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April 29, 2009

A Riddle

Posted by John Baez

If pigs could fly…

… what would the newspapers say?

SWINE FLEW!

On a more serious note, just as a kind of test of our social network: if anyone reading this gets the swine flu or knows someone who gets it, how about noting the fact here?

I hope none of us gets it, but only time will tell. Maybe it’ll spread a lot next winter, which is flu season in Europe and America. But maybe we’ll have vaccines by then, at least in these rich countries.

Posted at April 29, 2009 7:11 AM UTC

TrackBack URL for this Entry:   http://golem.ph.utexas.edu/cgi-bin/MT-3.0/dxy-tb.fcgi/1957

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Re: A Riddle

How can I tell apart a swine flu from the usual flu without going to the doctor? I mean, not everyone has harsh syndromes, so maybe one gets the swine flu and thinks it is just the usual influenza and not even bother to go to a doctor…

Posted by: Daniel de Franša MTd2 on April 29, 2009 12:46 PM | Permalink | Reply to this

Re: A Riddle

Normally, you feel a lot worse with a flu than with an ordinary cold (fever, chills, muscle aches – miserable). If you have flu-like symptoms, and you are now in North America, please see a doctor.

Posted by: Todd Trimble on April 29, 2009 1:57 PM | Permalink | Reply to this

Re: A Riddle

A little more to the point of Daniel’s question (as far as I understand it, at least) is that right now the H1N1 strain is the “usual flu”. If you get the flu right now, this is probably what you have.

Posted by: John Armstrong on April 29, 2009 3:34 PM | Permalink | Reply to this

Re: A Riddle

Well, there is an epidemic of flu here right now. But people don’t seem to be that bad, in fact, I don’t know anyone that even had a fever.

Posted by: Daniel de Franša MTd2 on April 29, 2009 4:18 PM | Permalink | Reply to this

Re: A Riddle

Daniele writes:

But people don’t seem to be that bad, in fact, I don’t know anyone that even had a fever.

Are you sure it’s really influenza? At least around here, most of the time when people get mildly ill, people call it ‘a cold’ if it’s not very bad, or ‘the flu’ if it’s worse. But I don’t think everything people call the flu is really caused by an influenzavirus.. And it seems that colds are caused by quite a number of viruses.

I keep wishing doctors would get a bit more specific about all these mild viral infections, but my friends tell me there’s no point.

Posted by: John Baez on April 29, 2009 4:35 PM | Permalink | Reply to this

Re: A Riddle

Oh, I see. There are 2 words for those, but people use them interchangebly, “resfriado” and “gripe”. So I just google and found that, in English, “gripe” is “flu” and “resfriado” is “cold”.

But, really, I’ve never seen a doctor personaly worried about classifications, since the degree of how much the classical symptoms show up is very random. And there is no cure for any kind virus anyway, other than the natural antibodies.

Posted by: Daniel de Franša MTd2 on April 29, 2009 6:51 PM | Permalink | Reply to this

Re: A Riddle

John A,

English leads to ambiguities, cf. usual. Current `swine’ flu is H1N1 according to at least one broadcast. Did you mean that if you get the flu nowit likely will be that one?

My understanding is that there are a list of symptoms for true influenza and if you only have some of them it’s probably not the flu.

Posted by: jim stasheff on April 29, 2009 7:40 PM | Permalink | Reply to this

Re: A Riddle

While we’re at it, I think that what Americans call a “stomach flu”, with vomiting as a symptom, isn’t influenza at all.

Posted by: John Baez on April 29, 2009 2:08 PM | Permalink | Reply to this

Re: A Riddle

Early this morning, at my gym, I was talking with a Dr. who is an infectious disease specialist and he said that it would be over 12 months before a vaccine could be rolled out due to the differences between this strain and what is currently in development.

Posted by: Zach on April 29, 2009 3:09 PM | Permalink | Reply to this

Re: A Riddle

From what I understand, if you think you have it then you should NOT go to see your doctor (disclaimer - look into this yourself, this was simply read from another website). You should phone your local medical services and ask them for advice. People with flu going to the doctors is a great way to spread it.

Posted by: Jonathan on April 29, 2009 4:16 PM | Permalink | Reply to this

Re: A Riddle

If pigs could fly, then they could catch bird flu.

I heard on the radio this morning, while driving to teach a polyomino lesson in High School Geometry, that the government in Egypt has ordered that all pigs in Egypt be killed. Is this an appeasement of the Muslim Brotherhood?

I’ll have the Pork and Pigeon Pie, please, with a pint of Skeptically Bitters.

Posted by: Jonathan Vos Post on April 29, 2009 4:18 PM | Permalink | Reply to this

Re: A Riddle

Swine Flu Outbreak Illuminated By Avian Flu Research

ScienceDaily (Apr. 30, 2009) — A new study by University of Maryland researchers suggests that the potential for an avian influenza virus to cause a human flu pandemic is greater than previously thought. Results also illustrate how the current swine flu outbreak likely came about.

Posted by: Jonathan Vos Post on April 30, 2009 2:15 PM | Permalink | Reply to this

Re: A Riddle

I had influenza several years ago, and never want to repeat that experience. I had a mild dry cough when I went to bed one night, and woke up in the morning with a very bad cough and a very high fever. I went to a clinic and received antiviral drugs, but later was coughing so much that I was vomiting and couldn’t hold anything in my stomach. Then it was off to the ER for six hours where I was pumped with saline, anti-nausea drugs, and ibuprofen and tylenol to help bring down a very resistant fever. One of the doctors said he hadn’t been as sick as I looked in many many years. I was sent home, barely escaping hospitalization, with a week’s worth of high potency antibiotic (a flourquinilone). I also had sore throat, and very distorted taste perception. For example, coffee tasted like, well, hmmm, sludge from a pig farm. A week later I returned to work, but on the second day I was feeling horribly out of breath, returned to the clinic, and received two more weeks of antibiotics.

It’s not a good idea to stay away from a clinic or ER if you are very very sick and coughing. And now we have a great interest in tracking this epidemic, and we can’t do that well if we don’t go in and get tested. Just call ahead of time, make sure they know you are coming, and suggest that you will need a mask as soon as you arrive. They should have one ready for you.

Early last winter I picked up an awful respiratory virus at work that was definitely not influenza, but it eventually lead to acute problems in my lungs, to the extent that it sounded like I had several kazoos in there. I again went to the ER, and this time I did not leave the hospital for two days, put on IV antibiotics etc. Later I was told by someone my age (late fifties) that she knew several people who just tried toughing out that sort of thing, and they didn’t make it. If you’re really sick, don’t risk it, and take action.

Posted by: Richard on April 30, 2009 1:06 AM | Permalink | Reply to this

Re: A Riddle

Richard’s comments are well taken. I heard that diarrhea was a common symptom of the current pandemic. So “stomach” symptoms may be common. It is not necessarily the virus that kills you, but the dehydration will do you in.

Several years ago, I picked up a flu virus in a routine MD office visit. My entire family spent Christmas day huddled in bed. The children were small and the bed king-sized, but it was a no-fun Christmas. I have gotten vaccinated ever since.

Other tip: Watch your hands as you grade papers. As much as you want to slap your hand to your forehead and exclaim, “What was this student thinking?” you want to keep your hands away from your face. Also wash hands after grading.

Posted by: Scott Carter on April 30, 2009 1:51 AM | Permalink | Reply to this

Re: A Riddle

What were the antibiotics for? Were they expecting a secondary bacterial infection from the flu?

Posted by: Dan Piponi on April 30, 2009 2:02 AM | Permalink | Reply to this

Re: A Riddle

Dan,

I have an antibody deficiency that takes the form of an very weak antibody response to a wide class of bacteria. I’m now successfully treated with IVIG, but I still have a tendency to develop secondary bacterial infections in the presence of nasty respiratory viruses. But you don’t even need an immune deficiency of any kind to develop secondary infections with influenza. Many people get these with influenza, and susceptibility tends to increase as you age. These secondary infections are probably the most common causes of death with influenza. In my case it was prescribed immediately because they knew I was very probably going to get into trouble. It’s a big red flag if you have influenza and you’re finding yourself short of breath.

Just a note about the word flu. It’s very unfortunate that we’ve adopted this word because it appears to be short for influenza, but it isn’t. When doctors use that word, they are usually referring to an unpleasant virus of unknown identity. Influenza is a specific type of virus. I think the public gets very confused about all this.

Posted by: Richard on April 30, 2009 3:58 AM | Permalink | Reply to this

Re: A Riddle

I don’t pretend to know why the doctors prescribed in antibiotics in that particular case. But there does seem to be a growing consensus that secondary infections after influenza are a significant factor in deaths, eg,
most of the 1918 deaths were due to secondary bacterial infection after the influenza opened important pathways.

(Of course, it’s always difficult to tell with really recent research how much of the “importance” is just because it’s new research and will be later seen as a piece of the picture but nowhere near as significant as when first hyped up.)

Posted by: bane on May 1, 2009 12:32 PM | Permalink | Reply to this

Re: A Riddle

another (age-old) riddle then :

Who Elevated the Swine Influenza Pandemic Alert Level To Phase 5?

Well. WHO did.

who?

WHO did

who?

….

Posted by: ericv on April 30, 2009 5:27 AM | Permalink | Reply to this

Re: A Riddle

I had the flu last week, and the symptoms matched those of swine flu. It was no different than any other flu. I did some internet research and it appears (correct me if I’m wrong) that the symptoms are identical to “regular” flu. And I read that the possibility of higher than normal mortality rates during a flu pandemic is only attributed to the theory of large numbers.

Conclusion: Other than being transfered between pigs and humans (that’s what we get for eating pork!… ever hear of carrot flu??), which, of course, makes it even more communicable, the swine flu is essentially regular flu with Hollywood-caliber P.R.! It sells… newspapers, vaccines, kleenex, fear.

Pay no attention to that CDC rep behind the curtain, take a hot bath, and go to bed. It worked for me…

Posted by: Rose on April 30, 2009 2:57 PM | Permalink | Reply to this

Re: A Riddle

Rose:

First of all, it is the “regular” flu. It’s just a particular strain which has picked up a media-friendly name.

Second of all, it is not called swine flu because you get it from eating pork. It was transmitted from pigs to humans the same way it transfers from humans to other humans.

Further, what makes it “even more communicable” is that it has adapted to be transmissible both from pigs to humans and from humans to humans. There are strains which have one or the other property, but not both.

Please don’t push misinformation here, or grind what sound like political axes over people’s diets when that is completely irrelevant to the matter.

Posted by: John Armstrong on April 30, 2009 7:49 PM | Permalink | Reply to this

Re: A Riddle

Hi John Armstrong,

I’m sorry you misunderstood my post. I have agreed all along with nearly everything you said:

* This is just another strain of the “regular” flu… yes, that was precisely my point.

* It is NOT transferred via the ingestion of pork. I absolutely agree. Was it my pork comment that made you think I believed it was? Sorry about that. I was only inferring that the close contact humans have with their livestock exacerbates these mutations. (And the “carrot flu” comment was just a joke. Sorry you missed that one, it was some of my best work!) :)

From what I read, the real concern here is that influenza, which is already potent enough in the human-to-human transmittable form, has mutated to a swine-to-human transmittable form, and may mutate yet to an even more proficiently transmittable form.

No politics, no axes, and no misinformation intended.

Take care, John Armstrong.

Posted by: Rose on April 30, 2009 9:40 PM | Permalink | Reply to this

Re: A Riddle

John,

It’s my understanding that it is not “regular” flu, and that it’s actually an unusual genetic mix of human, swine, and avian influenzas. Someone correct me if I’m wrong.

Posted by: Richard on April 30, 2009 10:42 PM | Permalink | Reply to this

Re: A Riddle

Yes, Richard, it’s a new strain with some new properties due to what amounts to cross-breeding, including easy transmissability from humans to humans. The symptoms, though, and the threat to life are pretty much identical. Reason to be careful, especially if you’re young, old, or already sick, but not reason to panic.

Posted by: John Armstrong on May 1, 2009 5:43 AM | Permalink | Reply to this

Re: A Riddle

what is it, if you have high flu and i lo flu?

solution: a no help flu

Posted by: nobody on April 30, 2009 5:11 PM | Permalink | Reply to this

Q: What is the scariest sound?

A: AHH-CHOOINK

Actually, pigs do sneeze which is most definitely how swine flu is transmitted to humans. A quick google turns up this transmission video though with more search I could probably find a more profoundly sneezing pig.

Posted by: RodMcGuire on May 1, 2009 8:56 AM | Permalink | Reply to this

Re: A Riddle

Some news:

A quote:

“There does seem to be a rule of thumb about this, which is that every pandemic in the 20th century essentially established the variants that would become the circulating seasonal influenzas until the next pandemic came along to displace them,” Morse [of Columbia University] says.

Each shift led to a stronger-than-usual flu season, but each one also calmed down after a year or two, once the population became exposed to the new viruses or were vaccinated. Morse says the question now is whether the new, H1N1 swine virus will keep moving from person-to-person efficiently.

“If it continues like that, we’ll expect to see this virus chugging along, and probably the next seasonal influenza will be a descendent of this one,” Morse says.

The question, then, is how nasty the virus will end up being. Professor John Oxford at St. Bart’s and the Royal London Hospital says there’s some reason for cautious optimism.

“In one sense it’s one of the mildest shifts because most people on the planet have got some memory, have come across H1N1 viruses since 1978.”

Even though health officials are calling this new virus H1N1, that’s also the type of virus that’s in wide circulation today. And it has an interesting history. It was the dominant flu virus through the 1920s, ’30s and ’40s. Oxford says it disappeared in 1957, when it was displaced by another flu virus. But then a strain of H1N1 suddenly reappeared in 1977.

“Now where could it have come from?” he asks. “We reckon now, in retrospect, it was probably released accidentally from a laboratory, probably in northern China or just across the border in Russia, because everyone was experimenting with those viruses at the time in the lab.”

It was nothing malicious, Oxford believes, just some flu vaccine research that broke out of containment. The descendents of this virus are still circulating. He notes that most people who have encountered the newly emerged H1N1 virus seem to have developed only mild disease, and he speculates that’s because we have all been exposed to a distant cousin, the H1N1 virus that emerged in the 1970s.

“That escaped virus perhaps will provide some benefit now in the face of this pig thing,” Oxford says.

This is well-informed speculation, not iron-clad assurance. And there is another less reassuring lesson from the previous big shifts in flu viruses. They caused mild disease when they first appeared in the spring, but they all caused big flu seasons when they returned in the fall as the new dominant virus. That’s one reason that health officials are taking the new virus very seriously.

Posted by: John Baez on May 4, 2009 4:08 AM | Permalink | Reply to this

Re: A Riddle

This speculation agrees with my own. Despite the fact that my state has gone from zero to over 100 suspected cases within a few days, I think that it will soon fizzle out as summer arrives. The viral genes (actually RNA, not DNA, I think) have traveled so extensively already, though, that they are probably permanently established in the wild, and will definitely return.

What I find very curious is how one variety of influenza can edge out another to the point where the other is completely submerged. By what mechanism does that happen? Why can’t they coexist? Does one perpetrate a kind of biological warfare against the other?

An amusing aspect to this news story is how panicky people are responding to it. Masks at all of our Walgreen’s drug stores and at their warehouse sold out within a few days that this news story broke, and well before there were any reported cases in my state. I remember that when I was a kid I had not only influenza and colds, but measles, german measles, scarlet fever, mumps, tonsils that had to be removed when I was 2, and an almost burst appendix in the second grade. I never had polio, but I remember the iron lungs and the sugar cube vaccinations. Our current situation just seems to pale in comparison.

Posted by: Richard on May 5, 2009 4:00 AM | Permalink | Reply to this

Re: A Riddle

A strain that has been widespread induces immunity in its host; this tends to damp down the incidence of infection, and the more immune individuals there are, the less virus there is in the population. This in turn results in an increasing number of individuals who have never been exposed to the disease, and consequently aren’t immune. Eventually their numbers reach the point where the strain is able to recover and cause another epidemic, although, from small numbers, this will take a time to build up. This is typical of predator/prey and parasite/host cycles.

Even when most people are immune to one strain (due to recent or not-so-recent exposure), they may still be vulnerable to other strains, so multiple cycles are going on, somewhat out of phase with each other. I’d guess that there is a lot of randomness in the relative phases of cycles and which strain, if any, causes an epidemic at any given time. (Perhaps there is also some cross-immunity between similar strains—don’t know anything about this, but it would allow the success of one strain to impact the success of another. Is there an epidemiologist in the house?) The great pandemics are caused by the appearance of new strains. The issue is complicated somewhat by the seasonality in flu epidemics.

Posted by: Tim Silverman on May 5, 2009 11:37 AM | Permalink | Reply to this

FLU is RNA Virus; Re: A Riddle

This Wikipedia data has not been double checked my me against biomedical literature.

The Orthomyxoviridae (orthos, Greek for “straight”; myxa, Greek for “mucus”)[1] are a family of RNA viruses that includes five genera: Influenzavirus A, Influenzavirus B, Influenzavirus C, Thogotovirus and Isavirus. The first three genera contain viruses that cause influenza in vertebrates, including birds (see also avian influenza), humans, and other mammals. Isaviruses infect salmon; thogotoviruses infect vertebrates and invertebrates, such as mosquitoes and sea lice.

2 a b “Index of Viruses - Orthomyxoviridae (2006). In: ICTVdB - The Universal Virus Database, version 4”. Columbia University, New York, USA. 2006. http://http://lemonparty.com//ICTVdb/Ictv/fs_index.htm.
3 Jones LD, Nuttall PA (1989). “Non-viraemic transmission of Thogoto virus: influence of time and distance”. Trans. R. Soc. Trop. Med. Hyg. 83 (5): 712–4. doi:10.1016/0035-9203(89)90405-7. PMID 2617637.
4 Barry Ely (1999). “Infectious Salmon Anaemia”. Mill Hill Essays. National Institute for Medical Research. http://www.nimr.mrc.ac.uk/MillHillEssays/1999/isa.htm. Retrieved on 2007-09-14.
5 Raynard RS, Murray AG, Gregory A (2001). “Infectious salmon anaemia virus in wild fish from Scotland”. Dis. Aquat. Org. 46 (2): 93–100. doi:10.3354/dao046093. PMID 11678233.

Posted by: Jonathan Vos Post on May 5, 2009 8:31 PM | Permalink | Reply to this

Re: A Riddle

New details on swine flu are on today’s Science article.

Posted by: Christine Dantas on May 29, 2009 2:49 PM | Permalink | Reply to this

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