Why experts are certain another influenza pandemic will occur
It's been 100 years since the world's last deadliest flu pandemic. Experts warn that another one is inevitable, but are we ready?
- 100 years ago, the Spanish Flu killed over 50 million people.
- According to the Centers for Disease Control and Prevention, over 80,000 Americans died of the flu last winter.
- Experts stress that the world needs to take precautions and prepare for the next pandemic.
Humans have been fighting the influenza virus for millenia. We've discovered new strains throughout the years and also devised greater methods for eradicating them along the way. But on the 100th year anniversary of the Spanish Flu pandemic, it's more important now than ever that we look back at one of the deadliest pandemics the world has ever faced.
Our global village is tied together in such a way that it makes containing a localized infection nearly impossible. Through air, freight-train and onwards through land and sea, the most populous and densely packed cities in the world are now just a stone's throw away.
The possibility that another epidemic could sweep through the world and claim millions of lives is no surprise to the experts. After all, it's happened before.
History of the Spanish flu pandemic of 1918
Let's look back at how the Spanish flu first got its start.
It was the fall of 1918 and the First Great War in Europe was just winding down. Americans had been shipped overseas and were helping assist the Allies as they fought against the Germans. Soldiers around the globe dug out and wintered through trenches in horrible and brutal conditions. They had probably thought they'd seen the worst of things by this point.
Lurking just somewhere over the horizon, however, was one of the deadliest flus the world would ever face.
Over a third of the world's population became infected. Erupting in pockets around the globe the outbreaks swept through Asia, Europe, Africa and America by bustling trade routes. Many also suspected rapid troop movement assisted in the spread of the disease. Around 675,000 Americans died of influenza during the two year pandemic.
The intensity and speed in which the pandemic struck was unfathomable at the time. With over 500 million people infected and an estimated 50 million deaths worldwide, the global death toll eclipsed even World War I casualties. The disease is not "Spanish" in origin per say, but because of wartime censorship in other countries, Spain was the first to report of the pandemic.
Our most recent flu seasons pale in comparison to the great plight wrought from the Spanish flu.
Latest trends in America’s flu seasons
For the most part, vaccinations, antibiotics and better global hygiene has drastically reduced the effects of influenza and other associated diseases. But viruses never rest — and they never stop evolving.
Officials at the Centers for Disease Control and Prevention have estimated that a preliminary figure of last year's winter flu season was around 80,000 deaths. This figure may be revised, but it's unlikely the numbers will go down. Dr. Daniel Jernigan, a CDC flu expert, believes that the deaths were higher than usual because there are both more Americans and more elderly people now.
Luckily, Jernigan believes that next year's flu season is stacking up to be both a milder strain and also more receptive to vaccination. "We don't know what's going to happen," he said, "but we're seeing more encouraging signs than we were early last year."
While we might be all right for the upcoming flu season. Others warn that a hidden virus could jumpstart a new global pandemic.
The U.S is not ready for a major pandemic
One of the worst case scenarios in the short term, could be the release of a hidden, lethal and highly infectious flu strain that breaks out into a crowded city. According to the John Hopkins' Bloomberg School of Public Health, this would be devastating for an unprepared city that lacked a strong public health infrastructure.
A fast moving virus could hitch a ride from one city to a next and spread internationally before health officials even knew what hit humanity. Scientists at John Hopkins believe that avian influenza viruses pose the greatest risk if they evolve into deadlier strains. Amesh Adalja from the Center of Healthy Security at John Hopkins states: "In terms of pandemic potential, an avian influenza virus is thought to be a likely candidate, based on prior pandemics."
Yet, there are safeguards that didn't exist 100 years ago we can use to preemptively ward off a potential flu pandemic.
For example we can:
- Improve vaccine research and deployment. Funding for high-priority vaccines is a must to create herd immunity.
- Increase pandemic preparation funding. Public health officials need to be able to deal with a multiple of infected at once.
- Create a global response network that can quickly intervene in a pandemic. For example, the World Health Organization (WHO) needs a counterpart that can take action once any kind of pandemic has been declared.
The more we do to combat these diseases now, the less risk we have for another worldwide pandemic later.
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Young people could even end up less anxiety-ridden, thanks to newfound confidence
- The coronavirus pandemic may have a silver lining: It shows how insanely resourceful kids really are.
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Philosophers like to present their works as if everything before it was wrong. Sometimes, they even say they have ended the need for more philosophy. So, what happens when somebody realizes they were mistaken?
Sometimes philosophers are wrong and admitting that you could be wrong is a big part of being a real philosopher. While most philosophers make minor adjustments to their arguments to correct for mistakes, others make large shifts in their thinking. Here, we have four philosophers who went back on what they said earlier in often radical ways.
New research establishes an unexpected connection.
- A study provides further confirmation that a prolonged lack of sleep can result in early mortality.
- Surprisingly, the direct cause seems to be a buildup of Reactive Oxygen Species in the gut produced by sleeplessness.
- When the buildup is neutralized, a normal lifespan is restored.
We don't have to tell you what it feels like when you don't get enough sleep. A night or two of that can be miserable; long-term sleeplessness is out-and-out debilitating. Though we know from personal experience that we need sleep — our cognitive, metabolic, cardiovascular, and immune functioning depend on it — a lack of it does more than just make you feel like you want to die. It can actually kill you, according to study of rats published in 1989. But why?
A new study answers that question, and in an unexpected way. It appears that the sleeplessness/death connection has nothing to do with the brain or nervous system as many have assumed — it happens in your gut. Equally amazing, the study's authors were able to reverse the ill effects with antioxidants.
The study, from researchers at Harvard Medical School (HMS), is published in the journal Cell.
An unexpected culprit
The new research examines the mechanisms at play in sleep-deprived fruit flies and in mice — long-term sleep-deprivation experiments with humans are considered ethically iffy.
What the scientists found is that death from sleep deprivation is always preceded by a buildup of Reactive Oxygen Species (ROS) in the gut. These are not, as their name implies, living organisms. ROS are reactive molecules that are part of the immune system's response to invading microbes, and recent research suggests they're paradoxically key players in normal cell signal transduction and cell cycling as well. However, having an excess of ROS leads to oxidative stress, which is linked to "macromolecular damage and is implicated in various disease states such as atherosclerosis, diabetes, cancer, neurodegeneration, and aging." To prevent this, cellular defenses typically maintain a balance between ROS production and removal.
"We took an unbiased approach and searched throughout the body for indicators of damage from sleep deprivation," says senior study author Dragana Rogulja, admitting, "We were surprised to find it was the gut that plays a key role in causing death." The accumulation occurred in both sleep-deprived fruit flies and mice.
"Even more surprising," Rogulja recalls, "we found that premature death could be prevented. Each morning, we would all gather around to look at the flies, with disbelief to be honest. What we saw is that every time we could neutralize ROS in the gut, we could rescue the flies." Fruit flies given any of 11 antioxidant compounds — including melatonin, lipoic acid and NAD — that neutralize ROS buildups remained active and lived a normal length of time in spite of sleep deprivation. (The researchers note that these antioxidants did not extend the lifespans of non-sleep deprived control subjects.)
Image source: Tomasz Klejdysz/Shutterstock/Big Think
The study's tests were managed by co-first authors Alexandra Vaccaro and Yosef Kaplan Dor, both research fellows at HMS.
You may wonder how you compel a fruit fly to sleep, or for that matter, how you keep one awake. The researchers ascertained that fruit flies doze off in response to being shaken, and thus were the control subjects induced to snooze in their individual, warmed tubes. Each subject occupied its own 29 °C (84F) tube.
For their sleepless cohort, fruit flies were genetically manipulated to express a heat-sensitive protein in specific neurons. These neurons are known to suppress sleep, and did so — the fruit flies' activity levels, or lack thereof, were tracked using infrared beams.
Starting at Day 10 of sleep deprivation, fruit flies began dying, with all of them dead by Day 20. Control flies lived up to 40 days.
The scientists sought out markers that would indicate cell damage in their sleepless subjects. They saw no difference in brain tissue and elsewhere between the well-rested and sleep-deprived fruit flies, with the exception of one fruit fly.
However, in the guts of sleep-deprived fruit flies was a massive accumulation of ROS, which peaked around Day 10. Says Vaccaro, "We found that sleep-deprived flies were dying at the same pace, every time, and when we looked at markers of cell damage and death, the one tissue that really stood out was the gut." She adds, "I remember when we did the first experiment, you could immediately tell under the microscope that there was a striking difference. That almost never happens in lab research."
The experiments were repeated with mice who were gently kept awake for five days. Again, ROS built up over time in their small and large intestines but nowhere else.
As noted above, the administering of antioxidants alleviated the effect of the ROS buildup. In addition, flies that were modified to overproduce gut antioxidant enzymes were found to be immune to the damaging effects of sleep deprivation.
The research leaves some important questions unanswered. Says Kaplan Dor, "We still don't know why sleep loss causes ROS accumulation in the gut, and why this is lethal." He hypothesizes, "Sleep deprivation could directly affect the gut, but the trigger may also originate in the brain. Similarly, death could be due to damage in the gut or because high levels of ROS have systemic effects, or some combination of these."
The HMS researchers are now investigating the chemical pathways by which sleep-deprivation triggers the ROS buildup, and the means by which the ROS wreak cell havoc.
"We need to understand the biology of how sleep deprivation damages the body so that we can find ways to prevent this harm," says Rogulja.
Referring to the value of this study to humans, she notes,"So many of us are chronically sleep deprived. Even if we know staying up late every night is bad, we still do it. We believe we've identified a central issue that, when eliminated, allows for survival without sleep, at least in fruit flies."
We must rethink the "chemical imbalance" theory of mental health.
- A new review found that withdrawal symptoms from antidepressants and antipsychotics can last for over a year.
- Side effects from SSRIs, SNRIs, and antipsychotics last longer than benzodiazepines like Valium or Prozac.
- The global antidepressant market is expected to reach $28.6 billion this year.