Some Thoughts on Swine Flu and Germ Warfare

A few final words from Karla Jennings, author of LeapFest play The Ruby Vector.

"When Pigs Fly, We Hurt"

The swine flu's an international invasion. Last week The New York Times said that WHO had confirmed cases in 41 countries, with eight U.S. deaths (this week's count is 11). Since thousands of Americans die of flu during a typical flu season, so far, at least, it hasn't achieved the awful potential officials fear it can. It might evolve into a stronger form, especially if it combines with the avian flu virus known as SARS. That could happen if infected birds swim and poop into hog farm ponds that are used to water the pigs and wash their sties. Pigs take up the avian flu virus, which messes around with the swine flu virus, and an eviler creature takes wing.

One great weirdness about the swine flu, according to The New York Times article and other sources I've read, is that it hits the strongest the worst. Epidemics typically nail people under 2, over 70, or immunologically fragile, but last week the CDC's Daniel Jernigan said only 13% of the 247 U.S. residents hospitalized for swine flu are over age 50. Typically, that number's 90%. Why are the geezers getting off so easy? Though most of those stricken in the U.S. had other medical conditions that put them at risk, that doesn't explain why the elderly, for once, are pulling the lucky straw.

The very young are more at risk since they're still developing their immune systems, while elderly immune systems have lost a lot of their punch, but the immune systems of those 15 to 50 are going full blast; they're the toughest among us. How can a virus most harm those best steeled against it?

It's the kind of puzzle bioweapons researchers love because they want to replicate it. Like Ruby Vector's Demyan Veronin, those guys don't care if Aunt Pearl or little Tommy Toddler die, they want to wipe out the Marine Corps. They want to kill burly, strapping soldiers. I came across two theories on how a natural virus does just that.

One is described in Wikipedia under "1918 Flu Pandemic." The Great Spanish Flu Epidemic of 1918 had a viciously high infection and mortality rate, killing 2% to 20% of its victims (depending on the country hit), as opposed to the usual 0.1%. Its symptoms were so unusual -- victims would hemorrhage from the nose, stomach, intestines, and ears -- that it was often misdiagnosed as dengue, cholera, or typhoid. It's estimated that 50 to 100 million people died worldwide, from the Arctic to the Pacific islands. Most were adults in the prime of life.

Suspect # One for this is a "cytokine storm." Cytokines are the immune system's signaling molecules. When an infection hits, they order the body's attack cells to sic'em, so the more cytokines you have, the better your body can attack invading bugs.

But the Spanish flu hit so hard so fast that it may have triggered the young adult's quickly-responsive cytokines into warp speed, overexciting the immune system into an out-of-control attack that ravaged its own body, causing vigorous young men and women to drop dead of their own internal friendly fire. That's what health professionals fear could happen with today's swine flu because the 1918 pandemic was caused by a -- you guessed it -- swine flu strain similar to what's creeping around the world.

Suspect # Two demonstrates the kiss me/kill me relationship we have with the bugs that embrace us. It's called the Protection Theory. It holds that younger adults aren't more vulnerable to the swine flu, but that geezers are tougher than they look because they have antibodies to the 1918 swine flu epidemic.

The CDC's Jernigan explained that from 1918 to 1957, all circulating seasonal type-A flus were weakened descendants of the deadly 1918 Spanish flu, which, like today's swine flu, is an H1N1 bug ("H1N1" refers to the virus's genetic makeup). So if you're old enough, the virus that left you groaning on the living room couch while Mom thoughtfully spread newspapers on the floor and put a wastebasket near your head could be what saves your life, should the new pig germ decide to visit you. And though it might seem as if it's leaving us, it's likely to return.

Knocking the Spanish

Sometimes you get flack for doing the right thing. That was the deal with Spain, which didn't participate in WWI. Because the open Spanish press reported the spread of a vicious new flu while countries at war censored their press and so kept mum about it, the world came to call it "The Spanish flu." It might have actually originated in Kansas, the prairie homeland of amber waves and creationist flatheads. Other possible origins are China, Brest (France), or Austria. It's hard to tell, since flu shape-shifts so easily; the 1918 flu might've been harmlessly toddling along worldwide until a mutation somewhere turned it into Doom.

The 1918 Kansas "Spanish Flu" was first detected at Fort Riley. Soldiers are great vectors for disease; they're packed together, highly mobile, and on the march. (A vector is a carrier that brings a germ from one location to another or one species to another.) Wikipedia notes how the 1918 soldiers spread the germ; "In civilian life evolutionary pressures favor a mild strain: those who get really sick stay home, but the mildly ill continue with their lives, go to work and go shopping, preferentially spreading the mild strain. In the trenches the evolutionary pressures were reversed: soldiers with a mild strain remained where they were, while the severely ill were sent on crowded trains to crowded field hospitals, spreading the deadlier virus. So the second wave began and flu quickly spread around the world again. It was the same flu in that those who recovered from first-wave infections were immune, but it was far more deadly, and the most vulnerable people were those like the soldiers in the trenches -- young, otherwise healthy, adults."

Which begs two questions: If the swine flu returns, will it be deadlier? And who -- discreetly appearing in anonymous facemasks and latex gloves, quietly collecting, quickly disappearing -- are taking swine flu samples not with the intent of curing it, but of making it worse?

it ain't over til it's over

LeapFest is over, the set has been struck, the last of the props are being sorted and stored. Three weeks and five terrific plays. I hope that you enjoyed the festival, and this blog.

Keep watching this space. Over the summer, there will be information about DrekFest (you don't want to miss THAT, trust me!) and our other summer programming, as well updates about our impending move, next season, and other exciting stuff. I will update the blog at least once a week, so stay with us!