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October 17, 2005
IS AVIAN FLU BEING OVERHYPED? Reader Patrick Cunningham emails:
As a medical researcher, I want to make a gentle but sincere plea to the blogosphere to calm down this flu hysteria just a bit. The main way that flu kills is by predisposing its victims to "superinfection" by bacterial illnesses - in 1918, we had no antibiotics for these superimposed infections, but now we have plenty. Such superinfections, and the transmittal of flu itself, were aided tremendously by the crowded conditions and poor sanitation of the early 20th century - these are currently vastly improved as well. Flu hits the elderly the hardest, but the "elderly" today are healthier, stronger, and better nourished than ever before. Our medical infrastructure is vastly better off, ranging from simple things like oxygen and sterile i.v. fluids, not readily available in 1918, to complex technologies such as respirators and dialysis. Should we be concerned? Sure, better safe than sorry, and concerns about publishing the sequence are worth discussing. Should we panic? No - my apologies to the fearmongers, but we will never see another 1918.
Patrick Cunningham M.D.
Assistant Professor of Medicine
Section of Nephrology
University of Chicago
I certainly hope that this is right. I do seem to remember seeing a study some years ago suggesting that many of those who died from the 1918 flu really died because inactive cases of TB reactivated under the stress of the flu infection. Far fewer people harbor inactive TB, in the U.S. at least, than did back then -- though in less developed countries I suspect the toll could be very high. However, as I've said repeatedly, much of the avian-flu preparation is also relevant to other possible pandemics, which might be even more dangerous.