New 1918 Style Flu Pandemic Fear

H1N1 Flu Virus.

H1N1 Flu Virus. By NIAID (H1N1 Flu Virus) [CC BY 2.0], via Wikimedia Commons

Guest essay by Eric Worrall

This isn’t a climate article, it is about a real problem.

Back in 1918, the infamous flu pandemic killed an estimated 3-5% of the population of the time – 50-100 million people. The awful potential of a new 1918 style flu Pandemic to sweep the world and kill millions, perhaps billions, despite all our medical advances, makes every flicker of infectious ability for novel strains of flu newsworthy.

Almost all of these flu scares are groundless – but one day the real new pandemic strain will arise.

Bird flu strain taking a toll on humans

By Dennis Normile Feb. 17, 2017 , 1:30 PM

SHANGHAI, CHINA—An avian influenza virus that emerged in 2013 is suddenly spreading widely in China, causing a sharp spike in human infections and deaths. Last month alone it sickened 192 people, killing 79, according to an announcement this week by China’s National Health and Family Planning Commission in Beijing.

The surge in human cases is cause for alarm, says Guan Yi, an expert in emerging viral diseases at the University of Hong Kong in China. “We are facing the largest pandemic threat in the last 100 years,” he says.

As of 16 January, the cumulative toll from H7N9 was 918 laboratory-confirmed human infections and 359 deaths, according to the World Health Organization (WHO). Despite its high mortality rate, H7N9 had gotten less attention of late than two other new strains—H5N8 and H5N6—that have spread swiftly, killing or forcing authorities to cull millions of poultry. But so far, H5N8 has apparently not infected people; H5N6 has caused 14 human infections and six deaths.

Read more: http://www.sciencemag.org/news/2017/02/bird-flu-strain-taking-toll-humans

Why am I mentioning this likely false alarm? The reason – how can we be totally sure it is a false alarm? This problem, the risk of a new Pandemic, is fixable – but we aren’t doing enough to fix it.

From Wikipedia;

Most influenza outbreaks disproportionately kill juvenile, elderly, or already weakened patients; in contrast, the 1918 pandemic predominantly killed previously healthy young adults.

There are several possible explanations for the high mortality of the 1918 influenza pandemic. Some research suggests that the specific variant of the virus had an unusual aggressive nature. One group of researchers recovered the original virus from the bodies of frozen victims, and found that transfection in animals caused a rapid progressive respiratory failure and death through a cytokine storm (overreaction of the body’s immune system). It was then postulated that the strong immune reactions of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults resulted in fewer deaths among those groups.[11]

Read more: https://en.wikipedia.org/wiki/1918_flu_pandemic

What more could be done to prevent the next Pandemic?

Flu is notoriously difficult to vaccinate against, because of its high mutation rate. Advances have meant we have a yearly flu vaccine which provides substantial protection – but it can be very hit or miss, because preparation of the vaccine is based on a model of which strains will likely be prevalent at the time the vaccine provides its protection.

A better way to produce vaccines, say a desktop system for producing vaccines on the spot for novel flu strains, would massively decrease the turnaround time for providing protection to people in hot zones. At the moment such a desktop system is science fiction – but I wonder how close we could get to such a system, if for a few years flu research received funding on the same scale as our climate heroes?

Other areas worth researching are how to handle cytokine storms, the body’s panic overreaction to novel diseases.

One of the treatments administered during the SARS outbreak in 2002-4 was to flood sick people with corticosteroids, to try to suppress their immune over-response, including cytokines. Not only has subsequent research demonstrated administration of steroids probably wasn’t very effective, some people who survived the SARS infection suffered crippling bone and joint problems, as a consequence of all the steroids they received to try to suppress immune system cytokine storm.

The following from PLOS Medicine is telling;

Conclusions

Despite an extensive literature reporting on SARS treatments, it was not possible to determine whether treatments benefited patients during the SARS outbreak. Some may have been harmful. Clinical trials should be designed to validate a standard protocol for dosage and timing, and to accrue data in real time during future outbreaks to monitor specific adverse effects and help inform treatment.

Read more: http://www.sciencemag.org/news/2017/02/bird-flu-strain-taking-toll-humans?utm_campaign=news_weekly_2017-02-17&et_rid=198068378&et_cid=1171731

There has been research to try to find a better way of handling cytokine storms, which is believed to have made the 1918 strain so deadly for young, healthy adults. For example in one study the drug Gemfibrozil apparently helped to protect lab mice against death from flu infection.

But we need more than a few mouse studies.

Research into managing cytokine storms in people, without completely depressing a patient’s immune system, or destroying their life with crippling bone and joint disease after treatment, could help prevent deaths when the next Pandemic strikes.

We won’t know when the next scare turns into a 1918 style Pandemic, or worse, until it is too late. The next Pandemic will almost certainly not emerge fully formed, it will likely stumble into the news like any other flu scare, like the latest China flu scare – a few deaths, low transmission rates, hiding on the tattered edges of modern medical care. But the new disease won’t quite die away, it will linger on, clinging to survival, just barely escaping eradication efforts, maintaining a small reservoir of infected hosts. Then suddenly something will change, a mutation which dramatically increases infection rates. The new Pandemic will leap across the world in days, bringing death to every human population centre on Earth.

We have to be better prepared, for when the inevitable happens. We have to focus the attention of our politicians on real threats, not the imaginary climate bogeyman which has ensnared their attention for far too long.

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133 thoughts on “New 1918 Style Flu Pandemic Fear

    • The Human Endocannabinoid System Meets the Inflammatory Cytokine Cascade
      http://www.whale.to/a/human5.html

      Phytocannabinoids have the ability to suppress this inflammatory cytokine cascade by inhibiting glial cell production of the cytokines interferon or interleukin. Here we see the seeds of chronic inflammation dissolved by the modulation process of cannabinoids bringing homeostasis to systems out of balance.

    • I normally get a flu shot in the Oct-Nov time frame. I recently checked why I didn’t remember getting my 2016 shot, and discovered there was nothing to remember.
      So I got my shot belatedly; and it seems that the other half of the country are having plenty of cases to justify doping it.
      So far it seems to have worked.

      G

  1. I’m a senior boomer senior, cutting edge, that has enjoyed my residual immunity to flu’s from my childhood. I have had one flu vaccination, when I enlisted in ’69. I don’t believe that I have had the flu since. When HPAI H5/H7 is incorporated into the annual flu vaccine compound then I will bite that bullet and vaccination.

    • I have not had the flu since high school and am a “senior boomer”. I had the swine flu vaccination in college and in the late 80’s I had a flu vaccine because I worked in day care. I got sick for quite some time after that vaccine (my immune system is known to over-react). Never again. My doctor is fine with my statement that I have a natural immunity. So does my spouse. Some people just don’t get the flu. (Should flu turn ugly, I may re-evaluate.)

    • Unfortunately, it is not possible to be “immune” to “the flu” (whichever strain of flu virus is currently prevalent). Everyone who comes in contact with the flu is infected. This is easily demonstrated by testing for genetic markers.

      Reactions to the infection varies among individuals. There is an active immune response even when a person doesn’t get sick. There are just differences in their biological metabolism and gene expression that allow their bodies to resist the cascade of responses that are the usual symptoms of flu infection.

      But keep in mind: you become a carrier if you are infected, whether you are symptomatic or not. It may require more intimate contact than a carrier who is hacking and sneezing, but you can still spread the flu to your less genetically fortunate friends and family…

  2. ” – but one day the real new pandemic strain will arise.”

    Now that’s the rhetoric needed to attract research funding…

    • At the moment such a desktop system is science fiction – but I wonder how close we could get to such a system, if for a few years flu research received funding on the same scale as our climate heroes?

      That kind of money encourages absolute power and we know what absolute power gets us.
      We have recently witnessed this in the left’s heroic efforts to save us from climate change.

    • Indeed for influenza is a zoonotic thing. The viruses spend parts of their life cycle between swine, humans and birds. Influenza is also one of the most genetically variable/mutable viruses out there that often gets virulent. The other one, the common cold, isn’t as zoonotic, and thus, much less virulent. Basically it boils down to this: Cold viruses are less virulent because killing off their sole or primary host, kills them off. Influenza, having three distinct hosts at minimum, can survive killing off one of them, but can’t survive killing off all of them.

  3. Here is another take on why we get the ‘flu. Dr. John Cannell published this in 2006, “Epidemic Influenza and Vitamin D”:

    SUMMARY
    In 1981, R. Edgar Hope-Simpson proposed that a ‘seasonal stimulus’ intimately associated with solar radiation explained the remarkable seasonality of epidemic influenza. Solar radiation triggers robust seasonal vitamin D production in the skin; vitamin D deficiency is common in the winter, and activated vitamin D, 1,25(OH)2 D, a steroid hormone, has profound effects on human immunity. 1,25(OH)2D acts as an immune system modulator, preventing excessive expression of inflammatory cytokines and increasing the ‘oxidative burst’ potential of macrophages. Perhaps most importantly, it dramatically stimulates the expression of potent anti-microbial peptides, which exist in neutrophils, monocytes, natural killer cells, and in epithelial cells lining the respiratory tract where they play a major role in protecting the lung from infection. Volunteers inoculated with live attenuated influenza virus are more likely to develop fever and serological
    evidence of an immune response in the winter. Vitamin D deficiency predisposes children to respiratory infections. Ultraviolet radiation (either from artificial sources or from sunlight) reduces the incidence of viral respiratory infections, as does cod liver oil (which contains vitamin D). An interventional study showed that vitamin D reduces the incidence of respiratory infections in children. We conclude that vitamin D, or lack of it, may be Hope-Simpson’s ‘seasonal stimulus’.

    http://www.anaboliclabs.com/User/Document/Articles/Vitamin%20D/9.%20Cannell,%20Vit%20D,%202006.pdf

    The article is worth reading, as is his 2008 followup, “On the Epidemiology of Vitamin D”.

    https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-5-29

    • aha! there’s a good candidate for why tropical countries have an ‘excess winter death’ statistic.
      (cuz obviously it ain’t coldness)

    • My grandmother was a young nurse at Naval Station Great Lakes during the 1918 flu epidemic. She said that when she arrived for work in the morning many of the previous day’s patients were gone. Dead. Bodies were stacked (in simple coffins) outside the wards.

      The 1918 flu pandemic (January 1918 – December 1920) was an unusually deadly influenza pandemic, the first of the two pandemics involving H1N1 influenza virus. It infected 500 million people across the world, including remote Pacific islands and the Arctic, and resulted in the deaths of 50 to 100 million (three to five percent of the world’s population)
      [ … ]
      More recent investigations, mainly based on original medical reports from the period of the pandemic, found that the viral infections itself was not more aggressive than any previous influenza, but that the special circumstances (malnourishment, overcrowded medical camps and hospitals, poor hygiene) promoted bacterial superinfection that killed most of the victims typically after a somewhat prolonged death bed.

      https://en.wikipedia.org/wiki/1918_flu_pandemic

      An interesting comment from 2007 …
      The challenge for us humans is to learn as much about influenza viruses as they have already learned about us. Arguably, we have not yet done so, but we are clearly gaining ground, and there is good reason to believe that the next decade will yield significant advances in fundamental knowledge and, more importantly, in prevention and control. Today, nearly a century after the event, mysteries surrounding the 1918 influenza pandemic remain largely unexplained. However, we must continue to examine and investigate this long-ago tragedy, allowing it to stand clearly before us as a challenge to complacency, as a modern problem with future implications, and as a grim reminder of the importance, to humanity, of continuing the fight against emerging and reemerging infectious diseases.
      https://academic.oup.com/jid/article/195/7/1018/800918/The-1918-Influenza-Pandemic-Insights-for-the-21st

      • Very interesting set of events during 1918 that led to the rapid spread of the flu. For those interested in the story I can recommend “The Great Influenza” by John M. Barry. A very interesting account of the pandemic.

      • Interesting note: Influenza is definitely not the “deadliest plague in history,” as the book’s cover asserts. That title goes to Malaria.

        Researchers estimate that 30-50% of the 150 billion or so humans who have ever lived died from malaria. At least a third and probably half of everyone who ever lived.

        Thanks in large part to misguided environmentalists’ over-reaction to the gross misuse of DDT and its subsequent banning in most of the world, malaria continues to kill half a million people each year, mainly children.

        Al Gore famously used lies about the spread of mosquitoes to try to link malaria deaths to CAGW.

        Very helpful.

      • In my reading of the internet, your ‘special circumstances’ were the use of DDT in all military clothing, blankets, etc. In the latest autobiography of Dorothy Day the author notes she assisted in nursing these young men. The use of DDT has also been linked to polio becoming so tragically devastating.

    • Researching my family tree I found a number of ancestors who died of “la grippe” in that time frame. That made it pretty personal, even if removed in time.

  4. Eric, this article ties in nicely with the one about spending 5 trillion on icecube makers in the arctic. Where would anybody prefer to spend 5 trillion? Medical research or frozen wind turbines in the arctic? Thanks well thought out article.

    • +1

      And, along those lines, a minor edit (even though the sarcasm should be obvious in the original….):

      I wonder how close we could get to such a system, if for a few years flu research received funding on the same scale as our climate heroes the climate villians?

      • Where would anybody {not brainwashed by the AGWists} prefer to spend 5 trillion? Medical research or frozen wind turbines …?

        …. You know the truth, love is all we need ….
        There’s a choice we’re makin’,
        we are saving our own lives ….


        (youtube — “We Are the World” song with children of the world)

        Put more money into the pockets of the enviroprofiteers (that’s who is behind the “save the Arctic” AGW brainwashing and like sc@ms)

        or

        save people’s lives.

        That isn’t a choice, it is a moral imperative.

        “Love your neighbor as yourself.”
        Leviticus 19:18

        So, all you tro11s and BEST guys, et al., what’ll it be? Money? or Love?

        Choose love.

      • And, yes, Paul Westhaver (at 7:16pm below), if triage is necessary, then, medical research money would be better spent on other medical conditions before the flu. And on getting reliable electricity and clean water to people. The relatively weak persuasive import of Mr. Worrall’s choice of the flu, nevertheless, does not negate his powerful underlying point:

        Big AGW is a BIG WASTE OF MONEY and

        worse,

        by sucking money away from medical research it kills innocent human beings.

        ******************************************

        As someone pointed out in a recent comment on WUWT, the “climate change” profiteer/true believer cult is a parasite.

  5. I have a letter from my maternal grandfather’s brother (Uncle Rod) who related the following story: my grandfather’s sister Maud Adele (they called her Janie) was an Army nurse at Camp Gordon (IIRC) in Georgia as soldiers were returning from WWI. Uncle Rod was working in NYC at that time, and their other sister May was working as a nurse for a doctor there too. As Uncle Rod left his office building at 5 pm, he received a telegram from a clergyman at the Camp who stated that Janie was dying of the Spanish flu, and might be already deceased by the time the telegram was delivered. Rod called my grandfather, also in NYC, and they hurried to the doctor’s office uptown. It was quickly decided that their sister May would take the evening train south. The doctor gave her a bottle of whiskey and told May to give Janie as much of it as she could stand if she found her still alive. May got down to Georgia and, incredibly, found Janie still alive, but just barely so and surrounded by dead people. May did as instructed, and Janie drank the whiskey over the course of several hours. She survived. The clergyman who sent the telegram had developed symptoms in the meantime and ultimately did not survive. Uncle Rod said that Janie had another severe illness in the 1930s, and it weakened her considerably further, as she had never been the same after contracting the Spanish flu.

      • I dont know about helping with flu but I think alcohol suppresses my immune system. There could be something in that in the suppression of the immune system cytokine storm.

  6. Flu mutates by coinfection with another flu virus, after which the two viral genomes get scrambled into a new viral composition.

    This usually happens in an animal, like a pig or a chicken, not in a human. This is why these scary new flu viruses are called swine flu or bird flu, they originated in a pig or a chicken, then got transmitted to a person tending their farm animals.

    Flu can be virulent with high mortality, or it can be highly contagious, or in the nightmare scenario it can be both. Often when it first jumps from an animal to a human it is not well adapted to human transmission and is unlikely to create a pandemic.

    If another coinfection happens in a person that then creates a virulent, contagious chimeric virus, that’s when things get scary. The one upside if there is one is that this second coinfection most likely would occur with a commonly circulating strain, for which the common flu vaccine already disseminated that season might provide some protection.

  7. My mother entered nursing around that time-frame, graduating in 1922. I heard her say more than once that the people who died were ones who, in what we’d call macho fashion today, didn’t stay in bed, feeling that they were stronger than the flu. That would be consistent with higher mortality among young people.

    If you catch a new flu, take no chances. Don’t go to work.

  8. The “Spanish flu” was called as such because the only news reports about it came from Spanish newspapers.
    Woodrow Wilson had given US newspapers the message that reporting on the flu would undermine national security, so any reporting would be at risk of jail.

    • Its ultimate source has not been determined. The first reported case was at Ft. Riley, but it almost certainly originated on the Western Front. A 2014 paper identified the source as Chinese laborers in France, but a Chinese study last year pooh-poohed this conclusion. In any case, it probably originated in a major transit camp in France, where pigs and chickens were kept and through which millions of soldiers passed.

  9. A lot could be done to manage a future pandemic through a change in culture and attitudes. The ‘tough guy’ culture of going to work or school even when sick likely amplifies final flu spread (or any contagious disease spread) by an order of magnitude. Changing culture to instead shame coworkers that show up sick (chastising them and sending them home at a minimum), would probably go a long way to reducing the final infection totals of contagious diseases.

    Also doing away with the idea and justification of ‘individual freedom’ trumping risk to other people getting an infection. Like what happened during the last Ebola scare. If it is known that you have a deadly contagious disease, you do not have a ‘right’ to travel and/or walk around exposing others to it. I would argue this extends to non-deadly diseases as well (which are often deadly under certain circumstances, i.e. very young, old and the infirm). Even developing a culture where walking around with masks is ‘okay’ might help in certain circumstances. Much of Asia is perfectly fine with doing this and is not worried about looking silly, etc. One of the biggest barriers to fighting contagious diseases is our lax attitude towards them, likely due to the fact that a serious deadly outbreak has not yet occurred in most people’s lifetimes, given people a false sense that it can never happen here.

    • The first time an imported infection kills thousands or millions in a Western nation, borders all around the world will slam closed. And probably never open again, at least to non-essential mass travel.

      But that may not ever happen, since VR is going to devastate travel over the next few decades.

    • There seems to be diametrically opposed camps in germ and disease control: The parent/adult who sterilizes everything and is terrified of germs anywhere and the parent/adult that has no idea what a sink, soap and towel are for. Middle ground would be nice.

      • I think you are referring to the “hygiene hypothesis”, which has some support from studies in Finland and Karelia, and various groups of Mennonite farmers in the US. Exposing children to disease has obvious ethical problems, and the tentative results seem to be in which diseases the children get, with the “clean freaks” having marginally better outcomes, but a much higher rate of allergies and other autoimmune ailments.

      • Tom: Kind of. (I’m really just observing that the whole issue is generally seen in extremes.) I do believe, without any proof right now, that allergies and auto-immune disorders are more prevalent in part because of the neatness obssession. I’m not saying to let kids get diseases, I’m saying that you don’t have to sterilize the pacifier if it falls on the floor, kids can eat some dirt without fatal results, if the dog likes the kids mouth, it’s not a crisis, etc. It’s a complicated issue and certainly needs more research and thought.

    • Far more effective would be the radical reduction of confiscatory tax rates so that people wouldn’t be hurt so badly by taking a day off and job creation would also drive an increase in employer benefits due to increased competition for workers.

  10. Whoa!!! Hold on AW. Calm down.

    First cytokine storms have little if anything to do with influenza virus lethality in human populations. Yes, SARS, a novel coronavirus does appear to have that as a morbidity/mortality contributor, but that does not appear to be the case for avian-human influenza viruses.

    Most of human influenza virus mortality occurs today in the very young (a naive first encounter w/o protective maternal antibodies), in the frail elderly, and in immune compromised individuals (chemo patients, HIV, and genetic immune deficiency people). All of those high risk populations have some degree of limited/impaired/compromised immune responses; responses that healthy individuals have, both young and old.

    Novel avian influenza viruses that do successfully make the jump to in humans generally have initial problems of transmissibility due to virus-receptor usage differences between its adapted birds and the human respiratory tract. The human airway ciliated epithelial cells express different sugar-moities on the influenza-susceptible cells. Translated, that means avian-adapted viruses need to get deep into the lungs to infect the susceptible cells and cause outward disease. Human-adapted influenza viruses very much tend to use an upper airway cellular receptor which makes it less pathogenic than avian-adapted influenza viruses that must get deep into the bronchial airways to initiate disease.

    What this means is that very close contact with high virus titer infected birds (and sometimes pigs where chicken and pigs are raised together, common in parts of east Asia) are needed for the influenza to jump to humans. This is why people who work on Chinese chicken farms and live-bird sellers in markets are typically the ones who get the avian influenza viruses first. Human-to-human spread of avian-adapted influenza is difficult, but not impossible. There would need to be some level of human-human transmission to allow the influenza a few host opportunities to evolve to more efficient human-human transmission But that means avian influenza viruses once adapted to humans have most likely have a lower R(0) (R-naught, in British parlance) than it did in its initial infections in the jump from birds.

    The 1918 H1N1 pandemic occurred (spread immediately on heels of closing months of WW1 returnees and soldiers still in boot camps) in an H1-naive population. Their complete influenza naive status meant their immune systems, as young adults, that large swaths of the population were “seeing” the influenza influenza for the first time. Herd immunity did not exist for influenza in general as it does today. The two broad families of influenza viruses circulating today are H1N1 and H3N2 viruses.

    The H5-avian viruses share a close homology with H1-viruses. So most of the human population today has a level of immunity to H5-viruses due to H1 infections and immune memory. Likewise, the H7-influenza viruses are in the H3-group, thus most people have a high level of pre-exsiting H3 immunity that would offer some immunity to H7-avian strains.

    Today’s influenza vaccines have both the seasonal H1 virus component, and the selected H3-virus component. H1 and H3 influenza viruses now circulate so widely in the NH winter-spring, (and in the SH-year around, for reasons not understood) that finding a young adult still naive to both would be difficult, but they do occur in isolated populations like the Inuits, where outside contact may be more limited and sporadic even in today’s air travel world.

    An influenza infection in a naive adult generally causes more severe flu symptoms (bed-ridden w/myalgia, high fever, nausea, diarrhea, weight-loss, fluid-loss, suppressed leukocyte counts) that likely allowed a secondary, lethal bacterial pneumonia in a pre-antibiotic era, and weakened body from dehydration. W/o antibiotics, those who got a severe pneumonia probably developed a secondary bacterial respiratory infection and expired from the inability to fight off the bacteria in their weakened state. This was likely the high-mortality mechanism in the 1918-pandemic. It was a completely influenza naive population, a highly transmissible respiratory virus, and no antibiotics, and limited supportive medical care to fight the secondary bacterial infections of the pneumonia that developed.

    Today, not only do large percentages of the human population have some level of T-cell mediated, broad influenza immunity, we also have antibiotics to help cope with secondary respiratory bacterial infections.

    So rest easy (easier). Influenzas do cause pandemics, but as we saw with the 2009 Swine flu (an H1-variant), the spread was rapid and quick, but the mortality was generally low (much lower than many initial, early predictions). The 2009 Swine flu H1 virus mainly infected K-12 school kids and the immune compromised, and elderly who had never seen an actual H1 infection in their lives, but many (most) had pre-existing H1-immunity from the seasonal H1 vaccines that likely lessened the impact of the Swineflu virus on their body.

    One last thought. I hold little regard for antiviral therapeutics for acute-infecting viruses like influenza. (1) The viruses mutate so quickly when spreading that resistance is usually rapidly acquired by the virus.(2) People who get sick usually wait a day or two to get to the Dr to get the drugs, thus the infections have gotten to the point where the drug does very little to shorten the illness. (3) The pharmaceutical companies promote these drugs because it earns them lots of high margin profit while most people’s insurance plans usually cover them.

    But Vaccines on the other hand, once validated and accepted, usually do work to curb, stop epidemics, and thus save many lives and lost productivity of the economy.

    • I regularly take flu vaccine, so I don’t need convincing of its efficacy. But its not 100% effective.

      As for cytokine storms, I just don’t know. Consider the flu currently doing the rounds in China. These people apparently live in a poultry farming region, so if there is any group with broad flu immunity it should be them – yet the H7 flu seems quite deadly. It must be fairly novel. The fact cytokine storms also occur with other diseases such as SARS suggests that it might be worth investigating this feature of immune response, though I accept there might be other, more pressing areas of study which provide more immediate benefit in terms of safety from pandemics.

      • Caveat: the H3N2 virus is less well understood than the H1- and H5- family of viruses. Lessons learned from H1/H5 thus may not readily apply to H3/H7 viruses. H1 and H5 viruses have been the focus of most of the intense research into influenza.

        In 2011-2012, when I was doing almost exclusive H1N1 and H3N2 work cultivating both those viruses in cell lines and making recombinant H1 viruses, the H1 viruses behaved much differently to the antiviral Tamiflu drug than did the H3N2 viruses. H3N2 was much more resistant right off the bat to Tamiflu (oseltamivir) than the H1N1 isolates, so that may be the same for an H7 influenza. But Tamiflu and Relenza (zanamivir) work as the neuraminidase inhibitors, neuraminidase is the N component of the H#N# nomenclature. But the two, H and N, have to be compatible molecularly/genetically for a well-adapted virus to be readily infective in whole animals. The reasons not entirely clear, but the complexity of the molecular problem arises because these orthomyxoviruses have 7 separate genetic RNA-strand components that encode the various virus proteins and these must be able to efficiently package in the virus capsid. There are also subtle but apparently important differences between H1 and H3 propagation in birds and humans that no one understands yet that probably apply to H5 and H7 as well.

      • Specifically addressing the above H7N9 article quoted above (by Dennis Normile), I would make a hypothesis that those who are getting infected and suffering high morbidity/mortality by the avian H7N9 influenza virus had no prior exposure/infection to H3N2, and thus no prior cross-protective cellular mediated immunity to H7N9.

        Various strains of H3N2 human-human influenza virus widely circulate in the Northern Hemisphere winter-early spring, and in Australia/NZ too. I would suspect those getting very sick from H7N9 and dying in China from H7N9 were/are naive to H3N2.

        This has to do with how close in sequence related-ness the Hemagglutinin (HA) (the H part) and the Neuraminidase (NA) (the N part) are related in terms of their RNA sequence between H3N2 and H7N9 are. The RNA sequences (A,G,C,U) codes those proteins that protrude on the surface of the virus to elicit both antibody and T-cell mediated immunity. The antibody responses probably are very weak to nonexistent between H3 and H7 viruses, but they would have more conserved T-cell mediated responses that could cross-protect the host form a more severe or lethal infection. This has been definitively shown in lab mice and lab ferrets that cross-protective T-cell mediated responses, even when antibody responses are non-existant, can provide a level of immunity that limits mortality and severe disease.

      • A minor technical correction to what I wrote above:

        Influenza viruses have 8 separate genetic RNA strands that package into a virus. (not the seven I wrote. A brain fart on my part. It’s been several years now since I actively wrote-studied-worked on influenza.)

    • Having a few chooks myself and visiting the local friendly GP during the
      ‘Bird Flu’ scare he gave me a script for Tamiflu and advised I fill it at the first sign of flu.
      Those that live eat and sleep with their fighting roosters were not protected by this drug.
      For them the virus had plenty of opportunities to jump the species barrier.
      When administered, Tamiflu failed to save them.
      The Australian government bought huge stocks of the drug, which no doubt is being re assayed annually, as it was never used.
      I concur with JB’s third point, the marketing was subtle and pressed all the fear buttons.
      Good for the bottom line.

    • I’m not sure that the issue over cytokine storms has been answered. Sure, a lot of people would have died due to secondary infections but the age distribution of those who died, suggests that something else was involved.

      • one theory suggests that at the time TB was also fairly prevalent
        and not always showing.
        until we sorted/culled the bovine herds ,milk was a method of infection.
        i copped the flu this winter
        hadnt had a cold or flu for many years
        knocked me round
        would I consider fluvax
        nope.

    • Indeed, most influenza deaths are either dehydration and/or secondary bacterial infections, typically pneumonia from streptococcal bacteria the patient either already had in the nose/throat or caught from others, but not always. There are rare forms that induce a form of cytokine mediated ‘septic shock’ via the products of apoptosis within the affected person.

    • I take oregano tablets whenever the common cold and flu season starts in the fall or winter. Also a daily zinc tablet will ameliorate the effects of colds & flu when they do take hold.

  11. The Spanish Flu was no ordinary illness. While most flu viruses attack the elderly and the very young, the Spanish Flu produced a reaction called a cytokine storm that essentially turned healthy immune systems against themselves. The stronger the immune system response, the worse the illness, so the flu was deadliest to the healthiest in the prime of their lives. In under two years, it would kill somewhere between 20 million to 50 million people worldwide.
    http://nypost.com/2017/02/11/how-to-react-when-the-next-big-plague-hits-humanity/

    • Actually, estimated 60 million, the death mechanism was ARDS. In other words, an over response of the young adult maximum healthy immune system.

  12. Geeze…..After 20 years of hand-wringing because of the MYTH of CAGW, it is to be replaced by asteroid impacts a la Bill Nye, gamma beams a la Neil Degasse-Tyson, and now 1918-esque pandemic a la Eric Worrall.

    I classify this as Fake News.

    Feed the poor. Blot out Malaria. Cure heart disease. Stop f’n around.

    • And do something about the 40,000 per year killed in auto accidents in the US. World wide, how many? How many seriously injured? In the US, cell phones and texting while driving have helped reverse a long downward trend. Good grief!

    • Auto related deaths in the US are roughly half what they were in the 1960s at the peak. Still, traumatic deaths will still claim many. We shifted livestock related trauma and wildlife related trauma to industrial and other non animal related mechanical trauma. Falls still kill people. People still kill people. People still drown ( a couple of liters of purified water in the lungs is enough to cause hypoxia and death). People will still get infectious diseases. In other words, mortal man, doomed to die. We aren’t going to get rid of either cancer nor cardiovascular diseases, for the causes involved are ‘built in’ facts of life.

  13. Most people who died of “flu” did so from a secondary bacterial infection. In 1918 that bacteria was called: Hemophylis influenza, now a well known bacteria to which there is an effective vaccination: Hib. A large proportion of the mortality from “flu” is from a secondary infection. Antibiotics have been effective against the most common of those secondary infection bacteria which in turn have skewed the impact of a “flu” pandemic. Doctors giving out antibiotics like “candy”probably have thwarted wide spread flu secondary infections. With the current effort and recommendations to use antibiotics “more judiciously”, we may see an upsurge in deaths from “flu” primarily because people will die of a secondary bacterial infection while physicians will be withholding antibiotics on Government recommendations.. Such are well laid plans of mice and men.

    • During the last ‘swine flu’ epidemic in Australia the ventilators were fully utilised.
      Medical ‘reports’ given by grim looking doctors on TV news observed that these patients had co-morbidities,
      the major one being obesity.

      • lewispbuckingham

        I believe your health department has an agenda regarding obesity and took this opportunity to say: “bad, bad, bad obese people”. Health departments are like this and they were messing with people’s minds about risk by skewing information on who is at risk for developing severe complications of “flu”. This risk news hasn’t changed for a couple of decades. In the USA the Center for Disease Control and Prevention (CDC) has a listing of who is vulnerable, especially those with specific co-morbidities. Obesity is one (and by way of sheer numbers 1/3 of USA population is classified as obese; hence, all should be dead by now from various flu illnesses over the years), although those with cardiac, diabetes and lung chronic conditions as well as the very young (<2 y/o/a) and older (over 65 y/o/a which I personally don't think is very old) as those at very high risk of dying from complications of seasonal "flu".

      • The older baby boomers should be getting their pneumovax to stave off “the old man’s friend.”

  14. Spanish flu came in 3 waves (some say 4 waves) and it was the 2nd and 3rd wave that had high mortality, with quite a bit of evidence that those who died had previously been infected in the first wave. With the implication that that first wave mild infection was causal for the severe fatal infection in the 2nd and 3rd waves. We know Dengue is similar in this respect.

    If we see another Spanish flu type pandemic we may find a vaccine acts like that mild first wave infection and we won’t know until it is too late. This problem delayed a Dengue vaccine for many years.

    • I’ve sometimes wondered if that was a bit like a bee sting allergy, where the first sting isn’t that bad but the second is deadly.

      • No, I think the problem is more the relative instability of RNA viruses over DNA viruses. The 1918 flu apparently started in Kansas, but at some point in its global spread mutated into a much more dangerous form, and that’s what started the huge wave of deaths among young adults.

  15. The real danger is that it could be a new panic pretext for Governments to appropriate more resources for the “science community”.

    • Yes, because the ability to transmit the virus around the world in under 24 hours provides an invincible bulwark! /sarc

  16. Well said. I also reckon that we could have solved our dependence on fossil fuels by now, had the money wasted on green nonsense been put into research instead.

  17. One thing that always comes to mind is our immune systems developed via this battle between immune systems and infections. Now that we try prevent every infection our immune systems wont evolve to handle new threats.

    The rule has always been, pay in deaths for your immunity until modern medicine.

    So the next pandemic is guaranteed not if but absolutely when and our immune systems will forever be open to this threat as it no longer evolves

    • I didn’t for a long time, as my father had Guillane Barre syndrome from a flu the year before the Swine Flu vaccine made it famous.

      That may not have been as serious as claimed, and I figure the risk/reward level is tilting to reward as I get older.

      The worst reaction I’ve had is a sore injection site for a day or two. The vaccines that are similar to the previous year’s generally give me no response.

      I sometimes wonder if those of us who have auto-immune diseases (including my daughter and me) have a generally stronger than average immune system that sometimes goes overboard.

      GBS is an interesting experience. I recommend you don’t try it.

      • That’s exactly correct. There is a genetic component to it (antibody formation is an interesting thing: it works by genetic families creating protein families where cytokines are intimately involved in the overall regulation process).

      • I believe people with auto-immune diseases have stronger immune systems. At one time, I tried allergy shots—and ended up in the ER over and over due to my system “over-reacting”. I try not to give it anything to over-react to now. :)

      • The innocent looking Campylobacter is a potent cause of Guillain Barre Syndrome in the immune compromised patient.
        https://www.avma.org/News/Journals/Collections/Documents/javma_223_4_445.pdf
        Under cooked chicken is a source.

        In some subjects, such as myself, a flu vaccination makes me sick as a dog for at least a week.
        I have been advised this is because the vaccine stresses my immune system and I succumb to whatever other viruses that are going around at the time.

  18. I usually get the vaccine every year. Two years ago I missed out. I got the flu. In the small community I lost a couple of old ladies, and nearly lost a whole lot more. They missed the vaccine.
    I used to work in ED departments. One year with a bad strain, 50% of staff (doctors, nurses, everyone else) got the vaccine, and 50% didn’t. The 50% with no vaccine all spent two weeks off, in bed, very very ill, in a small city in the middle of a mass outbreak.
    Read the case reports of the 1918 pandemic. It is well studied if you are schooled in biology. It is scary. 5% of the worlds population is a lot of people, particularly in the modern jet age possibly making it worse..

  19. The 1918 pandemic began in Australia in December, in high summer, when D levels will have peaked in the population.

  20. I’m gonna be The Devil’s Avocado from he11 here – sugar-eaters and drinkers stop reading now.

    Hadn’t there just been a bit of a war going on in 1918, so no physically malnourished people around then was there?. And mentally, if you’re ‘down-in-the-dumps’, you maybe don’t look after yourself as well as you might?

    Then there was the wonder drug Aspirin, safe in the short-term in low doses but incredibly toxic when handed out and consumed by the handful – as it was then.

    And why are human females capable, during their lifetimes of making 20+ babies when only 2 will suffice to keep the species going? Why did Mother Nature kill 9 out of 10 of human babies – if not to select out the very best ones – and that is exactly what made us what we are now.

    We are unravelling all that hard work to the extent that stories like this will become self-fulfilling. Undoing it with antibiotics especially but with a plant based diet (yes lettuce and broccoli, you’re in the firing line again)
    All those irritants, allergens and toxins plants create and use to try protect themselves exactly from being eaten are driving out immune systems nuts – to the extent that when a real threat like flu comes along, it gets under the very cluttered radar.

    Finally, We Are Not Special and to imagine ourselves as being so will lead to a *very* big fall sometime…

    • Read up on the 1918 flu. While the war had a big impact, possibly including the high density housing in the US (e.g. Fort Devens Massachusetts), there were places like a small town in Colorado that blocked entry to nearly all visitors. They did allow the mailman in, and he came one day while he was coming down with the flu. A large percentage of the town got sick.

      It wasn’t until I read a book on the 1918 flu that I realized how big an impact it had in areas I had lived in for decades.

      Check out http://www.telegram.com/article/20061105/column21/611050532

      From http://www.pbs.org/wgbh/americanexperience/features/primary-resources/influenza-letter/ , a letter from a doctor at Fort Devens:

      Camp Devens is near Boston, and has about 50,000 men, or did have before this epidemic broke loose. It also has the base hospital for the Division of the Northeast. This epidemic started about four weeks ago, and has developed so rapidly that the camp is demoralized and all ordinary work is held up till it has passed. All assemblages of soldiers taboo. These men start with what appears to be an attack of la grippe or influenza, and when brought to the hospital they very rapidly develop the most viscous type of pneumonia that has ever been seen. Two hours after admission they have the mahogany spots over the cheek bones, and a few hours later you can begin to see the cyanosis extending from their ears and spreading all over the face, until it is hard to distinguish the coloured men from the white. It is only a matter of a few hours then until death comes, and it is simply a struggle for air until they suffocate. It is horrible. One can stand it to see one, two or twenty men die, but to see these poor devils dropping like flies sort of gets on your nerves. We have been averaging about 100 deaths per day, and still keeping it up. There is no doubt in my mind that there is a new mixed infection here, but what I don’t know. My total time is taken up hunting rales, rales dry or moist, sibilant or crepitant or any other of the hundred things that one may find in the chest, they all mean but one thing here — pneumonia — and that means in about all cases death.

      Bacterial pneumonia doesn’t set in this quickly, this pneumonia seems to be directly caused by the flu triggering the cytokine storm.

      IIRC, some men were evacuated from Devens to South Carolina, but some men on trains were already infected, and by the time the train reached the destination, many were dead or dying.

      • Virulent forms of pneumococcal (a streptococcus) pneumonia can kill a young, healthy person in 48 to 72 hours. And yes, cytokines are involved via the products of massive ‘septic shock’ apoptosis.

  21. “I wonder how close we could get to such a system, if for a few years flu research received funding on the same scale as our climate heroes?”

    Indeed! And how many other of mankind’s real problems could we go at least some way to solvjng with that sort of financial input? I’m sure there are a large number of very keen young science graduates just begging for the chance to do some useful research into all sorts of conditions that threaten mankind or would make some genuine improvement to the lives of future generations if the climate scaremongers could only be induced to get a proper job.

  22. The article points out the largest issue of our times in science — the misapplication of public funding. Imagine 1/3 of the monies spent on construction (not operation) of windmills if applied to medical research would have produced. Then there’s just the issue of having cheap energy for third world nations. The list is endless of beneficial projects.

    • Heh, very funny. Viruses are basically a coated bit of DNA/RNA, with the coat being a handful of proteins needed to get the virus into the cells they use to reproduce themselves, via a takeover of the normal DNA/RNA metabolism that the self-replicating cells have.

    • Glad to see someone beside me is thinking CO2 low dose long term is not the innocent we have been told.
      Also, in reading the internet there were very strong correlation graphs of the use of DDT and the rise in polio. Recall that WWI the young men were sent with every bit of clothing, blankets, towels, food containers, everything saturated with DDT. Researchers have great difficult in verifying this as most specific wording has been redacted.

  23. This post from 2016 may be of interest – some people such as my paternal grandparents may have ha an immunity to the 1918-19 flu.

    Best, Allan

    https://wattsupwiththat.com/2016/11/28/germanys-merkel-contemplates-social-media-crackdown-to-counter-fake-news/comment-page-1/#comment-2356132

    Hello again Crispin and thank you for your comments. Blessings on your great-grandmother and your entire family.

    For no particular reason, your comments reminded me of my paternal grandparents, an Ontario farm family who left their own young three boys with the help while they cared for others during the great Influenza epidemic of 1918-19.

    My grandma told me about it when I was little, but it was much later before I learned how bad this flu was. It the most devastating pandemic in recorded world history, killing between 20 and 40 million people, more than all the deaths in the Great War (WW1).

    Nobody in my family caught this flu, even though both grandparents were closely exposed to it. It was reportedly an avian flu virus, and I have wondered for years if they had developed an immunity. My grandma kept chickens and “candled” the eggs, selling them to private customers in Montreal. This involved considerable handling of the eggs prior to shipment, a task that the entire family helped out with.

    … just some random thoughts at 4am – time for coffee.

    More on glacier melt soon…

    Best personal regards, Allan in Calgary

  24. Just how do you develop and produce a vaccine that fits into this (US-only) timeline?

    http://www.pbs.org/wgbh/americanexperience/features/timeline/influenza/

    March 11

    At Fort Riley, Kansas, an Army private reports to the camp hospital just before breakfast complaining of fever, sore throat, and headache. He is quickly followed by another soldier with similar complaints. By noon, the camp’s hospital has dealt with over 100 ill soldiers. By week’s end, that number will jump to 500.

    [N.B. This is probably from the first wave before the flu mutated into it historic form.]

    August 27

    Sailors stationed onboard the Receiving Ship at Commonwealth Pier in Boston begin reporting to sick-bay with the usual symptoms of the grippe. By August 30, over 60 sailors were sick.

    Soon, Commonwealth Pier was overwhelmed and 50 cases had to be transferred to Chelsea Naval Hospital. Flu sufferers commonly described feeling like they “had been beaten all over with a club.”

    September 13

    US Surgeon General Rupert Blue of the United States Public Health Service dispatches advice to the press on how to recognize the influenza symptoms. Blue prescribed bed rest, good food, salts of quinine, and aspirin for the sick.

    Royal Copeland, the Health Commissioner of New York City, announces, “The city is in no danger of an epidemic. No need for our people to worry.”

    October 22

    869 New Yorkers die of influenza or the resulting pneumonia in a single day. In Philadelphia, the city’s death rate for one single week is 700 times higher than normal.

    November 20

    In only five days, influenza leaves 72 of the 80 native Inupiat inhabitants dead in the small town of Brevig Mission, Alaska. Local survivors bury the victims in a mass grave.

    December 4

    The U.S. public health service publishes an estimate that 300,000 to 350,000 civilian deaths can be attributed to influenza and pneumonia since September 15. The War Department records indicate that another 20,000 deaths have occurred among soldiers.

  25. A few days ago, Bloomberg had an article about the flu vaccine.
    This year it is 49% effective.

    Two years ago, it was 7% effective.

    Darn those mutations!

  26. Passenger pigeons were once the most numerous bird in the US, perhaps the world. They disappeared in the 1890s and were extinct by 1914.

    They were NOT hunted to extinction, They died from bird flu, which made the jump to human 30 years later to 1918 pandemic.

    The H5N1 scare 10 years ago saw 100% OVERNIGHT mortality in chicken farms that were unlucky enough to be exposed by random carrier.

    Be afraid of influenza, be very very afraid.

    • I never bought the hunted to extinction story. It seemed logistically difficult to get the last few million and also too convenient for the ‘mankind is the only villain’ theorists. What is the evidence for the flu hypothesis?

      • The “hunted to extinction” actually did make sense if you consider the pidgeons defense was to stick together in huge flocks, making them easy targets. Also, people reportedly destroyed nests, crushed eggs, etc in an effort to keep others from getting into their supply of tasty and pricey birds. There was a mad rush to sell as many pidgeons as possible because the price was good. Consider that if the birds defense was to stick together in large flocks, as the flocks shrank, there was no defense for the remaining birds. The pidgeons had unique habits and survival methods compared to other birds. In defense of humans, no one thought that many birds could ever be hunted to extinction so they never considered limiting the hunting of the birds (until too late, perhaps). Sometimes humans are the cause, though it’s not always something they could have foreseen. Really, it’s no different than any other species hunting another species to extinction. Humans do what seems logical (or profitable, perhaps) at the moment. 20/20 hindsight is great, but useless for prevention of things like this.

        The loss of the passenger pidgeon wasn’t a ecological disaster in any way. Species go extinct—I read Darwin and he agrees with that. :)

      • It wasn’t just hunting but loss of habitat. The hardwood forests of the eastern US were largely cut and burned down to make way for crop farms, mainly of corn. This caused the pigeons to become even more concentrated into easily picked off groups.

      • Extinction was demonstrated by Cuvier in 1798, who showed that mammoths and modern elephants were different species and genera, so was well established as fact long before Darwin’s 1859 “Origin of Species”. Buffon had earlier speculated about extinction, but Cuvier provided instances of it. By the 1820s even former extinction skeptics like Thomas Jefferson had come around, thanks in part to the discoveries of Mesozoic fossils earlier in the 19th century, many by Mary “She sells seashells by the seashore” Anning of Dorset, England.

  27. COLD WEATHER KILLS MANY MORE PEOPLE THAN HOT WEATHER. This trend is true in cold and also in warmer climates.

    Excess Winter Mortality is the number of people who die in the four Winter months, as compared to the 4-month average for the non-Winter months.

    Excess Winter Mortality globally is about 2 million people per year, including about 100,000 per year in the USA and up to 50,000 per year in the United Kingdom. Excess Winter Mortality rates are high even in warm countries like Australia.

    Paradoxically, rates of Excess Winter Mortality are sometimes greater in warmer climates than in cold ones, probably because people in cold climates adapt better to cold weather.

    Sensible governments encourage practices that reduce Winter Mortality, such as cheap energy, central heating, good home insulation, and free flu shots.

    When governments foolishly adopt costly green energy programs. they drive up Winter Mortality – real people die in increasing numbers due to doctrinaire government incompetence..

    A common-sense approach for governments would be to encourage cheap energy policies, not to drive up energy costs and winter mortality rates. Governments that drive up energy costs to “fight (fictional) global warming” are following imbecilic polices that preferentially kill off the elderly and the poor.

    How is this related to influenza? The flu is a major contributor to Winter Mortality. Greater and lesser flu’s are a chronic seasonal threat to all societies. Governments that adopt imbecilic policies that drive up energy costs and increase deaths from influenza are incompetent governments that should be defeated.

    That includes most federal governments in Western Europe, Canada and the Provinces of Ontario and Alberta, Australia and some of its States, etc.. Governments in the United Kingdom and the United States recently were changed and adopted sensible energy polices, after years of delusional green energy nonsense.

    Cheap, abundant, reliable energy is the lifeblood of society – it IS that simple.

    When imbecilic politicians fool with energy systems, innocent people suffer and die.

    Regards, Allan

    Reference
    Cold Weather Kills 20 Times as Many People as Hot Weather September 4, 2015
    by Joseph D’Aleo and Allan MacRae
    https://friendsofsciencecalgary.files.wordpress.com/2015/09/cold-weather-kills-macrae-daleo-4sept2015-final.pdf

  28. I was wondering on this “cytokine storm” thing if that might be why hantavirus and meningitis B have very high mortality rates in the young. There are others, but those came to mind.

  29. Death from infectious disease is caused by malnutrition. In the winter most people are very deficient in Vitamin D. The average American diet is hideously deficient. Just look into their bloated pale faces and the high fructose glazing on their eyes There’s no wonder they have to take several courses of antibiotics every year. There is no better antibiotic than the healthy human immune system. The immune system requires good nutrition.

    The flu vaccine is a fraud if not a threat to your health.

    • Not agreeing with the flu shot being a “fraud”, but Americans do lack Vitamin D, in part from sitting in front of a computer or TV and in part because of their obssession with sunscreen. It is perfectly acceptable and quite probably desirable to be outside an hour a day without suncreen. The sun is supposed to be our life-giver, not our mortal enemy.

  30. An interesting study would be to chart the relationship between an imagined dependence on flu shots and a belief that government needs additional empowerment to combat climate change.

  31. Keep antihistamine and Sudafed in your home health kit to prevent pneumonia, which is the fatal stage of pandemic influenza.

  32. One reason there won’t ever be a repeat of the 1918 flu pandemic and that all recent “repeat of 1918” pandemic scares have never materialized is that in 1918 no one knew what a virus was! As recently as the 1960’s m.d.’s were “preventing” the common cold with antibiotics! Every pandemic scare seems to presuppose that knowledge about basic measures to prevent exposure and the spread of viruses doesn’t exist.

  33. The Spanish flu probably did not kill as many people as the Black Death pandemic of 1346-53, but the estimates of dead overlap. The Plague outbreak also lasted longer.

    • Percentage of total population killed of course was much higher for the Black Death, when there were perhaps 400 million people, versus 1.8 billion in 1918.

  34. With all the worry about the dangers of modern life, it’s nice to remember and be thankful that–in the developed nations of the world at least–life expectancy continues to increase, and overall health continues to improve.

    Unfortunately, those facts are rarely mentioned because happiness doesn’t sell self-help books or wack-job nutritional schemes. Fear makes money. (Hello, CAGW!)

  35. One problem with this scenario is that flu seems to have exhausted it novelty. Its combinatorial arsenal for producing heavy-hitting mutations is very small. So far, the only mutations that have ever resulted in an antigenic change big enough to cause a pandemic occurred in only 7 residues around the active center of the HA. There is not a lot of room for fitness-preserving variation there.

    There hasn’t been anything new in flu since 2009, and annual vaccination automatically recommended by physicians hardly makes any sense. In this situation, you might want to do it once every 5 years or so, because if you are like most people, you will retain immunity to flu for 5..7 years after exposure.

    Details here:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4403388/

  36. I am astounded by the claim of cytokine storm and other possibilities rather than the most obvious cause: DDT. While the many of articles relating DDT to polio and the 1918 flu deaths seem to have disappeared, recall that the Army sent its men overseas with every blanket, towel, clothing, tents, food containers, everything saturated with DDT. There seems to have been a wash of the literature of the time as researchers have dug only to find oblique references and inferences. Perhaps there is infor out there I have not been able to find. Books?

    • Minor little problem with your “1918 flu pandemic and DDT” scenario–DDT was not introduced as an insecticide until 1939.

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