HUNKERING DOWN MIDWINTER

Greetings from my cave.

It’s nice and warm in here, if a bit confining. I have all I need, at least for the moment—food, drink, entertainment, husband, cats. I’m good in here until I’m forced to take out the garbage—and forage for cat food.

Outside, the third snow of this winter of our discontent covers the slopes of the mountain. It’s been well below freezing for more than a week (and don’t even ask about the wind chill factor), so the few inches that fell on Tuesday night haven’t yet begun to melt in the thin sunlight. This kind of winter wonderland would be situation normal in Wisconsin or Michigan or Maine. But here in North Carolina, well below the Mason-Dixon line, we just aren’t used to slogging through the snow to get to our ice-encrusted vehicles, or driving over the snowpack to reach the grocery store. 

In the south, as the rest of you probably know from watching the nightly TV news, we have two options when the winter weather turns bad: hunker down in our caves and wait until it warms up (my choice), or take our lives in our hands out on the slippery roads with our fellow citizens who don’t know how to drive in these conditions, resulting in massive pileups in three inches of snow. Even NASCAR great Dale Earnhardt, Jr. wrecked his car in North Carolina this week, in less snow than the residents of Montana see come down in an hour. The story was he was stopping to help someone else who had slid off the highway. No good deed goes unpunished.

But the weather is not the only reason to stay inside until spring. According to the Center for Disease Control in Atlanta, this year’s flu season is already shaping up to be “moderately severe,” though some states, like California and Texas, are suffering an unusually high number of cases. The more virulent H3N2 strain is widespread across the entire United States (except Hawaii), accompanied here and there by pockets of H1N1 and Influenza B. This year’s flu vaccine is said to be no better than a 30 percent match for the predominant strain, though vaccination will reduce the severity of the disease no matter what strain you catch.

As usual, young children, the elderly and those with compromised immune systems are most vulnerable to the deadly complications of flu (pneumonia, meningitis and sepsis). But the highly publicized flu deaths of a ten-year-old boy from New Jersey, a healthy young bodybuilder in Pennsylvania and a middle-aged marathoner/mother of three in California have captured the public’s attention. In all three cases, the victims had sought medical attention early, but succumbed anyway.

Between this very scary flu and a killer cold that has been sweeping through the Marshall community sickening people for weeks at a time, I’m afraid to leave my cave at all. And with the howling wind blowing snow into sparkling drifts outside my (double-glazed) windows, I just don’t see the need to do so. At least until the kibble runs out. Maybe in April.

Cheers, Donna

*Information for this post taken from "Questions and Answers About This Year's Flu Season," by Donald G. McNeil, Jr. The NY Times, January 18, 2018.  https://www.nytimes.com/2018/01/18/health/flu-season-facts.html

FLU: A VIRAL SWORD OVER OUR HEADS

Well, folks, here in the northern hemisphere it’s officially fall. We’ve survived Halloween, the brightly colored leaves are piling up on our lawns, baseball has given way to football in our stadiums and Sunday-afternoon living rooms. And you can’t take a step in the grocery, pharmacy or local Walmart without an in-your-face reminder to GET YOUR FLU SHOT NOW!

Yes, friends, flu season blows in with the first signs of frost on the old pumpkin, bringing the familiar misery of aching muscles, a feverish head, a cough that won’t quit, nasal congestion and the general feeling of being hit by a truck. You can be feeling fine at noon, and by dinnertime want to crawl under your covers with an intravenous chicken- soup drip. And stay there for two weeks.

Ah, but all this can be avoided if you just GET YOUR FLU SHOT NOW, say the experts—everyone from your own doctor to the faceless lab rats at the Centers for Disease Control in Atlanta. They remind us the flu is not just a painful inconvenience; it can be a deadly disease, especially for the elderly, the very young and those with compromised immune systems. The CDC estimates that between 12,000 and 56,000 people die in the U.S. every year from the flu (depending on the virulence of the strain and the length and breadth of the season). Another 710,000 become sick enough to be hospitalized. 

Those numbers are scary enough to convince me. I get my flu shot regularly, and I can count on a couple of fingers the times I’ve had the flu in my lifetime. (That’s plenty for me, by the way.) Health authorities also say the shot can lessen the impact of the flu if I do happen to get it. 

But those folks who contend they get the shot and still get the flu are not just the exception to the rule. In any given year, the efficiency of the vaccine developed for that season may range from as low as ten percent (!) to perhaps sixty percent. Compare that to the efficiency of the measles, mumps, rubella (MMR) vaccine (97 percent) or the yellow fever vaccine (99 percent).

The reason for this is that the flu virus is highly mutable, constantly mutating as it reproduces, even within a single season. The virus has even been known to mutate as it is being replicated within the eggs used to grow it for producing vaccine. That makes it nearly impossible to predict which strain (or strains) will predominate in the population doctors are seeking to vaccinate each season.

Researchers are working to develop a “universal” vaccine that will trigger the human body to produce immunity against all strains of the flu virus. But the work demands that our immune system respond to a part of the virus that remains unchanging throughout all its mutations. Not an easy task. 

And there’s another problem. “The real challenge is that there is already an established and very mature, private-sector enterprise producing flu vaccine that has in place a system of annual delivery that guarantees a certain amount of money,” said Michael Osterholm, founder of the Center for Infectious Disease Research and Policy at the University of Minnesota. If a multi-year universal vaccine is invented, Osterholm argues, “flu vaccine is practically an orphan drug.”

No matter the obstacles, the need for a universal vaccine is great. Because a viral Sword of Damocles hangs over our modern civilization, held by a thread of a single devastating mutation in the flu virus. One mutation is all it would take to unleash a global pandemic of the kind that killed five percent of the world’s population 100 years ago.

Soldiers afflicted with what many called the "Spanish flu" in 1918.

In the flu pandemic of 1918-19, a virus which is thought to have first appeared at an army training camp in Kansas attacked 25.8 million people in the U.S. alone, killing 670,000. The virus triggered an overwhelming response in the healthiest immune systems, a cascading storm of symptoms that killed young adults within hours. As a result, fifty percent of U.S. military deaths in World War I were due to influenza. Hospitals, public health systems, and other public services were overwhelmed. There were not enough doctors or nurses to treat the sick, not enough coffins for the dead. Schools, offices, theaters and other public places were closed for fear of spreading the flu. The pandemic was never “cured.” It simply burned itself out after 18 months, disappearing as quickly as it had come.  

But that was before the wonders of modern medicine, you say. Yes, but also before widespread global travel at jet speed. (Even at the speed of steamships, the flu in 1918 spread throughout the world, from the Arctic to Africa.) Public health experts live in fear of another such global pandemic. 

The next great wave may begin as the mutation of an avian flu, which even now is infecting people in China who come in contact with infected chickens. (The chickens often show no symptoms, complicating government efforts to close down open markets.) The flu, known as H7N9, is deadly to some 45 percent of humans who contract it. If the virus ever mutates to allow transmission from human to human, experts say, this avian flu could be the source of a new global pandemic the likes of which we’ve never seen.

So, GET YOUR FLU SHOT NOW!

Cheers, Donna

*Information for this post taken from: 

“Journal of the Plague Year:1918 Outbreak,” by John M. Barry. Smithsonian Magazine, November, 2017.

“Animal Vector: The Birth of a Killer,” by Melinda Liu. Smithsonian Magazine, November, 2017.