Great Influenza
John Barry, the famous author who brought the 1918 Spanish Flu into the homes of millions with his riveting book, The Great Influenza: The Epic Story of the Deadliest Plague In History, spoke at MIT on October 5, 2009 on the Current Status of H1N1 Flu.

His message is a bit unsettling from the frontlines of H1N1 research: this novel influenza virus is very hard to pin down. In spite of international scientific scrutiny, H1N1 continues to baffle and elude, worrying health officials defending against the pandemic, and challenging some ideas about influenza in general. Says Barry, “A lot of things we thought we knew, the virus demonstrates we knew wrong.”

Barry examines the current pandemic in both historic and scientific context. Most influenza viruses share certain features: They can jump to other species by way of mutation, or by mixing genetic components with another virus that happens to be infecting the same cell at the same time. Influenza pandemics go “as far back in history as we can look,” with 10 occurring in just the last 300 years. Four of the most recent pandemics appear to have rolled out in waves of varying lethality, infecting at peak times some 30% of the human population.

Before last year, the latest pandemic threat seemed to be H5N1, an avian flu jumping to humans. But, says Barry, “while we were all looking at H5N1, this H1N1 virus snuck up on us…and we have no idea yet how serious it will be.” The problem for researchers is that H1N1 simply won’t behave in predictable ways.

When ordinary influenza viruses are transmissible between humans, novel molecular markers are present. The current H1N1 doesn’t bear these markers, yet is transmissible. There are conflicting reports on whether this flu is more infectious than the seasonal flu. There’s evidence that some people over 60 are resistant, perhaps because they carry antibodies to previous influenzas. And although H1N1 doesn’t exhibit conventional molecular tags for virulence, it is virulent. Unlike seasonal flu, when H1N1 kills, it targets younger people, and it does so through viral pneumonia, as opposed to complicating bacterial infections. “Depending on how you ask the question, it’s either extraordinarily mild, more mild than seasonal flu, or more than 100 times as virulent as seasonal influenza.”

While H1N1 seems stable for the moment, and to some, unthreatening, its path can’t yet be plotted. Some of the most infamous flu epidemics take two years to travel around the world, moving from sporadic activity to “blanketing the entire globe and causing enormous morbidity numbers.” If this flu takes off, history tells us, short of a “retreat on a Vermont mountain with shotguns,” there will be nowhere to hide, says Barry. “This virus is going to find me.”


CDC has just revised their very excellent teaching brochure…check it out!

Updated: H1N1 Flu and You Brochure (PDF – 184 KB)


Microsoft Word - Cp002_2009-0511_Planning Consideratons For Mass
Mass gatherings1 are highly visible events with the potential for serious public health and political consequences if they are not planned and managed carefully.

WHO has just released a new publication just in time for the Hajj.  A helpful tool on managing large numbers of people from the perspective of public health.  Information in the report can be useful for smaller event planning as well.

WHO: Interim Planning Considerations for Mass Gatherings in the Context of Pandemic (H1N1) 2009 Influenza (PDF – 163 KB)