This is an interesting question – would it be better to allow a first wave of swine flu infection spread in order to build immunity to a more deadly strain should the virus mutate?
The question is prompted by groundbreaking research published in the Journal of Infectious Diseases on the Spanish Flu pandemic of 1918. The research suggests that it may be better to allow a first wave of swine flu infection in order to prevent deaths on a mass scale especially if the swine flu virus mutates in a similar process to the flu pandemic of 1918.
The research found that people who were initially infected by a mild form of the Spanish flu virus were better inoculated against the deadly strain that soon emerged to kill 40 million people worldwide. The death rate amongst this group was approximately 70 per cent lower. The report stated that:
Exposure to influenza in the spring and summer of 1918 provided mortality and morbidity protection during the fall pandemic wave. The intensity of the first wave may have differed across US cities and countries and may partly explain geographical variation in pandemic mortality rates in the fall. Pandemic preparedness plans should consider that immune protection could be naturally acquired during a first wave of mild influenza illnesses.
Lone Simonsen an epidemiologist at Georgetown Washington University and one of the co-author’s of the study said, “In 1918, with the benefit of 20/20 hindsight, it would have been better to allow a first wave of infection in order to build immunity to the merging virus while it was still mild.” However it remains to be seen whether swine flu will behave in the same way as Spanish flu.
The research comes at a time when new thinking is required to meet the challenges of diseases in the 21st Century. In an article by Larry Brilliant an epidemiologist and Chairman of the National Bio-surveillance Advisory Subcommittee, he says, “And there is worse news: The 2009 swine flu will not be the last and may not be the worst pandemic that we will face in the coming years. Indeed, we might be entering an Age of Pandemics. In our lifetimes, or our children’s lifetimes, we will face a broad array of dangerous emerging 21st-century diseases, man-made or natural, brand-new or old, newly resistant to our current vaccines and antiviral drugs. You can bet on it.”
Some of the intricate interrelationships between environmental degradation and the increased contact between humans and animals, population growth, climate change, economic and social problems all demand an integrated approach to meet the challenges of disease in the new century.
As Larry Brilliant says, “Reducing the number of terrible forms of suffering is what we all want, but I fear that if we don’t take seriously the factors that could make the next decade the Age of Pandemics, we will start moving backward, adding lethal diseases…” This is where projects like the Global Viral Forecasting Initiative illuminate the intellectual shifts needed to shape this century.
While I have no reason to question the conclusions come to by Barry, Viboud, and Simonsen in the case of “Spanish flu” I find it highly improbable that any government would be willing to put this suggestion into practice. Not only would a government that did nothing while people died be thrown out of office, there are a lot of assumptions involved that make such reccommendations suspect. There’s no reason to assume that there would be a second wave if the virus was contained the first time, or, if there was, there’s no guarantee that a new variant wouldn’t sweep through and take public officials by surprise when they were expecting a reduced emergency the second time around. Wouldn’t initiating containment measures be the best approach for slowing the influenza’s spread and the development of a vaccine a more likely means of defense?
I can’t believe that, if we are entering an “Age of Pandemics,” that doing nothing is really the best approach. There are other preventative measures that should certainly be taken before such pandemic preparedness plans are put into practice.
I find it highly improbable that any government would be willing to put this suggestion into practice.
The hip way to build immunity is apparently to attend a swine flu party
The CDC has stated that it "does not recommend swine flu parties as a way to protect against novel H1N1 flu in the future.
What about a swine flu tupperware party? Just don’t open that tupperware!
This NYT article has more on the parties.
I can’t help finding the idea of ‘swine flu parties’ incredibly selfish and shortsighted: so maybe – if you’re lucky and don’t get severely ill – you’ll acquire boosted immunity… but how many other people (who may not be as lucky) do you risk getting sick in the process?!
As the NYT article makes clear, the assumption that infection now — while the virus seems relatively mild — is just that, an assumption. While it may seem to build on the logic of using attenuated viruses as vaccines (which can be very effective – as in the case of poliovirus), there is not enough data at this stage to ensure that actively promoting infection now is the right way to go.
Eric I would agree with you, from my research so far it would seem that containment is the best approach as it needs to be seen just how virulent the virus actually is, and how it adapts. Simonsen also said that the containment strategy being implemented may actually work.
If anyone is going to a swine flu party one should not leave without their designer surgical mask!
Would allowing it to spread not make it more likely to mutate in the first place?
Apologies for the late reply Global Changes. There are people far more qualified to answer your question. This is interesting from RAND, Getting Ready for the Next Flu Epidemic.
As of today, June 3, we still cannot predict a second wave. But we have seen the patterns and rates of the current first wave. Is anyone ready to support the policy of letting this first encounter with the virus run its course free in exchange for the possibility of payback when a probable second wave comes (immunity)? I am writing this from a third world country where politics, economy, cultural patterns, housing conditions, and vaccine availability (when a vaccine is developed) are all factors that seem to be AGAINST the current containment official policy. This virus is unstoppable. So please, let´s be real. Give me real options.