When Pigs First Flu

I've been following with keen interest the news of the outbreak of swine flu in Mexico, and it's reported spread; I have a personal connection with swine flu.

In 1976 I was a young newspaper reporter on a community "shopper" newspaper, the Meramec Community Press. An outbreak of swine flu at Fort Dix had alarmed the CDC; the strain seemed very mutated from the original H1N1 virus and suggested a potential for a pandemic. At the time it was thought that the 1918 pandemic was a swine-flu mutation. In 1976 we did not have the genetic science to exhume 1918 victims and determine the exact strain-that science came a bit later and it was proven to be an avian flu strain that caused that devastating outbreak. At any rate, the government decided it was urgent to create a vaccine and distribute it to the American populace as a preventitive. A crash program was implemented and the CDC was charged with eliciting the support of the press in getting the word out. And that is where my story comes in. I was assigned that story by my editor, and so began educating myself on influenza and the means proposed to forestall epidemics and pandemics.

I learned that influenza viruses of all types ongoingly mutate; most of these mutations are of insignificant impact, but occasionally a mutation occurs that is sufficient to render previously established antibodies in the organism ineffective at staving off infection. This mutation then has the potential for wide-spread impact, an "epidemic" is possible. If an epidemic spreads very widely, it becomes a "pandemic". This happened in 1918. The scope of the 1918 pandemic was bolstered by a couple of compounding dynamics: there was a world war going on, which created conditions of great crowding in many areas-military bases, artificially densified urban centers, transportaion depots, etc. Too, there was a great movement of people ongoing-soldiers moving between bases and depots, refugees travelling long distances to escape the war and it's effects, or moving from one part of the country to another for war-related industry. Many dynamics coincided to create a sort of "perfect storm" for viral transmission. I believe the U.S. alone suffered something like half-a-million cases. Estimates world-wide range from 20 to 100 million cases.

So, in 1976 the CDC and the government regarded this situation very seriously. A public-vaccination program was implemented, with a target stockpile of 200 million vaccine doses. Achieving this goal was confounded by the discovery that the vaccine-production process was incapable of producing the kind of two-for-one vaccine yields previous vaccine processes (like that for polio) yielded. In essence, the operation was only capable of 50% production efficiency. Nonetheless, a public campaign promoting widespread implementation was begun.

I spoke with several CDC press liaissons in the following weeks, and recieved a ton of literature; I spent many, many nights poring over the materials and trying to decide exactly how to boil it all down for public consumption. Too, it was not a foregone conclusion that the entire press establishment was in support of such a crash-course of vaccine development and dissemination. I had plenty of press corps colleagues opposed to the program. Ultimately, I decided to support the CDC's effort, with the approval of my editor and indeed the direct support of our publisher. One of only three meetings I had with him in my time on the staff resulted in my being appointed lead-writer on the subject for the whole chain of papers. Heady stuff for an 18 year old.

As the approved vaccine became available, the CDC decided to capitalize on favorable press where such existed, and some of the very first stocks were shipped to the Department of Public Health in my little community, Jefferson County, Missouri. Over the course of my three article story I had made friends with that staff, and they invited me down to witness the arrival. The director of the department opened the shipping container and asked me if I wanted to go first.

So I did, and the CDC staffer who'd accompanied the shipment told me I was likely one of the first people west of the Mississippi to recieve the inoculation. I was given the standard pamphelet advising about possible side-effect symptoms I might experience, and I took pictures of all the staff getting their shots. Then I went home to write my final article.

I'm sorry if this will disappoint, but I experienced no side effects-no aches or pains, no low-grade fever, nothing. I could've been given a placebo for all I knew. And no epidemic, much less pandemic, occurred. Only about 24% of the nation's population had recieved the vaccination by the time the government called it all off.

Interestingly, this pretty much marks the advent of the public influenza-vaccination paradigm that exists today. I think the CDC and the government were unwilling to dismantle the instrumentality they'd created to distribute the swine-flu vaccine. Every year, the CDC cooks up a vaccine representing the most-likely strains expected to spread during the flu season, and everyone's welcome to get the shot.

Before we proceed to my final thoughts, however, we should take note of a few important facts:
-the vaccination cannot encompass every strain in circulation. Much study has shown that, to contain a significant portion of the killed-virus of each target strain in a single dose, the maximum number of strains covered can't exceed 5, and indeed, usually only covers 2-3.
-each strain represented is a specific mutation, and may provide only small protection should that strain further mutate.
-epidemiologists and other immune-system researchers are quick to point out that the human organism has at any given time somewhat finite resources to devote to producing antibodies-our bodies cannot just devote themselves entirely to producing antibodies against every viral possibility in the world.

And therein lies the crux of my biscuit: I haven't had a flu shot since that innoculation in 1976. One of the epidemiologists I spoke with a great deal had impressed me with a statement I still think about; to his way of thinking, he said, it was better to be ongoingly exposed to the great realm of potential viral mutation and, by natural exposure to varying iterations of viruses, develop a base library of antibodies most likely to suppress the strains most often encountered, and to be predilected to the most recently encountered mutations of those strains. He pointed out that the original proposition for the innoculation campaign had been to only target those most likely to be unable to recover from sickness: the very old, the very young, and those with compromised immune systems. This ideal seems lost, although it's still part of the rhetoric in the press releases each flu season even today.

So there's lots of meat to chew on here. I suppose if a "Captain Trips" virus pops out of the jungle, or escapes some weapons lab, or just percolates up out of nowhere, there won't be a lot anyone can do about it. Too, another recent epidemiologist acquaintance advises me that influenza vaccination only has an expected efficacy for about 5-12 years. She notes, too, that that is merely an informed guess-ultimately, the coding for a particular antibody (once learned) should be permanently in the body's "library", the real question being whether the particular body will recognize the latest iteration of mutation and start producing the best-fitting antibody.

Finally, I should note that since 1976 I have had two occasions of significant flu-one in 1984 and one just last year. Otherwise I seem to float through the flu season experiencing nothing greater than run-of-the-mill colds and the like.

I wonder how effective that old H1N1 vaccine really was? I wonder what the coming weeks will bring?