Influenza season is back. And so is the concern for the next pandemic. What’s ahead for the 2013¬–2014 flu season?
Nobody knows for sure. Despite the fact that the biggest pandemic threat we face is influenza, the effective rate of predicting a pandemic is zero. The influenza virus has fooled us every time scientists have tried to outsmart it.
The explanation of why we can’t get it right is the fact that influenza viruses have been around a long time, probably longer than humans, and utilize the biological laws of nature for their benefit. Nothing personal, but humans are just a carrier for the life cycle of the virus.
Because we consider ourselves outside of nature, we’re completely unaware of what the virus is doing in nature. It’s only when some one gets sick that we start analyzing the virus.
Symptoms of the Flu
- Fever and extreme coldness (chills shivering, shaking)
- Nasal congestion
- Runny nose
- Body aches, especially joints
- Sore throat
- Irritated, watering eyes
- Reddened eyes, skin (especially face), mouth, throat and nose
- Petechial rash
- In children, gastrointestinal symptoms such as diarrhea and abdominal pain
Since influenza usually starts in wild birds, and then infects poultry and pigs before it jumps to people, the strategy to prevent a pandemic has been to clear out open markets, kill pigs and chickens by the millions and bury them in mass graves. Besides being inhumane, this practice may only work to prevent the spread of bird flu among chickens, or swine flu among pigs. The “if they’re all dead, we can’t get infected” theory doesn’t work as well for humans. First, you can’t kill sick people.
Second, wiping out farm animals just drives the virus underground. It continues to evolve in wild host animals, like migratory ducks that mingle with domesticated poultry in small rural farms in remote regions in Asia. Then it comes back nastier then ever.
Historically, influenza outbreaks start in China and Southeast Asia. This is because people in these regions have lived in close proximity to domesticated livestock—pigs, chickens, and ducks—for thousands of years. Influenza viruses incubate in animals and then spread to humans. They know this turf well.
This rule changed in the Mexican Swine Flu outbreak of 2009, however. Why did it appear in Mexico? I was in Mexico City during that time, and it was like a ghost town.
When the virus mutates into a strain that humans can catch from other people, it has the potential to go pandemic, and people were afraid to go out in public.
The Numbers Game
The “H” and “N” used in the name of a flu virus stands for hemagglutinin (H) and neuraminidase (N). These are two proteins on the surface of the virus that allow it to move in and out of host cells. At least sixteen different hemagglutinins and nine different neuraminidases have been identified.
Bird flu—like H5N1—starts in wild migratory birds. H7N9 is a new form of influenza virus that came out of Mongolia and Siberia. Unlike seasonal flu that infects the upper part of the lungs, H7N9 attacks deep in the lungs. The risk of dying from H7N9 infection is high. It’s the scariest flu of the coming season. For now, it’s only in China, but give it a few months.
Types of Bird Flu
Swine flu, like H1N1, starts in pigs before it jumps to humans, but is also found in birds. It was responsible for the 2009 Mexican flu pandemic. The H3N2 variant is already in pigs in the United States, and has infected some people. The CDC is watching this one, because it seems to spread easily from pigs to humans, but has yet to make the leap to human-to-human transmission.
Types of Swine Flu
What’s Coming in 2014?
So far, fall and early winter 2013 are mild, but it’s to soon to predict what late winter and spring 2014 look will be like. Some influenza experts are predicting higher than normal activity from December through February.
Remember, influenza virus has an ancient relationship with people and animals. Infection severity is unpredictable. Mild viruses can turn nasty, and severe viruses can play out fast and then disappear. We just don’t know all the rules.
The reason it can kill is that it provokes a powerful immune response that triggers massive inflammatory activity in the lungs. This hyperinflammatory response mechanism is your immune system in overdrive. It floods the body with toxic cytokines that uncontrollably spin into shock. The most severe reactions are in healthy younger people with the strongest immune systems. Those most susceptible to dying from the flu are elderly people with weakened immunity, and young children who have not built up immune memory against the flu.
In October, most flu activity in the Western Hemisphere was found in Mexico. That could change. Watch the CDC and WHO influenza charts in December.