Friday, May 1, 2009

The Flu and the Swine Flu

First of all, let me say that the current (Influenza A) flu vaccine does NOT give any protection against the Swine Flu. (Yes, I know the CDC is calling it A/@#$%^, but everyone knows what we mean by the swine flu and Lyme Disease, and Legionnaire's Disease, and Marburg virus). However, everyone should get a booster dose of the regular flu vaccine!

We have always known that the half-life of the adult antibody level induced by the Influenza A vaccine is only 3 to 4 months, so you should get a booster 6 months after your first inoculation with the same vaccine. I and my family all take it, as does my entire staff. I offer it to my patients, but 90% of them refuse it, since HMO's and MCR do not pay for the booster shot.

In fact, there was a recent article in a refereed medical journal that demonstrated that a vaccine with 4 times the strength of the standard dose would maintain viable flu antibody levels for one year.

Insofar as the new strain of flu, called swine flu is concerned, let me point out several facts, some of which need further investigation:

1) Pigs can carry viruses without getting ill (just as monkeys can carry simian hepatitis virus, which is lethal to humans, but not to the monkeys.) A pig can carry strains of virus from other species (chicken, duck, human), and they can mix and exchange RNA strands with each other, conferring new properties. Two new properties seem to be the ability to jump to humans with the ability to then jump to other humans, and, unlike the current Influenza A for which you may have been vaccinated, it is susceptible to Tamiflu. (75 mg 2 x day for 5 days for treatment, or 1/day for 10 days for exposure)

2) Fortunately for us humans, the infection is relatively non-lethal, and confers immunity. Since your infectivity begins the day BEFORE you show any symptoms, it is rather easy to tranmit. However, ordinary flu killed over 10,000 patients in the US alone this winter, nowhere near what has happened yet.

3)The flu apparently started either in Mexico, or on the California-Mexico border. We cannot be sure, because we do not have the index aminal. A greater problem is that we have absolutely no idea why it is so terribly more lethal in Mexico that elsewhere in the world---many theories, but no proofs.

4)Sterilizing your hanbds before eating is always a good idea, and perhaps so is wearing a properly applied surgical mask in crowds, as well a covering your cough. Patients with immunosuppression (steroids, AIDS, chemotherapy, anti-organ rejection drugs, etc.) should check with their doctors about special precautions to minimize exposure.

5) Two good sources of relatively unbiased information is the CDC website (Centers for Disease Control of the National Institutes of Health), as well as the IAC website (International Anti-infection Coalition).

6) I wonder if any organization is doing routine influenza surveillance on pigs around the world, much as they survey birds in China. It might be worthwhile to include swine influenza antigens in the next flu vaccine. Rather than protect against 2 strains of A and one strain of B, why not protecgt against 3 different strains of influenza A, since B is almost never lethal.

7) Take any government warning as understating the case, and any government re-assurance as too positive. The flu is like the economy, with random variations and unpredictability, and anyone with a definite forecast is operating on unvoiced assumptions that have not been tested or proven.

1 comment:

  1. If you are interested in following the future epidemiology of H1Ni Swine flu, including the 3 different strains currently circulating in pigs in Canada, then you should sign on to ProMED, an infectious disease newsletter operated by the Dept. of Infectious Disease at Harvard University. This is where a Dutch doctor who had been in China first announced the existence of SARS to the world.