I am sure that by now you heard about the Swine Flu that is raging in Mexico. I am not sure if raging is the right word since a mere 150 dead in a country like Mexico is barely above the noise. Not that I want to be callous about the loss of life, but, as some people have pointed out, this may be much ado about nothing.
It is interesting to note that this swine flu has already killed almost as many people as the much talked about bird flu of 2006/7/8. That flu did kill an enormous number of birds, but somehow the human toll never materialized. What also did not materialize was the much feared human to human transmission. This time it is different, since it is clear to all that the swine flu does transmit from human to human.
It does not transmit through eating pork and all the worries (and falling stock prices) about that sector are based on a misunderstanding of the disease. Maybe people are confused because in the earlier (bird) flu, contact with birds was strongly discouraged. But then again, not all diseases are identical. Maybe the public can be forgiven for not understanding these "subtleties."
Another reason why the swine flu has caught headlines (apart from the bird flu hangover, and the human to human transmission) is that we all know a pandemic flu is coming. Although we don't know where and when, we can be pretty sure -given the life cycle of flu pandemics- that we are in for a big one. A big one means one that kills tens of millions worldwide. Much like the big earthquake we are all waiting for in here in California, a major flu pandemic is a certainty.
Unlike what most people seem to believe, flu is a very deadly disease. It is not because we all suffer several bouts of flu during our life times, and recover swiftly and pretty much without sequelae in about 1-2 weeks, that we should think of flu as an innocent disease. It is up there with all the major killers that get a lot more coverage in the press.
Furthermore, a pandemic flu, like the one in 1918, is quite a bit more virulent than a "regular" flu. There are many reports of perfectly healthy young people who died within hours of developing symptoms. Some that survived the initial attack died several days later. Granted a large number of those died of bacterial superinfections -and we now have some remedies for those- but it would be ill-advised to be too cavalier about that. It may very well be that such a virulent flu followed by a bacterial lung infection is refractory to antibiotics (even if the bugs are not resistant). That is true because there is a difference between killing the micro-organism and ending the disease process. That too is something the public does not understand very well.
Showing posts with label pandemic. Show all posts
Showing posts with label pandemic. Show all posts
Monday, April 27, 2009
Monday, December 17, 2007
bird flu
You probably forgot about the bird flu. There is little visible evidence of it, especially here. It is no longer front page news, so why bother? Shouldn't we worry about the subprime meltdown and the stagnating economy? Just like it is hard to think about dire consequences of global warming during an ice-storm, it is hard to think about bird flu when there are no cases. These things may be invisible but they have not gone away. Both are increasingly likely as the population expands and becomes more mobile. And the "economy" plays a key role in the spread of both.
The US economy is driven by consumer spending. Fully two thirds of it depends on unnecessary and wasteful spending. Economists call this type of waste discretionary spending. It just sounds better. Discretionary spending spits out millions of metric tons of CO2 each year. It slowly accumulates, largely unnoticed. But it may turn our beloved planet into another Venus before long.
Discretionary spending in the US is crucial not just for US retailers, but for the millions of Chinese, Taiwanese, and other Asian widget manufacturers. It relies on global trade and shipping of goods. And since the great plague of 1499, we all know that such trade carries unwanted stowaways. But discretionary spending also feeds an even more efficient method to spread disease: airline travel. That next flight could be far more damaging than the ones that hit the world trade center.
Flying is not just bad for the environment, it will be the enabler and main conduit for a global pandemic. And when it comes to pandemics, all experts agree it is no longer a matter of "if," but "when." Sooner or later, a killer respiratory virus will emerge. It could be a variant of the current H5N1 that is quietly chugging along in bird stocks. But it need not be. H5N1 has almost all the needed properties, except one: it does not transmit efficiently from one person to another. You could say, so what, if you don't have that you are like a car without wheels. True, but while the car will never develop wheels to solve its problem, viruses do mutate and acquire new traits. And they do so very rapidly.
Ironically enough, one problem could "solve" another. Or at least delay it significantly. Because, unlike wars, diseases do kill large numbers of people. And unlike endemic flu, epidemics and pandemics kill the younger, more vigorous ones. The ones with the best consumptive and reproductive potential. The ones who can mount a serious immune response. Because, unlike what you may think, it is the immune response that kills in these cases.
What is especially bothersome is that a second killer wave due to bacterial super-infection could also re-appear. Bacterial super-infection played a big role in the flu of 1918, when no antibiotics were available. Even though we now have antibiotics, our over-exploitation of them has caused widespread resistance. We are quickly heading back to a pre-antibiotic condition.
Because, once again, we over-indulged ourselves. Driven mostly by the desire to make a quick profit, antibiotics were over-prescribed. And they weren't just over-prescribed to humans. Soon enough people discovered they could grow more and bigger cattle if they mixed antibiotics into the feed. But guess what? The bugs did not disappear, they just mutated and became resistant. It is called evolution. You may not believe in it, but you can see it every time you read a headline about MRSA, or "flesh-eating" strep.
But why worry? These are isolated cases happening in immune suppressed people, and they do not spread. So, it is a small price to pay for some extra beef. Or is it ? These superbugs don't matter much until you get a full blown pandemic. Only then are conditions ripe for the perfect storm. And only then is it time to pay the piper.
The US economy is driven by consumer spending. Fully two thirds of it depends on unnecessary and wasteful spending. Economists call this type of waste discretionary spending. It just sounds better. Discretionary spending spits out millions of metric tons of CO2 each year. It slowly accumulates, largely unnoticed. But it may turn our beloved planet into another Venus before long.
Discretionary spending in the US is crucial not just for US retailers, but for the millions of Chinese, Taiwanese, and other Asian widget manufacturers. It relies on global trade and shipping of goods. And since the great plague of 1499, we all know that such trade carries unwanted stowaways. But discretionary spending also feeds an even more efficient method to spread disease: airline travel. That next flight could be far more damaging than the ones that hit the world trade center.
Flying is not just bad for the environment, it will be the enabler and main conduit for a global pandemic. And when it comes to pandemics, all experts agree it is no longer a matter of "if," but "when." Sooner or later, a killer respiratory virus will emerge. It could be a variant of the current H5N1 that is quietly chugging along in bird stocks. But it need not be. H5N1 has almost all the needed properties, except one: it does not transmit efficiently from one person to another. You could say, so what, if you don't have that you are like a car without wheels. True, but while the car will never develop wheels to solve its problem, viruses do mutate and acquire new traits. And they do so very rapidly.
Ironically enough, one problem could "solve" another. Or at least delay it significantly. Because, unlike wars, diseases do kill large numbers of people. And unlike endemic flu, epidemics and pandemics kill the younger, more vigorous ones. The ones with the best consumptive and reproductive potential. The ones who can mount a serious immune response. Because, unlike what you may think, it is the immune response that kills in these cases.
What is especially bothersome is that a second killer wave due to bacterial super-infection could also re-appear. Bacterial super-infection played a big role in the flu of 1918, when no antibiotics were available. Even though we now have antibiotics, our over-exploitation of them has caused widespread resistance. We are quickly heading back to a pre-antibiotic condition.
Because, once again, we over-indulged ourselves. Driven mostly by the desire to make a quick profit, antibiotics were over-prescribed. And they weren't just over-prescribed to humans. Soon enough people discovered they could grow more and bigger cattle if they mixed antibiotics into the feed. But guess what? The bugs did not disappear, they just mutated and became resistant. It is called evolution. You may not believe in it, but you can see it every time you read a headline about MRSA, or "flesh-eating" strep.
But why worry? These are isolated cases happening in immune suppressed people, and they do not spread. So, it is a small price to pay for some extra beef. Or is it ? These superbugs don't matter much until you get a full blown pandemic. Only then are conditions ripe for the perfect storm. And only then is it time to pay the piper.
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