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Flu Vaccine

January 20, 2004

A public radio commentary

With flu season slowly ending I'm reminded of an old joke. "A camel," it goes "is a horse made by committee." I'm reminded because the same can be said about the flu vaccine.

Every year countries across the globe assemble committees of experts to decide what should go into the latest flu vaccine. It isn't a simple task. The flu virus mutates constantly and there are many variants out there, any of which could suddenly cause a worldwide pandemic. So, they must decide whether to use the previous year's formula, or bet that some new strain will dominate.

The committees must make their decisions by late winter well before influenza attacks, because once a strain shows epidemic promise, it's too late to act. It takes time to make the vaccine - some 83 million doses in the United States alone - and it takes time for the vaccine to take effect.

The committees work in the shadow of the great flu of 1918. It is still the world's deadliest pandemic, and one which our medical system cannot treat any better than in 1918.

At the end of the First World War, this flu strain killed over 20 million people around the globe. Nearly every section of the world suffered: The United States, Central and South American, Europe, Asia, and even remote Eskimo villages. In fact, more people died from the flu than did soldiers fighting in World War I.

What was unusual about the 1918 flu was its virulence. You see, influenza is normally deadly to the very young and the very old, but in 1918 twenty-something soldiers, although apparently at the peak of health, died within days of catching the flu. This flu strain struck hard at the most delicate of human membranes, the lungs.

Lung tissue is a gossamer net where the blood exchanges gaseous waste for oxygen. Lungs are light, elastic, and soft, yet doctors were astonished to find young men with lungs so full of fluid that they could no longer float in water.

Medical science has no clear idea of what made the 1918 flu so deadly. They fear that at any time it could reappear, killing millions. If the percentages are the same as the 1918 pandemic, then about one and a half million people will die in the United States alone, compared to the 10,000 currently killed by flu in non-epidemic years. It may be even worse in our current age.

There was only one country not significantly affected by the 1918 flu - Australia. They established a strict maritime quarantine before the 1918 flu could hit their shores, which they kept up vigorously until the winter of 1919, by which time the epidemic had ended. But today, could any country react quickly enough in the age of the jet to stop a flu pandemic? I doubt it.

Copyright 2004 William S. Hammack Enterprises