Welcome back Leesa and good articles in the Horizon section today Edward, Gip, Sharron and Mark!

FYI-- Here is a tidbit of info on the personal front regarding the flu. My husband was just sick with the flu, quite possibly swine flu/H1N1, and I found it very interesting that I did not come down with any symptoms. I found this article to be interesting with regard to the 1976 swine flu vaccination which I had. Apparently there may be some protection for those of us that had the shot in 1976 mentioned here in this article. That could be the explanation for the current flu afflicting younger people.

Interesting article, Deb.  Based on my recent experience, I'd say that the majority of the people seeking treatment for flu-like symptoms were under age 21, and most were under 18. 

I caught the swine flu in 1977 -- but was only down for 2 days -- most of my friends were out for at least a week.  I've had no ill effects from my exposure, so far.  Must be some natural antibodies in my system.  (I rarely catch respiratory or stomach bugs.)

Good to hear that you had some resistance!

Leesa

Clonnie Yearout:

Dave Hanson:

George Washington required the Continental Army to get vaccinated for small pox.

I suppose I'm a fool for questioning a history professor, but here goes:  The smallpox vaccine was developed in 1796 by Edward Jenner, an English physician.  Washington was President from 1789 until 1797, so he would have had the authority to order a vaccination of the troops, but I was not even aware that there was a Continental Army in existence at that time.  I suppose it could have happened, and I certainly have no proof that it didn't, but the timing and circumstances would have had to be quite remarkable.  I also wonder how the vaccine would have been administered.  Surely there were no hollow needles available, and any method used to introduce the vaccine under the skin would have been as likely to produce infection as inoculation.  Washington himself died in 1799, probably as a result of being bled three times in less than 24 hours as treatment for a sore throat, proving that medical knowledge was severely deficient in that era.  I'm not trying to impugn your stated fact -- just wondering....

There's much history I am ignorant about, but this is a rare instance where I actually know what I think.  (Among my stronger suits in the field of American history is the life and times of George Washington.)  I would not characterize you as a "fool" for questioning this, but I think maybe it was a bit cocky to do it with that slight touch of sarcasm italicized above.  (Were I a canine and not a human, that would be expressed in the form of one of Liberte's mild growls... with her tail wagging, i.e., without mailce.)  

You are confusing Jenner's development of the cowpox vaccine (a milder, safer alternative) in 1796 with exposure to smallpox for innoculation.  It's a widely known and accepted historical fact that General Washington ordered the innoculation of the Continental Army for smallpox two decades before Jenner's official discovery of the cowpox vaccine.  Yes, introducing it under the skin was the method used; and yes, that does introduce a mild case, which is a form of innoculation.  Controlled exposure was the common form of innoculation in the 18th century.  Implementation of Washington's general order for smallpox innoculation began in January 1777.  By all accounts, it worked well.  According to Bruce Chadwick in George Washington's War, "a medical historian later wrote that Washington's efforts to save the army and populace from smallpox was as important a factor in winning the war as victory in any battle."

We cited that example, not for a history lesson, but to make two simple points: first, there is nothing unprecedented about mandatory vaccination; and second, there might be mild risks associated with vaccination but there are overriding benefits.

The fact that Washington died from a throat infection, made worse from repeated bleeding, illustrates that medical knowledge two centuries years ago was relatively deficient (compared to 2009), but we would not characterize it as "severely deficient."  Such knowledge should be understood in its historical context.  Two centuries from now, people surely will say our knowledge of many things was severely deficient.  It's like saying an infant is severly ignorant compared to a well-educated, mature adult.

Dave and Ricky

 The European H1N1 vaccine contains adjuvants that cause an inflammatory response in the body. I suspect the American version is the same or similar. "Adjuvants" are added to enhance an immune response. They are suspected of causing autism and other neurological disorders in past faulty vaccines. The use of adjuvants enables the use of less antigen to achieve the desired immune response, and this reduces vaccine production costs. With a few exceptions, adjuvants are foreign to the body and cause adverse reactions.

 The H1N1 vaccine basically covers 3 of 25 potential types of "flu." Granted, it is the 3 best guesses to cover an emerging future flu. I do not remember ever having the "flu," and can't reflect first hand knowledge about the severity of symptoms. I understand my travels include true daily exercise to the point of breathing hard(sucking wind), and sweating, with few exceptions. I eat right, and have always felt water to be the best thirst quencher, and my treat is Dr. Pepper. It is my belief, you have a choice. Be a couch potato, and take every flu shot that comes down the pike, and perhaps that will work. Or, you can heat the core body daily via exercise. A truly healthy person, and a vaccinated couch potato, may both still come down with the flu, but with less severe symptoms. One has natural immunities doing the job, and the other has a mystery cocktail being pumped into the body once or twice yearly, to hopefully do the same. Big Pharma is counting on you being a couch potato, and sucking up the 200,000,000 doses of vaccine. Your choice. Maybe it's time to get off the couch, and quit looking for the easy way out. Gip

Gibson Brown:

A truly healthy person, and a vaccinated couch potato, may both still come down with the flu, but with less severe symptoms. One has natural immunities doing the job, and the other has a mystery cocktail being pumped into the body once or twice yearly, to hopefully do the same. Big Pharma is counting on you being a couch potato, and sucking up the 200,000,000 doses of vaccine. Your choice. Maybe it's time to get off the couch, and quit looking for the easy way out.

The link between vaccinations and autism and other mysterious neurological disorders is speculative at best.  I think your phrase "with few exceptions" might be a slight overstatement.  Minor adverse reactions from various drugs and treatments are common; serious harm from approved medical care are rare.  Personally, I do not think it is a good idea to let the exceptions become the rule (i.e., the "take nothing that might possibly harm you" approach).

I know people who boast, "I've never been sick a day in my life."  To them I say, "Good for you.  Most of us humans aren't so blessed."  It is remarkable that you can't recall ever in your life having any form of influenza.  Maybe you've never had a cold either.  To the extent that it is the result of a healthy lifesyle, you deserve a pat on the back.  To the extent that it is the good fortune of inherited DNA or just lucky avoidance of exposure to infectious microbes, you should be thankful.  I've had my share of flu.  I rarely get a flu shot.  In the case of the current swine flu scare, as I've written before, I think it's been ridiculously over-hyped, but I don't think it's fake.  People have to weigh the risks and act responsibly.  Personally, I don't fault government officials--federal, state, local--for taking aggressive steps to protect public health by containing the spread of swine flu. 

Leesa McGregor:

bobchristenson:

This is not exactly on topic, but recently I read on ABC news that Robert Melamede  of the company Cannabis Science  is developing a lozenge made from cannabinoids  that helps suppress the immune system. Apparently the immune system on overdrive is partly what kills people who have swine flu and he wants to market his product for that specific reason. I would never suggest that anyone with a lung infection light up a joint but you could just switch from oregano to some other special ingredient for your spaghetti sauce. It might not cure you but you'll have a much more enjoyable time while you're sick. 

 

 Bob:   Isn't a compromised immune system one of the factors that make the flu so deadly.  If the cannabinoids suppress the immune system further, doesn't that make it more deadly?  Or maybe I'm reading your choice of "suppress" incorrectly.

Leesa

Leesa, I guess "control" might have been a more accurate word. This might seem counter-intuitive ,but an overactive immune system will kill you too. The body can't distinguish between "good" cells and organs and the  "bad" swine flu infected cells so it eliminates them all. If you can get your body back to its normal immune response the bad guys die and the good guys live to fight another day.

bobchristenson:

The body can't distinguish between "good" cells and organs and the  "bad" swine flu infected cells so it eliminates them all. If you can get your body back to its normal immune response the bad guys die and the good guys live to fight another day.

My general knowledge of medicine is very limited and this is a complex aspect of the field of internal medicine.  As I understand it, the basic idea behind innoculations for prevention is similar to that of antibiotics and more aggressive treatments for illnesses: strengthening the body's capacity for producing natural healing mechanisms.  Low-level contact with various viral and bacterial threats to a minor degree helps stimulate the immune system to ward off more serious threats.  Some innoculations seem to work better than others, and much depends on both the person and the nature of the threat. 

Flu commonly makes the patient feel awful for a short time while the body fights it off.  Unless the patient is already in a vulnerable state for whatever reason, or the patient does not get plenty of rest and fluids to aid the recovery, it can worsen to the point of becoming life-threatening.  The person does not die of flu, per se, but more likely from pneumonia or dehydration.  The latter can cause vital organs to shut down.  Viruses can be deadly, but bacterial dysentery was the number-one cause of death throughout much of history.  Most of that could have been prevented with better sanitation (reducing the contamination of food and water).  Today, if properly treated with bed rest, fluids, and maybe antibiotics, dysentery, like influenza, is not likely to kill you, but it will sure make you feel miserable.

I think we should acknowledge that great strides have been made in eliminating many age-old pathogenic threats and minimizing others.  Most people live longer and healther lives in large part due to the availability of clean water.  So-called "third world" developing countries still struggle with simple public health problems.  Today, over two million children die each year because they are not immunized; nearly as many die annually from lack of safe drinking water and inadequate sanitation.  Worldwide, a child dies every ten seconds due to preventable disease. 

Gibson Brown:

 The European H1N1 vaccine contains adjuvants that cause an inflammatory response in the body. I suspect the American version is the same or similar. "Adjuvants" are added to enhance an immune response. They are suspected of causing autism and other neurological disorders in past faulty vaccines. The use of adjuvants enables the use of less antigen to achieve the desired immune response, and this reduces vaccine production costs. With a few exceptions, adjuvants are foreign to the body and cause adverse reactions.

 

Gip, my man,  I love you but you are off base on this adjuvant thing.  Here is a quote from the CDC about the H1N1 vaccine (& all flu vaccines):

Vaccines against novel influenza A (H1N1) virus infection are being produced using methods similar to those used for seasonal influenza vaccines. Licensure of vaccines against novel influenza A (H1N1) virus will be based on the same licensure standards used for seasonal influenza vaccines, as is done routinely each year when strains are changed in the seasonal vaccine. Both live, attenuated and inactivated influenza A (H1N1) 2009 monovalent vaccine formulations will be available initially; as with seasonal influenza vaccines, neither of these vaccines will contain adjuvants. The Food and Drug Administration (FDA) and WHO have selected A/California/07/2009 (H1N1) for use as the strain for the vaccines currently being manufactured.

Link is-  http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5810a1.htm

This additive and adjuvant misinformation has taken on proportions similar to other urban legends.  I am speaking only to the present day vaccines, not the ones often cited from back in the 70's. The additive that is suspected of being linked to autism is thimerosol, I believe its a preservative.  They offer a vaccine for the seasonal flu that is thimerosol free for children under 18.

Leesa, Nice to have you back!  You said in your official answer-

"The vaccine does not prevent the flu, it only lessens the symptoms. 

I believe that this is incorrect.  A successful vaccine will prevent the specific flu it was engineered for, if the patient has had a sufficient antibody reaction.   However, there are so many different types of flu virii ( plural of virus??) that it is somewhat of a crapshoot.  I am not sure how it would just alleviat some of the symptoms. 

I am a big believer in the flu vaccine.  I have been vaccinated every year for the past 23 years.  I have had the flu only once.  This was while I was in the AirForce, stationed in MS.  Arguably, I was at my healthiest at this time, what with mandatory PT, etc.  Taking care of oneself is an important part of being healthy -  I totally agree with Gip on this.  But there are large variations in peoples immune systems.  2 equally healthy people can react totally differently to the same exposure.  I also believe that other factors, especially stress, effect our immune systems.  High stress compromises the body's ability to take care of itself.

As an aside, maybe related, I believe that in general we do not challenge our immune systems enough.  There have been studies that children raised on farms have fewer allergies - from being exposed to so many more antigens at an early age.  I also believe that the innundation of antibacterial soaps is having a detrimental effect on us.  We need the constant stimulation of our immune systems by the everyday bacteria and spores to keep them "in shape".  The use it or lose it philosphy applies somewhat here.  These products have an important place in health care, but have you tried buying a bottle of liquid soapthat is not antibacterial???  Very difficult.

I'll have an official response later - just wanted to stir the pot with a few observations. 

My daughters best friend has the swine flu ( presumptive diagnosis - not actual tested for it)  and my daughter has been sick for a week - but not with the flu.  There is a lot of respiratory junk going around right now.  Have they invented antibacterial tissues yet??

Robin

Dr. Dave...I know people who boast, "I've never been sick a day in my life..."

Hey Dave. having re-read my post after a day of golf at the best deal in the tri-counties, "Countryside Golf Mecca," in beautiful Roanoke, Virginia, I must say my take on the writer was that he is a "it rhymes with pompous grass." As to being one of "those people," my wife will vouch for the past 21 years for the flu part, and don't make me go get my mother! I've been slammed from eating sea food that would kill a possum, and have been stupid with alcohol...responsibly of course blah blah. I was the kid who played number #1 on the varsity tennis team, playing indoor tennis before school at what was then "Arrow Wood or Arrowood"(at Country Side), team practice or a match after school, then eat dinner and go play some tennis. Then do it again the next day. Boot camp was a breeze physically speaking. I live sports to this day. I walk 3+ miles with my wife and hounds every day.

 However, in my case there is a reason for the madness so to speak. From the "we all have our quirks dep't," I peg the meter when evaluated by the expert doctor's, the one's the really smart doctor's send you to, when "tested" for ADD. They appeared startled, and they normally have a doctor's poker face. Turns out my quirk is, a small dose of anything remotely boring changes the channel of my brain looking for enough "stimuli" to make it stop changing. Certainly the amount of posting in this forum could raise the first red flag, and I assume it is likely "that" is a given across the board. Turns out, playing sports creates for me the best and maybe only effective medicine available to deal with such a malady.

 I was diagnosed in my thirties when I finally had to admit there was a pattern, and I needed to find out what the deal was. In hindsight, there was a reason I could not do homework directly after school, but found the tough subjects fairly easy after an afternoon of basketball, or football, or baseball, etc. It certainly explains my need from knee high on up, to push myself physically daily. I was self medicating and did not know it. It is why people like yourself, our very own soon to be Dr. Ally, and this panel in general, which is full of such accomplished people, blow my mind. The stick-to-it-ness it takes to excel academically and/or professionally is HUGE when seen through my eyes. I excelled in the U.S.C.G. because we ran and exercised daily, and the thought of being out at sea on a buoy tender scared me to death. Electronics was so hard and new, yet I finally had enough fear to learn how to study. After 4 years I was tri-qualified on three aircraft as a radioman/navigator, doing Search and Rescue/drug enforcement over the Gulf of Mexico, chasing rusty shrimp boats, and going out in crazy weather for "may day" responses. I received my first glimpse of "Big Brother" in the Guard, and it was not pretty. I have chased the big brother dog ever since, in a compulsive manner. I keep hoping to bump my head on something that will squelch my fears, and let me let it rest...has not happened.

  I know up front I am not average when it comes to exercise. There is a reason I hit a golf ball 400 yards...ADD. Knowing what you know now, it is a no brainer why I hit 100+ golf balls per day in a Rain Man type manner, every one as hard as I can. I do it to function normally, and take advantage of my more than capable brain. Ally can tell you the chemicals excreted from exercise, which I need on a daily basis for me to tick. This forum and writing in general is one of the few things that keep me focused. Motorcycles cheat death and I ride daily...go figure. I love it when Joe C. or Sharron blast me into next week, as it allows me to focus, and I love the challenge. Joe C. is scary smart.

 So there you have it Doctor Dave. We all have our quirks. I am here to tell you the same thing you have heard all of your life...exercise and proper diet is the best defense against illness. Utilize Marvin's common sense approach to healthy habits, and let them keep their flu vaccine's to themselves. I openly divulge what is a semi-embarrassing admission of ADD, and all the stigma that goes with it, because I know that "straight up" and "as it is" wins the day. Gip

Robin..."Gip, my man,  I love you..."

Thanks Robin. I love you too. Gip

Luanne Traud:

Should governments or employers mandate swine flu -- or any -- vaccination?

A little context:

In 1918, the three Blalock brothers John, Huston, and Perry aged 29, 25, and 15, respectively, lived in the small town of Bates,  Arkansas (Scott County). On Thursday, October 10, John felt too ill to go to work as a forest ranger--a rare occurrence, because he had six children ages 1-10 to support. On Friday, Huston, who had three children under the age of 5, also fell ill. On that same Friday, little brother Perry was too sick to attend school.         

John's oldest child, the then-ten-year-old Edna Mae, remembers her father's illness, "He was on fire with fever, delirious, pouring sweat, and coughing up more blood than you can imagine."  On Wednesday, October 13, 1918,  John Earl Blalock died--only three days after falling ill, in perfect health, and at the peak his manhood. Perry died three days later.  Houston hung on until the 28th.

The cause of death for all three was given as hemorrhagic pneumonia, the most common cause of death associated with the 1918 pandemic of the H1N1 influenza virus, popularly referred as the "Spanish" flu.  Medical historians* estimate that at least one quarter of the American population had clinically recognizable cases of flu during this time.

In less than three weeks, all the young males in the Blalock family had died; the older males and all the females were untouched.  Nine children under the age of 10 became fatherless.
 
A little opinion:

Do I think governments and employers ought to mandate swine flu (or any) vaccination?  Well, it's hard to know what "mandate" means in this context. Does it mean "strongly recommend?" Does it mean "don't look to us for sympathy or help if you skip the vaccination and get sick." Or does it mean "You'll be fined or lose your job?"  I would have very different responses to each of these mandates.

Putting aside public epidemiology policy for a moment, though, folks seem to line up idiologically in the following ways:

1. The threat of  N1H1 is real, important, and exigent.  They will take the vaccine.
   
2. The swine (N1H1) flu warnings sounded by the Centers for Disease Control (and analogous institutions in every member-country of the G20) are examples of greed on the part of Big Pharma and/or an increasingly easily gulled public.  They won't take the vaccine.
   
3. Like General Jack D. Ripper in the movie Dr. Strangelove, some believe it is a conspiracy by an Orwellian government to "sap and impurify our precious bodily fluids."  They won't take the vaccine.
4. Corporeal invincibility:  they believe that their own healthy bodies and/or clean living are capable of fighting off almost anything.  They won't take the vaccine.
5. Finally, there are those who believe that their lives are in the hands of fate (i.e., supernatural powers). They won't take the vaccine.

So, here we are:  some who will dutifully follow the instructions of their government and cheerfully queue for their inoculations, and others who will refuse to do so for many reasons. What are the likely logical cases?

CASE ONE:  The H1N1 virus is not as virulent as feared.
Here, all five idiologies win: aside from a few rare adverse reactions to the vaccine, we all move on.  The winter of 2009-10 joins that of 1976-77 to build the "flu panic" meme.

CASE TWO:  The H1N1 virus crashes into North America with a force greater than or equal to its 1918 cousin. 
Here, only idiology #1 wins; however, for #2-4 this is potentially a Darwinian Moment:  Nature will statistically modify the human genome slightly, but on a large scale. Those who eschew inoculation and thereby perish from H1N1 will self-deselect based upon a single trait: the inability to perceive that the known risks of H1N1 are more dangerous than hypothetical ideologies.

Here's an illustration of this logic.  Only one person ever has survived a jump from the Golden Gate bridge.  After his shattered body was reassembled, he granted an interview to a local publication.  The reporter asked him why he had jumped; he answered:  "Problems."  The reporter asked him what he thought about on the way down:  "That I actually had only one problem that couldn't be solved:  that I had just jumped off the Golden Gate Bridge."

Game on.

Remember the story of the Blalocks at the beginning of my post?  Six years after John's death, his wife Mary Etta died. John and Mary Etta Blalock's next-to-youngest child, Janice Emmaline Blalock--fatherless at age two, and then an orphan at eight--was my mother.

Me, I'm getting the first shot of vaccine I can find.  This one's for you, Ma!

*Crosby A. America's Forgotten Pandemic: The Influenza of 1918. Cambridge University Press; Cambridge: 1989.

Gibson Brown:

Having re-read my post after a day of golf... I must say my take on the writer was that he is a "it rhymes with pompous grass." As to being one of "those people," my wife will vouch for the past 21 years for the flu part, and don't make me go get my mother! ... in my case there is a reason for the madness so to speak. From the "we all have our quirks dep't," I peg the meter when evaluated by the expert doctor's, the one's the really smart doctor's send you to, when "tested" for ADD. Ally can tell you the chemicals excreted from exercise, which I need on a daily basis for me to tick. This forum and writing in general is one of the few things that keep me focused. Motorcycles cheat death and I ride daily...go figure. I love it when Joe C. or Sharron blast me into next week, as it allows me to focus, and I love the challenge. Joe C. is scary smart....  So there you have it Doctor Dave. We all have our quirks.... I am here to tell you the same thing you have heard all of your life...exercise and proper diet is the best defense against illness. Utilize Marvin's common sense approach to healthy habits, and let them keep their flu vaccine's to themselves. I openly divulge what is a semi-embarrassing admission of ADD, and all the stigma that goes with it, because I know that "straight up" and "as it is" wins the day. Gip

In my opinion you should not get the swine flu vaccine.  You seem to have an exceptional immunity system, and if by chance you do get the swine flu this season, it will not kill you.  You might miss a day or two of wacking golf balls, that's all.  Cheers.

Joe Campbell:

Remember the story of the Blalocks at the beginning of my post?  Six years after John's death, his wife Mary Etta died. John and Mary Etta Blalock's next-to-youngest child, Janice Emmaline Blalock--fatherless at age two, and then an orphan at eight--was my mother.  Me, I'm getting the first shot of vaccine I can find.  This one's for you, Ma!

Ricky:

(Among my stronger suits in the field of American history is the life and times of George Washington.)  I would not characterize you as a "fool" for questioning this, but I think maybe it was a bit cocky to do it with that slight touch of sarcasm italicized above.

I never read the sale papers that come with the RT (don't want to be tempted to buy something), but I happened to notice that the front of the Walgreens flier yesterday contained an an ad for flu shots ($24.99).  That has to be a first.  The ad doesn't say that the shot if for swine flu, so it's probably the generic, yearly catch-all.  Wonder how many people will get the shot and think they're protected against the H1N1 strain...  I get the flu shot every year to protect me from all the funk I come across in the course of my job.  Apparently it has provided some protection because I've never had the flu.