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03 May, 2009

H1N1 Influenza A - Mexican Swine Flu: Other Dangers In The Long Run

We are now up to 835 laboratory confirmed cases with 20 deaths (that's up from yesterday's numbers of 661 and 17 respectively). There are an additional 4120+ suspected infections and 101 deaths awaiting confirmation. (source)

Internet chatter abounds regarding a possible imminent move by the World Health Organization (WHO) to put us at their highest level of alert, Level 6, meaning a worldwide pandemic is officially underway. Not only is it obvious to anyone closely following the emerging situation that we meet the stated definition of a Level 6, but Bloomberg reports "WHO Expecting to Move to Top Pandemic Alert for Flu" and from Reuters, "WHO warns flu pandemic still imminent, serious." To clarify, the WHO is saying that there is not YET evidence of community spread OUTSIDE of North America, but it seems to many of us who're keeping a close watch that they like to play around with the parameters in these situations. In this particular case, it involves what they are willing to accept as evidence and what a sustained level of transmission actually means.

Now, keep in mind that designation of this outbreak as a full-fledged worldwide pandemic does NOT mean a high death toll is expected, only that they expect the disease to continue to rapidly spread, infecting many, many people all over the globe. we have had pandemics before with low-to-modest death tolls. in my opinion the greatest dangers posed by H1N1 Influenza A, commonly referred to as Swine Flu, are represented not by the disease itself, but by other factors. consider for a moment why it is that we have seen fewer deaths from this disease in the U.S.. I submit, after all my research, that this at least partly due to the fact that we have better access to health care here in the U.S. and are therefore more likely to consult a physician and receive antiviral medications early-on in the progression of the illness (it has been basically proven that antivirals such as Tamiflu are useless unless taken within the first 48 hours after the onset of symptoms). Further, should we in the U.S. fall gravely ill, as an increasing number now are, there are still ventilators available to help us breathe when our own lungs fail, thus extending both the time needed for our bodies to beat the illness as well as the time during which life-saving measures can be employed. One real danger lies in the possibility that if this bug becomes very widespread, we could see the number of patients requiring ventilators outstrip the number of machines available as each hospital only has so many. This type of scenario would lead to many more deaths, so hopefully it will fizzle-out before that becomes a reality.

Another danger manifests itself through our very efforts to treat the disease. It is a scientific fact that as the illness spreads, the increased usage of antiviral drugs and antibiotics will actually hasten the rate at which it mutates and becomes resistant to those treatments.

There is now apparently some doubt as to where exactly the disease originated with some thought leaning toward somewhere along the Mexico-California border. The disease is also now confirmed to be transmissible from human-to-pig, further reinforcing the dire possibility that it could pass from a person to an animal in a country where deadlier strains are already present in some livestock.

It was reported in 2005 that H5N1 Avian influenza could be infecting up to half of the pig population in some areas of Indonesia without causing symptoms. This is very dangerous because the animals can harbor both bird and human flu viruses, and act as a mixing vessel for the emergence of a strain of avian flu that can easily infect humans. There are now signs that the virus could be spreading unchecked through the pig population. If H5N1 were to mutate with the current H1N1 A strain and become transmissible between humans, it would be devastating to the human population.

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