Unless you are living in a cave, you are well familiar with the swine flu (aka H1N1 virus) pandemic currently happening all over the world. The current count of confirmed cases worldwide stands at 331, but certainly by day's end, the count will rise. The death toll due to H1N1 virus currently stands at 13, with 12 of those deaths occurring in Mexico, and one here in the US.
Many people have wondered, "Why are young people dying at a more elevated rate than those who are elderly?" It has to do with the immune response to the virus itself. Unlike other flu viruses, which enter the cells of the respiratory tract, transmit their genetic material, make the victim generally miserable for a week or so, and then succumb to the body's immune response, victims of H1N1 flu are actually falling prey to their own immune systems. It's a sad irony that the very system designed to protect you from pathogens like viruses and bacteria in this instance is what brings about your demise.
But how does this happen? One of the components of an immune response is the inflammatory response. This is generally mediated by macrophages and T cells, which become activated once exposed to a pathogen. Activation of each of these cells involves their binding to the pathogen (H1N1, in this case), and the result is the production of cytokines. Cytokines are a class of chemicals used in cell signaling, but are not limited to the action of the immune system. The cytokines released during an infection with H1N1, however, trigger a phenomenon known as a cytokine storm. The cytokines released mobilize other T cells and macrophages, which mobilize even more T cells and macrophages. This "storm" sets off a cascade of events that eventually ends in death for some flu victims, and the underlying cause is essentially an overzealous immune response, similar to an anaphylactic response when someone is exposed to allergens.
Once the cytokines have been produced, their release stimulates an inflammatory response that results in the death of lung tissue, swelling in the lungs, fluid buildup and subsequently, death. It is thought that cytokine storms are the reason why so many people died during the flu pandemic of 1918 (the death toll was thought to be as high as 100 million globally), as well as the SARS outbreak of 2003.
Deaths due to these cytokine storms are why health experts are suggesting that schools be closed, events be cancelled and travel be restricted. This particular strain of H1N1 seems to be spread rather easily, and by limiting contact with others who may be potentially infected, the transmission of the disease can be slowed down. A vaccine does not yet exist, and will take months to generate; however, health officials are optimistic that one can be created in time for fall/winter flu season. Yet cities are cancelling festivals, concerts and events where large groups of people are expected to congregate. Likewise, school systems are closing schools as well as shutting down entirely, all in a bid to stave off further spread of the virus. But is it excessive to close an entire district down for one case of swine flu?
What do you think about the media's role in spreading the news about the flu? Is the press coverage adequate to protect the public, or is it causing more harm than good? How much press coverage is too much, and what duty does the media have in informing the public about public health emergencies?
Posted by scienceguru on May 3, 2009
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