liveonearth (liveonearth) wrote,

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.
Tags: books, diagnosis, disease, flu, pandemic, public health, vaccines, viruses

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