years due to the totally new strain. This has been the case for as far back as records go.

So what has been different this time around that's causing so much media sensationalism?

A couple of things are different.

1) The media have correctly realised that flu can be dangerous. The fact that in some cases they are blowing it out of proportion is largely irrelevant. One of these cyclic pandemics will eventually occur that has mortality rates similar (or higher than) the 1918 outbreak.


2) We are in a better position to do something about it (due to antivirals and faster development of vaccines). Given we don't yet know the final mortality rate of H1N1, it is surely wise to use all the treatments available. If that turns out to be overkill this time around, so be it.

What would you do if you were in charge?

What we're seeing is nothing new, and nothing to worry about anymore than other years.

We don't yet know that - however this time around you are probably correct.

[eiren]

I think with anything that's naturally cyclic it's very dangerous to try to affect it. In making everyone immune, you are putting selection pressures into the equation that can possibly make things worse.

To give a parallel example, MRSA is a direct result of our overuse of antibiotics. There are other strains of bacterial infections that are not as widely reported as MRSA that provide perhaps an even greater risk than anything else... especially those that resist Vancomycin which is our current secret weapon against bacterial infections.

[GasDad]

Originally Posted by eiren

I think with anything that's naturally cyclic it's very dangerous to try to affect it. In making people immune, you are putting selection pressures into the equation that can possibly make things worse.

To give a parallel example, MRSA is a direct result of our overuse of antibiotics. There are other strains of bacterial infections that are not as widely reported as MRSA that provide perhaps an even greater risk than anything else... especially those that resist Vancomycin which is our current secret weapon against bacterial infections.

Given that viruses do not (unlike) bacteria exchange DNA or RNA, please could you explain how this immunity could be transferred to new strains that are coming down the bird->pig route in the future?

If we begin treating birds and or pigs with antivirals you'd have a very strong point - but I can't see a mechanism by which the immunity can be transferred.

Or am I missing something and is there also a Human -> Pig infection route ?

[eiren]

Flu virus has a single strand RNA genome that spreads via the DNA of living cells, i.e. it's a parasite. It uses the host cell to replicate. So it can spread in the same manner.

Viruses 'mutate' via antigenic shift or genetic recombination... this is much, much faster than mutations in bacterial cells (antigenic drift) that can lead to immunity.

The rate is different in various forms of virus... for instance it's very slow in Smallpox but fast in Influenza.

[GasDad]

Originally Posted by eiren

Flu virus has a single strand RNA genome that spreads via the DNA of living cells, i.e. it's a parasite. It uses the host cell to replicate. So it can spread in the same manner.

Viruses 'mutate' via antigenic shift or genetic recombination... this is much, much faster than mutations in bacterial cells (antigenic drift) that can lead to immunity.

The rate is different in various forms of virus... for instance it's very slow in Smallpox but fast in Influenza.

That really isn't an explanation of how viruses can acquire immunity in a way the precludes the use of antivirals.

But bacteria undergo (under certain circumstances) horizontal gene transfer - this lets immunity spread to bacteria lines that haven't been exposed to the antibiotic.

There is (AFAIK) no such similar method of genetic transfer amongst viruses. This surely means that resistance (for antivirals)in one strain will not (unlike bacterial antibiotic resistance) be passed on to another.

[eiren]

I think you touched on a good alternative method of treatment above, in giving pigs the antiviral treatments.

It's effectively 'cutting out the middleman' and since the middleman in this case is required as the vector to humans, it would be very effective.

The trouble is... how do you go about giving that treatment to all livestock in poor areas of the world? It's not really practical.

I think the main thing to take from it all is not to panic or overreact. What's happening is nothing unusual.

Treatments now would have nothing to do with any potential much more lethal versions of Influenza, since they would be a new strain for which current immunisations would have no effect on.

[GasDad]

Originally Posted by eiren

Treatments now would have nothing to do with any potential much more lethal versions of Influenza, since they would be a new strain for which current immunisations would have no effect on.

Exactly - and the point I'm making is that using say Tamiflu now, will not make the next version of say Spanish Flu antiviral resistant. So from a virology point of view there isn't any good reason not to prescribe anti virals.

There is of course a clinical cost benefit analysis to be done with regard to efficacy and potential side effects.

Eiren if you were in the government what would you do.

[xit2050]

Originally Posted by eiren

The trouble is... how do you go about giving that treatment to all livestock in poor areas of the world? It's not really practical.

I think the correct question to ask is: who would pay for it?

(the problem with your question is: isn't it just as difficult to give the treatment to all people in poor areas of the world?)

[eiren]

I wouldn't do anything other than ensure people know the real facts, and give them option to go get a normal flu jab as per every year if they are worried.

I certainly wouldn't spend lots of limited funds on stock piling Tamiflu and advisory boards.

I think the current Government haven't really grasped the situation very well, and have allowed a huge amount of unnecessary hysteria to be generated.

[GasDad]

Originally Posted by eiren

I wouldn't do anything other than ensure people know the real facts, and give them option to go get a normal flu jab as per every year if they are worried.

That is now happening (or about to)

I certainly wouldn't spend lots of limited funds on stock piling Tamiflu and advisory boards.

Remember when the first announcements were made about H1N1, the projected fatality rate was a lot higher. As such Tamiflu etc made perfect sense as a way of delaying the spread until a viable vaccine was available.

From an economic point of view, Tamiflu is probably still a sensible option - it would certainly pay for itself in terms of preventing loss of tax revenue.

The government(s) of the world are in a very difficult situation. One day there will be serious flu-pandemic that has mortality rates in excess of 1%. But decisions about education, briefs to the media, release of anti virals etc have to be made before full data is available - otherwise they would be too late.

Do nothing and it could (at best) destroy the economy. Do the right thing, just in case it is a worst case scenario, and be chastised for doing too much.

I know what I'd rather our government did.

We still don't know the full effects of H1N1 - it will almost certainly infect 1/3 of us without mass vaccination. How many people (in the UK) will die as a result, no one really knows

[eiren]

Well they do know the pathogenesis and virulence of it already. So unless a new strain comes along, they're confident it's just a mild form in the majority of people.

If a new strain comes along, the current immunisations will be useless.

It's not likely though, since the cycle is 5-6 years for totally new forms of virulence.

[GasDad]

Originally Posted by eiren

Well they do know the pathogenesis and virulence of it already. So unless a new strain comes along, they're confident it's just a mild form in the majority of people.

The point is nobody was sure of that 5 months ago.

[xit2050]

Originally Posted by GasDad

it will almost certainly infect 1/3 of us without mass vaccination

Who told you that?

[GasDad]

Originally Posted by xit2050

Who told you that?

Given that every other flu pandemic has (or at least those in the last century for which reliable epidemiological data was available) - why should this one (unchecked) be any different

[Mullicious]

Originally Posted by xit2050

Who told you that?

The media told him. Didn't you know? Most people here eat up what the mass media tells them.

[GasDad]

Originally Posted by Mullicious

The media told him. Didn't you know? Most people here eat up what the mass media tells them.

I've said to you before my media includes "Nature", "Science", and various papers emailed to me, as well as Scientific American etc, and the other mass media.

Perhaps you could enlighten us with your deep knowledge (and source of information) as to a) what was wrong with what I posted and b) what you think/know is going to happen

- or are you simply going to go away again, and pop up with another idiotic posting in a months time.

[j0hn]

if its as simple as pigs then why not kill every single pig on the planet and be done with it?

no more flu???

[GasDad]

Originally Posted by j0hn

if its as simple as pigs then why not kill every single pig on the planet and be done with it?

no more flu???

Bacon Butties tbh

[Mullicious]

Originally Posted by GasDad

I've said to you before my media includes "Nature", "Science", and various papers emailed to me, as well as Scientific American etc, and the other mass media.

Perhaps you could enlighten us with your deep knowledge (and source of information) as to a) what was wrong with what I posted and b) what you think/know is going to happen

- or are you simply going to go away again, and pop up with another idiotic posting in a months time.

I have far more important things at the moment than trying to disprove the claims you make, the bottom line is, there isn't much evidence for swine flu even existing, I believe someone is offering a substantial amount of money to prove its existence, over normal flu?

I am not offering a source, I'm telling you to wait and see. The proof will be in the pudding, not in who can pull the most crap off the internet.

[eiren]

Normal flu is swine flu. All human influenza virus comes from birds, then goes to pigs, and then finally to humans.

[GasDad]

Originally Posted by Mullicious

I am not offering a source, I'm telling you to wait and see..

: rolleyes:

[Mullicious]

Are you that childish? I am saying, wait and see. The proof is most certainly in the pudding.

[GasDad]

Originally Posted by Mullicious

Are you that childish? I am saying, wait and see. The proof is most certainly in the pudding.

No - I'm trying to have a reasoned debate - but that's impossible with you - as your posts basically amount to you saying "no that's wrong" - without offering any explanation as to why, proof as to why things may be different, or even a workable hypothesis as to what might happen. But apparently I'm the childish one.


Lets try one more time - can you at least state

1) what you think will happen
2) What you would have done in the governments position 5 months ago.