Swine Flu

The philosophy of the flu

Do viruses exist just to give us a hard time or are they bent on destroying the world?

  • more
    • All Share Services

Gina Kolata is a flu historian (and a writer for the New York Times). The bulk of her new book, “Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It,” concerns scientists’ attempts to dig Eskimo and Norwegian corpses out of the permafrost to extract lung tissue and find samples of the virus that caused the Spanish flu.

Spanish flu — sounds so quaint. Yet in 1918, the Spanish flu wiped out 40 million people. It killed more American soldiers than the Kaiser. Yet, history forgets the disease. Hemingway wrote great stories about WWI combat, but no great works about the flu. Kolata’s book tries to answer the question, “Why is the Spanish flu forgotten?” Her book makes a reader consider that the true history of mankind is a chronicle of various diseases’ attempts to wipe us out. For this, and many other reasons, “Flu” is the last book you want to read this winter.

I did not have the great year 2000 flu when I began her book. I did not have it when I was finished. But shortly after I spoke with her (by phone), the flu struck. I don’t believe the book made me sick. But I now recall certain passages such as: “William Sproat thought little of the attack of diarrhea that struck him on Saturday, October 23, 1831. He recovered immediately and simply put it out of his mind.” By dinner time, it was another story. William Sproat was racked by “agonizing stomach cramps … Sproat doubled over in pain, and a watery, white-speckled diarrhea poured from his bowels, seemingly gallons of it. Each attack was heralded by violent intestinal spasms. He began vomiting. Sproat barely made it home, where he crawled into bed, shivering with fever, writhing in pain.” Five days later, Sproat was dead. Of cholera.

Thanks to Kolata’s book, I now know that the great year 2000 flu feels exactly like cholera. Many nights I lay awake at 3 a.m. — feverish, sweating, eyes hurting, hacking up phlegm and worse — realizing that not only do I feel like William Sproat, but I’m also the equal to one of those Eskimos buried in the permafrost since 1918. Kolata’s book made me see how a considerable percentage of mankind’s dead died of forms of the flu. The 2000 flu is the ultimate equalizer between the living and the dead.

Yet this realization only rubs my nose in a maddening paradox: The flu is the essence of life. Yes. A flu virus has no consciousness. No brains. No animal instincts. Yet it possesses a fiercer hunger for life than I do. Is this flu the essence of God or the devil?

I explored this notion with Gina Kolata in an interview. I invite you to read our talk with ironic detachment. Neither one of us guessed how sick I would soon be after the interview was finished.

Your book was really scary. Were you worried about catching the flu while you wrote it?

No. You know how some people are constitutionally gloomy? Well I’m constitutionally the other way. I’m obnoxious. I never get sick.

I’m that way. But when I first started the book I thought, I can’t read this. I’m going to get sick. [Ha! Little did I know ...]

This is how I rationalize things. I’m naturally immune to smallpox. They couldn’t vaccinate me. It never took. Maybe I’m naturally immune to the flu. Who knows?

Why does America have historical amnesia about the Spanish flu?

That’s a really good question. I have two ideas. One: That it was just part of the nightmare of World War I. And when it was over people badly wanted to forget it. Every time I talk about this book on radio shows, people call in, ‘My parents died.’ There are all these family tragedies. In a sense, the Spanish flu is a personal tragedy rather than a historical one. That brings me to my other hypothesis and that is the ‘great man of history’ theory. No great leader was killed by the Spanish flu. Every side died equally during World War I. It was sort of historically neutral. Historians tend to emphasize the big events like battles and leaders, while all across the world children were losing parents. Families were being decimated.

You could write the history of the planet as sickness.

That would be interesting, wouldn’t it.

A fact in your book amazed me — until this century every major city kept being depopulated by diseases.

That surprised me too. I didn’t realize that cities couldn’t even maintain their populations. All this stuff really surprised me. Why, when we study history, we don’t learn how public health measures make such a difference until something like the flu comes along and makes it all seem like a joke?

Did you get a flu shot?

I did this year — for the first time. Flu shots got a really bad name because in the ’60s and ’70s they weren’t good at guessing what the flu was going to be.

Then Gerald Ford’s swine flu fiasco [the epidemic that never materialized] in 1978 made everyone sick.

That’s when I first decided that I never wanted a flu shot. They were immunizing people against the flu that never came, and then there was the whole threat of nerve diseases from the shots. Why would I want that?

If some new fatal flu appears, the shots aren’t going to work are they?

That’s what’s so scary. They have to know six months in advance to make enough for everybody.

I wasn’t quite clear on this: Are the Spanish flu and the swine flu the same thing?

It’s hard to know. When the 1918 flu was killing everyone, all of a sudden there was a flu epidemic that was killing pigs everywhere in the Midwest. It’s not clear whether people gave the flu to pigs or pigs gave it to people. In the 1930s, when they looked at people who survived the 1918 flu they all seemed to have antibodies with the flu that had affected pigs. The thought was, whatever that flu was in 1918, it at least superficially resembled the flu that affected pigs.

We can get flu from pigs — wasn’t the Hong Kong flu from birds?

That’s why they had the horrible episode in Hong Kong a few years ago, they thought maybe something like the 1918 flu was coming back because young people were dying of the flu and it turned out to be transmitted from chickens, so they killed all the chickens, ducks and geese in Hong Kong.

In general we can’t get it directly from birds. They get the flu all the time and don’t get sick. They have an enzyme that we don’t have. So in order to get a bird flu something has to change in it. Pigs can get flu from birds and pigs can get flu from people. They can be sort of a mixing bowl. So the two flu viruses can mix and match — and have some bird flu characteristics and some human flu characteristics, which will allow it go get into people’s lungs. Actually there are all sorts of animals who can get infected with flu — that’s why we can never wipe flu out from the world.

Is the flu virus a real species or is it a linguistic thing, that is, a certain virus that gives you a lung disease is called a ‘flu’?

It’s a linguistic thing. They started calling it a flu before they actually learned there was such a thing as a virus.

Smallpox is caused by a virus, right?

Yes.

So in a way, can you call smallpox a flu?

No. You couldn’t. It’s like saying because salmonella poisoning is caused by bacteria and pneumonia can be caused by bacteria so they both can be called salmonella. It’s different viruses causing different things.

Flu can be transferred through the air, right?

Right. That’s why it’s so scary. With AIDS you can say, ‘There are ways of not getting AIDS.’ But if something is being transferred by the air, it’s very hard to avoid it.

How long is flu’s airborne life span?

Not very long. Less than an hour. Viruses are strange creations. They have to live inside a cell.

Does Michael Jackson have the right idea with his gauze mask?

They don’t work. Back in 1918 many cities passed laws that you couldn’t go out without gauze over your mouth. It was useless. The virus passed right through.

So we need space helmets?

We need to really barricade ourselves in our houses like survivalists or something.

There’s no way to predict when a new virus will break out, is there?

That’s really frightening. First of all, I think AIDS was really humbling for the 20th century. Around 1980, scientists were in this phase where they said, ‘Oh we’re conquering everything.’ And here’s a new virus breaking out. With flu there’s always new viruses breaking out. If it’s an old one then everybody already has antibodies to it, so the virus has to keep changing to find a new population to infect. There are so many animals and so many people that can have flu viruses mutating away in them, it’s inevitable that every year there are new flu viruses.

The medical establishment is always worried about new influenzas. Do they know enough? Are they prepared enough to really get going on this? They’re concerned about how long it takes to make vaccines. They’re also concerned that in 1976 when Ford started to do swine flu vaccine, scientists got a reputation for crying wolf. Scientists now worry if they say, ‘This flu could be deadly. You really should get vaccinated,’ people will just say, ‘Yeah. You told us this before.’ So there’s so much cynicism. There’s a whole anti-vaccine movement going on even with vaccines for children that most people think are crucial.

Were the scientists cautious when they were digging up the Spanish flu corpses?

Sort of. The woman, Kristy Duncan, who went to that island off Norway, was. She was very worried about starting another epidemic. Everyone wore space suits. They had a little tent over the grave site. Then of course it turned out that the ground the miners were buried in wasn’t even frozen, so they were totally decayed.

I remember reading about that in the newspaper at the time and thinking, Why do you want to preserve a virus?

To know what it looks like. This could help forecast when a bad flu is going to come. If they can answer why this flu killed so many people in 1918, then if they then see a virus somewhere with these same characteristics they can say this is the one that we have to worry about.

In your book you mention these places where they have bits of people’s bodies laying around for years and years.

It’s just amazing. I went into this warehouse in Washington, D.C., called the Library of Congress of the Dead, and it was just row after row of boxes. And in the boxes were pieces of people’s brains and hearts. They died of ordinary things. And they died of strange illness. And along with each person’s piece of tissue were slides of their cells and their medical records. It’s just amazing to think that it’s there.

There is also one of those places in England. It’s not as well organized. It’s in the basement of this old hospital. Everything is written out by hand — this spidery handwriting. Some things are mislabeled. But they actually have a repository, too.

It sounds like there could be a little jar of bubonic plague sitting around and a cleaning woman opens it up …

I think because the things are mainly preserved in formaldehyde that anything in them would be dead.

So let’s talk preventive stuff about the flu. Do you use pay phones?

Ha! I do. I have a cousin who always carried around Lysol and sprayed the phones. I always thought that was crazy. I guess you could get infected from a pay phone.

Can you wipe flu germs off of a pay phone?

You probably could. You can overdo your paranoia. You gotta have a life.

If your number’s up, your number’s up. [Pause.] Can viruses die?

Die?

They’re not eternal, right? They’re parasitic and live off the host?

Yes. If they haven’t spread on to somebody else and the host dies, the virus will die too.

Then viruses are alive, right?

Some people would say they are. Some people would say they aren’t. Because you normally think if something is alive it can live on its own and reproduce itself. But viruses have to go into a cell and take over the cell’s machinery to reproduce itself.

What drives them?

What drives them?

What drives them to stay alive? Is God in a virus?

You’re getting beyond where I think I can answer. I don’t even have a hypothesis. [Pause.] I always have a hypothesis, but not on this one.

Mankind didn’t come from a virus, did we?

I don’t think so. We couldn’t. Because a virus has to live in a cell.

Yes. Moving from person to person and animal to animal. You’ll be fighting it off, but you would spread it to somebody else and then it would blindly reproduce in the next person while they fight it off and it spread to somebody else.

This is basically “Invasion of the Body Snatchers.”

[She laughs.] Yes. I should have thought of that for my book.

David Bowman is the author of the novel "Bunny Modern" and the nonfiction book "This Must Be the Place: The Adventures of the Talking Heads in the 20th Century."

Our hand-cleaning paranoia

A new study says sanitizers aren't going to keep you from getting sick. But is it time to stop stressing?

  • more
    • All Share Services

Our hand-cleaning paranoia

It’s going to take more than a squirt of Purell to make you invincible. Just in time for back-to-school and flu season, a University of Virgina study out this week decrees that those stinky hand sanitizers so popular among your germ-phobic companions have remarkably little effect on whether you’ll fall prey to colds and flu. As the Daily Progress reports, “Influenza infections hit 12 of 100 subjects who used sanitizer, compared with 15 per 100 subjects who didn’t take special precautions.”

But you might want to think twice before you engage in an enthusiastic round of mud-pie making at the nearest preschool and run your fingers all over the stripper pole at Scores, only to cap it off with nothing more than a brisk rubbing of your palms on your pants. While coating your digits in sanitizers won’t do much to save your throat from those seasonal airborne viruses, it will help block the spread of gastrointestinal disease and other illnesses transmitted via physical contact. Alcohol, that magic ingredient in so many situations, is the germ buster that gives it an advantage over plain old soap and water.

Washing your hands old-school and paper towel-enabled isn’t more trouble than it’s worth either, despite a report this week from the American Society for Microbiology and the American Cleaning Institute that made the rather gross revelation that roughly 15 percent of Americans don’t wash their hands after going to the bathroom. That figure, by the way, actually represents an increased vigilance — 10 years ago, only 67 percent of restroom users were remembering to wash up after doing their business. Kind of makes you reconsider sharing that platter of nachos, doesn’t it? It’s as simple as this: The Centers for Disease Control says, “Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others.”

Having recently gone through a serious health crisis and come out the other side with a compromised immune system, I’m all for illness prevention measures — especially when they’re cheap and simple. My oncologist has specifically stated that frequent hand cleaning should be part of my daily routine — and that of anybody who wants to touch me. You’d better believe I want the nurse who’s changing my bandages, the sous chef who’s handling my food, and anyone who’s just left the ladies’ room to be sporting a freshly cleansed pair of mitts. You can’t walk 15 feet at Sloan-Kettering Cancer Center without hitting a hand sanitizer dispenser, and I like it that way just fine.

But I’m also comfortable with the old axiom that you’ve got to eat a peck of dirt before you die. Living in New York City, across the street from a public park, I generally assume I will come in contact with at least a peck of dirt, defecation, vomit, semen and rat germs well before lunchtime on any given day. I also have two children, and even with the best of parental intentions, the average 6-year-old is going to have all the hygienic vigilance of a Gathering of the Juggalos.

At one end of the spectrum there will forever remain the adamantly unwashed, the steadfast pee-and-run types. And unless you want to deck yourself out in a Hazmat suit, those people will likely touch your plate or sneeze in your direction. At the other you’ll find plenty of hopefully determined Lady Macbeth wannabes, eager to whip out their purse-size hand cleansers and maybe wipe down all immediate surfaces along the way. Although the latter may have an immunity leg up, both groups will likely include casualties this season in the war on colds and flu.

But I’ve only got so much paranoia to go around, and I have to save some of it for whoever’s reading my Facebook profile. And there’s something consoling about being reminded that a little dirt under your nails or sitting on a bus isn’t going to make the gods smite you with a touch of plague.

Continue Reading Close
Mary Elizabeth Williams

Mary Elizabeth Williams is a staff writer for Salon and the author of "Gimme Shelter: My Three Years Searching for the American Dream." Follow her on Twitter: @embeedub.

WHO to send swine flu vaccine to poor countries

Stockpile of vaccines to supply Azerbaijan, Afghanistan and Mongolia, followed by dozens of others

  • more
    • All Share Services

The World Health Organization plans to start shipping swine flu vaccine to Azerbaijan, Afghanistan and Mongolia in the next few weeks, flu chief Keiji Fukuda said Thursday.

Another 35 developing countries are in line to get the vaccine soon. The U.N. health agency has prioritized sending the shots to northern hemisphere countries first, which are being hit harder by swine flu than countries in the southern hemisphere.

The agency had hoped to send the vaccine earlier, but the effort has been delayed by manufacturing problems and bureaucracy.

When WHO declared swine flu to be a pandemic, or global outbreak, in June, it warned the virus could have a devastating impact in countries across Africa with high numbers of people with health problems like malnutrition, AIDS, and malaria. Most people who catch swine flu only have mild symptoms like a fever or cough and recover without needing medical treatment.

WHO has a stockpile of about 180 million swine flu shots, donated by six drug makers and a dozen countries.

Countries hoping to get swine flu vaccine from WHO must meet three conditions. They have to formally ask for it, agree to certain terms and conditions on how it will be used, and develop a national plan to make sure the right people — like health workers and those with underlying health problems — get it first. WHO is hoping to send enough swine flu vaccine to cover about 10 percent of populations in poor countries.

Countries likely won’t start vaccinating their populations until a few weeks after they receive the vaccine, but Fukuda said it wasn’t too late to ship the vaccine — even though swine flu appears to have peaked in several northern hemisphere countries, like Britain and the U.S.

“This is a virus that we don’t expect to suddenly disappear,” Fukuda said, adding WHO expected the virus to keep circulating for the next few years.

Fukuda said it was “premature” to consider whether the pandemic might be on the decline, and that WHO would consult experts before making such a declaration. He said flu activity this year had peaked “extraordinarily early” and warned there were still several months of winter to come.

Continue Reading Close

800,000 doses of kids’ swine flu vaccine recalled

Hundreds of thousands of children's swine flu vaccine doses may not be usable, health care officials say.

  • more
    • All Share Services

Health officials are recalling hundreds of thousands of doses of swine flu vaccine after tests indicated they may not be potent enough to protect against the virus.

The Centers for Disease Control and Prevention notified doctors about the recall Tuesday. The recall involves about 800,000 doses made by Sanofi Pasteur. The doses are pre-filled syringes intended for young children, ages 6 months to almost three years.

Health officials recommend children those ages get two doses, spaced about a month apart.

Health officials say it’s not clear how many doses have already been given, but they don’t think children need to be re-vaccinated. The lots passed potency tests when they were first shipped, but tests indicate the potency waned after.

Health insurance industry secret weapon: Swine flu

Treatment and prevention of swine flu hurts insurer profits. The timing couldn't be better

  • more
    • All Share Services

The first time I read the The Onion report, “Obama’s Declaration Of Swine Flu Emergency Prompts Pro-Swine-Flu Republican Response,” I laughed (because it’s darn funny), but then I cried — because it’s just not too far from the truth. Whatever Obama does, is, by GOP definition, bad. Which means satire like The Onion’s cuts too close to the bone.

Republican leaders announced Wednesday that they were officially endorsing the swine flu. “Thousands of Americans — hardworking ordinary Americans like you and me — already have H1N1,” Republican National Committee chairman Michael Steele said during a press conference. “Now Obama wants to take that away from us. Ask yourself: Do you want the federal government making these kinds of health care decisions for you and your family?”

Ho ho ho. But then I read about what the swine flu is doing to healthcare insurer profits in Brett Chase’s Portfolio blog, Heavy Doses.

The cost of treating and preventing the flu is adding to medical claims, which means health insurers are reporting lower earnings this quarter even as Washington lawmakers accuse them of having inflated profit.

Declining profits might seem, at first blush, like a bad thing for the healthcare insurer industry. (Did you know, by the way, that the United States is the only developed country in the world that even has a for-profit healthcare insurance industry?) But maybe not. With healthcare reform all-but-certain, perhaps it is advantageous for the healthcare industry to take a profit hit, right about now.

More Chase:

While the flu trends are severe, they may “conveniently” have an impact on profits for the second half of this year, Thomas Carroll, a Stifel Nicolaus analyst in Baltimore, writes in a recent note to clients.

“Influenza impacts health plan profits on an annual basis, and given reform activities, (health insurance) managements may overly emphasize the potential impact,” Carroll says.

Now I’m rethinking whether The Onion’s report really is satire. Maybe Republicans do oppose efforts to combat the swine flu. Because, perversely, no swine flu would mean higher profits for the healthcare insurers which would mean a better chance of tougher reforms getting passed.

Ha. Ha. Ha.

Continue Reading Close
Andrew Leonard

Andrew Leonard is a staff writer at Salon. On Twitter, @koxinga21.

Glenn Beck flirts with sanity

In a special about swine flu and the vaccine for it, the Fox News host sounds almost reasonable -- almost

  • more
    • All Share Services

Glenn Beck flirts with sanityGlenn Beck

Fox News

Glenn Beck isn’t going to tell you whether he’s decided to get the swine flu vaccine, and whether he’ll be getting his kids vaccinated too. “I’m trying to give you the facts tonight, with no opinion,” the Fox News host said at the top of his hour-long special about H1N1 and the vaccine for it.

It may, of course, have been just that simple. But watching the show, it seemed like there was something else at work: It seemed like Beck was leaning towards the pro-vaccination side, that he, for once, doesn’t believe the conspiracy theories. It was one of those moments where some of what Beck does seems like an act, a vestige of the showmanship he learned while a DJ on morning radio.

The man knows his audience. He has to know that his usual trips down into conspiracism mean that there are people watching him who do believe that the government will be injecting an RFID chip into your arm so that they can ship you off to a camp where you’ll be held as punishment for refusing to be vaccinated. But he doesn’t agree with them, and that means a little dance — Beck debunks some of those fears, sure, but first he gives a little nod in their direction.

“We must take this threat [of swine flu] seriously,” Beck said near the top of the show. “I think the government has done a responsible job so far. However, the arrogance of those in science and politics that we have seen lately should give us pause.”

To start the special, Beck had two doctors on. One, Marc Siegel, is a Fox News contributor; he took the pro-vaccination side. The other, Kent Holtorf, specializes in bioidentical hormone therapy, an alternative medical treatment of dubious value. He took the anti-vaccine side. These sorts of he-said she-said debates, especially when conducted regarding issues of science, tend to give far too much credence to people who don’t have evidence on their side. In this case, that was Holtorf, who argued against many vaccines generally, relying in part on an argument that’s been repeatedly debunked about thimerosal, an additive, making some of the shots harmful.

In this segment, beyond the basic issue of having an anti-vaccination argument like this one on his show at all, Beck wasn’t too bad. But he did revert to type on a couple of occasions, playing to the more paranoid in his audience — after Siegel pointed out studies showing that the claims about thimerosal aren’t true, for instance, Beck held up a copy of an old cigarette ad that featured an illustration of a doctor.

Beck even went so far as to debunk some of the wilder rumors floating around the Internet, which include a myth that the swine flu vaccine contains an RFID chip that will allow the government to track people. But he wasn’t content to leave well enough alone, and started going back to his usual bag of tricks — not too surprising, considering the fears in some circles about RFID chips being the “mark of the beast,” a sign of the End Times.

“You have to know that the technology exists, but you also have to know that at this time there is no connection to the swine flu, there is no connection in any government contract, we can not find any government contract on these chips,” Beck said. “However, it exists, and you must stay vigilant. Be aware, watch for it. Watch the companies and the government. I don’t trust the government either. I know the days we’re living in. Vigilance is the key word.”

Continue Reading Close

Alex Koppelman is a staff writer for Salon.

Page 1 of 5 in Swine Flu