In the first part of this article posted yesterday, I discussed my thoughts on the possibility that the current A(H1N1) Swine flu may defy the expectations of all those thinking it will act exactly like the "normal" seasonal flu and disappear over the Summer, only to return during the colder months that make up the regular Flu Season; conversely, I wondered at the possibility that it will simply remain with us, perhaps posing a bigger problem in the Fall/Winter, but never really going away.
The second question I discussed was, if the thought above proved to be true, might this resiliency on the part of the virus not provide greater opportunities and thus increase the chances that A(H1N1) might recombine with H5N1 Avian Influenza sometime in the not too distant future?
Regarding mutation, officials are watching this virus very closely, and have expressed concern for the fact that it seems that it cannot be subtyped. The following quote from the Pandemic Flu Information (PFI) forum explains: "Failure of subtyping means, that some of the primers are failing. This is bad because the primers are chosen from highly conserved regions. So, at the least, that mutations are making it difficult to identify the new H1N1. It could also mean that the new H1N1 has reassorted with another virus. Finally, it could mean a totally new virus."
I discussed yesterday that there are a growing number of H5N1 cases in various parts of the world that exponentially increases the chances of an infected individual becoming co-infected with that disease and the A(H1N1) strain, thus becoming a breeding ground for a possibly disastrous mutation. Now, recently discovered facts would seem to indicate that the virus itself main contain attributes that will aid in such a recombination. A quote from another recent article tells us the: "... neuraminidase of the 2009 H1N1 influenza A virus strain is more similar to the H5N1 avian flu than to the historic 1918 H1N1 strain (Spanish flu)."
Further, we already knew the new strain contained a signature from Eurasian avian flu. It is because of all this that I fear that, if A(H1N1) makes its way into areas where H5N1 is already circulating, the viruses may be able to take advantage of the similarities already evident in their genetic blueprints, thereby GREATLY increasing the likelihood of a new strain.
And, it is not only recombination with H5N1 Avian Influenza (the so-called "bird flu") that could be a danger. Thus far, A(H1N1) has been treated fairly easily with the antiviral drug Tamiflu. We know, however, that the normal seasonal flu is now largely immune to that treatment. If A(H1N1) were to acquire the Tamiflu resistance, it could prove to greatly increase the number of serious illnesses and deaths stemming from this disease. In fact, this has been stated as a major concern of the CDC.
If that sounds unlikely to you, here's a quote from a recent article that provides proof that this flu is prone to mutation: "Viruses isolated from patients during the first two weeks of the current outbreak already have changes on the outer surface on the neuraminidase protein that could interfere with antibodies against the virus or alter the effectiveness of future vaccines." It goes on to say that so far none of the mutations have altered those parts of the protein targeted by antiviral drugs, but leaves no guarantee that this will always be the case.
And sadly, even at this point in the game it seems we aren't even 100% sure how the virus spreads in some cases. Amazing.
This discussion will continue here on the blog tomorrow with Part 3 of this article.