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Reflections on the Current H1N1 Flu

10/05/2009 2:00 PM 34"401
John M. Barry, Author

Description: John M. Barry brings unsettling news from the frontlines of H1N1 research: this novel influenza virus is very hard to pin down. In spite of international scientific scrutiny, H1N1 continues to baffle and elude, worrying health officials defending against the pandemic, and challenging some ideas about influenza in general. Says Barry, "A lot of things we thought we knew, the virus demonstrates we knew wrong."

Barry examines the current pandemic in both historic and scientific context. Most influenza viruses share certain features: They can jump to other species by way of mutation, or by mixing genetic components with another virus that happens to be infecting the same cell at the same time. Influenza pandemics go "as far back in history as we can look," with 10 occurring in just the last 300 years. Four of the most recent pandemics appear to have rolled out in waves of varying lethality, infecting at peak times some 30% of the human population.

Before last year, the latest pandemic threat seemed to be H5N1, an avian flu jumping to humans. But, says Barry, "while we were all looking at H5N1, this H1N1 virus snuck up on usand we have no idea yet how serious it will be." The problem for researchers is that H1N1 simply won't behave in predictable ways. When ordinary influenza viruses are transmissible between humans, novel molecular markers are present. The current H1N1 doesn't bear these markers, yet is transmissible. There are conflicting reports on whether this flu is more infectious than the seasonal flu. There's evidence that some people over 60 are resistant, perhaps because they carry antibodies to previous influenzas. And although H1N1 doesn't exhibit conventional molecular tags for virulence, it is virulent. Unlike seasonal flu, when H1N1 kills, it targets younger people, and it does so through viral pneumonia, as opposed to complicating bacterial infections. "Depending on how you ask the question, it's either extraordinarily mild, more mild than seasonal flu, or more than 100 times as virulent as seasonal influenza."

While H1N1 seems stable for the moment, and to some, unthreatening, its path can't yet be plotted. Some of the most infamous flu epidemics take two years to travel around the world, moving from sporadic activity to "blanketing the entire globe and causing enormous morbidity numbers." If this flu takes off, history tells us, short of a "retreat on a Vermont mountain with shotguns," there will be nowhere to hide, says Barry. "This virus is going to find me."

About the Speaker(s): John M. Barry is a prize"winning and New York Times best"selling author whose books have won more than twenty awards. In 2005 the National Academy of Sciences named The Great Influenza, a study of the 1918 pandemic, the year's outstanding book on science or medicine, and the Center for Biodefense and Emerging Pathogens gave Barry its 2005 "September Eleventh Award." Rising Tide: The Great Mississippi Flood of 1927 and How It Changed America, won the 1998 Francis Parkman Prize of the Society of American Historians for the year's best book of American history. Barry serves on advisory boards at MIT's Center for Engineering Systems Fundamentals, the Johns Hopkins Bloomberg School of Public Health, and on a federal government Infectious Disease Board of Experts. He has advised federal, state, and World Health Organization officials on influenza, crisis management, and risk communication. He has been keynote speaker at a White House Conference on the Mississippi Delta and he has lectured at the National War College, Harvard Business School, and in many similar venues. He is also co"originator of Riversphere, a $100 million center being developed by Tulane University which will be the first facility in the world dedicated to comprehensive river research.

Host(s): School of Engineering, Center for Engineering Systems Fundamentals

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MIT World — special events and lectures

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