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Pox Americana

    Everyone's worried about Avian Flu, or, as we prefer to call it here at the blog, "H5N1." An epidemiologist told me that he was at a gathering of health experts last week and everyone kept asking everyone else, "Do you have Tamiflu?" And half the people, he said, were referring to the stock.

    The Post ran a story today that gave the straight dope on Avian Flu. The good news is that, at the moment, the Avian Flu is avian. It is not human. People can get sick and die from direct contact with infected birds, but the virus isn't yet "human adapted." A researcher told me today that we don't know what kinds of mutations are necessary before a virus can make the full jump from one species to another (I know it's frowned upon, but I've actually been doing my own reporting on this). Today's Post story, by the way, says that if the H5N1 strain shows up in this country, we can still eat chicken, with one caveat, in the words of an expert: "I think you wouldn't want to eat raw birds..." Ruh-roh

    Influenza constantly mutates and remains infectious year to year, which is similar to what happens to our fear of a coming plague. Just a few years ago we were nervous about terrorists using smallpox against us. Purely for laughs, here's a piece about scary microbes at Fort Detrick, written more than a decade ago when we were all nervous about Ebola and various other pathogens that could make people essentially explode.

By Joel Achenbach  |  October 18, 2005; 3:35 PM ET
 
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Comments

Avian flu is avian? Who'd a thunk it! But wait -- no more chicken sushi? Denied!

Posted by: Achenfan | October 18, 2005 4:20 PM | Report abuse

Yeah, I thought you could only get it from drinkin' that thar Avian Water.

Posted by: TBG | October 18, 2005 4:27 PM | Report abuse

The bird flew? This is news?

Posted by: Hon Teux | October 18, 2005 4:36 PM | Report abuse

I enjoyed the purely-for-laughs piece about scary microbes at Fort Detrick. I was a big fan of all things Ebola back in those days ("The Hot Zone" was a real page turner for me). The idea that any virus in the world is less than 24 hours away by plane used to disturb me (although I seem to have gotten over that).

["So I went to USAMRIID . . . and it was nice to see that their faces were not hanging from the underlying bone."
Ha. That's funny.]

Posted by: Tom fan | October 18, 2005 4:41 PM | Report abuse

Nice little play on words in your title, Achenbach, on Elizabeth Fenn's nifty historical research/book, "Pox Americana," Charles C. Mann, in his recent book "1491," also mentions Fenn's work at some length around page 100.

But orthopoxes are not avian flu viruses, nor the hemorrhagic Ebolas/Marburgs. And one's perspective on vaccination depends on one's experience with it.

I had eczema vaccinatum as a kid. But three miles due south of our home lives Charlie Barber, the person who, as a teenager, had to take care of his mother, father, and brother, who had the last cases of smallpox in the United States. Lillian Barber was the last person in our country to die of naturally occurring smallpox in Elsa, Texas in the late 1940 (1949, I believe). Charlie's and my outlook on inoculation are entirely different.

My 2003 poem, part 1:

The Rolls-Royce of viruses:
long, breathtakingly beautiful, dazzling to behold,
virions shaped like barrels or bricks of gold,
a knobbly and crinkled surface like a jewel-encrusted scepter.
Mathematical in structure, regal in design,
master of a secret code to defeat human hosts,
amazingly stable over time, to this a toast!
Two hundred proteins locked together, complex like the Saxon Lindisfarne,
more than 187,000 letters, vested with authority,
the largest most complex of nature's viruses--
a genomic tome of raveled mysteries.
Imperial power to create long lines of DNA successors,
commander and hijacker of a vast army of cells
to produce legions of its own likeness,
clean, murderous capability,
elegant killer.
***
Oh, the nicknames for this affliction!
The Speckled Monster, Kiss of the Goddess,
A Destroying Angel, A Demon in the Freezer,
The Greatest Killer in History, The Most Terrible of All the Ministers of Death,
Invisible Fire, The Great Fire,
Rotting Face, Finger of Almighty God,
Heavenly Flowers, The Scourge,
Pox and Pockes, Variola Rex!
And without doubt named in tongues far different than ours,
the ancient virus has secured its place in history,
A spotted and pimpled and lethal record across the centuries.

Posted by: Linda Loomis | October 18, 2005 4:48 PM | Report abuse

As I recall, during the Ebola scare a CDC official suggested that a truly virulent virus, although horrible, did not present a civilization damaging risk. The theory went that such a nasty bug would immediately attract enough attention to warrant quarantine and thus prevent further spread. Something stealthful, like AIDS, was actually considered more of a risk to the planet. I wonder where a H5N1 mutant would fall on this continuum? PM post...sweeet.

Posted by: RD Padouk | October 18, 2005 4:53 PM | Report abuse

Maybe this will be of interest, an e-mail written by me on Oct. 10 to Cary Clack, metro columnist for our local paper:

Cary, today you wrote:

Maybe a virus that killed 50 million people is one of those things.

The scientists say the resurrection of Franken Flu carries minimal risk to the public and all 10 vials of the germ are locked away at the Centers for Disease Control and Prevention.

On the same day of this announcement, a cargo plane carrying six vials of an unrelated flu virus that were labeled dangerous goods crashed and burned in Winnipeg.
***

Would it be so hard to look at examples closer to home, rather than Winnipeg? In the last decade a very dangerous simian flu virus from the Southwest Foundation for Biomedical Research fell off a UPS truck on Loop 410 and lay on the roadside for some hours. I don't know the year, but I'm certain the Express-News archives has the story. Or call Dr. Fernando Guerra--he has all the details. I shared this story several years ago with the Davis, Calif. group opposed to placing a Level 4 biolab on the UC Davis campus.

Posted by: Loomis | October 18, 2005 4:55 PM | Report abuse

RD Padouk...interesting.

The bird flu doesn't scare me per se. It's the news that there is a dog flu that worries me. Two reasons: (1) Love dogs and (2) what gave the 1918 flu its kick was the bird to pig to human bridge. If there is ever a flu that can go from bird to dog (or cat) to human, then it's the end of the world as we know it, and I won't feel fine.

Posted by: irregardless | October 18, 2005 5:01 PM | Report abuse

i loved the movie outbreak!

the movie i mentioned in the previous boodle (sorry to veer off topic) was Trilogy of Terror. Did anyone see it? it was a made-for-tv movie in 1975 - i must have seen it years later cuz i was only 3 in 75 but i know i saw it as a kid and it scared the bejesus out of me! the killer zuni doll had me cowering in my bed at nite!

Posted by: mo | October 18, 2005 5:08 PM | Report abuse

if we can't eat raw chicken, whatever will we do with our nation's jerk training programs (not the congressional school for boys)?

Posted by: cap girl | October 18, 2005 5:08 PM | Report abuse

Ever since the flu issue came up, I've been waiting to have my "Linda Loomis" moment when I tell everybody that both my grandmothers lost their mothers in the big 1917-1918 flu epidemic. (One was in Baltimore, one was in western Oklahoma) I believe that had a big impact on my life because both my parents were raised by mothers who were motherless from a young age.

TBG: That's funny!--I'm going to use that.

Posted by: Reader | October 18, 2005 5:13 PM | Report abuse

If there's a Part 2 to that poem (unlike Mel Brooks' "History of the World, Part I), it's probably best left unshared..presuming it's anything like Part 1.

Say, anyone got any poems about the atomic structure of plutonium? Perhaps a nice sonnet about mechanical engineering?

Posted by: Raoul Duke | October 18, 2005 5:18 PM | Report abuse

I'm curious. Did any of you ever learn about the 1918 flu in school? Or anywhere while you were growing up?

My husband and I were shocked when we first saw the PBS film "Influenza 1918" on their American Experience a few years ago. My mother used to talk about her father suffering from the flu when he was a soldier at Ft. Meade during WWI, but I had never heard of the incredible scope of the epidemic.

Over 20 million people died worldwide and 675,000 in the U.S. in just a few months; 195,000 died in Oct. 1918 alone.

Then I asked my great aunt about it and she described people putting bodies out on the curb in the mornings (I believe she lived in Annapolis at the time).

I just couldn't believe that this had happened here to a generation that was still alive when I was growing up and I had never learned about it! My family had never talked about it until I started asking. My mother (who was born in 1924) didn't reallly know much; it was my great aunt who filled us both in. Even my mother had never been told about it beyond that her father had been sick.

Posted by: TBG | October 18, 2005 5:39 PM | Report abuse

Thursday, August 11, 2005

Virginia Mason nurses can shun flu shots
Arbitrator rejects plan to force them

By ANGELA GALLOWAY
SEATTLE POST-INTELLIGENCER REPORTER

An arbitrator has ruled that Virginia Mason Medical Center may not force its nurses to receive flu vaccinations.

Last fall, Virginia Mason announced plans to become the nation's first hospital to require employees and volunteers to receive the shot.

In a September memo, the hospital told workers: "Staff must be vaccinated by Jan. 1, 2005; staff who cannot document vaccination by that date will face termination if they are not taking influenza prophylaxis."

The policy was never implemented because of last year's vaccine shortage.

Soon after the requirement was announced, the Washington State Nurses Association filed a grievance. The two sides entered into binding arbitration.

The arbitrator decided on Tuesday that the policy violated the company's contractual duty to negotiate with the union.

Virginia Mason still hopes to increase the number of vaccinated workers and is considering offering workers financial or other incentives for getting the shots this fall, said Charleen Tachibana, vice president and nursing officer.

About 50 percent of the hospital's workers opt for the shot, Tachibana said. While better than the industry average of about 38 percent, such a rate is "deplorable," she said.

The union encourages its members to receive the vaccination, said Anne Tan Piazza, a spokeswoman for the Washington State Nurses Association.

But it's another matter when the company threatens termination to those who refuse, she said.

The association is pleased with the precedent set by the arbitrator's award, she said. "In the future, if the hospital wants to have a policy requiring vaccination, they must first come to the table and negotiate with the association," she said.

Posted by: Loomis | October 18, 2005 6:07 PM | Report abuse

Apparently, cats can carry avian flu. After all, they do eat birds raw.

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/sep0304cats.html

But some other websites rebutt that. Dogs don't get bird flu, but Thai scientists erroneously thought a dog tested positive for it.
http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/oct042004avflu.html

I anticipate Jurassic Park 3 will have avian flu vs dinosaurs, with the dinosaurs losing, all with plenty of gross graphics (Velicoraptor snot, anyone?).

Posted by: Wilbrod | October 18, 2005 6:12 PM | Report abuse

Errrrgggg.. totally off topic, but for some reason it just galls me to see "Undersecretary of State Karen Hughes."

Ugh.

Posted by: TBG | October 18, 2005 6:17 PM | Report abuse

The 1918 flu panepidemic was not discussed widely because those who remembered didn't want to be reminded of it... at least in many families. I always heard about the 1918 flu panepidemic in my family.

My great-grandparents lost 7 siblings (blood or by marriage) in less than 3 weeks, right before Christmas. My great-grandmother nearly died.

The story gets told mostly because my great-grandfather was heroic. taking care of so many people and two farms even though he should have been in bed. He wouldn't quit.

Contrast it to the other relatives who wouldn't help family or even attend the funerals for fear of getting sick. (That kind of thing leads to permanent family schisms.)

So-- are you a hero or Ruh-roh, a coward?
Only you will know when the sneezing starts...

Posted by: Wilbrod | October 18, 2005 6:29 PM | Report abuse

Am I going to get avian flu when I go to Hong Kong? Because that would not be good.

Posted by: jw | October 18, 2005 6:41 PM | Report abuse

**********Notice of Grievance**************

This is to confer notice that the International Association of Cuisine Fowl hereby registers its grievance against all farmers, chicken processors, butchers, transporters, health officials, or associated persons who have undertaken to destroy thousands of IACF members without notifying and obtaining the approval of IACF leadership as provided in our contract with farmers, processors, and associated persons. The above described persons are hereby ordered to cease and desist from all further destruction of Association members until such approval has been obtained. Please conduct yourselves accordingly.

*************

Posted by: CowTown | October 18, 2005 7:15 PM | Report abuse

Wilbrod, as someone who frequently has daydreams of being The Hero, although my heroic acts have been startlingly mundane, I think you're wrong about the avian flu. It won't be sneezing and bad flu symptoms, if it's anything like the 1918 flu they recreated. First really bad symptom is bleeding from deep in the lungs. Although I'm a mom and a would-be hero, how'm I gonna help someone who's bleeding in their lungs?

Posted by: suecris | October 18, 2005 7:19 PM | Report abuse

TBG: Dissing Bush appointees is never off topic in the Boodle.

Posted by: Susan | October 18, 2005 7:24 PM | Report abuse

Mr. Achenbach: Your writing holds up well over time (the test for all great literature). Eight years after its original publication your article about Fort Detrick is still very funny.

"It's a thrilling book, the reader frantically racing through the narrative to see if the virus is going to wipe out the Washington suburbs, crash into the White House, and force senators to evacuate the Capitol by helicopter, elbowing like mad, whopping each other with pork barrel bills as they scramble to grab the chopper's landing gear. (You tell yourself that, had that happened in 1989, you probably would have heard about it, but this doesn't make you read any more slowly. You also tell yourself to have some decency and stop rooting for the virus, for gosh sakes.)"

Posted by: Susan | October 18, 2005 7:32 PM | Report abuse

Blame it on Colbert I. King--my interest in the subject of Pox Americana. It was King's Oct. 25, 2001 Washington Post op-ed, "Keeping Perspective on Anthrax" that got me started on this--uncovering a story--the story of being pretty darn sick at the start of fourth grade. One small fact led to another, the whole thing just blossomed, and the pursuit of information has led me down an incredible road--a long four years. There are a couple of people over at CNN who deserve some credit, too--not to mention a huge debt of gratitude to Dr. Jonathan Tucker.

Posted by: Loomis | October 18, 2005 7:32 PM | Report abuse

Yup, no doubt about it--viruses are hugely, uproariously funny--even side-splitting, a real barrel of laughs [I'm laughing so hard that I'm crying]--the more virulent the virus, the funnier the humor--until it happens to YOU!

Thanks, Reader and Wilbrod, for sharing your stories.

Posted by: Loomis | October 18, 2005 7:38 PM | Report abuse

Avian flu has been on the scientific community map for years, and on the radar of various non-MSM outlets for much longer than this post-Katrina Doomsday hysteria gripping Amerika.

Don't get so intestinally uproarious. After all the mortality rate is ONLY 50%. This place is overpopulated anyway. Just eat your Wheaties.

Posted by: Bildung Beatle | October 18, 2005 9:33 PM | Report abuse

TBG:

My mother's brother, wife and daughter died in the 1918 flu epidemic. They lived in central Wisconsin and I can remember visiting the cemetary where they were buried when I was tracing family history. It was a terrible period according to my mother, who was training to be a nurse at the time.

It seems incredible that so many people died of that one disease, but when one reads about Avian flu pandemics it seems more credible.

They (whoever "they" are) always say that 50,000 (+ or - a thousand or two) die every year from "ordinary" flu - a reason we all need flu shots - but I rarely hear of people I know now who died from the flu. Have the rest of you?

bdl

Posted by: boondocklurker | October 19, 2005 2:38 AM | Report abuse

Jim Henson, of muppets fame, died from the flu. Got to the hospital too late for anyone to do anything for him. Of course, I didn't know him personally, but he certainly had an influence in my house.

Posted by: TBG | October 19, 2005 8:02 AM | Report abuse

jw,

You're going to Hong Kong? Vacation? Business?

Posted by: Sara | October 19, 2005 9:41 AM | Report abuse

Viruses. Three year ago, my now 16 yr. old g-girl was stricken with Wegener's Granulomatosis, an often fatal disease that is usually found in adult males. The doctors told us it either kills the patient or itself. THe cause is unknown. It attacks the immune system, respiratory tract and kidneys. The tragic thing is that oftentimes symptoms don't show until significant damage has occurred. Hilary spent 21 days in ICU while they diagnosed the disease and treated her with many medications including steroids. When she was released, the doctors said she had 50% use of both kidneys and when we asked, were told that kidney transplant was not necessary. She was to continue taking medication and come back in one month for a check-up. She couldn't go to school or any public places until the disease killed itself off. My Hil is a very intelligent, sociable child; who loves to talk and laugh. the social isolation and intellectual deprivation was devastating. She never cried or complained. She was just very very quiet. Every day thereafter for 10 days, Hilary's body swelled excessively. When we questioned the doctors we were told that htis was a side effect of the steroids and not to worry. Oh, I can't go on and on like this, so I'll just say that she was life-flighted back to the hospital near death. The nurses were shocked at her appearance and her condition. Then it was discovered that the doctors had made a terrible, irreversible mistake. They released her without any mention of a renal diet or that her sodium intake could not exceed 1200 miligrams. Her kidneys were destroyed. The doctors said they had good and bad news. The good news was that the disease had killed itself off; the bad news, she needed a kidney transplant. My then 18 yr. old g-girl donated her kidney. Hil's life was saved, thank you Mary Mother of God for intervening, however, her quality of life has been seriously compromised. My questions of why she wasn't put on a renal diet were ignored. My pleas for an apology were ignored. But she's also a real trooper and her condition has not interfered with her goal of being the first college graduate of the family and becoming a doctor. She plays trumpet in the band, is on the softball team, is in honors classes and volunteers with hearing impaired children. She must also take anti-rejection medication for the rest of her life. Fortunately, she has none of the disfiguring side effects that many children with kidney transplants suffer. I just want someone at that hospital to say they are sorry. That they didn't intentionally neglect her. I understand that doctors are human. We don't want to sue. WHat good would that do? They just won't apologize. The rest of the family has come to terms with the situation and so have I for the most part, but I can't seem to get past the anger. (I am careful not to express anger in Hil's presence, but she knows me like a book and surely is aware). An apology would mean so very much to me. Sorry for the rant, but I just had to tell someone.

Posted by: Nani | October 19, 2005 9:54 AM | Report abuse

re: Hong Kong. I'm going for vacation, sort of. Actually, I'm freeloading off my girlfriend, which is really the only way to fly. I'll try and write a dispatch from there in emulation of Joel's trip to Japan.

Posted by: jw | October 19, 2005 10:01 AM | Report abuse

I feel like such a cad posting after Nani's, which I read only after.

That's a horrible story, Nani, but I'm glad that your daughter is ok. I'm sorry to say that in this age of lawsuits, it'll be hard to find anyone willing to apologize, for fear of it being interpreted as admission of error in the lawsuit you promise not to bring. Some people find it hard to beleive that good people like you still exist, but it's inspiring that even faced with such tragedy you were able to act nobly.

Posted by: jw | October 19, 2005 10:07 AM | Report abuse

I feel like such a cad posting after Nani's, which I read only after.

That's a horrible story, Nani, but I'm glad that your daughter is ok. I'm sorry to say that in this age of lawsuits, it'll be hard to find anyone willing to apologize, for fear of it being interpreted as admission of error in the lawsuit you promise not to bring. Some people find it hard to beleive that good people like you still exist, but it's inspiring that even faced with such tragedy you were able to act nobly.

Posted by: jw | October 19, 2005 10:07 AM | Report abuse

A touching, moving story indeed, and I think jw's comments are right on the money. It is nice to hear that she is doing so well after such a traumatic experience at such a tender age.

Posted by: Raoul Duke | October 19, 2005 10:35 AM | Report abuse

Oh, Nani, I'm glad that your granddaughter made it through all right. I know how frustrating doctors can be. My mother had meningitis and encephalitis three summers ago and our doctor just kept telling her it was stress and she should quit her job and that her husband should quit his job because he traveled too much (so he basically wanted them to become hippies that lived in a box on a corner--that's not stressful at all). We finally had to leave the state and go out west to our old family doctor that would actually run tests and finally give her a real diagnosis. They said if she had gone three or four more days without intensive medical care she would have died because her brain had swollen so much. To this day our doctors here still insist that it was just stress. And that same doctor told my coworkers husband to go home and lie down because he had a "stress-related side ache." That night his appendix burst and ate away at his internal organs. He was in ICU for a few days because he almost died.

I have very little faith in the Minnesota medical community. We have the Mayo Health system that is supposed to be so miraculous, but unless you go to the hospital headquarters in Rochester they won't take the time needed to figure out what is making you sick. The hospital in Rochester, though, will not rest until they've figured it out so I have all the faith in the world in that place. I've had a weird stomach problem most of my life, but no one has been able to figure it out. Eventually I had to go to Rochester and tell them that none of their clinics could figure it out, so I had to undergo a whole day of weird tests, everything from ultrasounds to food allergy tests. Turns out I have a problem digesting dairy and fat, so I cut out dairy and most meats and now I'm better. And soy yogurt is actually really tasty. Cheerios with soy milk is more flavorful than Cheerios with regular milk. But Rice Dream ice cream is something I will NEVER try again. My ice cream days are pretty much over.

Posted by: Sara | October 19, 2005 10:45 AM | Report abuse

Suecris, more details.

My grandfather cooked (including baking bread) and cleaned for 8 children, including a 1 year old baby, took care of 2 extra farms when his brothers were sick in bed with the flu, and his wife was seriously bedridden.
(I know, when a woman does it, it's motherhood, but a guy does it, he gets called a hero.)

He was coughing, but persisted because there was nobody else remotely well enough to do the work. And it might have been the only way for him to stave off worry and grief. The sheer work and stress may have saved his life.

I suspect the 1918 flu worked somewhat like the hantavirus that killed mostly young healthy men-- in other words, it's a runaway immune response that causes bleeding to the lungs and black feet and hands and kills so quickly. That's why the young and strong died.

It is also worth mentioning that only 50% died and not all of those 50% died so suddenly with such dramatic symptoms.
Maybe nursing is all that can be done, but don't underestimate its value. It can make the difference between life and death in cases where nothing can be "medically done".

Posted by: Wilbrod | October 19, 2005 10:52 AM | Report abuse

What I don't understand is why the press, this column included, always refers to the H5N1 virus "mutating" rather than using the more accurate term "evolving"? Are the media afraid of offending the creationists and intelligent design folks? The flu virus does not just mutate, it mutates and through the process of natural selection the best adapted, most successful viruses are selected to infect others.
Jerry S

Posted by: Jerry S | October 19, 2005 11:35 AM | Report abuse

No more chicken sushi? My husband wanted to retire to Iraq and open a put n'slut with a chicken sushi minibar drop down menu of 720 'millies'. So watch out Wilma.

Friedman, however, has said that the idea has been stolen, and was in Saddam's playbook all along.

Posted by: sisjen | October 19, 2005 3:25 PM | Report abuse

Saw a grizzly cross a dirt road in front of me, and it was as long as the road was wide. Had lost floaters try to climb into my canoe, had to pull my paddle out of their hands. Nearly drove right off a mountain, the view was so expansive. Lived in a teepee in Montana. But the only fox I've ever seen was in my yard in Annandale 2 years ago, but my neighbor felled the tree that hid their home inside since. I'd never seen an ecosystem die before.

Posted by: sisjen | October 19, 2005 3:45 PM | Report abuse

Nor had I ever killed a boodle.

Posted by: sisjen | October 19, 2005 3:48 PM | Report abuse

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