Scott McPherson's Web Presence

This week, an elderly Central Florida woman named Catherine "Cay" Thompson died of swine (H1N1/2009) influenza.

The news report, a capsule of which can be found here, says the Lake County (just north of Orlando) woman had recently traveled to California.  the new report also says local health officials are "shocked" that a flu case should come so early in the season.

A more detailed Orlando Sentinel account can be found here.

There are a few takeaways to these articles that just jump out at me.

First, are we surprised that a (previously) pandemic virus would still be circulating in the United States outside of flu season?  Pandemic viruses do not follow the seasonal pattern.  When do we determine that a pandemic virus loses its characteristic ability to infect people outside of "flu" season?  We all know the WHO said "stand down, please" to the H1N1/2009 pandemic, declaring it over well before now.  But when exactly does a virus lose its ability to infect outside of flu season?  I would imagine that occurs when the virus burns through the population enough to establish more of a seasonal-looking infection pattern.  I would also imagine that occurs due to natural mutations in the virus itself.  But since the WHO declared the 2010 vaccine formula would be used again in 2011, it would seem that any evolution in the virus, to this point, and based on surveillance, was very minor.

The Sentinel article states the woman and her church group traveled to California, and she fell ill while there.  She then returned early back to Florida.  It does not state how long she was in California before she fell ill, but we all know that influenza takes several days to manifest symptoms.  She died on August 25th, and I cannot find a church calendar that would shed light on when she might have first been exposed to the virus.

Even with these gaps in the travel calendar, I think we can draw up a theory.  The answer to how this unfortunate woman contracted influenza may be found, not from the visit to California, but much, much closer to home.  Orlando, as everyone knows, is a massive tourist destination.  South Americans love Disney just as much as the Brits and the Europeans and the Chinese and the Japanese.  And, indeed, India is struggling with swine flu right now.  But it is amazing how we fail to look south and, instead, default to looking to our left and right for answers.  It's flu season right now in the Southern Hemisphere.  And it is officially Hot as &@%%$ in Florida right now.  Well, actually, pretty much everywhere.  So the chances of a flu virus circulating in 90-degree-plus temperatures is remote.

In my opinion, it is far more likely that this woman actually contracted influenza at the Orlando International Airport, rather than being infected in California.  One sneeze from a Chilean or Argentine would have done the trick.

The other takeaway from this story is the woman's apparent lack of immunity to H1N1.  We all know that pandemic viruses disproportionately attack the young, sparing the elderly, who -- hypothetically -- have been previously exposed to a similar strain of the returning pandemic virus.

But this was not the case with Mrs. Thompson.  There are references in the stories to her immune system, and how the virus overtook it.  But Mrs. Thompson, being 80 years of age, would have had to have lived through the transformation of the Spanish Flu (1918 A/H1N1) and its many mutations.  She would have lived through the near-pandemic 1943, 1947 and 1951 attacks of H1N1.  She would have lived through the transition from H1N1 to H2N2 in 1957.  And she would have gone through two waves of the swine flu, which attacked Orlando pretty hard, precisely because of its status as a global vacation destination. She also appeared to be in relatively good health, based on her levels of activity within the church.

Where I am going with this blog entry is that we should take a closer look at the virus that felled Mrs. Thompson.  It would be wise for public health experts and scientists to tke a look at Mrs. Thompson's killer through an electron microscope, because the death of an otherwise-healthy 80-year old woman from swine H1N1 should not be simply relegated to statistic status.