Tag: Influenza

Vaccination Nation

 

“What made eradication possible was a really good vaccine and political support. There was a real incentive to do it. You don’t ask a cow if it wants to be vaccinated. You just do it.”
— Ron DeHaven, former CEO of the American Veterinary Medical Association, speaking about the eradication of rinderpest, a cattle disease related to the measles virus.

Rinderpest and smallpox are the only two infectious diseases that have been eradicated around the world. Smallpox is the only disease to be eradicated that infects only people. Eradication of other infectious diseases, like COVID-19 for one, is unlikely because there are alternate hosts in the animal population, and while it may be feasible to vaccinate domesticated animals such as cows to the point of herd immunity, it is unrealistic to think the same can be done for wild animals.


Ruins of 19th-Century Smallpox Hospital - Roosevelt Island - New York City - USA - 01 (41147019525)
Ruins of the Smallpox Hospital built in the 19th century on Roosevelt Island in New York City. Photo by Flickr user Adam Jones.

Cows have another favorable trait in reaching herd immunity besides being easily available for their shots, which is that they don’t subscribe to bizarre, illogical, and unscientific conspiracy theories egging them on to refuse vaccinations, if that was a possibility for them. Rinderpest, like its cousin infecting humans, the measles virus, is among the most contagious diseases on the planet, and the more contagious a disease is, the higher the percentage of a susceptible population must be vaccinated in order to achieve herd immunity. For measles and rinderpest, that’s over 90 percent.

Smallpox is – was – in the middle of the scale as far as its contagious qualities, but among the deadliest at around 30 percent fatalities. Influenza, with notable exceptions throughout history, such as the 1918-19 Spanish Flu outbreak, is at the lower end of the scale for both contagiousness and deadliness. COVID-19, like the other Severe Acute Respiratory Syndrome (SARS) viruses to which it’s related, is higher up the scale for contagiousness than the annual flu, but it is nowhere near as deadly as smallpox, though deadliness as always is strongly affected by a victim’s socioeconomic circumstances. The poor, as always in any affliction, die in droves, while the better off have access to the best care and are less likely to be infected in the first place.

One by one through the nineteenth and twentieth centuries, diseases that had killed hundreds of millions over thousands of years were brought under control with vaccines and other public health measures, such as better sanitation. There have always been people of skeptical of the effectiveness of vaccines or suspicious of the motives of the medical people, often affiliated in one way or another with a government entity, who administered the vaccines. The difference in then from now is that before about 1980 evidence of a world without vaccines was still readily available to everyone, rich and poor, living in the industrialized northern hemisphere or in the largely agricultural southern hemisphere.



In 1947, when the threat of disfigurement or death from smallpox was still very real to everyone, the citizens of New York City lined up for blocks to receive vaccinations in order to stem a possible outbreak.

 

Today, people in richer countries no longer see the effects of smallpox at all, and rarely do they see the effects of less disfiguring, less deadly diseases like measles. If COVID-19 were to leave visible scars on those who suffered and survived, instead of just the internal scars it does leave, one wonders if at least some of the people ready to dismiss the seriousness of the disease and the severity of the outbreak would be as obstinate about complying with public health measures.

If there were still children crippled by polio in every neighborhood, would there still be people who are more willing to believe an insane theory about vaccines they read in their Facebook “news” feeds than the scientific fact of once rampaging infections brought to heel in the past two hundred years? No doubt there will always be some hard cases who can’t be reached through reason, no matter what. The amount of the U.S. population vaccinated against COVID-19 is currently about 43 percent, and it needs to be over 70 percent to reach herd immunity. It will be best to cross that threshold before cold weather sets in again, forcing people back indoors. If it’s not, then COVID-19, a disease that will likely never be eradicated, only controlled, could surge once more, making this summer of relative freedom appear in retrospect like a fool’s paradise.
— Vita

 

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The Gut Puncher

 

Norovirus, the most common cause of gastroenteritis, also known more inexactly as stomach flu, is making an unwelcome visit to the Winter Olympics in Pyeongchang, South Korea. Considering how norovirus thrives in crowded conditions, its appearance in Pyeongchang before the Games even began is a nightmare for organizers, as well as for the poor unfortunates who come down with the illness. One of the names it has become rather unfairly known by is “cruise ship virus”, as if the illness were more prevalent on cruise ships than anywhere else. Norovirus actually afflicts cruise ship passengers no more or less than people existing in similarly crowded conditions elsewhere, but when it strikes on a cruise ship the outbreak attracts notoriety because of reporting requirements in the industry and because changes in the itinerary of cruise ships to offload sick passengers easily become common knowledge.

Rembrandt Saskia in Bed
A Woman Lying Awake in Bed, circa 1635-1640 drawing by Rembrandt (1606-1669).

As much as the cruise ship industry chafes under its unfairly exaggerated association with norovirus, the citizens of Norwalk, Ohio, might have been perturbed that for the last third of the twentieth century their small city not far from Cleveland lent its name to the virus until the International Committee on Taxonomy of Viruses (ICTV) changed it officially from Norwalk virus to norovirus. An outbreak of the virus at a Norwalk elementary school in 1968 led to the first scientific isolation and identification of it under the microscope, though it had been known to exist from similar outbreaks around the world since at least the 1920s. The history of the virus before then is unknown, which could be due to any number of factors, including the similarity of some of the symptoms to influenza and the low risk of life-threatening complications compared to those brought on by the influenza virus, leading to it not receiving as much notice over the years as influenza, or getting lumped together with it. It is also possible it wasn’t until the mid-twentieth century that the virus mutated to become the causative agent of misery we recognize it for today, drawing our attention, our fear and loathing, and our research efforts toward a vaccine to limit the suffering.
— Vita

 

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Can This Be Flu?

 

Since gastroenteritis is commonly known as stomach flu, and since this is influenza season, people can mistake one illness for the other or believe they are different names for the same illness. They are not. Gastroenteritis is technically not influenza, though it is most often caused by a virus and usually presents with some of the same symptoms in the early stages – headache, body aches, chills, and fever. It is in the lack of respiratory distress symptoms that the two illnesses diverge, that and the continued nausea and diarrhea brought on by gastroenteritis. Nausea may subside to a low level, and vomiting may cease after the first bouts simply because of a lack of contents to regurgitate as the sufferer no longer desires solid food. Diarrhea continues, however, since the sufferer’s inflamed intestines do not absorb liquids as they should.

Influenza Pandemic Masked Typist
Typist wearing mask, New York City, October 16, 1918, during the “Spanish flu” influenza pandemic. Wearing a mask would have helped stave off the influenza virus, which is most often inhaled, but done little to protect the wearer from a gastroenteritis virus, which is ingested.

That last part is the most important in understanding how to treat gastroenteritis. Fluid intake becomes even more important than in treating a case of true influenza because while the overall risk of life-threatening complications is less, the risk of life-threatening dehydration is greater. As with any illness affecting them, pregnant women need to carefully monitor their symptoms as well as take special care using medications. In poor areas of the world, where access to clean water may be limited, dehydration is the biggest killer in cases of gastroenteritis. In wealthier areas, even though a sufferer got the infection by ingestion of contaminated food or water, access to cleaner supplies of both after the illness develops makes chances for recovery much greater. The important things to remember in getting well from a bout with this illness which, dreadful as it feels at the time, are that the risks of developing something more serious are lower than with the actual flu virus, and that dehydration needs to be remedied not just by drinking water but by replenishing salts, sugars, and electrolytes in the right combination.
— Ed.

 

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A Spoonful of Honey

 

In 1964 when the Walt Disney Studio made Mary Poppins, a spoonful of sugar may have helped the medicine go down in the most delightful way, but today honey has proven healthier and more effective in treating the symptoms of the common cold. Cough drops made with honey for soothing the throat, and mint or eucalyptus to clear sinuses are popular, as are herbal teas with a spoonful of honey added. Unlike sugar then, honey is a soothing remedy as well as a sweetener.

Linus Pauling
Linus Pauling in 1954.

Vitamin C is for many people another component of fighting off the effects of a cold, despite evidence it has no specific role in the fight. Being otherwise healthy and well nourished, a person with a cold has no need of supplementing their diet with extra vitamin C. Linus Pauling, an American who won two Nobel prizes in the mid twentieth century, the first for chemistry and the second for peace, exerted tremendous influence from the 1960s until his death in 1994 in asserting the value of vitamin C in alleviating cold symptoms or preventing the onset of a cold altogether. Pauling’s influence was so great that he not only boosted sales of vitamin C supplements, but inadvertently set the ball rolling for the entire nutritional supplement industry, resulting in the enormous sales displays at today’s grocery stores and drug stores.

Considering the variety of foods now available year round to consumers in wealthier countries, it’s questionable whether most nutritional supplements are necessary. Many people will nonetheless take a multi-vitamin every day on the grounds that it can’t hurt, as insurance. In addition to the outsized influence wielded by Linus Pauling, it could be that the idea of combating a cold with vitamin C is a holdover from the time when people in colder countries did not have ready access to fresh fruits and vegetables in the winter cold and flu season. Poorer people in particular would have seen their health deteriorate in the winter due to poor nutrition and a consequently weakened immune system.

VitaminSupplementPills2
A store vitamin supplement sales display. Photo by Raysonho.

Canja de galinha
A bowl of Canja de galinha, or Portuguese chicken soup. Photo by Flickr user Sebástian Freire.

At such a time, the gift of an orange in a sick person’s Christmas stocking would have been most welcome. As long as the difficulties of transport to the north could be overcome, oranges, one of the few fruits available fresh after November, could supplement diets starved for fresh fruit all winter, not just at Christmas. Oranges are higher in vitamin C than other fruits commonly available in temperate countries, and therefore people might naturally jump to the conclusion that it was the lack of vitamin C, rather than poor nutrition generally, that contributed to susceptibility to colds.

An old remedy for cold symptoms that science has found real value in is chicken soup, due to its chemistry and the healthy effects on the respiratory system of steaming liquid both before and after ingestion. Doctors say liquids in all forms except those containing caffeine or alcohol are a good remedy for a cold. Herbal tea, chicken soup, hot chocolate, all are good. An aspirin or other pain reliever now and then for an adult is okay, but not for infants and toddlers, and aspirin not at all for children under 16. Honey also is not recommended for infants. Meanwhile, all the vitamin supplements in the world, vitamin C included, won’t help unless poor nutrition was a problem before the cold came on. The best way to avoid coming down with a cold in the first place? Good hygiene and healthy eating, including when a cold settles in despite everything. Feed a cold, and feed a fever. Starving never helped anyone overcome anything, unless they called the starving fasting, but then that’s a whole other story.
― Izzy

 

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