How Influenza “Flew” Through Time

1. When Pigs Fly The History, Treatment and Social Response to Swine Flu and Other Infectious Diseases Group A: Brown, Canning, Carter • How Influenza “Flew” Through Time • In 465 BC Hippocrates first described flu like symptoms that he observed in his patients. Since then it’s been a seasonal battle between humans and the influenza. The flu’s capability to mutate through transgenic shift makes the disease a potential threat to human life each year. There have been four recorded flu pandemics to date in history. A disease is classified as a pandemic when it spreads worldwide causing disease and death everywhere it hits. An epidemic on the other hand is a more contained spread of disease; it stays in one region of the globe. The influenza virus is constantly changing in the arms race against modern health improvements. A recent study revealed that there are at least 500 varieties of the influenza virus with more emerging all the time. Influenza is unpredictable, it has advanced beyond our means of fighting it in the past, and the threat looms for this to happen again in the future. • Flu Pandemics • 1918 Spanish Flu • -H1N1 • -Killed up to 100 million worldwide • -500 million infected, which was 1/3 of the world population • -Lowered life expectancy in the US by 12 years • “If the epidemic continues its mathematical rate of acceleration, civilization could easily disappear from the face of the earth within a few weeks” – US Surgeon General Victor Vaughan (1918) • 1957-58 Asian Flu • -1-4 million deaths • -70,000 deaths in United States • -Vaccine came out in August 1957 • 1968-69 Hong Kong Flu • -1 million deaths • -Similar to Asian Flu • -Killed 34,000 in United States • -Came to US through Vietnam War • 2009-10 Swine Flu • -H1N1 • -Still Occurring • -16,455 deaths • -213 countries have reported cases • -Striking similarities to Spanish Flu Source: CDC.gov • Influenza has been one of the world’s greatest all time killers. When a deadly strain emerges it has the capability of killing healthy adults in a matter of hours. The Spanish Flu created ghost towns, only to fade away as all of those who were vulnerable to the disease were killed. Influenza has the capability to infect horses, birds, pigs, and humans. This allows for many different variations to form, with the potential for harming humans increasing. Science and medicine have been able to suppress a repeat of the devastating affects of the Spanish Flu so far, but the chance always exists for the flu to mutate into a form that extracts enormous tolls from human life before a vaccine can be created. Modern Flu Treatments Vaccines work by injecting a small amount of the virus into the body, which triggers an Immune response. The body then produces lymphocytes, which recognize and attack viral DNA. Swine Flu Vaccine Source: Conant Medical Group Vaccine Production Process- Vaccines are typically made using chicken eggs, but some can be made with hen’s eggs or yeast cells. A company called Protein Sciences in Meriden, CT uses insect cells instead of eggs, because they are quicker and safer. The bits of virus that are used need to be kept frozen, to prevent their intensities from changing. When they are needed, they are warmed up in a water bath or at room temperature. They are added to a machine to help them multiply. When the vaccine is finished growing in whatever substance it is in, it is removed and mixed together, because they are usually made in separate parts. Allergy Concerns: Vaccines that are made in eggs are clearly a concern to people with egg allergies. Though surprisingly few people that are allergic to eggs are actually allergic to the vaccines made in them. Drug Companies: GlaxoSmithKline Biologicals and Wyeth Biotech are two large vaccine manufacturers. Scientists: Jonas Salk attended New York University to study medicine. In 1938 he began studying the influenza virus with Thomas Francis Jr., a microbiologist, and together they made an influenza vaccine for American soldiers during World War II. In 1947, Salk became head of research at the University of Pittsburgh’s Virus Research Lab, where he worked on a flu vaccine and polio vaccine simultaneously. He developed a polio vaccine in 1952, which he tested on himself, his family, and other volunteers. It was cleared for public use when none of these people showed negative side effects. An oral form of the same vaccine, developed by Albert Sabin, soon replaced Salk’s treatment method. Safety Concerns: Vaccines are relatively safe, and are certainly preferable to the diseases which they prevent. One in three people will get a sore arm, with redness and swelling, about an hour after injection. 10 to 15% of patients will incur tiredness, headache, or fever from injection. In rare cases, about 1 or 2 out of a million, people can contract Guillain-Barré syndrome (GBS), a serious neurological reaction. Swine Flu: There was an initial outbreak of Swine Flu in 1976, which was confined to a military base. The vaccine available then was not safe, as it caused an increased risk of the serious neurological reaction, GBS, mentioned above. When Swine came back recently, it took less than 4 months to become a world wide pandemic. The H1N1 vaccine comes in three forms: a Nasal spray called FluMist, a single-vial injection, and multi-vial injections. The first two treatments are preferable to the third, because the multi-shot injections contain Thimerasol, which is partially composed of ethyl mercury. Though this is less toxic than other forms of mercury, it is still not desirable to have in ones’ body. The Thimerasol is added to prevent bacterial contamination in the vials. Social Reponses and the Role of Media The media’s level of response to an outbreak greatly influences public sentiment and, by extension, public policy in response to a virus. The media can play an important role in protecting the public by distributing accurate and relevant information, help foster a sense of panic that could ultimately cause more unrest than appropriate, or prevent the public from responding adequately by downplaying an actual threat. Following the recent outbreak of the H1N1 virus, many people believe the media coverage of the outbreak elevated public anxiety to unnecessary levels. In the 1980’s, the public relied on print media for information about AIDS in the United States. However, during recent swine flu outbreak, the public learned about the virus and its spread through a myriad of sources, including many internet-based media such as online databases, blogs, Facebook, and even Twitter. CDC’s Twitter update on September 4rth, 2009: “ RT @CDCFlu Update 9/4/09: 9,079 hospitalized cases of novel H1N1 flu, 593 deaths, 53 states/territories reporting: http://is.gd/2SUMb” h Source: htp://twitter.com/CDCEmergency An excerpt from Metro, a London daily newspaper, on April 26th, 2009: “The sudden rise of swine flu may trigger a pandemic that could wipe out 120million people, an expert has warned. More than 80 people are now thought to have died as the first scare hit Britain. The death toll of the H1N1 virus could reach 50million – as high as the Spanish Flu of 1918, according to John McCauley, of the National Institute For Medical Research.” Source: http://www.metro.co.uk/news/635961-swine-flu-could-kill-up-to-120m Media Imagery Over-Reporting Past Outbreaks: In 2003, the emergence of Severe Acute Respiratory Syndrome (SARS), gained international media attention. Most studies evaluating the media’s performance during the SARS outbreak determined the media coverage was excessive, sensationalist, and sometimes inaccurate (Bergeron and Sanchez, 2005). Source: Newsweek Archives Age Distribution of Deaths Caused by 1918 Flu Worldwide Images, often used in contemporary news media, are sometimes more influential than written word. This image of President Obama wearing a mask in campaign poster suggests protecting oneself from the H1N1 virus is patriotic. Source: http://littlemountainhomeopathy.files.wordpress.com/2009/08/obama-h1n1.jpg Using the media, the World Health Organization (WHO) and the Centers for Disease Control (CDC) brought attention to a few cases in the United States and the worst-case scenarios regarding the spread SARS. The WHO and CDC’s use of the media cultivated a sense of fear among the public and caused governments to enact large-scale quarantines and travel bans. However, the WHO, CDC and media’s response had arguably more detrimental effects on society than the virus itself; it paralyzed economies, brought attention away from the spread of more threatening diseases, such as Aids and malaria, and unnecessarily increased the public’s sense of risk. As of July 2003, SARS had infected only 8,400 people and caused the death of 774 people worldwide. In the United States experienced only 33 probable cases and no confirmed deaths (Siegel , 2005). Age Distribution of Deaths Caused by 2009-10 Swine Flu in US Bibliography Bergeron, Sheri L. and Ana L. Sanchez. 2005. “Media Effects on Students during SARS Outbreak”. Emerging Infectious Diseases. 11(5). Bond, Allison. "Vaccine Production Is Horribly Outdated. Here Are 3 Ways to Fix It." Discover Magazine. 27 July 2009. Web. 16 Mar. 2010. <http://discovermagazine.com/2009/jul-aug/27-vaccine-production-horribly-outdated-3-ways-fix-it>. Crosby, Alfred W. America's Forgotten Pandemic: the Influenza of 1918. 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