source: flu ward.
http://www.slate.com/id/2127872/
1) A lapse of almost 9 decades of worldwide spread of a virulent influenza A H1N1. Once again influenza A H1N1 is making a come back. The spanish flu pandemic lasted from March 1918 to June 1920 (27 months). How long is this 16th April 2009 A H1N1 gonna last? 27 months, longer or shorter duration?
2) This time round, equipped with triple reassortment evolution (with pig + human + bird elements), are these viruses gonna make a big come back? or a smaller scale?
3) From history, we learned that, spanish flu 1918 killed approximately 2.5% to 5% world infected population and infected more than 20% world population, ? 50millions. Also known as "the greatest medical holocaust in history". Till now, according to WHO, 5728 cases reported infected with AH1N1 in 33 countries.
4) Another lesson we learned, it was initially misdiagnosed as cholera, dengue, typhoid. Are we gonna make the same mistake with such a massive advancement in medical technologies and knowledge as well as widespread of medical information that travels in the speed of light?
5) 2 genetic processes was postulated: genetic drift and antigenic shift has lead to this massive death toll. This was caused by an extremely high infection rate of up to 50% and severe complications of the infection due to cytokine storms. So which type of genetic mutation that as has lead to current influenza A H1N1? What are the factors that promotes these mutation to occurs? Fitness of survival theory?
6) Influenza A viruses are found in many different animals, including ducks, chickens, pigs, whales, horses, and seals.
Influenza B viruses circulate widely principally among humans, though it has recently been found in seals.
7) Spanish flu infected young healthy adults predominantly. Why is that so? Explanation is cytokine storm. The stronger immune system would potentially have a stronger overreaction. Could this AH1N1 reacting the same?
8) Another oddity in spanish flu was that the outbreak was widespread in summer and fall (in the Northern Hemisphere) hwoever normally influenza is usually worse in winter. Thus this explain the seasonal flu vs AH1N1 pandemic flu.
9) In spanish flu, 2nd wave infection was much more deadlier than 1st wave flu infection. During the 1st wave, which begins in early March, the epidemic resembled typical flu epidemics. Those at the most risk were the sick and elderly, and younger, healthier people recovered easily. But in August, when the second wave began in France, Sierra Leone and the United States, the virus had mutated to a much more deadly form. This has been attributed to the circumstances of the first World War.
10) Was spanish flu a form of biological warfare? Is this AH1N1 a form of biological warfare? Or may be just due to fitness of survival theory.
reference:-
2) Kobasa, Darwyn; et al. (2007). "Aberrant innate immune response in lethal infection of macaques with the 1918 influenza virus". Nature 445: 319–323.
3) Aoki, FY; Sitar, DS (January 1988). "Clinical pharmacokinetics of amantadine hydrochloride". Clinical Pharmacokinetics 14 (1): 35–51.
4) Carrington, Damian (2000-05-11). "Seals pose influenza threat". BBC.
5) Gladwell, Malcolm. "The Dead Zone". The New Yorker (September 29, 1997): 55.
