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Novel H1N1 Influenza A Virus Conquering the World

Written By David D'Angelo on Thursday, June 4, 2009 | 6/04/2009

With 66 countries and close to 20,000 cases of Influenza A (H1N1) or Novel H1N1 Influenza A virus spread across the globe the question remains will this pose an imminent threat to mankind? 9 days ago I wrote an article in which at that time 46 countries were affected and there 12,515 cases and 91 deaths. As of today there were 20 more countries affected, 7,000 plus more cases and 26 more deaths. Will this be greater than the Black Death or Bubonic Plaque? The Black Death of 1347 to 1352 killed 25 million in Europe over 5 years (estimated to be between 25 and 50% of the populations of Europe, Asia, and Africa - the world population at the time was 500 million).

This virus is spreading very fast at a rate that had never been expected. In the early 2002 when SARS was feared it never reached as many as 66 countries nor did it reached the Philippines. SARS did not even jumped to as fast a rate as almost 50% a day. Based on these figures at the current rate the rate of spread is almost 4% per day or 770.92. Calculating in a month there will be around 23,127 cases and then within a year if not prevented 277,531 might be affected. This might even be a very conservative figure since at this rate there could be more than 1 Million cases by 2010.

Last week another expedited-review paper appeared in the high profile journal Science, this one summarizing the genetics of the novel H1N1 influenza A virus causing the current outbreak cum pandemic. This time there is quite a bit of interesting material in this paper for non-virologist scientists with a strong interest in knowing what we are dealing with. And the first conclusion is that we are indeed dealing with swine influenza, whatever else you want to call it. Here is a short summary of the paper, which can be found here.

This virus is said to be very similar to the virus which cause the 1918 bird flu pandemic which is also of Influenza A (H1N1) subtype.

The 1918 flu pandemic (commonly referred to as the Spanish flu) was an influenza pandemic that spread to nearly every part of the world. It was caused by an unusually virulent and deadly Influenza A virus strain of subtype H1N1. Historical and epidemiological data are inadequate to identify the geographic origin of the virus. Most of its victims were healthy young adults, in contrast to most influenza outbreaks which predominantly affect juvenile, elderly, or otherwise weakened patients. The flu pandemic has also been implicated in the sudden outbreak of Encephalitis lethargica in the 1920s.

The pandemic lasted from March 1918 to June 1920, spreading even to the Arctic and remote Pacific islands. It is estimated that anywhere from 50 to 100 million people were killed worldwide, or the approximate equivalent of one third of the population of Europe. An estimated 500 million people, one third of the world's population (approximately 1.6 billion at the time), became infected.

But the good news can be seen from the same report stated above:

There are some interesting observations about this virus, 76 isolates of which have been sequenced in whole or in part (17 from Mexico, 59 from the US). Of most interested are what they don't have: any of the markers suspected to be of importance for pathogenicity, virulence and transmissibility in humans on the basis of the reconstructed 1918 virus or H5N1 ("bird flu"). This was spun as "good news" ("we do not see the genetic markers we believe made the 1918 virus so virulent"), but it has a flip side, something flu scientists knew but often didn't emphasize when talking to the public about the latest "breakthrough" unlocking the secret of the 1918 virus: we still don't know how to go from the genetic sequence to the biology. Said another way, we still can't tell from looking at the genetic sequence of a flu virus whether it will infect humans and then cause serious disease and be easily transmitted.


Whatever happens let us be vigilant and follow these simple steps as publicized by
MedlinePlus:

The virus is contagious and can spread from human to human. Symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue.

There are antiviral medicines you can take to prevent or treat swine flu. There is no vaccine available right now to protect against swine flu. You can help prevent the spread of germs that cause respiratory illnesses like influenza by
  • Covering your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Washing your hands often with soap and water, especially after you cough or sneeze. You can also use alcohol-based hand cleaners.
  • Avoiding touching your eyes, nose or mouth. Germs spread this way.
  • Trying to avoid close contact with sick people.
  • Staying home from work or school if you are sick.



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