The next treat influenza epidemic may kill you… but there are things you can do to not be a victim of it when it hits.
Influenza epidemics and you
Influenza epidemics come around every year, of course. They are caused by viruses. Every time we survive a strain, those of us with decent immune systems retain cells that are good at killing that strain, so we’re unlikely to get it ever again.
The bad news is, the flu viruses mutate very rapidly, swapping surface proteins with one another to create new combinations that our immune systems have never seen, so we can get a different strain next year. The same viruses infect both pigs and some birds (chickens and waterfowl like ducks), so there’s plenty of opportunities for mutation and transmission.
How could influenza, a disease most of us have had multiple times, become so deadly? Could it happen again? And what can we do if it does? (If you prefer listening to reading, this podcast Salty and I posted months ago addresses the same questions.)
They were young, vigorous men – just the kind of people most likely to die of a cytokine storm flu.
Most influenzas don’t rise above the level of ‘nuisance’. They are respiratory infections — the stomach viruses we commonly call ‘stomach flu’ are a different kind of virus. Thousands of people die of flu every winter, it’s true; but almost all of them are very young, very old, or otherwise have lousy immune systems.
How does a flu get so deadly?
Some influenzas have a particularly nasty effect. Some of them provoke a ridiculously, lethally strong immune response; so strong that the immune response itself quickly kills the victim. This hyper-aggressive immune response is called a cytokine storm, and even with modern medical care cytokine storms are often fatal. Just as the immune system fills a sprained ankle with fluid to make it swell, the immune system during a cytokine storm fills the lungs with fluid, suffocating the suffer. Some of the flus that cause cytokine storms have fatality rates over 90%; and the young, previously healthy adults are those most likely to die. The Great Flu (sometimes called the Spanish Flu) of 1918 was such a strain.
Could such a deadly pandemic happen again?
So, could such a pandemic happen again? Absolutely. Every year we raise more swine, raise more chickens (allowing more opportunities for mutations) and move people around the globe faster (promoting rapid spread). We’ve come very close recently, in fact. Remember the Bird Flu scare of a few years back, with its 80% fatality rate among people? It slaughtered (and caused people to slaughter) millions upon millions of birds, but it wasn’t very good at passing from one human to another. It was one mutation short of the killer combination, in other words. I consider a massive and deadly flu pandemic to be the single most likely SHTF scenario.
Bird flu was one mutation away from being a killer pandemic of humans. As it was, it was just really hard on the birds.
What can we do to protect ourselves?
The best defense, of course, is not to get exposed in the first place. The problem is that the perfect answer, isolation, won’t work for many people. Ok, if you head out to a retreat in the woods and have no contact with other humans (or birds or pigs) for months or years, that might do it; but that’s what it would take. There’s usually an incubation period of a few days where an infected person could be spreading the virus but has not yet become ill; or has not become ill enough to realize it’s more than a garden variety sniffle. They’re out and about, leaving a trail of viruses in their wake.
The next best defense is much, much easier, and surprisingly effective: Wash your hands. A lot. Most people actually get exposed by touching an object with viruses on it, then touching their face or their food. Maybe the guy who got off the elevator just before you got on was coughing, and tiny droplets with virus in it landed on the button of the floor you’re heading toward. You press the button then scratch your nose. Done. You’re exposed.
Cleanliness is next to not-dyingness
Soap and water, paying special attention around and under the nails where germs often hide, is the best defense. Alcohol sanitizers aren’t quite as good, but they’re still very helpful. So is developing habits that minimize handling common objects and minimize face touching. Push that button with your knuckle instead of your finger, and follow Mom’s advice about washing before eating.
How about those masks? Well, if you’re the one with a cough, be a good soul and wear one, will you? That’s how they’re most effective; keeping the virus from being coughed over every surface in sight. As for wearing one to protect yourself, the cheap surgical masks or hardware store dust masks reduce inhalation, but don’t stop it. They have air leaks around the sides. They do make it harder for you to accidentally touch your face, which is a plus.
Useful for reducing disease transmission — but not dependable for stopping it.
Also, if there’s a pandemic on, I’m going nowhere Near a hospital unless my need is desperate. The health care folks do the best they can, but there’s really nothing you can do with a building bursting to the seams with the desperately ill that will prevent them from being very germ-rich environments.
Will flu vaccines protect you?
Flu vaccines for the seasonal flu are for different strains than the pandemic killers this post is about. You may or may not choose to get a seasonal flu vaccination (I do, but then I come in contact with a lot of people and don’t want to be a transmission hub); but it won’t help against a pandemic strain. If a pandemic strain is recognized, people are going to be busting their hind parts to get out a vaccine for it; and I (who am not a doctor so will not advise You) will definitely be in line for that one.
Remember that whole Swine Flu ‘debacle’ back in the 80s? There was a cytokine storm flu strain in Mexico that got the infectious disease people really spooked; we in the U.S. had a Massive immunization campaign … and that strain never became a real problem. People poked all kinds of fun at the health services for being so ‘alarmist’. That’s got to be a really frustrating thing about being in Public Health; when a prevention campaign works, people think you ‘did all that for nothing’. *sigh*
By the way, for those of you who are interested in the biology, at the end of the regular length of the podcast, we put on an addendum just for those (like me) who are into such things.
