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"Scientists see this flu strain as relatively mild

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"Scientists see this flu strain as relatively mild

Genetic data indicate this outbreak won't be as deadly as that of 1918, or even the average winter.

By Karen Kaplan and Alan Zarembo
April 30, 2009
Source LA Times

"As the World Health Organization raised its infectious disease alert level Wednesday and health officials confirmed the first death linked to swine flu inside U.S. borders, scientists studying the virus are coming to the consensus that this hybrid strain of influenza -- at least in its current form -- isn't shaping up to be as fatal as the strains that caused some previous pandemics.

In fact, the current outbreak of the H1N1 virus, which emerged in San Diego and southern Mexico late last month, may not even do as much damage as the run-of-the-mill flu outbreaks that occur each winter without much fanfare.

"Let's not lose track of the fact that the normal seasonal influenza is a huge public health problem that kills tens of thousands of people in the U.S. alone and hundreds of thousands around the world," said Dr. Christopher Olsen, a molecular virologist who studies swine flu at the University of Wisconsin School of Veterinary Medicine in Madison.

His remarks Wednesday came the same day Texas authorities announced that a nearly 2-year-old boy with the virus had died in a Houston hospital Monday.

"Any time someone dies, it's heartbreaking for their families and friends," Olsen said. "But we do need to keep this in perspective."


Flu viruses are known to be notoriously unpredictable, and this strain could mutate at any point -- becoming either more benign or dangerously severe. But mounting preliminary evidence from genetics labs, epidemiology models and simple mathematics suggests that the worst-case scenarios are likely to be avoided in the current outbreak.

"This virus doesn't have anywhere near the capacity to kill like the 1918 virus," which claimed an estimated 50 million victims worldwide, said Richard Webby, a leading influenza virologist at St. Jude Children's Research Hospital in Memphis, Tenn.

When the current virus was first identified, the similarities between it and the 1918 flu seemed ominous.

Both arose in the spring at the tail end of the flu season. Both seemed to strike people who were young and healthy instead of the elderly and infants. Both were H1N1 strains, so called because they had the same types of two key proteins that are largely responsible for a virus' ability to infect and spread.

The Centers for Disease Control and Prevention and the National Institutes of Health published genetic sequence data Monday morning of flu samples isolated from patients in California and Texas, and thousands of scientists immediately began downloading the information. Comparisons to known killers -- such as the 1918 strain and the highly lethal H5N1 avian virus -- have since provided welcome news.

"There are certain characteristics, molecular signatures, which this virus lacks," said Peter Palese, a microbiologist and influenza expert at Mt. Sinai Medical Center in New York. In particular, the swine flu lacks an amino acid that appears to increase the number of virus particles in the lungs and make the disease more deadly.

Scientists have identified several other differences between the current virus and its 1918 predecessor, but the significance of those differences is still unclear, said Dr. Scott Layne, an epidemiologist at the UCLA School of Public Health.

Ralph Tripp, an influenza expert at the University of Georgia, said that his early analysis of the virus' protein-making instructions suggested that people exposed to the 1957 flu pandemic -- which killed up to 2 million people worldwide -- may have some immunity to the new strain.

That could explain why older people have been spared in Mexico, where the swine flu has been most deadly.

The swine virus does appear able to spread easily among humans, which persuaded the WHO to boost its influenza pandemic alert level to phase 5, indicating that a worldwide outbreak of infection is very likely. And the CDC reported on its website that "a pattern of more severe illness associated with the virus may be emerging in the United States."

"We expect to see more cases, more hospitalizations, and, unfortunately, we are likely to see more deaths from the outbreak," Health and Human Services Secretary Kathleen Sebelius told reporters Wednesday on her first day at work.

But certainly nothing that would dwarf a typical flu season. In the U.S., between 5% and 20% of the population becomes ill and 36,000 people die -- a mortality rate of between 0.24% and 0.96%.

Dirk Brockmann, a professor of engineering and applied mathematics at Northwestern University in Evanston, Ill., used a computer model of human travel patterns to predict how this swine flu virus would spread in the worst-case scenario, in which nothing is done to contain the disease.

After four weeks, almost 1,700 people in the U.S. would have symptoms, including 198 in Los Angeles, according to his model. That's just a fraction of the county's thousands of yearly flu victims.

Just because the virus is being identified in a growing number of places -- including Austria, Canada, Germany, Israel, New Zealand, Spain and Britain -- doesn't mean it's spreading particularly quickly, Olsen said.

"You don't ever find anything that you don't look for," he said. "Now that diagnostic laboratories and physicians and other healthcare workers know to look for it, perhaps it's not surprising that you're going to see additional cases identified."

And a pandemic doesn't necessarily have a high fatality rate. Even in Mexico, the fatalities may simply reflect that hundreds of thousands of people have been infected. Since the symptoms of swine flu are identical to those of a normal flu, there's no way to know how many cases have evaded government health officials, St. Jude's Webby said.

As the virus adapts to its human hosts, it is likely to find ways of spreading more efficiently. But evolution also suggests it might become less dangerous, Olsen said.

"If it kills off all its potential hosts, you reach a point where the virus can't survive," he said. Working to calm public fears, U.S. officials on Wednesday repeatedly stressed the statistic of yearly flu deaths -- 36,000.

Sebelius and Homeland Security Secretary Janet Napolitano also rejected calls to close the borders, which several lawmakers reiterated Wednesday on Capitol Hill.


"We are making all of our decisions based on the science and the epidemiology," Napolitano said. "The CDC, the public health community and the World Health Organization all have said that closing out nation's borders is not merited here."

Though scientists have begun to relax about the initial toll, they're considerably less comfortable when taking into account the fall flu season. They remain haunted by the experience of 1918, when the relatively mild first wave of flu was followed several months later by a more aggressive wave.

The longer the virus survives, the more chances it has to mutate into a deadlier form.

"If this virus keep going through our summer," Palese said, "I would be very concerned."

karen.kaplan@latimes.com

alan.zarembo@latimes.com

Staff writers Noam Levey in Washington, Thomas H. Maugh II in Los Angeles and Ken Ellingwood in Mexico City contributed to this report."
http://www.latimes.com/features/health/la-sci-swine-reality30-2009apr30,0,3606923.story

Entry #1,127

Comments

1.
jarasanComment by jarasan - April 30, 2009, 11:15 am
Thanks Konane.

Sanity makes a comeback? The grown ups are speaking? Logic and reason not forgotten? Not a big pharma conspiracy? The govt. has saved us? Communication in 2009 is better than 1918? The media loves to hype and runs cover for the govt. take over of a car company?
2.
JAP69Comment by JAP69 - April 30, 2009, 11:17 am
The human natural immune systems is not as strong in younger generations now.
To much intake of synthetic drugs has lowered the bodys capacity to generate its own defense system. Take a drug just for a snotty nose now a days. If you do not take your children for medical care you can get reported for child neglect.
3.
konaneComment by konane - April 30, 2009, 12:43 pm
Thanks Jarasan!! Kinda funny when there's infighting, not able to get their stories straight. Biden was probably quoting from his mom and grandmoms common sense stuff. Common sense doesn't have much place in our sophisticated contemporary technology driven government, does it??? Current media .... mouthpiece for leftist government.
4.
konaneComment by konane - April 30, 2009, 12:48 pm
Thanks JAP!! No kidding about natural immunity. Our generation was told to turn off the tv, get some sun, better yet do some chores outside. Most people now live too crammed together for kids to safely do these things.

Also if people as kids were taught to wash their hands, carry that practice into adulthood likely we'd have less communicable illnesses.
5.
emilygComment by emilyg - April 30, 2009, 1:37 pm
Common sense is dead.
6.
time*treatComment by time*treat - April 30, 2009, 2:15 pm
Given that "live" virus was delivered not too long ago, I'm more wary of their "cures" than the disease.
7.
konaneComment by konane - April 30, 2009, 2:16 pm
Thanks Em!! Sure is, buried in the 70's when ambulance chasing attorneys built new careers via personal injury suits based on sheer lack of common sense. Stupidity got well fed grew to epidemic levels where we're led to believe government is know-all, answer-all, provide-all.
8.
konaneComment by konane - April 30, 2009, 2:50 pm
Thanks Time*treat, with you on that one especially remembering what Ron Paul said in his video about people dying from the swine flu vaccine. Jogged my memory and was highly reluctant back then to get vaccinated. If I'm going to croak from this virus will do it the old fashioned way.
9.
jarasanComment by jarasan - April 30, 2009, 5:38 pm
After visiting two hospitals and entering thru the emergency rooms today, psychosomatic (psychophysiologic) comes to mind................................. Anyway, I've never had a flu shot and have yet to catch a full blown flu of any kind.   As stated above:   Eat healthy, get outside, and practice good hygiene, much of the youth of recent generations has been weakened physically and yes, mentally, not only in this country but everywhere.
10.
konaneComment by konane - April 30, 2009, 5:50 pm
Thanks Jarasan!! Am sure lots of folks are worried as we were back in 1968 ... survive or croak. However, as with any virus no one has immunity to some died, the rest of us thought we were going to.

Recent years but not this fall have had flu and pneumonia shots, considering pneumonia shot more important. After thorough questioning of nurses giving those shots in Costco they assured me the vaccines for both were KILLED type.

"much of the youth of recent generations has been weakened physically and yes, mentally"     

Yes the powers that be want to control, engineer every aspect of our lives and God forbid we take our health into our own hands using timeworn methods of common sense and proper hygiene.

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