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ziggy (25)

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Journal of ziggy (25)

Wednesday November 02, 2005
10:44 PM


[ #27426 ]

I read John Barry's The Great Influenza recently. I read Gina Kolata's book on Flu when it came out, as well as Laurie Garrett's The Coming Plague about a decade ago. (Although the subjects sound bleak, the writing is excellent and topical.)

This new book on Flu was already on my bookshelf and my to-read list before W. gave it high praise right before the fear-of-a-pandemic news cycle started last month. Worrying about pandemic flu is so fashionable, it's easy to forget that Barry's book is some of the best popular science writing of recent memory. It would be a must-read even if it weren't so topical.

The Great Influenza is a very scary story, so scary that it makes 28 Days Later seem about as light-hearted as Fantasia. Doubly so because it was real, and most lethal among the healthiest part of the population -- 18 to 40 year olds (i.e., pretty much all of us). Triply so because the best and brightest minds in the world were completely stumped by this disease for a few years after the pandemic. Easily a must-read, because we must learn the lessons of this story if we are to avoid repeating them.

Back in 1918, the H1N1 strain was responsible for killing more people in less than 24 weeks than AIDS has killed in 24 years. H1N1 was also responsible for more deaths than war-related casualties from WWI.

But that's not the whole story. Influenza wasn't the proximate cause of death in many of those cases. Flu's primary mode of attack is through the lungs; once it compromises the immune system, the lungs are defenseless against pneumonia, bronchitis and other opportunistic infections.

In some cases, especially among the young and healthy, flu attacked the lungs so fast that many woke up perfectly healthy in the morning, and were dead by dinnertime. Today, some of those people would be recognized as suffering from ARDS, or acute respiratory distress syndrome, where a young person's fully primed immune system overreacts to the invading flu virus, and fills the lungs with antibodies so fast that the lungs shut down. Ick.

Yet for all of the death, H1N1 had approximately a 5% mortality rate overal. Double that in 18 to 40 year olds, and even higher in some areas (like Army camps, where thousands of GIs were gathered before shipping out to the front). In non-lethal infections, the symptoms were bad enough that weeks of bed rest was the best treatment -- not your typical three-days-and-back-to-work influenza. And, all that time, you're worrying if you would be one of the 5% or the 95%. Worse yet, if you were healthy, you were worrying about catching the flu, or perhaps being one of those unlucky souls that got sick and died in the same day.

All of this is quite sobering, especially because a flu capable of becoming a global pandemic will reappear, probably in our lifetimes.

Kinda makes "Perl vs. PHP" and "Windows vs. Linux vs. OpenSolaris" and other such permathreads sound even more pointless by comparison.

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  • We are a specialist society, and some of us choose to specialize in computer languages.

    If we are dead, then it won't matter, but if we survive, then we will still need our specialties.

    I know that there is a small hoard of folks, mostly in Atlanta, that spend all of their waking hours analyzing the next potential threat. This is their specialty, and I'm happy to indirectly support them in their mission.

    For this reason, I try not to worry about things like the Flu. If I were too worried, I would have to

    • Some specialties have a large impact, while other specialties don't.

      I can trust that civil engineers are going to do their job when they design a bridge, and that there are sufficient checks and balances (read: board certifications, regulations, inspections) that their creations are a net benefit to society. For example, Galloping Gertie [] is well known because it isn't a frequent occurrance. And when it was recognized that the bridge was experiencing catastrophic failure, everyone was kept away and no one