Nathan Wolfe’s jungle search for viruses | Video on TED.com (Why it’s important to beat H1N1, now)

November 29, 2009

Here’s Nathan Wolfe explaining how viruses work, quickly and at a high enough level to be entertaining, and explaining why we need to worry about H1N1.

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Wolfe also explained a lot at the TED Blog:

Take us back a step or two: How did swine flu enter into the human population?

Swine flu has been known since at least the early part of the 20th century, since the 1930s. It was originally a virus of bird origin — all influenza viruses were originally bird viruses — and it probably spread to humans before it was in pigs.

Now, we still haven’t received definitive information on the underlying genetics of this particular virus. But initial reports suggest that it may be what’s known as a “mosaic virus,” which includes components of swine influenzas, bird influenzas and human influenzas. A cosmopolitan virus like that wouldn’t be unprecedented. (Editor’s Note: see Joe DeRisi’s 2006 TEDTalk for more on state-of-the-art virus detection.)

But in any case, this is a virus that appears to come from pigs, and pigs in close proximity spread the flu in much the same way that humans do — coughing, sneezing, and so on. The virus probably initially entered into human populations through people who work with livestock.

Is swine flu here to stay?

Whether this particular virus will sustain itself and become a permanent part of the human landscape is unclear, but that’s certainly what we’re watching for. As it is, the virus may just disappear because of the weather; summers aren’t good for flu viruses.

So this heat wave is working in our favor?

It might be. The virus has had a good start, from the flu perspective, considering that this is really the end of the season. But the unseasonably hot weather may bode poorly for this virus’ potential to establish itself definitively and cause a pandemic. Had this happened in September or October, it would be much more concerning.

Having said that, it’s not impossible that a virus like this might “go into hiding” — in the southern hemisphere or the tropics — and might come to light again next year. So there will be a lot of discussion about expanding the fall flu vaccine to try to control it next cycle.

Is it really possible for us to prevent future outbreaks like this?

Yes, I believe it is. We spend tons of money trying to predict complex phenomena like tsunamis, hurricanes, earthquakes. There’s no reason to believe that a pandemic is harder to predict than a tsunami. And we’d be foolish not to include forecasting and prevention as part of our overall portfolio to fight these pandemics.

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H1N1 vaccine, a citizen’s duty

November 17, 2009

Claudia Meininger Gold practices pediatric medicine in Great Barrington, Vermont.  When someone recently suggested offering flu shots at polling places, it struck her that, like voting, getting a flu shot is a good citizen’s duty.  She wrote about it in the Boston Globe.

AS A pediatrician, I received my swine flu vaccine without a moment’s hesitation. I wanted to be available to treat the onslaught of illness, and to be able to go comfortably into a room with a coughing, miserable child knowing that I was not putting myself or my family at risk. I was astounded, therefore, to read recently, in a popular newsletter for pediatricians, a column by a pediatrician stating that he would not recommend the vaccine to his patients. His arguments were that the illness was relatively mild and the vaccine might not be safe.

In my practice, there are many parents who choose not to immunize their children. As a mother myself, I sometimes wonder if part of the motivation for this choice is to combat the helpless, scary part of loving someone so much. It can become overwhelming to contemplate everything that can possibly go wrong. Perhaps parents refuse vaccines because it is something they can control, a way in which they can “protect’’ their child. In the case of swine flu, or H1N1, this action is, in my opinion, misguided.

There are many different fears associated with vaccines, but the specific fear around H1N1 has its origin in a 1976 outbreak of Guillain-Barre syndrome, a disease that damages nerve cells, after mass vaccination against a swine flu. The website of the US Centers for Disease Control and Prevention addresses this issue:

“Several studies have been done to evaluate if other flu vaccines since 1976 were associated with GBS. Only one of the studies showed an association. That study suggested that one person out of 1 million vaccinated persons may be at risk of GBS associated with the vaccine.’’

The current method for making the H1N1 vaccine is the same as that for the seasonal flu vaccine. The only difference is that seasonal flu vaccine is prepared in anticipation of flu season, while manufacturing of this one was begun while the pandemic was in its initial stages. High-risk groups, such as the elderly and young children, receive the seasonal flu vaccine without a second thought.

It is true that for the majority of people H1N1 is a mild illness, generally causing two to four days of feeling lousy. But the virus is highly contagious. The sheer numbers are staggering. A school in Chicago closed last month when 800 of its 2,200 students were sick. With any flu there are people who will have complications and die. As the number of cases continues to climb, statistics are not in our favor.

For high-risk groups, such as pregnant women, talk of “mild illness’’ is meaningless. Stories are multiplying of the devastating losses of both baby and mother. In our small town there are young adults who were previously healthy now on respirators in intensive care units.

In a recent op-ed in The New York Times, Douglas Shenson proposed the use of polling places for vaccination. This led me to think of vaccination as a responsibility of being a citizen, analogous to voting. Just as one vote does not determine the outcome of an election, one person immunized does not halt the spread of illness. Yet voting is a civic duty. Similarly, vaccination, while benefiting the individual, serves to protect the population as a whole. Short of shutting down the country, mass immunization is the only way to stop the spread of this virus.

In addition, I feel that as a physician, it is my responsibility to uphold the recommendations of the CDC. If every individual citizen took it upon himself or herself to decide what was best for the country, there would be chaos.

Washing hands, covering our mouths when we cough, and staying home when we are sick are all ways to contribute to the common good. As responsible citizens, when the opportunity arises, and in keeping with CDC guidelines, we should all do our part and immunize ourselves and our children.

Dr. Claudia Meininger Gold, a pediatrician, practices in Great Barrington.  Copyright to Boston Globe.

 

<!– Citizen, heal thyself: Get the swine flu vaccine Boston Globe Just as one vote does not determine the outcome of an election, one person immunized does not halt the spread of illness. Yet voting is a civic duty. Similarly, vaccination, while benefiting the individual, serves to protect the population as a whole. Claudia Meininger Gold November 16, 2009 –>
Claudia Meininger Gold

Citizen, heal thyself: Get the swine flu vaccine

By Claudia Meininger Gold November 16, 2009

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AS A pediatrician, I received my swine flu vaccine without a moment’s hesitation. I wanted to be available to treat the onslaught of illness, and to be able to go comfortably into a room with a coughing, miserable child knowing that I was not putting myself or my family at risk. I was astounded, therefore, to read recently, in a popular newsletter for pediatricians, a column by a pediatrician stating that he would not recommend the vaccine to his patients. His arguments were that the illness was relatively mild and the vaccine might not be safe.


Fighting the flu in Texas

September 27, 2009

Texas government worries about the flu, with good cause.

The Texas Department of State Health Services set up a flu information page at its website, urging Texans to act now to prevent trouble later:

Flu season is here — here’s what you can do:

  • Stay Informed
    TexasFlu.org is the DSHS site for flu information in Texas. Bookmark it. Sign up to receive Twitter and e-mail notices when information is posted.
  • Get a Seasonal Flu Shot Now
    Don’t wait. Get your seasonal flu vaccination now. It’s one of the best ways to protect yourself and others from seasonal flu. Also, be prepared to get the 2009 H1N1 flu vaccine later. It is expected to be available in mid-October.
  • Stop the Spread
    Wash hands frequently. Cover coughs and sneezes. Stay home if you’re sick. Have a plan to care for sick family members at home
  • 18 Texas kids have died from influenza in the past 52 weeks.  Health officials hope immunization will keep pediatric and other deaths low, for both the regular seasonal flu viruses and the novel H1N1 which is the subject of a WHO-declared pandemic.

    (By the way, “pandemic” does not have “panic” at its root; it’s a combination of “pan” from Greek and roughly meaning “all people“, and “demic” meaning a health issue “people. (See Mr. B’s comment below.)

    According to the World Health Organization (WHO), a pandemic can start when three conditions have been met:[1]

    • emergence of a disease new to a population;
    • agents infect humans, causing serious illness; and
    • agents spread easily and sustainably among humans.

    A disease or condition is not a pandemic merely because it is widespread or kills many people; it must also be infectious. For instance, cancer is responsible for many deaths but is not considered a pandemic because the disease is not infectious or contagious.

    Complaints that deaths are low from H1N1 should be regarded as a compliment to the work of health care workers and officials; and statements that we don’t have a flu pandemic ‘because not many people have died’ miss the definition of “pandemic.”)


    No, WHO is not taking over the world with swine flu scares

    August 9, 2009

    Turn up the craziness that is opposition to health care reform, and you get genuine, full-blown “hot zone” conspiracy wholly ungrounded in reality.

    Like coathangers, hoaxes multiply in the closet!  Put ’em in the dark, they’ll invent stuff beyond your wildest imagination.  It’s a perfect storm of voodoo science, voodoo history, paranoia and just plain hysteria.

    TinFoilHatArea sign

    But they’ll swear it’s true.

    A new hoax claims the World Health Organization (WHO) got a secret law passed to allow them to take over the world just as soon as they can get a few more people to catch swine flu.  No, really.

    Under special pandemic plans enacted around the world including the USA, in 2005, national governments are to be dissolved in the event of a pandemic emergency and replaced by special crisis committees, which take charge of the health and security infrastructure of a country, and which are answerable to the WHO and EU in Europe and to the WHO and UN in North America.

    If the Model Emergency Health Powers Act is implemented on the instructions of WHI, it will be a criminal offence for Americans to refuse the vaccine. Police are allowed to use deadly force against “criminal” suspects.

    Through their control of these special pandemic crisis committees with the power to enact legislation to be set up most countries, the WHO, UN and EU become the de facto government of a large part of the world.

    Mass murder and death will also bring economic collapse and disruption, starvation and wars – and these events will lead to a further population reduction.

    Absolutely false.  WHO has no such plans.  Check with your health professionals, they’ll tell you swine flu is a real concern (even though it looks like swift action has prevented a lot of trouble so far, and may prevent a lot of ill health later).

    If you made up this sort of stuff for a movie, they’d tell you “Dr. Strangelove” pushed the envelope as far as parody would go, and you should give up writing comedy, even dark comedy.

    Did you notice the typographical error there in the second paragraph, where “WHO” turns into “WHI?”

    That’s a DNA-style marker for this hoax.  Watch for it as it shows up at other sites where tinfoil-hat bedorned people mindlessly copy this chunk of fiction and pass it along as if it were just news about the new shopping center going in around the corner.

    Much of the nuttiness appears to originate at WakeNews, from someone named Jane Bürgermeister who has grabbed .pdfs of a couple of WHO memoranda on the dangers of swine flu, and claims that instead of warnings about swine flu based on research, they are textbooks for how to use swine flu as a weapon of war against civilians.  Or it may be originating at a website she may run, Case About Birdflu (this is the url, I kid you not:  http://birdflu666.wordpress.com/) (This post, about her being fired, and with lots of “attagirls” from too-willing nutters, should be a roadmap for Prozac salesmen.)

    Do not any of these people ever stop to wonder, “Hmmmm.  Curious about how this doesn’t appear on the WHO website, and how there are no links to anything that sounds even tangentially rational — I wonder if it’s true?”

    Wall of Shame: Here are sites that repeated the hoax blindly, without even bothering to correct the typo (notice how few of these sites will allow you to point out an error):

    Reality:  No plans to take over the world; tough plans to fight swine flu

    Swine flu, more specifically the H1N1 virus, poses severe threats to real people, including you.  WHO has plans to combat the disease and its spread — laid out publicly here, for example.  There is even a Center for Strategic Health Operations (SHOC in the odd acronymical lexicon of the UN).

    Preparations to fight epidemics and pandemics are part and parcel of public health operations around the world.  Almost every county in the United States has a public health office that makes plans for how to protect the local community from such diseases, and how to treat people who get the disease to help them survive.  Those who spread these hoaxes rarely know that they have people in their towns to do this work — the United Nations and WHO have no authority to intervene in these cases.

    What about the Model Emergency Health Act? Proposals under that name exist — none allow people to be executed for refusing vaccinations.  As a matter of U.S. policy, almost all health legislation includes an out for religious objectors — Christian Scientists, for example, generally refuse vaccinations and much other treatment.  Jehovah Witnessses refuse transfusions.  In almost every case, those religious beliefs can be accommodated so long as the rest of us bother to protect ourselves against disease.

    All of the proposals are designed to help public health officials fight disease.  Public health officials might be described as the embodiment of the name Milquetoast.  They are rarely in the forefront of your run-of-the-mill power-mad megalomaniac.  Former public health officials who rose to power in any circumstance can be counted on one hand, if there are any.  Contrast that with former religious officials, or former business executives, or former college presidents, and you begin to see reality.  WHO is not populated with people who wish to take over the world á la Pinky and the Brain.  WHO does not answer to people who resemble Pinky or the Brain in any way, either.

    You may review the first (and most worrisome) draft of the Model State Emergency Health Powers Act in .pdf here.  Note carefully the strong defense of the rights of individuals recognized in the preamble to the draft bill.  The 2003 version of the Model Act can be reviewed at Alaska’s site; you can also find a section-by-section analysis and other explanatory material.

    This document tracks state legislative actions so far — I dare anyone to find the trampling of civil rights and lunatic claims made at the websites listed above.  If you do find troubling actions, please note them in comments here. Note well that the documents in the previous three links are maintained by officials at the State of Alaska — Sarah Palin’s appointees and public health team.  It’s unlikely that Sarah Palin would be involved in a massive, international conspiracy to imprison millions of citizens just because they are not immune to influenza.  Of course, maybe you know Palin better than I do and you think she’s a megalomaniac just looking for her chance to play Mussolini in America — but I doubt it.

    U.S. Centers for Disease Control (CDC) are deeply involved in preparations for influenza outbreaks, and swine flu is no exception.  CDC features a page showing international preparations for swine flu; note that plans to round up recalcitrant non-inoculants for execution are not in the program.  From that page you can get to the WHO page on international preparations, and there you can link to to international health regulations on the issueWHO’s “edict” so far:

    Concerning public health measures, in line with the Regulations the Director-General is recommending, on the advice of the Committee, that all countries intensify surveillance for unusual outbreaks of influenza-like illness and severe pneumonia.

    That’s it.

    There is an Emergency Committee set up to deal with H1N1 specifically. The group has met four times; here is the report from the fourth meeting, in June:

    11 June 2009

    DG Statement following the meeting of the Emergency Committee

    The Emergency Committee held its fourth meeting on 11th June 2009.

    The Committee considered available information on transmission of New influenza A (H1N1) in a number of locations in countries in different regions of the World Health Organization, and concluded that the criteria for a pandemic have been met.

    Following the advice from the Committee the WHO Director-General decided to raise the level of influenza pandemic alert from the current phase 5 to phase 6. At this early stage, the pandemic can be characterized globally as being moderate in severity.

    As previously recommended by the Director-General, countries should not close borders or restrict international traffic and trade.

    Countries should assess their specific situation and make a timely transition from focusing national efforts on containment to focusing on mitigation measures, including appropriate non-pharmaceutical interventions.

    WHO remains in close dialogue with influenza vaccine manufacturers. It is understood that production of vaccines for seasonal influenza will be completed soon, and that full capacity will be available to ensure the largest possible supply of pandemic vaccine in the months to come.

    You can see that the paranoia reflected in the sites on the Wall of Shame, is unwarranted.

    Coda: You gotta love the guys who quickly see a way to make a buck on this fear.  Here’s a guy who will sell you a “smartroom” decontamination unit to retrofit any room in your home to make you safe from swine flu — just $1,899! Crazy with dollar signs in his dreams.

    The SmartRoom is designed to protect you and your family from all viruses and bacteria. It can be quickly and easily installed. The SmartRoom is lightweight, compact and is totally collapsible for storage.

    The SmartRoom features an Ultraviolet Biological Airlock that you attach to any room entry in your home or office. The Smartroom Tri Filter Biological Filtration Unit creates a Biological Saferoom under positive air pressure or a Quarantine Room under negative air pressure.

    If it were only so easy to protect from swine flu.  If only it were so easy to protect ourselves from the conspiracy crazies.

    Update, August 11, 2009:  More than 19,000 tinfoil hatters (TFH) have signed a petition against WHO’s imagined mandatory vaccine campaign.  Sign a petition against a problem that doesn’t exist!

    Update, September 12, 2009: See this debunking of pseudoscience anti-vaccine claims at Respectful Insolence.


    Friends don’t let friends be hoaxed:  Don’t be fooled!  Share the news.

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