Don’t know much about history
This flu season is shaping up to be one to remember. People younger than 40 have never lived through a flu pandemic. The H1N1 flu is the first flu pandemic since the 1968-69 Type A Hong Kong flu, which killed about 1 million people worldwide. And unlike the baby boomer generation, younger people are lacking some defenses against this strain of H1N1 influenza. According to the Centers for Disease Control, only those who were born before the 1957-58 Asian flu pandemic have any immunity at all against the current H1N1 flu pandemic.

Only a few people are old enough to remember the 1918 flu pandemic, sometimes called the Spanish flu, which swept the world in one year, leaving as many as 100 million dead in its violent wake. The world-altering events of 1918, including World War I, have overshadowed the steep toll taken by the terrifying onslaught of that deadly influenza. Although between one-third and one-half of the global population was infected, the 1918 flu has been reduced to a footnote of history.

The 1918 H1N1 virus was actually not a swine flu, but, according to New Scientist magazine, it was an avian flu that evolved directly into a human flu. The 1957 Asian flu pandemic changed the genetics of human influenza by displacing the H1N1, which had been circulating since 1918 with a less virulent H2N2 bird flu. Since people have the best immunity to the first influenza to which they are exposed, only those born before 1957 would have had exposure to H1N1.

However, another factor aside from inexperience may be partly responsible for today’s ambivalence toward receiving the H1N1 vaccine. It was the 1976 failed plan to immunize all 215 million Americans against the swine flu. As the New Yorker put it last month, “many Americans associate the term ‘swine flu’ with one of the country’s most prominent public-health debacles.” A series of highly unusual events occurred, including the failure of the much-feared epidemic to ever materialize. The fact that in 1976 one person died of the swine flu but 25 people who were vaccinated died of Guillain-Barre syndrome has created a persistent belief that vaccines are at least as threatening as the diseases they prevent.

The details were this: in 1976, one soldier died of swine flu after he and four others came down with it while at Fort Dix, N. J. Several hundred other soldiers tested positive for that flu strain but only the five men became ill. President Gerald Ford declared that every American should be immunized and four pharmaceutical companies were contracted to produce a swine flu vaccine. Mindful of the devastation that the 1918 flu had created, the Centers for Disease Control ramped up for the enormous undertaking.

The soldier’s death at Fort Dix occurred in the spring of 1976 at the tail end of the flu season. Officials, aware that the virus was unpredictable, feared it could return when the next flu season got under way. It could mutate into something more virulent or something milder. What they did not expect was that the anticipated epidemic would simply not materialize.

Nevertheless, in 1976, reports of people contracting Guillain-Barré syndrome from the 1976 swine flu vaccine were alarming. (Guillain-Barré syndrome (GBS) is a rare nervous system disorder that results from nerve damage caused by the body’s own defenses, usually in response to an infection or other illness. GBS causes muscle weakness, loss of reflexes, and numbness or tingling in the arms, legs, face, and other parts of the body. It may progress to complete paralysis. Author: Monica Rhodes, Yahoo Health.)

In 1976, 25 people died from Guillain-Barre syndrome after receiving the swine flu vaccine. The program was stopped. But now the CDC says that it is unlikely most of those deaths were caused by the vaccine because Guillain-Barre syndrome occurs in people who have not had been vaccinated. Two new studies found that one out of every 100,000 people contracts Guillain-Barre syndrome. Flu vaccinations only add another one case per one million people, including the H1N1 vaccine.

The cause of the syndrome is not fully known.”

The unexpected behavior of the 1976 swine flu virus was as unusual as was ferocity of the 1918 flu, which first made itself known as the “three-day fever” in the spring of 1918 only to come roaring back with a virulent mutation in the fall.

And this history of the flu is why scientists and the medical community are so concerned about the current H1N1 flu pandemic, which has behaved in a pattern similar to the early wave of the 1918 influenza.

Another disturbing aspect about this strain of flu is that the hardest-hit patients have been older children and young adults, those who are usually in the best health at the time they get the flu. This was true for the 1918 flu, and the phenomenon has been attributed to something called a “cytokine storm.” It is where the immune system of a healthy individual fights back against the invading virus with such power that it sometimes overwhelms the body’s ability to survive.

It leaves the lungs wide open to secondary infection such as pneumonia, and that, too, is often deadly.

2What is a parent to do?
This is where the parents of the 21st century part ways from those of the 20th century. Unlike the older generation, younger parents do not trust the corporations making the H1N1 vaccine. They are suspicious of the motives behind the government’s push for mass immunizations. There are some valid reasons. These parents have seen the number of vaccinations that their children receive skyrocket. However, they have never witnessed the horrors of the illnesses for which prevention is now possible. Many in this group say that they have never had the flu, attributing their good health to virtuous habits instead of the fact that there has been an absence of flu pandemics.

Although people younger than 40 were born into the era of HIV and AIDS, they have not seen how quickly an airborne infectious virus can travel through a classroom or a movie theater. They have never known the fear of contagious illnesses like polio or measles and have never had to avoid public places as the only means of protecting their families from these diseases for which there is no meaningful treatment and no cure. Many do not fully embrace the importance of prevention as the primary way to avoid the illnesses. Even chicken pox, shingles, one type of pneumonia, bacterial meningitis and cervical cancer now can be largely prevented through immunization, yet this demographic sometimes sees the vaccine as the real danger.

In an ABC/Washington Post poll conducted in mid-October, nearly 40 percent of parents were not planning to get their children vaccinated against H1N1. The reasons given by parents for their refusal to get their children vaccinated were primarily concerns about the safety of the vaccine. Others felt that their children were not at risk or that H1N1 is not a particularly dangerous flu. In other words, nearly half of the parents polled feared the vaccine more than the flu.

Dr. Ali Javanbakht is a primary care physician in Carpinteria and he is hearing from concerned parents who are suspicious of the H1N1 vaccine’s safety.

“I tell them it is not a new vaccine, really, because it is using the same equipment, the same process as the seasonal flu vaccine that has been made for decades,” Javanbakht said. “The only difference is the virus pieces being used, so by all measures, it shouldn‘t be all that different than what you would expect from the seasonal flu vaccine for safety. It can protect a lot of people.”

But the severity of this strain of flu is definitely a concern to Javanbakht. “Certainly, what we’ve seen so far this flu season is that a lot of people have gotten really, really ill with it. Terrible fevers and chills. Another concern is the complications of the flu, namely pneumonia, which is a very serious and very real complication that can make people very sick and even be deadly.”

Many parents are simply confused. They have heard all of the dire warnings from officials about the flu, yet it is difficult to impossible to find the vaccine.

Jaime Chambers of Thousand Oaks is a television reporter with two young children. As a reporter, he has heard many conflicting statements about the situation. He said his uncle is also his family’s pediatrician and has strongly recommended giving children the H1N1 vaccine.

“The problem with going to get it is, the lines are so long,” Chambers said, “and there are so many kids that you are also running the risk of contracting the H1N1 because it is so rampant. What we’ve done so far is we have just kept the kids at home because the school is harboring H1N1. I don’t have scientific proof of this; I just know that all the siblings of all the kids that are sick are still going to school and they are probably contagious. And there are at least three confirmed cases of H1N1 on our street, definitely confirmed. It’s just kind of scary.”

Pat Kightlinger, a news photographer who lives in Ventura, has three young children, including an infant. He said he was also concerned about the safety as well as the necessity of the vaccine.

“I had some reservations early on because I didn’t know whether two flu vaccinations would be overkill or if they needed all these shots,” Kightlinger said. “I hesitated because I have never received a flu shot in my life for me personally.”

However, after speaking with his family’s pediatrician, Kightlinger decided to head for a clinic where everyone in the family was vaccinated, except for the infant. That is because the nasal mist, which is the only vaccine currently being offered, is not appropriate for children that age. But he intends to get the baby immunized when the shot is available.

Kightlinger said the event that really convinced him to get the vaccinations was seeing how sick a friend’s toddler became after getting the H1N1 flu. “She had a fever of 104 to 105 degrees for four days and was hallucinating. It took a full week before she was better.”

Why this strain is not just another flu virus
There is another reason why this flu is spreading so quickly. Despite the highly infectious nature of this pandemic, 40 percent of workers in California do not get paid for sick days and must work while they are ill. Some large companies, such as Walmart and Disney, also dock workers disciplinary points for staying home when they are sick, according to a study by the Public Welfare Foundation. A large portion of workers without paid sick days are in the service industries, and that includes food service. Although legislation has been introduced in Congress to require companies with more than 15 workers to pay for sick days, it is not yet a reality. The poor economy also is pressuring workers to work while sick and contagious because they cannot afford to do without the pay.

Young people who are healthy are being hit the hardest by H1N1 flu. Javanbakht said the resulting illness can be extremely serious, despite medical advances. “Part of the problem with the swine flu is that what makes people so ill is their immune response. It launches a massive response that causes a lot of fever, and younger, healthier people have more active and strong immune systems. That gives them a stronger response, which actually makes them feel sicker.”

One young Ventura County woman’s story sadly illustrates how quickly a case of the flu can turn into a desperate struggle for life. This woman was 28 years old and an athlete. The Web site that is listed below is best read chronologically. It is a series of updates for her close friends and family to follow after she was initially hospitalized. What is so recognizable in the entries is an absolute certainty that she will get better and come home. No one enters the hospital expecting to die from the flu, especially young, healthy people. If you think this flu will only kill someone else or someone you don’t know, the Web site www.kolfinna.sca-caid.org may change your mind.

According to a recent update by the Centers for Disease Control and Prevention, as of Oct. 17, at least 22 million Americans have contracted pandemic H1N1 influenza and 3,900 have died, including 540 children. Of those deaths, 440 have been older than 65. The CDC said during a normal flu season, 90 percent of the deaths are in people older than 65.

Doctors say most people who come down with H1N1 will recover in a few days to a week, assuming there are no genetic mutations in the virus. However, influenza is notoriously unpredictable. There is no way to accurately know how any individual will react to this flu. That is still beyond the knowledge of medical science.   

joanbien@sbcglobal.net