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.