If my email inbox and patients questions are any indication, the recent outbreak of Swine Flu raises several concerns in the minds of many people. What I will do in this article is to address some of the concerns many of you have raised.
If one was to release a genetically engineered influenza virus into society, one of the best places on Earth to do it would be Mexico City. Several factors are present in Mexico City which make it an ideal location to spread disease. Mexico City is the largest city on Earth. The population density is very high, and many people live in poverty. People come in close contact with each other on a daily basis. Mexico City also has inadequate sanitary standards compared to modern day standards. The combination of these factors lead to a great number of people being infected before the extent of the outbreak is clearly recognized. By the time the influenza virus is detected and analyzed, it will have already been distributed throughout the world. This, in fact, has already occurred.
The death rate is on the order of 10%. This is a high figure for any influenza virus. The death rate, however, is not the only reason this particular swine flu is bad. This form of the influenza virus appears to have an efficient human to human transmission. Drug resistant strains have already been discovered. It is the combination of these three factors, a high death rate, efficient transmission, and drug resistance, which make this Swine Flu strain a more serious threat to the population.
Why Does This Swine Flu Only Kill Healthy People?
Certain strains of flu affect individuals differently. The general garden variety flu generally affects the elderly and those with compromised immune systems to a much greater extent than the young and healthy population. The current Swine Flu, however, appears to affect people who have a healthy immune system to a much greater extent than those who are elderly, in poor health, or have a compromised immune system. Whenever this is seen, there are several possibilities that exist which will explain this occurrence. This occurrence, incidently, is also seen with the H5N1 “bird” flu. As of this writing, it is not known which of the following scenarios apply to the current Swine Flu outbreak. Most likely, multiple factors are involved.
The first scenario involves the death of people who have an immune system which is out of balance. In these people, an excessive amount of cytokines are released in response to the virus. Cytokines are one method in which the body deals with an infection. Cytokines are chemical mediators produced by specific types of white blood cells called T-Cells. If the T-Cell response is exaggerated, massive amounts of cytokines may be released in response to the viral infection. When the immune system is out of balance, a massive cytokine release occurs at the end stage of the H1N1 viral infection. In those without an imbalance, the massive cytokine release does not occur.
Another scenario involves the survival of those with an underdeveloped or suppressed immune system. An underdeveloped immune system is typically found in younger children. Children have immune systems that are still developing, and generally do not have full immune capacity at their young age. The elderly, people who are chronically ill, the immunosuppressed individual, or those taking certain medications would fall into the category of people who have a suppressed immune system. In both of these groups, the immune system is incapable of producing the massive cytokine release leading to death. In other words, the immune system is unable to efficiently combat the virus, and the virus reaches end stage and just burns out.
Tamiflu and Relenza have a preventive effect against human flu Type A. As the Swine Flu virus mutates, depending on the mutation, these medications may be found to be more effective or less effective. Most likely what will happen is a drug-resistant strain of the Swine Flu will arise, and spread more effectively since it will be difficult to eradicate.
How About Those Surgical Masks People Are Wearing?
Surgical masks provide some protection. These masks are termed N95 surgical masks. Once worn, they must be discarded and not worn again.
The dust masks found in the corner hardware store offer no protection whatsoever against a virus.
I Got a Flu Shot. Am I Protected?
If you received a flu shot for this past winters flu season, you are not protected against the recent Mexican Swine Flu outbreak. Remember, this is most likely a genetically engineered flu. The recent outbreak of the Mexican Swine Flu was not foreseen by the developers of the vaccine at the beginning of the last flu season, therefore, its components were not part of the vaccine.
The CDC, in cooperation with other agencies, is currently developing a vaccine. It will arrive too late.
More coming on this subject, if necessary, at a future date.
