Swine Flu Pandemic - Preparation

[fash]

Hi,

I am from Mumbai/India...

As of now ...not even a single H1N1 case has been registered in India or surrounding countries...
i wonder why?..is it because of the intense heat/summer..that influenza gets suppressed ?
it seems from the google Swine flu map...that North America & Europe are the worst hit...again
i wonder why?? Guess more info on 1918 pandemic ...country wise is needed.

However i am sure..that it will hit india...maybe bigtime..& am worried that the resources
to fight may not be available for such a large population.

regards
fash

[Centuron]

As a disclaimer, I went to med school 20 years ago, and a lot has changed since then. Also, I am certainly no immunologist or epidemiologist.

That said, I do remember that we used steroids quite often in children with viral illnesses when I was a pediatric intern, because sometimes the inflammatory response to the viral infection was worse than the infection itself. However, it has to be done very carefully in a hospital setting with close monitoring, because (I think) the steroids make you more susceptible to bacterial illnesses. Kids who were really bad off ended up on steroids, oxygen, IV fluids, and antibiotics all at the same time. Those were the days before we had a lot of antivirals available. Oh yeah, they also used asthma meds like albuterol to keep the airways open.

Since nobody in modern times has really treated this kind of virus before, doctors will be learning on the fly. I know that's not very reassuring, but that's the way it is ... in my opinion.

Ah. Well, it's true it isn't very reassuring, but also not completely unexpected. My hope would be is that even if the pandemic cycle is bad, that doctors this time may find something useful to lessen or prevent this same kind of problem in the future.

I had heard about the use of steroids, though I've always been wary of them myself.
I'd been reading about a possible option to mitigate cytokine storms by the manipulation of the cytokine OX40, which supposedly prevents activated T-cell death. By reducing this cytokine, it inhibits T-cells from prolonged activation, and thus from pooling in a single 'storm.' The theory sounds plausible, at least to a layman like me, and it was supposedly proven in laboratory study, but any further research about it or the manufactured way to manipulate OX40 seems unknown after 2004, so that may not be an option.
Anyway, it just seems logical to focus on understanding and safely mitigating CSs, since they seem to contribute to pandemic death and since treatment would be therapeutic (as opposed to the preventative nature of vaccines). But again, that's just from my layman's perspective.

In the meantime John's ideas seem sensible. Prepare for the worst and hope for the best. Keep well, everyone!

[Witchiepoo]

I don't know anything (more than anyone else here) about cytokine storms. But in general, there is a big difference between theory/labwork and what actually happens to patients in real life. Any attempt to manipulate the human immune system in such ways during an epidemic would be "experimental," as far as I'm concerned. If I were making a decision for myself or a family member, I would put a lot more faith in my own immune system than any treatment plan based on guesswork, with no actual data to back it up.

Doctors will not be able to "prevent" such things from happening in the future. The only thing that will (maybe) prevent these viruses from constantly emerging and killing people is a change in modern-day agricultural practices.

[John]

> I don't know anything (more than anyone else here) about cytokine
> storms. But in general, there is a big difference between
> theory/labwork and what actually happens to patients in real life.
> Any attempt to manipulate the human immune system in such ways
> during an epidemic would be "experimental," as far as I'm
> concerned. If I were making a decision for myself or a family
> member, I would put a lot more faith in my own immune system than
> any treatment plan based on guesswork, with no actual data to back
> it up.

> Doctors will not be able to "prevent" such things from happening
> in the future. The only thing that will (maybe) prevent these
> viruses from constantly emerging and killing people is a change in
> modern-day agricultural practices.

That's fair enough, but the question I have is whether there's
ANYTHING that can be done.

For example, whenever I'm home sick with the flu, I take lots of
vitamin C and lots of hot showers, and that seems to help.

Are there any other SIMPLE things that we can do to prevent cytokine
storms from killing us? Or do we just have to lie back and take it?

Sincerely,

John

[Witchiepoo]

As I said, my knowledge about cytokine storms is limited. Perhaps someone else can address the specific question of how to prevent a cytokine storm once you're sick.

There is one thing that I think people might be confused about, though. People don't have a cytokine storm because their immune system is "too strong." A strong, healthy immune system will make it more likely for your body to repel the virus in the first place, before it has a chance to invade your body and create panic, so to speak. So anything that you can do to keep yourself healthy will actually help. It might be as simple and old fashioned as eating properly, exercising, sleeping well, not smoking, etc.

[jusme]

Like everyone I am staying informed to recent out break of H1N1 flu. I see that there is a source from C D C contributing Info. I have found an interesting artical on The raw story.com titled "Farmers fear pigs may get swine flu from people ". I have learned so much from reading this site as the info. can be backed with research of history ,graph's and it is without a doubt contributed by people much smarter than myself.

But I also feel that we are subjected to for the most part a lot of mis-information in our everyday life? I also believe in the theory that they (Gov) "allows " us to hear and see what they "want "us to know and the media run's with it and before you know it takes on a life of it's own! So we all must ask the question's first--- 1. How accurate is the information ? As one can plainly see it changes by the nano-second.2. Consider "Who " has the power and control to get the information to us ? What is the usual average of accuracy ? And 3. More often than not it turns out somewhere down the road that 1% of it was accurate ! We have been shocked and awed along with a lot of other countries and come out feeling the effects of a drug induced haze and then realizing what we have lost and it was to late to effect it.

There is a quote that states "Take what you can use and throw the rest away " ! Don't let this put us in that haze of fear and lose touch with the everyday situations most of us are experiencing.This flu won't pay your rent or find you employment. It won't change the fact that everything that is happening to you,your family, friends,neigbors all the problems and injustices around the world will stop and cower in fear to it ! In reallity this is just one of the many bullets that are always aimed at us on a daily basis. Duck !( prepare).Use all methods to asscertain information so you can make informed choices. I for one don't believe most of what I hear from the" officials ' ? And usually I can't trust what I'm allowed to see !

My nine year old grand daughter attending a school here in central Fl.was told no more hugging and they are not allowed to hold hands.But the school was out of tissues ?

I believe in my grand mothers wisdom "and ounce of prevention is better than a pound of cure." We can be and should be in this toxic world always on our guard ! But we must be equally on guard to our rights and freedoms.

There are many sources and another is global research.com Remember Bush told us after the 911 tradgedy "go shopping "!

I have noticed also how with the market going up post's have dropped. It is not the human condition to be dis-stressed 24/7. We are subject to "snap " on overload.I think some people just have to take a "calgon " and get away.They will return. This is not a bottom .We haven't seen the real "bust yet "!

Dear readers "Go Gently " stay healthy and trust your own logic and and your God given instinks.

Jus me

[ainsleyclare]

John,
Sorry for the delay in responding to your direct comment:


>It's really hard for me to see how a vaccine could make much
>difference.

>Let's assume the best scenario: A vaccine is developed by September,
>and it's still effective against whatever mutated virus emerges in the
>Fall.

>Then you're still talking about a world with 6.5 billion people, and
>I doubt that more than 1-2% of them could be vaccinated before the
>flu season begins. So we're still talking about huge worldwide
>mortality.

Looking at the graph you posted of the 1918 flu, there was a small wave of flu activity late in the spring, then a much larger wave of flu activity the following fall. I'm thinking that if a vaccine could come out in September, perhaps that larger wave could be reduced? Of course, I'm making the assumption that a large percentage of the population would be vaccinated. I heard recently that the average flu vaccination rate (for the seasonal flu) is approximately 30% in the USA, and I'm guessing many more people would line up to be vaccinated against this new H1N1 strain. I couldn't find data for worldwide vaccination rates.
At least three factors will dictate overall mortality: vaccination rate, vaccine effectiveness, and virulence of the virus. The vaccine effectiveness will be due in part to how much or little the virus mutates over the course of the season, but I take some comfort in the fact that most years, the flu strains that are selected for the flu vaccine are similar enough to the flu strains ciruculating the next season that the flu vaccine provides good protection. Virulence of the virus is still unknown; early reports were scary, but more recent data indicates that most people have mild disease. The genome of this new flu virus has already been sequenced and examined, and it fortunately does not have some of the traits that made the 1918 virus so virulent.
So, if we have good vaccine effectiveness (which your best case scenario allows), high rates of vaccination, and a virus that is not extremely virulent, then the vaccine could make a big difference. Keep your fingers crossed.

[Witchiepoo]

I had an odd thought this morning. It's quite possible that this particular swine flu virus is not The Big One, but as it spreads throughout the world, mutates, and recombines with other swine and bird flu viruses, it could eventually become The Big One. In that case, people who have prior exposure to the current virus (and survive) might have a better natural immunity to whatever else comes along. Oddly enough, this scenario would mean that current isolation and quarantine procedures are actually counterproductive.

With that in mind, I'm going to forget about masks, gloves, and stocking food, and just live my life.

[Amon]

ainsleyclare:
Considering how paranoid many Americans are about government-mandated programs? It would be nigh-impossible to get a high vaccination rate in the first place, and a lot of this also depends on the virus staying mostly the way it is come the second wave, which seems unlikely.

Again, I have no way whatsoever of backing myself up here. These are just my thoughts on the matter, but honestly, I think you may be behaving way too optimistically with that post.

[ainsleyclare]

I hadn't even thought of a government-mandated vaccination program; just made the assumption that people are paranoid enough about this flu strain that they would choose to get vaccinated as soon as a vaccine was available. I know I will!

Yes, I may be too optimistic.