July 10, 2009

H1N1 v H5N1

This may seem off my usual topics but anyone who has any time trapped in a lift with me will know that my secret obsession is flu pandemic planning. This interest started surprisingly due to art history: as a youth studying, it was a source of fascination that the career of the Austrian Expressionist Painter Egon Schiele was cut short by the 1918 flu pandemic. William Carlos Williams talks about the experience of being a doctor at the time in his excellent autobiography. Anyway, at the time I was also studying history and it seemed bizarre that an event that had killed more people than the first world war was never mentioned. So over the years I have taken an interest in the story of the virus and the ongoing epidemiological research. Some years ago the science consensus was that another pandemic was inevitable - though not mentioned publicly, the UK government are planning for up to 600,000 deaths. In Scotland plans are in place for inflatable temporary morgues to be sited in parks to deal with the bodies. I bought my supply of Tamiflu a few years ago. The general expectation was that the next pandemic would be the Bird Flu H5N1 virus. (Flu is a relatively simple virus; the H and N are molecules on its outer shell with the numbers indicating the particular configuration of the mutation). So the Swine Flu outbreak was something of a surprise - though the World Health Organisation response was implementation of the plans put in place for the Bird Flu. The mortality figures are rising slowly but not in the apocalyptic way predicted. If this is the deadly hit, then it could be following the same pattern as 1918. The disease hits in a mild form in the spring then mutates over the summer to kill millions in the coming winter. If this is the case, there is a theory that while risky to certain groups it is advisable to catch it now so you are immune when it mutates. People who caught the first wave in 1918 were much more likely to survive the killer wave. While whatever happens we are in a much better position than they were in 1918, I incline towards the school of thought that it H5N1 will still prove to be more scary than H1N1. In the spirit of preparedness and maybe helping you stay alive, I'd recommend you keep an eye on http://crofsblogs.typepad.com/h5n1/ which is an excellent source of news on H1N1 and H5N1.

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