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H3N2 exhibiting troubling tendencies as epidemic worsens and young, healthy people die

Posted on Monday, January 22, 2018 at 11:08AM by Registered CommenterScott McPherson | CommentsPost a Comment

One of the key differences between seasonal flu and pandemic flu is panflu's atack on the healthiest people. Whereas seasonal flu largely takes its aim on very young children and very old adults, pandemic flu sets its sights on teenagers through adults in their prime.

The reason for this is what was first detected in 1918.  It is known as the cytokine storm.  Cytokines are the Paul Reveres of infection-fighting.  In normal circumstances, this is (Christian Bale as Batman voice) good, good. They inform infection-fighting cells that something is very wrong, and they need to do something about it.

But when a virus comes along that ramps up so quickly inside a human, those cytokines go nuts, releasing so much information to so many infection-fighting cells that they overwhelm a patient's ability to absorb the battle raging within.  Simply put, the cure kills the patient.  The patient's own body kills it.

If you look back at the 1918 H1N1 Spanish Flu pandemic, you will see that the overwhelming majority of those killed by the virus were young, virile, healthy teens and young adults. Soldiers who got sick in the morning were dead by sundown.  Remember, this occurred all over the planet.  I refer you to John Barry's seminal work "The Great Influenza" and urge you to read this if you never have, or to re-read it if it's been awhile. Barry's work also is a great history of how American medicine came out of the snake oil and sorcery era to become a world-class deliverer of health care.

But I digress. We are seeing way too many cases of otherwise healthy adults and children felled by this H3N2 virus.  Now, medical people will tell you that H3N2 is a much nastier virus than H1N1 today, and they are right.  But this year's epidemic appears to be much worse than normal, putting it on par with the 2014 flu season (also an H3N2 substrain).

In the recent days, news accounts of the deaths of several young people all over the country have been reported. Pennsylvania. Ohio. California.  Arizona. California againConnecticut (a very healthy 10-year old boy). And in Alabama, a young adult, father and Crossfit participant, lies in a medically-induced coma, fighting for his life.

We are going to read, see and hear more such stories.  There is irony in this year's flu season.  The irony is that a seasonal flu that evolved from a pandemic flu with the lowest mortality rate of any of the 20th century's pandemics -- the 1968 Hong Kong Flu, H3N2 -- would be exhibiting tendencies one would think would be more closely related to 1918's pandemic H1N1 Spanish Flu.

This obviously does not mean that H3N2 is (re)evolving into a pandemic strain, as H1N1 did back in 2009.  At least not now. What it does mean is that conventional triage regarding flu -- that it hits the really young and the really old the hardest, and the ones in the middle will be fine -- needs to be re-evaluated.  Healthy, young, and non-immuno-compromised people are dying from the flu.  We don't know yet if the numbers of deaths of these people are above average, below average, or right on par with other flu seasons. We do know it is a nasty season, with no signs of abatement, despite the CDC's proclamation of last week. By the way, the CDC has admitted this year's flu has hit epidemic status -- which I predicted several says before the issuance of the statement.

We cannot assume anyone -- anyone -- is safe from the most severe effects of this flu.  This would absolutely extend to those who are fit as a fiddle and could wrestle a bear.  We are seeing the cytokine storm claim otherwise healthy, young adult victim after victim. If you have a loved one who fits that category, and he/she is sick with flu and not responding to treatment, assume nothing.   

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