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Public Ambivalence May Keep Many from Swine Flu Vaccine

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By Rachel Howell Stockton

The flu has probably been around since Adam; Hippocrates mentioned an illness that certainly presented itself in flu-like fashion about 2500 years ago. The Plague of Athens is thought by some to have actually been an influenza outbreak.

Although the first documented flu epidemic didn't occur until 1889, based on records kept by the early colonists, the flu made its visitation on a regular basis during the United States' colonial days. At times, the flu can mimic other diseases, such as diphtheria and typhoid, which leads us to the obvious conclusion that some instances of the flu were likely misdiagnosed much of the time.

Cold weather, however, does not cause the flu. Until the 1930s, the medical profession thought the illness was caused by "bad air". In fact, the term "influenza" is derived from an Italian word meaning "influence", because it was thought that the illness was "influenced" by cold weather and bad air, hence the following children's rhyme: "I had a little bird, its name was Enza, I opened the window, and 'in-flew-enza."

But research came to a head in the thirties when scientists discovered that the culprit was in fact, a virus. So, why do so many people contract the flu in the winter months? Simply because most people spend their time indoors, and close quarters are a breeding ground for the airborne virus.

The Spanish flu lives in infamy as the "greatest holocaust in medical history;" one of the most terrorizing pandemics that has ever stricken the planet. By some estimates, the virus claimed more lives than did the "black death."

Why is it important to look at the history of the 1918 outbreak?  Put simply, there are disturbing similarities between the swine and Spanish flu.

Public Ambivalence

The first 600,000 doses of the swine flu vaccine is set to arrive on Tuesday, with another 7 million doses received by the end of the week.  The US government has promised to foot the bill for the shot, should there be enough interest.

The problem at this juncture is simply that not everyone is eagerly awaiting the vaccine’s timely arrival.  A poll conducted by the Harvard School of Public Health showed that only 40% of the 1,042 adults interviewed were “certain” they would get a flu shot.

This is somewhat surprising, considering all of the data we’ve been given about the swine flu, its complications and its victims.

Vulnerable Victims

The CDC has stated that those who are at the highest risk of complications from the swine flu (which, ultimately are what causes death, rather than the flu itself) are children, young adults, and pregnant women.  Clearly, this is a different subset of patients negatively affected than those typically at risk for the seasonal flu.

Young adults were also vulnerable to the Spanish flu in 1918, and ironically, the reason for this is that they had good immune systems.  That particular strain of the flu attacked certain cells in the lungs that other strains didn’t reach.  In response to it, the immune system of healthy patients turned on itself, releasing cytokines at an alarming rate.  Too many immunity fight cells end up in the same place.

Within mere hours of being stricken, sufferers were too weak to walk; many died within the first 24 hours. Those who weren't so lucky either drowned in their own body fluids, or bled to death while losing the lining of their intestines.

Flu Complications

While the incubation period from 1-3 days, once the symptoms show themselves, they hit the patient swiftly and powerfully, leaving them bedridden for up to a week. Muscle aches, high fever, chills, sore throat and a terrible cough are its hallmarks.

It takes a strong immune system to fight the flu; by the time the virus is gone, it's left quite a bit of damage to the lungs. The epithelial cells surrounding (and protecting) the lungs, are severely damaged, leaving a breeding ground for bacterial pneumonia.

The Bottom Line        

Staying well is certainly a good incentive to get immunized, but if that's not enough motivation, consider the social implications if not enough people get flu shots. If those who choose to forego the shot end up getting sick, the number of victims affected by that choice could potentially increase exponentially. Given the highly contagious nature of the virus, a decision to become immunized could help prevent all of those you come into contact with, from co-workers, to the little old man who sacks your groceries, from getting sick.

Should the similarities between the Spanish flu and the current swine flu epidemic cause us to panic?  Certainly not!  That’s because we have something that citizens in 1918 did not have:  a free flu vaccine to protect ourselves and our families.  To not take advantage of that seems to be almost an insult to those who suffered so horribly from the earlier pandemic.




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