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Microbiology: notes for the honors paper

I've been reading Flu; The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It because it was the first one of the recommended books on the list that I could find in the NCNM library. It's very interesting. The first half of the book is a history of the 1918 flu, which I knew had happened, but I had not realized how many people died. In the US 1/2 million people died in about 3 months. Worldwide the numbers are less certain, but somewhere between 20 and 100 million. The author of this book, Gina Kolata, seemed to suggest one time that she thought the number of deaths worldwide was more like 40,000.

In any case, the number of deaths in the US was greater than the sum of the deaths from World War I, World War II, the Korean War and the Vietnam war. There were piles of bodies coming out of hospitals, and piles of bodies in the streets. People were wearing fabric over their faces to try to avoid infection.

I just hadn't really known. Pandemics of flu virus at the time were happening about every 11 years. Why haven't I heard about more pandemics since then? Except for in this book, of course.

The paper I am to write is supposed to reflect on how my medical practice will change based on the information in this book. I'm only 3/4 of the way through the book. This information will influence both my personal choices and my practice as a medical doctor.

I was already planning on living at the end of the road, top of the drainage. I would like to live in an isolated valley community with the ability to monitor and possibly control access to the valley. Being positioned in such a way allows for the possibility of isolating the population within the valley from outsiders. If there were to be another pandemic, such a community would have the option of sealing the entrance to the valley, and requiring anyone who wishes to come in, including members who have temporarily left, to spend some time in a quarantine area before getting full admission.

The book Flu also tells of the 1976 effort by the Ford administration to vaccinate the entire US population against a swine flu that they believed was descended from the flu of 1918 and might cause another pandemic. The ultimate failure of the program occurred because doctors began to diagnose any case of neuropathy occurring after vaccination as Guillain-Barre Syndrome (GBS). GBS, as far as I can tell, is another one of those diseases that is diagnosed without knowing the cause or mechanism or treatment, it is just a name for some symptoms. After last week reading about the implication that the HPV vaccine is causing GBS among young women, and then to read that this vaccination program was dealt its death blow by people promoting the idea that it caused GBS, I am suspicious. As a doctor I will refrain from diagnosing diseases for which there is not a test. I will refrain from using diagnoses that seem (to me) to be a product of politics or marketing. Rather than naming someone's neuropathy, I will do all I can to facilitate their healing. I will not feed public panic, and I will not be a pawn of the pharmaceutical companies who create diseases to sell drugs.

More to come on this, I just wanted to get started thinking in writing about it.


( 9 comments — Leave a comment )
Jan. 18th, 2008 04:36 pm (UTC)
I will not feed public panic, and I will not be a pawn of the pharmaceutical companies who create diseases to sell drugs.

Funny you meantion this, two of my cow-orkers were just talking outside of my cube about this. One had high cholesteral. The other had that toe fungus that lamasil (sp) is suppose to cure, as well as restless leg syndrone.

The guy with the cholesterol problem looked at the side effects of lipitor and didn't want to take it. After conserable research, he tried dily niacin tablets. His cholesterol immediately dropped to below normal levels.

The other guy's doctor told him not to take lamicil (sp), that all he needed to do was rub Vix on his infected toe nails until the fungus was gone. It worked.

As for his restless leg thing, he didn't like what he read about the medication's side effects. So, he did some research. What he found claimed that he had a twin iron-potassium deficiency. So he started taking iron and potassium supplements, and a little while later his legs stopped doing there thing at night.
Jan. 18th, 2008 06:20 pm (UTC)
Yep. Good thing your cow-orkers =-] are paying attention to their options. If you believe big pharma you need to take lots of expensive drugs for the rest of your life to be happy in the least.
Jan. 18th, 2008 04:41 pm (UTC)
When I worked at the Large Pharmaceutical Company in England, it was in the flu clinical studies area. From what I understand, the flu always starts out in roughly the same place on earth each year(I don't know where), and travels. It takes a different form each year. The clinicians study the virus and race against the clock and the virus to develop a vaccine for Europe and the United States before it reaches those areas. It is a race against the clock every year, and they use the people in the poorer countries as the guinea pigs for their research. It is fascinating and sick, all at the same time. The flu vaccine is one of this company's biggest money makers.
Jan. 18th, 2008 05:16 pm (UTC)
Don't migrating geese and ducks spread it? It lives in their butts?
Jan. 18th, 2008 06:24 pm (UTC)
Swine. The 1918 flu has a variant that survives still in pigs. And ferrets can get it too. It's a big challenge finding animals to infect so you can study the disease.

They grow the viruses in chicken eggs.
Jan. 18th, 2008 06:23 pm (UTC)
Flus need dry air to travel in the air, that's why they usually travel in the winter. I don't know about it always starting in the same place---haven't gotten that impression. The different forms are variations on two proteins, and a new flu can vary on one or both proteins. Flus that have two new proteins are the hardest to stop.

No fair using poor people for guinea pigs! Looks like you don't want to tell us who you worked for?
Jan. 18th, 2008 06:30 pm (UTC)
Some novels and movies have dealt with the use of populations in poorer countries as the guinea pigs. An especially angry book about this is John Le Carre's The Constant Gardener.
Jan. 18th, 2008 08:04 pm (UTC)
I saw the film, haven't read the book. The film was quite good.
Jan. 18th, 2008 10:12 pm (UTC)
Le Carre is often angry at the British foreign service, the Americans, the West, the Israelis -- which has been seen as a typical british leftist knee jerk reaction. On the other hand, testing populations of the poorest countries -- especially in Africa -- is a dirty little secret in the pharmaceutical business as you know. I fear that industries will always look for a way around human subject restrictions for cheaper alternatives just because there are countries they can go to in order to do so.
( 9 comments — Leave a comment )



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