Spanish Flu 1918 & immune system

marzinn wrote: ....... watching and waiting are the key words.

And remainging calm, there being nothing to worry about?

...that sounds just like a page out of the government's 1918 playbook. 

Pardon the poke, but I don't think anybody is seriously going about stating that we should fatigue, stress or otherwise trash our immune systems so that when we get sick our "weakened"  immune systems will save us.  However, it appears pretty documented that  cytokine storm and its sequelae is the primary cause of death in both 1918 and the current AF.  Since that is a "strong" immune response, naturally there has been talk of "weakening" it.   A wholly different ball game.

I, myself, desire a strong body and immune system: but I do NOT want a strong immune response to Avian Flu, God forbid I or my family should get it. That has not been shown to be helpful anywhere that I've seen. So, how do we walk that line? Who knows?  Who's had to before?

Personally, I'm going to exercise and take generally health promoting supplements, but, should the AF go H2H, I plan on augmenting with Vit E, D, Selenium and Curcumin, to some extent.  I haven't decided on a balance yet.  Some of these are just starting to show promise in reducing infection and increase immune response while at the same time reducing inflammatory response.

Hopefully this is all in the realm of idle talk

Oh good discussion Bannor.

The light bulb has just went off for me!

Yes, of course it is not the strength of the immune system but the strength of the immune response that causes the cytokine storm.

My next question would then be what is the relation between a healthy vs. compromised immune system and a cytokine storm response?

Also where do you get your information on how best to control a cytokine storm? You mention supplements you are going to try to find a balance with.

Need more input....................

--------the story continues so click the link for more info..

the last part reads:

CHEMICAL STORM

The H5N1 viruses brought in a storm of cytokines -- the immune system's signalling chemicals -- including IP-10, interferon beta, RANTES and interleukin-6.

And the later, Vietnamese strains caused a bigger cascade than the 1997 strain.

This could be because of continued mutations, the researchers said. "The H5N1 viruses have continued to reassort, acquiring different internal genes from other influenza viruses of avian origin," the researchers wrote.

The study, published on the Internet at http://respiratory-research.com/, explains the severe respiratory distress suffered by H5N1 patients, who often say they struggle to breathe.

Michael Osterholm, an infectious disease expert at the University of Minnesota who has been advising the US government on the risks of a flu pandemic, said the study supports predictions that any possible H5N1 pandemic would be especially severe.

It means being young and healthy could actually work against people who become infected.

"Anyone could experience this very severe, life-threatening illness," Osterholm said in a telephone interview.

"This is looking more and more like an H1N1 1918."

The worst recorded influenza epidemic was in 1918, when an H1N1 strain swept the globe in a few months, killing anywhere between 20 million and 100 million people, depending on the estimate. In comparison, a pandemic in 1957 killed 2 million and one caused by an H3N2 virus in 1968 killed 1 million.

"In 1918, even among the very young and the very old, there was a ten-fold increase in deaths," Osterholm said. "There was a 1,000-fold increase in young adults."

This, in turn, could be bad news in trying to treat an pandemic, Osterholm said. Antiviral drugs such as Tamiflu and Relenza can help if given within a day or so of infection.

"The idea that we may have 24 to 48 hours is based on the H3N2 model," Osterholm said. But if patients develop respiratory distress from a cytokine storm, even that may be too late, he said.

------------------------------------------------------------ -------

The strongest evidence comes from the clinical presentation of virulent influenza cases and the evidence in mice that infection with influenza virus carrying the HA gene from the 1918 virus seems to strongly activate some immune cells to over-produce a half dozen or more cytokines. An animation from The New England Journal article on H5N1 influenza by Mike Osterholm is meant to illustrate how a positive feedback could cause a cytokine storm, but it is only suggestive of one possibility, because we don’t know how a cytokine storm is produced in influenza (if indeed it is).

However, it is reasonable and plausible to say cytokine dysregulation might be involved in some virulent influenza infections. In desperation, clinicians have treated patients with potent anti-inflammatory drugs, usually steriods. There is no evidence that this helps. A “cytokine storm” of a more limited nature is sometimes seen in cancer chemotherapy patients, where it is treated in its earliest stages by iv. benadryl and steroids, with some success. However in these cases, there is no infectious agent involved; even if steroids worked for influenza-induced cytokine storm, they cause a general downshift of the immune system which might allow the virus to run rampant and kill the patient via ordinary viral pneumonia. In ordinary infection-related sepsis, steroids are shown to slightly increase mortality (Crit Care Med. 1995 Aug;23(8):1430–9.) This is but one of the complicating considerations that clinicians will have to navigate during an outbreak.

<<<<This is a bird flu website , isn't it?..that is what we are talking about ...we know much of what is being studied is also still unknown and unwritten about bird flu. If they knew everything they would have the vaccine. But are you going to say Osterholm is wrong? 

 Key word is cytokine dysregulation-weak , strong , healthy who knows what  goes haywire due to the virus.  Cytokines are as follows:>>>>>>>

Cytokines are important components of the immune system that act as messages between cells. In this context, the purpose of the immune system is to protect us from microbial infection (viruses, bacteria, parasites, fungi).

<<<<<<This has been my point all along. >>>>>

http://health.ivillage.com/infectious/infflu/0,,wbnews_8ft7r hnw,00.html

FRIDAY, Nov. 11 (HealthDay News) -- As concern mounts over the potential spread of avian flu to humans, researchers believe they've discovered one reason why the infection can prove so deadly.

Experiments with human cells have found the H5N1 virus can trigger levels of inflammatory proteins called cytokines and chemokines that are more than 10 times higher than those that occur during a bout of the common flu.

This massive increase in cytokine and chemokine activity can inflame airways, making it hard to breathe. It also contributes to the unusual severity of the avian flu, which can result in life-threatening pneumonia and acute respiratory distress.

According to the latest World Health Organization data, 125 cases of human H5N1 infection have been reported worldwide, including 64 deaths. All of these cases have occurred in Southeast Asia, and involved bird-to-human transmission. However, experts warn that if the virus mutates so that it can pass from human to human, a global pandemic could ensue.

Reporting in the Nov. 11 online edition of Respiratory Research, Michael Chan from the University of Hong Kong and his collaborators in Vietnam looked at the levels of cytokines and chemokines in human lung tissue exposed to the H5N1 virus.

They compared protein levels induced by strains of the H5N1 virus with levels induced by a more common, less virulent human flu virus, called H1N1.

Chan's team found that H5N1 induces more pro-inflammatory proteins than H1N1. After infection with H5N1, levels of the chemokine IP-10 in bronchial epithelial cells reach 2200 picograms per milliliter , compared with only 200 picograms per milliliter in cells infected with H1N1. Similar results were found for levels of other chemokines and cytokines.

"The recent re-emergence of H5N1 disease in humans is a cause for renewed pandemic concern and highlights the need for a better understanding of the pathogenesis of human H5N1 disease," the study authors wrote. "Such understanding will lead to new strategies for managing human H5N1 disease and enhance our preparedness to confront pandemic influenza, whether from H5N1 or other influenza A subtypes."

One expert said the findings are in line with symptoms seen so far in patients infected with the avian flu strain.

"These findings fit with what we see clinically," said Dr. Christian Sandrock, an assistant professor of pulmonary critical care and infectious diseases at the University of California Davis. "This is what we would expect with this virus."

When the H5N1 virus comes into contact with the cells of the trachea and small air sacs in the lungs, it drives up the production of these cytokines, Sandrock explained. The cytokines trigger inflammation, a normal response by the body to help fight the virus.

"The problem is that sometimes the inflammation can be so bad there's collateral damage," he said. "That collateral damage can cause inflammation and damage to your lungs enough so that you are unable to breathe, and you get acute respiratory distress."

The findings provide a scientific reason for what is being seen clinically, Sandrock said. "But there's still a lot we don't know," he added.

"This study confirms earlier work that H5N1 induces a cytokine 'storm,'" said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota School of Public Health, in Minneapolis. "It helps us understand the pathophysiology of the disease."

The noted increase in cytokine production is what distinguishes avian flu from other flu, Osterholm said. "The hyperproduction of cytokines is very relevant. It points out that the way people actually experience severe illness with this virus is different than what we see with other influenza viruses."

"This is basically a cytokine storm induced by this specific virus, which then leads to respiratory distress syndrome," Osterholm said. "This also makes sense of why you tend to see a preponderance of severe illness in those who tend to be the healthiest, because the ability to increase the production of cytokines is actually higher in those who are not immune-compromised. It's more likely in those who are otherwise healthy."

More information

Find out more about avian flu at the U.S. Centers for Disease Control and Prevention.

SOURCES: Michael T. Osterholm, Ph.D., professor, public health, and director, Center for Infectious Disease Research and Policy, University of Minnesota School of Public Health, Minneapolis; Christian Sandrock, M.D., M.P.H., assistant professor, pulmonary critical care and infectious diseases, University of California, Davis; Nov. 11, 2005, Respiratory Research online

This is a story from HealthDay, a service of ScoutNews, LLC.

Please don't discount a natural remedy which seems to have some validity-

Kimchi-

http://news.bbc.co.uk/1/hi/world/asia-pacific/4347443.stm

Korean dish 'may cure bird flu'

By David Chazan BBC News Kimchi is a traditional staple of Korean cuisine South Korea's spicy fermented cabbage dish, kimchi, could help to cure bird flu, according to researchers. Scientists at Seoul National University say they fed an extract of kimchi to 13 infected chickens - and a week later 11 of them had started recovering. The researchers said the results were far from scientifically proven and if kimchi did have the effects they observed, it was unclear why. South Koreans are reported to be eating more kimchi as a result of the study. "I'm eating kimchi these days because I've heard in the media that it helps prevent bird flu infections," one man said. Love it or loathe it, once you have eaten it, you will never forget it. Kimchi is made by fermenting cabbage with red peppers, radishes and a lot of garlic and ginger. The idea that it could help poultry to fight off bird flu sounds like a dubious folk remedy. But the theory is being floated by some of Korea's most eminent scientists. "We found that the chickens recovered from bird flu, Newcastle disease and bronchitis. The birds' death rate fell, they were livelier and their stools became normal," said Professor Kang Sa-ouk. Sars link There was an increase in kimchi consumption two years ago, when thousands of people in Asia contracted Sars (severe acute respiratory syndrome). Kimchi was reported to have helped to prevent Sars. The claim was never scientifically proven, but according to some Koreans, people in other countries followed their example and started eating kimchi. "After the Sars outbreak, I went to China and I noticed that the Korean restaurants there sold most of the kimchi they'd made that day," a Korean man said. So one of Korea's national specialities may soon find a much bigger market. Whether it really is an effective remedy, only time and more research will tell. http://english.chosun.com/w21data/html/news/200503/200503080 010.html   Research Shows Kimchi May Be Effective Against Bird Flu BBC Reports Kimchi Could Cure Bird Flu Kimchi, a traditional Korean vegetable dish, has been found to be effective in treating avian influenza and other viral diseases affecting poultry. A research team at Seoul National University said their findings show that a lactic enzyme in kimchi has remedial effects on chicken and other types of poultry, which had been infected with avian flu, Newcastle's disease and bronchitis. The experiment was conducted on three groups of 13 chickens infected with the bird flu virus. The first group was given only water, while the other two groups were given either a concentrated or diluted fluid containing kimchi's lactic enzyme. A week later, all chickens in the first group died, but 11 chickens each in the second and third group survived. "Kimchi is already known to have antibacterial powers. But this is the first time kimchi's effectiveness in curing viral diseases has been proven," said one researcher. The team is planning to conduct further studies on the lactic enzyme and distribute it to poultry farms across the nation after obtaining permission from the National Veterinary Research and Quarantine Service.

It's quite easy to make at home.  I make it by the gallon all the time.  Many recipies on the net.  Also can buy at oriental food stores in any city.  I eat it everyday and haven't caught the BF yet.  It's a little spicy and takes some getting used to but once you do you'll love it.  Add to salads, as side dish, or just a good snack.

READ

http://www.globalsecurity.org/security/ops/hsc-scen-3_pandem ic-influenza.htm

As expected, many of the deaths in 1918 were from pneumonia caused by secondary bacterial infections. But Spanish flu also caused a form of primary viral pneumonia, with extensive hemorrhaging of the lungs, that could kill the perfectly fit within 48 hours or less. Many people died from this very quickly. Some people who felt well in the morning became sick by noon, and were dead by nightfall. Those who did not succumb to the disease within the first few days often died of complications from the flu (such as pneumonia) caused by bacteria.

The male death rates in 1918 far exceed the female death rates among adults. One of the most unusual aspects of the Spanish flu was its ability to kill young adults. The reasons for this remain uncertain. In general the rate of death is highest for the very young and older persons. The 1918 pandemic followed a strikingly different pattern, with the highest mortality in young persons 25-30 years old. With the Spanish flu, mortality rates were high among healthy adults as well as the usual high-risk groups. The attack rate and mortality was highest among adults 20 to 50 years old. The severity of that virus has not been seen again in humans.

The reasons for this difference are still poorly understood. It is believed that a subset of victims experienced a primary viral pneumonia which caused a very rapid clinical decline and death. It is widely belived that cytokine storming [Immune-complexes-mediated pathogenesis] could be one of the mechanisms that resulted in damaging the lung tissue. Normally, when the lungs are under attack from a virus, T-cells, defenders from the immune system, are then sent to the site of the infection. The presence of T-cells initiate a second immune system attack by chemicals, known as cytokines, that cause inflammation. A cytokine is a small protein released by cells that has a specific effect on the interactions between cells, on communications between cells or on the behavior of cells. The cytokines includes the interleukins, lymphokines and cell signal molecules, such as the interferons, which trigger inflammation and respond to infections. When the lungs are infected with the flu virus, the T cells release chemical signals that cause them to stay longer in the lungs. The systemic symptoms of seasonal flu are caused by cytokine release, which is part of the human immune response.

A Cytokine storm [a systemic inflammatory response syndrome] -- immune system "friendly fire" -- is believed to be the underlying reason for the high death rate among young adults. It results when too many immune cells are in an endless loop of calling even more cytokines. During the flu infection the immune system has an "all hands on deck" attitude to the viral assault. More T cells are always arriving, and they in turn release more signal and stay longer, leading to a build up of T cells and chemical signals. The exaggerated immune response produces inflammatory molecules that lead to too many cells clogging up the airways and preventing efficient transfer of oxygen into the bloodstream. This Acute Respiratory Distress Syndrome [ARDS] is what makes the Cytokine storm so deadly in pandemic flu. It is suggested that the high death rate among healthy young adults was due to their strong immune systems producing a cytokine storm. The very young and very old would have had weaker immune systems, and thus weaker immune responses that would not result in a cytokine storm.

I believe the major problem is the cytokine storm in the body as a strong response from the immune system, and that is what scientists are trying to find  a solution to,an alternate venue to counteract the virus within

the human immune system,  I have read research on "peripheral protection" no immunologist have been able to figure it out yet.