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Sunday, April 26, 2009

Masque of the Red Death

There have been many outbreaks of disease throughout recorded history that have gone beyond local epidemics, and into the realm of pandemic... cutting huge swaths through cities, countries and even civilizations.

The Bubonic Plague, for example, has resurfaced repeatedly throughout history.  And due to ideal conditions for its proliferation, it is presumed to have been responsible for as many as 200 million deaths throughout history.

Then there are others, such as influenza, which have been with us as more of an annoyance than a real danger... except, of course, when it suddenly appears in a strain that cuts us down like wheat.  Such was the case with the 1918 Spanish Influenza pandemic that some estimates reckon may have killed off between 2.5% and 5% of the human population at the time.

These days, just before 'flu season' the news media trots out a few experts who talk about the importance of getting a flu vaccine... and a few others who patiently explain the folly of giving flu vaccines to anyone but the most vulnerable (the elderly and very young), because the process of trying to guess which strain of flu will dominate any given area in any given year is a sucker's bet at best.

Then, of course, if a particularly virulent batch of bird flu pops up, the talk shows will immediately start booking experts who relate horror stories about how it's only a matter of time before some potent combination of animal and human virus pops up and smites us with a pandemic of never-before-seen proportions.

I have to tell you folks, I usually switch the channel when they start predicting the end of the world based on a localized outbreaks of bird flu.  But there is something about the way the media is treating this Mexican swine flu thing... kind of like a kid who has been crying wolf for years and suddenly finds himself staring into the drooling maw of the real Canis Lupus... that has me wanting to lock myself (along with my family and friends) away in a mountaintop somewhere until this all blows over.

But anyone who has read their Edgar Allan Poe knows the folly of such a solution.

Posted by David Bogner on April 26, 2009 | Permalink

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An outbreak of the swine flu in Israel? I don't think it will happen. No pigs around here.

Posted by: Lila | Apr 26, 2009 6:14:28 PM

Last week my stomach said, "uh-0h" when my cousin in Mexico told me that school was cancelled for his daughter because of this flu and they were encouraging people to walk around with surgical masks. Two days later it was a blip on the news. Now I'm hearing it's in the states and in Spain. My cousin is planning to travel to Israel in a few weeks for a family simcha. Which makes me very nervous.

And the swine flu is transmitted person to person, BTW, and is known to mutate....

Posted by: Baila | Apr 26, 2009 7:10:23 PM

Remain calm, all will be swine, I mean fine.

Posted by: Jack | Apr 26, 2009 7:41:04 PM

Lila: Yes, it will be in Israel. What is novel about this strain of AH1N1 is that it has evolved to person to person contact (P2). Therefore the lack of swine husbandry in Israel and elsewhere in the contiguous states is meaningless.

The outbreak in Mexico seems quite virulent, while the US cases, not so much.

Uhm. This isn't plain vanilla swine flu but a recombinant form. Not
known if this is really new, either, according to

http://scienceblogs.com/aetiology/2009/04/swine_flu_a_quick_overview--an.php


Reliable sources on this current outbreak (which I predict will be
found all over the US: Spring break --> Mexico --> exposure --> home &
illness; so far mild illnesses in US)

For whatever reason, most cases in US have been mild (not
hospitalized).


http://Epandemicchronicle.com/

http://www.newfluwiki2.com/frontPage.do

http://scienceblogs.com/effectmeasure/swine_flu/

http://afludiary.blogspot.com/


http://biosurveillance.typepad.com/biosurveillance/

If you twitter:

http://twitter.com/CDCemergency

http://twitter.com/FluTrackers

http://twitter.com/sophiazoe

Posted by: Liz Ditz | Apr 26, 2009 8:44:43 PM

C'mon, Trep (this is my Loma Linda U epidemiology training speaking here); I don't even see a 1% kill rate on this version of swine flu, and that's in 3rd world Meeheeco. I'll start drawing the shades when it gets up to around 100 deaths per 1000 infected.

Interesting, though, how the deaths seem to be more among the middle ages (;o/) and not amongst the elderly and young.

As for Poe? Interesting chappie. I just recently read a "remix" of his Masque in the novel "The Terror," which is about a doomed arctic expedition at the turn of the century, by Dan Simmons. Grown up reading, but recommended, as he takes an actual expedition, with the actual people, and fictionalizes it into an adventure/horror story.

Posted by: Wry Mouth | Apr 26, 2009 10:18:14 PM

Don't panic just yet.

This isn't any more severe than a regular flu. As Wry Mouth said, it's killing very few people (just like the regular flu). The only thing that is catching the attention of public health officials is that it's a novel virus, i.e. one that none of us has seen. So it's a perfect set up for a pandemic since there's a virus that has just become able to be transmitted between humans and all 5 billion of us have no immunity! But the bottom line is that we may all get the flu. Not the end of the world.

Of course the panic that all this attention may cause, the unnecessary trips to the emergency rooms by nervous ninnys, people hoarding medicines, all that could end the world...

Posted by: Albert | Apr 27, 2009 12:31:55 AM

up to about 1 in 16 dead now. If you live in Mexico. I trust the CDC will monitor it for me, so I don't have to worry. (Note: we live pretty much adjacent to a high-traffic corridor from Mexico to LA, so I understand I and my neighbors are at some risk -- particularly since our CA legislators don't seem to give a d--m about border restrictions.)

Posted by: Wry Mouth | Apr 27, 2009 7:05:03 AM

Lila... So far it isn't here. But it is only a matter of time since Israelis are noted for being world travelers. And it isn't passed directly from pigs to humans anymore. It can go directly human to human. Although, this could give some credence to the Arab claims that we are the children of apes and pigs. :-)

Baila... If I had any relatives coming from Mexico right now (or anywhere abroad for that matter) I would ask them to wear masks for the first couple of days until I was sure they were symptom free, just as a precaution.

Jack ... ouch.

Liz Ditz... I have a theory about this... but it is a layman's theory at best. See today's post.

Wry Mouth ... The fact that this seems to kill healthy adults rather than infants and elderly is precisely what scares the hell out of me. This is what happened in 1918 too. See my post today.

Albert... You know I usually defer to you on medical matters. But in this case I have to remain skeptical. See my post today for more about why I am scared spitless.

Wry Mouth ... and so it begins...

Posted by: treppenwitz | Apr 27, 2009 9:00:51 AM

You are getting more Israeli by the day. Israelis LOVE to get hysterical over potential health threats...it must be a latent hypochondria gene.

Posted by: westbankmama | Apr 27, 2009 9:58:58 AM

Westbankmama: the fact that so many people travel nowadays is what is making this flu so scary.

Posted by: Ilana-Davita | Apr 27, 2009 10:14:41 AM

The Spanish Flu ravaged a population weakened by WWI, malnutrion, poor hygiene etc. Does anybody have a detailed analysis of the Mexican victims? Could they be part of the slum population suffering malnutrion, poor hygiene etc?

Posted by: Ruth | Apr 27, 2009 11:12:25 AM

westbankmama ... I'll take that as a compliment. :-)

Ilana-Davita ... actually, in 1918, the soldiers being shipped all over the world to fight plus the supply network that was required to support the war effort provided a very nice conduit for the transfer of infection around the globe. Disease doesn't care if it travels on a troop transport ship or a cruise ship.

Ruth ... Actually quite the opposite is true from what one would suspect. I go into it in more detail in today's post, but essentially what they found odd about the 1918 flu is that it was most deadly among healthy adults and not the weaker elements (elderly and infants) as one would think.

Posted by: treppenwitz | Apr 27, 2009 11:22:33 AM

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