It has been a long time since I blogged anything about the flu. For starters, I am busier than ever at work, which cuts severely into my blogging time. But also because I just have not felt the muse. The swine flu pandemic was blessedly mild overall, although there are thousands of families still coping with the loss of a loved one due to H1N1/2009 who would harshly disagree with my assessment. But it wasn't 1918, so we breathed a sigh of relief.
There are many seemingly divergent storylines currently out there, which I will just list at random. I am not so sure they are not somehow interconnected, however.
First has to be the continued number of human bird flu infections and deaths in Egypt. Overlaying this ongoing problem is the sudden departure of Mubarak, the takeover by the Egyptian military, and what this portends for both transparency and NAMRU's operations within the nation.
Second is the realization that this year's seasonal flu vaccine was way off the mark. I began to notice last month that my employees were getting sick from flu, and I knew they had received their vaccinations in the late fall. My deputy, in fact, was tested type A-positive last month. That's pretty specific. Here in Tallahassee, doc-in-the-box and emergency rooms were positively overrun with flu cases. Things are looking better, but the WHUMP! of flu cases in January was much more severe than at the same time last year. And last year was the dang pandemic! Almost everyone who got flu this year who I am personally acquainted with, had, in fact, received the vaccine months prior.
Third is the ongoing Siege of Japan by H5N1 in poultry. We all have read the articles about the culling of hundreds of thousands of birds in Japanese poultry farms. this has spread to the mainland, especially South Korea.
What is clear to me is that the H1N1/2009 pandemic was not sufficient to push the other subtypes off the radar. This runs contrary to previous pandemics where a dominant substrain was capable of, and able to, sufficiently supplant the previous Big Dog of Flu. H1N1 was replaced by H2N2, which was replaced by H3N2, and so on. Swine flu was not able to eradicate H3N2, nor was it able to eradicate B. for that matter, I do not know what research existed prior to the mid-1950s to actually track Influenza B. for all I know, Influenza B has been around since the Chinese domesticated ducks some 4,000 years ago.
Or, since B mutates more slowly than A, and is therefore not capable of producing pandemics (so says Wikipedia), it is not subject to the King of the Mountain game like Influenza A.
But someone apparently blew the call on the vaccine this season. I get the feeling the only strain they got right was, in fact, the pandemic strain!
The other strain that H1N1/2009 did not push off the radar is H5N1. In fact, so far this year, bird flu activity seems to be much more intense than at the same time last year. Human cases and deaths in Egypt seem to be at the same levels as last year, but H5N1's overrunning of the Japanese poultry industry is disconcerting.
Finally, there seems to be some concern that this year's flu outbreaks are more severe than last year's. Again, this is not scientific, but my people got hit and hit hard by the virus. Their symptoms were severe, with one person requiring hospitalization. In one case Tamiflu did nothing, although there is a chance it was not administered in time.
H1N1 had a comeback in the late 1940s and early 1950s, with several epidemics (the Liverpool Flu of 1951, for instance) that were considered equal to, or more severe than, the 1918 pandemic, depending on location. Shortly afterward, H2N2 (re)appeared, seemingly wiping H1N1 off the face of the Earth.
I openly wonder if the appearance of swine flu in 2009 was, in fact, the Beginning of the End of H1N1 as it was in the 1950s, and we are at the brink of the introduction of a different substrain of flu.