Saturday, October 20, 2012

Flu Season is Here - The Realities, The Risks

Just to let everyone know I'm still here (yes, I usually post something on Friday nights).

Friday night was spent, however, at the risk of TMI, with my head in a bucket.

Consider this a public service announcement, at least around these parts and into MO where friends live, there's a nasty short lived"bug" going around.  I felt kind of tired yesterday morning but not "sick" so I went to work. By afternoon I was throwing up, and it didn't stop, No one noticed though, many off, several home with sick kids, vomiting like crazy, or sick themselves. I went home.

I talked to someone who had it in their family.  They said "you'll puke nonstop for 12 hours. The entire family had it.  Only then will you be able to take a sip of water that stays down".  They weren't kidding about the non stop part, it was about every 10 minutes.  I was trying to talk on the phone with Partner in Grime and every fourth talking point, I'd interupt  him with "excuse me"  (sounds of upchuking). It was like trying to watch the recent moderators at the debates.

I took a bubble bath (replacing the small floaty plastic 7th fleet with my bucket), let Barkley for a quick potty break and went to bed with my bucket. I was too sick to go out for Gatorade and didn't want to infect any friends who offered to drive over and stay, so I put a Tablespoon of sugar and a pinch of salt in some water and tried to sip it. That was about as successful as The Battle of Archeloos,and probably less messy.

My friends were wrong, but not by much. It was 15 hours.

I got on the scale this morning, I'd lost six pounds.  Sure I felt lighter, but not in a good way.



But the reason I'm grossing up your otherwise normal Saturday reading is this (ahh, I was hoping she'd be blogging about furry kittens with bacon).  There is lots of hysteria about some strains of flu, particularly  H1N1, the"swine flu, on the TV the last few  years, most of it being at CNN. Why the fuss? It's a flu that acts much like our normal flu and has infected only a small number of people in the country."Regular" flu affects anywhere from 5 to 20% of the population and is responsible for an average of 36,000 deaths that are flu-related, in America each year, yet that has barely been mentioned in the news. No one worries about "regular" flu, just these fancy strains on TV. Recently a healthy high school athlete died, this year's first flu death. He hadn't got a flu shot, who would think a healthy kid would need one?  Right?

A few years ago, when H1N1 popped up, here and in Mexico, there was much talk of conspiracies and Doomsday theories to keep peoples eyes away from the economy ("It's Captain Trips!! Start walking across Kansas for the great showdown in Las Vegas. Beware a man whose boots make sparks").   Even the poor pigs got bad press over this, with the virus originally being called the “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But in actuality, study has born out that this new virus is very different from what normally circulates in North American pigs. It's actually a quadruple reassortant virus, with two genes from flu viruses that normally circulate in pigs in Europe and Asia and avian genes and human genes.

Another thing that came up in the conversations was people referencing the WHO "level 5" warning.in the Spring of what I believe was 2009. Remember, if that sort of warning pops up again - this warning level is primarily a means to qualify and communicate 1) that this outbreak has crossed regional borders and 2) it has the capability to be spread between human(s). It is not a reasonable scale for giving an accurate indication of how serious or life-threatening the illness may be.


Unfortunately, the media takes that, and runs with it even if the paucity of the facts doesn't add up to the level of threat they are going to make it out to be. Now THIS is why we should keep medical and scientific discussions in Latin and Greek. Attach a catchy namelike swine flu to illnesses and even journalists teleprompter readers can pronounce them.  Keep everything in unfamiliar and difficult to pronounce terms and you won't be able to whip people into a panic. With a populace already highly frustrated by the economy, leadership, or just modern stresses, with the media blasting "Run for your lives - WHO Warning Level 5 !" the mortality concerns of the outbreak are only going to be exaggerated and fear builds.

Yes, the 1918 Spanish Flu epidemic killed 10's of millions, with the cytokine storm effect resulting in the deaths of primarily the young and the healthy, as was the case in many SARS deaths, wherein, the immune systems of the young and healthy counteracted so vigorously it killed them. Yes, the 1918 flu was caused by an H1N1 strain. But the H1N1 subtype is now very common, causing many of the seasonal flu outbreaks over the past 90 years. The current vaccine even includes a strain of H1N1, first identified in Brisbane in 2007. Anyone remember the "Swine Flu Outbreak of 1976"? That was a rehash of the 1918 strain and it killed about 90 people, tragic yes, but not the 18 million of the original episode. I was a school kid, but I remember, especially the scary public service announcements, the ominous echo of kettle drums, bad acting, dismissive attitudes resulting in feverish visits to the hospital and the obligatory "old person death". Fear mongering at its finest.


But if the new flu's contain H1N1 and H1N1 subtypes have been around for years, should you ignore them?   NO. It's simple. The arrangement of genetic components of the new flu have never been seen before—whether in pigs or people. That, in and of itself, concerned a lot of folks.  Also, by being different from recent strains, the body's immune system may not be able to mount an effective response. Nor is there adequate data yet to see if this strain will target typical "flu death" groups, the very young and elderly, or go another course, even if that course results in few deaths. For people will die from this strain, just like any flu strain. Any flu can kill you, not just one with a unique name.

Scientists are constantly studying new and old strains and the flu vaccine each year gets tweaked using such studies. The sequencing and resurrection of the influenza strain responsible for the 1918 pandemic has helped researchers to interpret the sequences of contemporary flu strains. We continually learn from the past,  If you look at sources other than the network news, there is accurate information out there (on medicine AND politics) There are many people, like myself, who have an identification with Orson Scott Card's concept of the Speaker for the Dead - someone who's job it is to make each death more than a statistic.


For I have spent some time in a bio hazard suit, and have some education in contagions. On my computer desk there are a few plushie microbe toys from ThinkGeek. Yersinia pestis. My favorite -  the microbe some folks think was responsible for the black death. They've done some interesting historical forensic DNA work on the issue to prove otherwise, as not all scientists believe black death was bubonic plague in it's pure form.

Certainly there was the speed with which it killed, death often occurred within three days of the first symptoms appearing. Anthrax or a haemorrhagic-fever-causing virus similar to Ebola would be more likely than plague to cause such a rapid demise, say some. But, in my personal opinion, black death was not at least primarily Y. pestis even as it does cause every symptom associated with the historical black death. The symptoms, the high mortality rate, the speed at which the disease spread, and the way the disease spread -- none of it jibes with typical bubonic plague


It's a puzzle, one that may give clues to other plagues that could pop up in our own backyards. Although pestis had evolved to be less fatal to its human hosts over time, it's really changed very little, the genome of the Black Death strain different from the modern & pestis "reference" strain by only about 100 nucleotides.  But each of those genetic differences can be found in at least one of the modern strains. Something made the Black Death "special", but we're not sure why,  rearrangements to the genome, are damn hard to determine from short fragments of DNA. One could try and resurrect the Black Death pathogen by modifying the genomes of the contemporary strains (oh, come on, it'll buff out!) in a controlled lab, where even an accidental infection could be handled with antibiotics. Perhaps they have.

It makes me really, really glad there are experts that continue to study this because Swine Flu panic notwithstanding, there are pandemic threats that exist, and bio terror is not just a source idea for a "thriller" (and having found out by 2 days in ICU that I'm one of those folks that can't take Cipro for Anthrax prevention or anything else, I am even happier.)


Yes, I'm a geek. A geek with a gun, and a little blue-eyed, plushy microbe named "Nessie" (though I do not yet have virus DNA sequences on my iPod).

So I wanted to say this, not as someone trained in science but only as Barley's Mom.  Get a flu shot.  If you see symptoms, stay home, do NOT go to work and spread it.

Use the same precautions you would use in any flu season- staying home if you are sick, washing your hands with soap and HOT water. (How long to wash? Sing the Happy Birthday song while scrubbing, that's the right length of time, but avoid doing that out loud or often or people will call for professional help). Avoid those openly sick, or if family, use normal precautions in their care. Seek medical help immediately with a sustained high temperature, difficulty in breathing or if you can't keep water down after a day.  Nausea and vomiting accompanied by pain in the chest and arm can be indicative of a heart attack, and heart attacks in women are persistently sneaky in their symptoms.

 I will get a shower and make a trek out for some broth and jello and saltines.  A colleague who is a doctor said "do the BART diet for a few days".  I was very disappointed this did NOT stand for Bacon, Ale, Roast beef and  Tortellini. 

Now for me, a quiet weekend of sleep, plenty of fluids, applesauce and toast and a few books.  Perhaps too, a little quality time with Mr. Barkley who sat up awake by the side of the bed all night, and who really doesn't look like he likes Mr. Yersinia pestis.

33 comments:

  1. Yeah, I've had the Martian Death Flu a few times, and was always thrilled by the weight loss afterwards. Such a pity that it's mainly water weight from dehydration, and it's quickly gained back.

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  2. B:
    That bug was here in Texas about 10 days ago, I had several employee's out with it for a couple of days... very nasty is the reports I've heard about it. Get well soon, and scratch Barkley's ears for me.

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  3. Oh, lovely - I'm sure I'll see that coming through soon. Thanks for the heads-up! I hope you feel better, and the bland diet soon changes back to bacon and all other things good.

    Work's giving their yearly free flu shots in two weeks, and while I hate getting stuck with a needle about as much as I hate stepping on a nail, I'll be getting it again, and encouraging Calmer Half to share the been-stuck misery with me.

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  4. ER RN here.... every year we get hounded by management about flu shots; this year it's the stick instead of the carrot: get the shot or mask, glove and gown all shifts. Last year was carrots: a free pork loin--whole-- if you were among the first 250; I was. I don't need to be hounded, yet work with physicians who do, and think nothing of going room-to-room without wiping a stethescope at least 5-6 times per shift. Keyboards, ATM machines, door handles... get the dang shot, folks; it will improve your odds at the least. I haven't barfed since i got sober, and don't want to break a 32-yr. run!

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  5. Erin - I ate one saltine and gained 10 pounds back. Figures.

    Suerte - nasty it right and none of the typical "flu markers", no sniffles, sneezes, aches and pains, just tired followed by hours of vomiting. Family friends in STL are dealing with it as well over there.

    Mike - I will go get one, I missed the free one at work being down in the basement working away on something at work, but will go pay for it. It's 20 or so bucks well spent. Congratulations on the 32 years. That is not an easy road.

    Miss D - give me a call later if you have time, I'm just curled up with videos and some chicken soup.

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  6. "Now THIS is why we should keep medical and scientific discussions in Latin and Greek. "

    Ahhhh... the Doctor peeks forth...

    "Yes, the 1918 Spanish Flu epidemic killed 10's of millions, with the cytokine storm effect resulting in the deaths of primarily the young and the healthy, as was the case in many SARS deaths, wherein the immune systems of the young and healthy counteracted so vigorously it killed them. "

    My Great Grandfather and Great-Great-Grandfather (Kane) died within a week of each other during the epidemic. Raised kosher Chickens in West St. paul and Scarred/Emotinally-Maimed my Grandmother for the rest of her life.

    "Although pestis had evolved to be less fatal to its human hosts over time, it's really changed very little, the genome of the Black Death strain different from the modern & pestis "reference" strain by only about 100 nucleotides. "

    Flu strains that kill their host too efficiently is not a recipe for continuation of that strain, thankfully. But a few random mutations and it is back (though our bodies have 'adapted' from the previous one somewhat as we a ancestors of the survivors)

    Being an epiemiologist is a thankless job in times of 'peace'. But when the 'Microbial War' breaks out, it is them who make a difference. We have fantastic knowledge of micro organisms and many means to thwart them, but we are running out of tools to hold them back as older antibiotics continue to become impotent to the latest superbugs.


    "Yes, I'm a geek."

    Me too. Gossip (as to who said what and who sleeps with who), Watching Sports, Social Games (rackets to one up thy fellow man), bore me to no end. Science is bottomless. So is self improvement.

    "I will get a shower and make a trek out for some broth and jello and saltines. "

    Yes! Dear Mum was part of the Medical profession. Same advice. BRAT diet? hmmmm... yep! Though toast may not be gluten free... ;)

    Tahnks for the romp through your profession (the basics). Thats stuff that even us quasi-edurbated people could use!

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  7. I have allergies which make a flu shot a bad idea. Always check with your doctor first.

    Mrs. (Dr.) Roscoe was horrified when the Cipro fad hit after the Anthrax scares. Whenever she has patients on that stuff, she monitors them closely, and the media wasn't exatly urging caution at the time.

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  8. Sorry to hear you are sick. Hope you feel better soon. Take care.

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  9. Glad you are feeling better. My daughter had a flu two or three years ago in November that really scared me.She was pretty sick at the time.
    Take care of yourself
    Dan

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  10. Thanks everyone - I didn't want this to be a "poor me" post but wanted to give heads up on this nasty little strain, it would have been scary had I not known what I was experiencing was the norm and it would be past in 24 hours.

    I'm feeling much better, just a headache. Had chicken broth and crackers and applesauce and 7 up. Going to make some homemade soup tomorrow, some bacon may fall in, if I feel back to normal.

    Roscoe - the Ciproo dang near killed me, ended up in cardiac care ICU with no prior history of heart issues, healthy as a horse. There was no damage to the heart, after ten gazillion dollars worth of tests after, and I was eventially cleared for flight dut, but well. . damn.

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  11. The Spanish Flu killed my maternal Grandmother in 1918, just after my Mother was born.
    Flu can be deadly!
    Watch your back, Brig!

    gfa

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  12. Glad to hear your Feeling Better, Brigid. :)

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  13. Dang, maybe I should have stayed on the road longer... Just my luck to get home as this stuff is 'flowing' East. Get better soon!

    Re the flu shots- Those damn things take me down EVERY time I get one... I'm out for 2-3 days.

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  14. "Martian Death Flu." I'm gonna have to remember that. That's hilarious.

    Ever since my pneumonia adventure a couple years ago, I make sure to get my flu shot. I got the pneumonia vaccine. I don't need the flu to progress into pneumonia.

    I simply cannot understand those who won't get the flu vaccine. If you're afraid of needles, you've got two options: the mist, or man up and close your eyes and let the nurse jab you. You're not just protecting your own health. You're protecting your family's, your friends', and that of anyone you come in contact with.

    And, personally, I sing Herman's Hermits "Henry the Eighth." Much more entertaining. And it gets even stranger looks than "Happy birthday" or "Old MacDonald."

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  15. My standard rule of thumb is whenever the "news" starts expounding authoritatively on "Breaking News" and using big words that they could only have found by getting the latest intern to pull out the dusty thesaurus, followed by "knowledgeable" talking heads "urging" people to _____ (insert panic-mongering here), I always research the subject. When the H1N1 was going around, I actually found myself on the CDC website, and found that the "500 deaths nationwide so far!!!elebenty!!1!" that the news was screaming was, in the big picture, nothing. Tragic for those affected, true, but compared to the "regular" flu, it was a mere fraction. Funny, though, watching peoples' faces at work when they start freaking and throwing network-news statistics out, and you bust out the actual facts.

    The worst, though, is when you've got something that attacks from both ends. That's a judgement call that nobody should have to make! Or clean up after...

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  16. Ugh, I hate getting sick,,,,I hope you feel better soon....

    Barkley's expression in the last picture is hilarious, LOL......

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  17. Hope you feel better real soon...

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  18. Not seen or heard about this in GA... yet. Flu shots in two weeks at work..may not be soon enough. Great post; glad to hear you're doing better.
    Cheers,
    Differ

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  19. Glad you have the weekend to recover. Get well soon.

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  20. I'd send a video care package, but "Red Dwarf" doesn't finish the new run of shows for another three weeks.

    The first couple of episodes are kinda weak but last week's show, "Lemons", was an instant classic IMHO.

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  21. Old NFO said...Re the flu shots-Those
    damn things take me down EVERY time i
    get one...I'm out for 2-3 days.
    Me to had my flu shot on Tuesday and
    False Flue Wed & Thur every year get
    the shot then False Flu.

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  22. Ajdshootist - I've only gotten the flu shot twice and no ill effects. But this year, I'm going for it. Tough for you and old NFO though.

    Roscoe - I'm sharing the other one you sent last year. We've all enjoyed it. Thanks again to you and the Mrs.

    Mrs. S. - thank you - I slept really wel, Barkley slept in his bed in my office (he has one there and in my bedroom_) seemingly satisfied I was OK, and preferring to be by the window by the entrance so he could watch for nocturnal mailmen.

    Differ - Hope so, for me it was a miserable 24 hours, andI bounce back,for someone like my Dad, it could have been fatal. Scary stuff.

    Cond0011 - thanks, stay warm up there, the weather is certainly turning.

    Erin - Martian Death Flu - bwahahahahaha. Everyone loved that. Found the watermelon tootsie pops on line but they didn't come with a new trigger, like yours.

    armedlaughing - thanks for the ecard, saw that this morning! I'm so sorry to hear that about your grandmother. I got a number of emails and comments from friends who had losses like that in their own families. The number of deaths, really, was staggering.

    naturegirl - he didn't know whther to run or bite it's head off.

    Rabidalien - you hit that square on the head. So true.

    AuntieJ - My stepmom died from pneumonia (with emphasema from 30 years of smoking before she quit, she just couldn't fight it). I contracted it caring for her at the end. I missed a whole week of work and it was probasbly 3 weeks before I felt human again. Glad you are OK.

    RichD - MUCH better this am. Am going to make some homemade soup and bread today, but otherwise rest and read some books. Did you come into town for the gun show?

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  23. My doc always calls it the BRAT diet, now I am wondering if that is a commentary on demeanor when sick. Feel better!

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  24. Hope you feel best soonest. I think there's a lot to be said for a short term hibernation including the intake of a lot of fluids. Pitiably Bourbon is probably not the best fluid to consume.

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  25. I was going to give you a ring today, but think its better to let you rest. I always keep a supply of gatorade and 7-up on hand, along with saltines and Liptons cup -o- faux chicken broth for emergencies such as you had. I work from home full time these days so think Im insulated from the more common illnesses that get spread at work, but still when we go out I have to think My immune system is going WTF are these things Im picking up from the people around me. Feel well B hope you are back to 100% soon.

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  26. Glad you're feeling better. We're all getting over respiratory crud around here. Nothing too bad, but just enough to make us feel a tad less than human for a few days.

    If you're looking for a good read and haven't found this one yet, "The Great Influenza" was excellent. Goes into the infancy of germ theory and modern medicine at the turn of the last century.

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  27. Glad you're feeling better. Sorry I didn't read this sooner so I could have offered at least some prayer, but I've been running all weekend. At least you had Sir Barkley there to keep you company! Be Blessed!

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  28. Me too, or actually me three, on the legacy of the Spanish Flu in 1918.

    My maternal grandmother died from it. Over the years I heard a few more stories, and found the album with the picture of a lovely woman dead much too young, and thus maybe some insights into my father's and uncles' formative years and personalities, by way of that and the very different characters and circumstances of the members of the extended family who took them in.

    My own flu story is more comic than tragic. Helping some friends with the business plan for a tech-sector startup, I spent two weeks down for maintenance, and for the worst several days seldom got out of bed for anything except the most necessary bodily functions.

    Admittedly I passed up a couple of other chances to join that company early in its brief gaudy hour, but founder's shares can be such a marvelous thing when it all rolls right that I still think of that as my Million Dollar Flu.

    Then there was my MLK Day Bug. It was the eve of the first celebration of the national holiday, so CNN was playing an overnight loop on his life and work. Staying in a hotel on a business trip, I was watching this with interest when I suddenly and urgently had to ascend to the throne... and soon was glad that I could lean over the bathtub without getting up.

    The TV stayed on because I was not willing to leave that convenient position for quite some time. I wondered if, despite the massive construction of that place (the old part of the St. Francis), it bothered the people in adjacent rooms. Eventually I decided that just leaving it on would be socially as well as hygienically preferable, as it provided noise jamming while I did sporadic imitations of Hero of Alexandria's steam engine.

    Not sure that was the flu, of course. Though not a medical professional nor a biologist, my received wisdom is that "stomach flu" or "24-hour flu" is either some other virus such as a norovirus or else food poisoning.

    Psychologically I associated this episode with a pizza slice I'd had on Union Square at lunch. I'm not at all sure the timing really points toward that particular walk-up joint or toward food poisoning at all; but flavor aversion is as irrational as it is powerful. Couldn't face this once favorite food for a couple of years after that.

    The storm passed passed, leaving me feeling tall, thin, fragile, and insufficiently strong for the higher gravity of this planet, but alive. When ready to take down the Do Not Disturb sign and confront the outside world, I got a can of Lysol, and left the maid quite a generous tip anyway.

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  29. @Rabidalien: In a "going at both ends" scenario, I recommend sitting on the toilet whilst leaning over the bathtub. That way you can just rinse the tub with water and you should be fine.

    If you do not have a handy tub over which to lean... barf on the floor, every time. It's less disgusting.

    And to everyone who loves that "Martian Death Flu" nomenclature: sadly, I cannot take credit for that. It was coined by Dave Barry circa 1990.

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  30. I hope you are feeling better! I'm always unlucky enough to be the first to get sick during the colder months. Maybe I should start wearing a gas mask to work.

    And on another note, I'm glad I'm not the only one who possesses an angry bird (or in my case four tweeters and a pig). ;)

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  31. Nora - I'm glad as well. Thanks for the note.

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