Effective Vaccines Are on The Way
Two developments, worlds apart, have been very positive,
for a simplified vaccination program, that would require a single
injection. CSL of Australia, that
country’s largest biotech firm, tested their vaccine on 175
volunteers. Half got a single injection. Half received a
second injection, on one of the following days: 7, 14, or 21.
Tests showed that the second injection conferred no
particular advantage. The initial injection seemed quite sufficient to
stimulate the protective immune reaction. This was very much the result in England
at the University of Leicester as well, although the test group included 100.
There were some side-effects. For some, there was pain at the injection site. A small percentage had a headache or
short term fever. All side-effects were rated as mild to moderate, and were
considered quite tolerable when compared to getting the flu itself.
Will They Arrive in Time?
Two important studies suggest that while the vaccines may
arrive in mid-to-late October, the flu could peak in some areas by early-to-mid
October, essentially beating the vaccines. In addition, it takes about 14 days
after vaccination for immunization truly to take effect.
Does this mean that
the vaccines will have represented a waste of time and effort?
The answer is no for two reasons.
First, the flu is emerging in different areas, such as individual states within the US, at different rates. This means that the peak in one state will be different from another. There will be some states that have been heavily hit; while the numbers of the sick in others will be quite small.
Second, the definition of
peak generally means that
half the cases that will occur, have occurred. This means that as many as half the potential
victims have not yet been infected. Immunizations are quite
likely to help those patients.
What are the Odds of Someone Getting the Flu?
If someone in your household has the flu there is about a
27% chance of your getting the flu, according to a University of Washington
study. If a kid in your child’s class gets the flu, the chances are
that the sick kid will spread it to two or three other kids. The lag times between exposure and symptomatology in the new
flu patients are between two and one half to three days. At that time, the new flu patients will themselves possibly spread the
flu. This is not inevitable if the
families of the affected family initiate good hygiene.
Two Countries with Extensive H1N1 Flu Experience
Mexico has been the country hardest hit by the flu thus
far, and bears the unfortunate stigma of having “seeded the virus” through immigrants
and travelers to other countries. An analysis by the Harvard School of Public Health offers a
paradox. They estimate that there
were between twice and three times as many H1N1 flu cases in Mexico during the
study period as were officially reported, seemingly a grim statistic. However, the number
of deaths that were the result of the flu, remained the same. In other
words, the percentage of people
who actually had the flu and died of the flu is actually only half to a third of the official estimate.
The flu, in other words, even in a hard hit country, is a lot less lethal than
was generally thought.
Australia has also seen many cases of flu. What tends to
make their experience unique is that they had many more experiences with official
quarantines. While the clinical
success of these quarantines was mixed, they had a profound effect on public
opinion, which in polls
indicated that they were highly effective (and of which they were generally in
favor). Likewise, the Australians had high hopes for eventual protection from
vaccines (given the very recent success of CSL with their vaccine trials,
this was not entirely without basis). Most Australians felt that they would not be very seriously affected by the virus. Unfortunately,
few Australians seemed aware, or had a strong personal belief even if aware, that hand washing and
similar preventive measures like restraining coughs, sneezes, etc., with disposable tisues, as opposed with
bare hands that were subsequently not washed --- ironically, practices with demonstrable
efficacy were at least as
important as quarantines or vaccinations in reducing the spread of the flu.
It’s Sometimes Not Just the Flu that Happens When You Get the Flu
It is not unusual for some flu patients, particularly
those with pre-existing respiratory or immunological problems, to get bacterial
infections in addition. It is
generally policy in the UK, that these secondary complications be treated
aggressively according to nationally published guidelines. However, there
has been a general protest by
antibiotics specialists (see Barlow below) that their use should be
much more judicious and varied,
with a number of alternatives strongly recommended. The fear of
these protesting doctors is that in the course of treating complicated flu patients, the existing policy exposes the
patients to CDAD (Clostridium difficile
diarrhea ) and MRSA (Methicillin Resistant Staphylococcus
aureus), which have a higher fatality rate than even complicated H1N1.
Tony Stankus, [email protected] FSLA, Professor, Life Sciences Librarian & Science Coordinator
University of Arkansas Libraries MULN 223 E
365 North McIlroy Avenue Fayetteville AR 72701-4002
Voice 479-409-0021
Fax: 479-575-4952
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