Saturday roundup

Thanks for the plug.

Also, I knew about the amalgam studies to which you refer. Believe me, I'll have something to say about it next week; the Medicine and Evolution series just got out of hand and dominated everything. I never got around to the amalgam studies. In fact, you've reminded me to look them up.

Believe it or not, the amalgam warriors are even more militant than the mercury moms who think mercury causes autism. There is also considerable overlap between the two groups, as you might expect. Boyd Haley is one prominent example.

Tara

I was reading a Brief History of Medicine this morning, and I came upon something that I wonder if you know is true or not. In regards to bird flu is it true that the cause of death for many in the Avian Flu of the early 1900's was from bacterial pneumonia, and the reason that so many people did not succumb to the 1957 Swine Flu was because of antibiotics.

Assuming this is accurate, what implications does that have for a regular person? Are we more able to survive pandemics because of antibiotics. What about antibiotic resistance? Will, or could, that have an impact on the death rate?

If it isn't true or accurate, then how did this information spread?

This sentence just cracked me up. Juvenile I know. :)

Can you name that virus over at Buridan's ass?

Thanks for the shout, baby!

Flea

Ah, this explains the traffic spike. Thanks! :)

Thanks for the plug. Peds grand rounds is now up at http://theclayexperience.blogspot.com/2006/04/welcome-to-first-pediatri…. It's small but has great potential. Hey Tara, kids get infected with all kinds of stuff. I'm sure you could come up with a submission for me. If I had any interest whatsoever in research(it's like kryptonite to me) I would have gone into infectious disease myself. I'm glad there are people like you out there.

In regards to bird flu is it true that the cause of death for many in the Avian Flu of the early 1900's was from bacterial pneumonia, and the reason that so many people did not succumb to the 1957 Swine Flu was because of antibiotics.

Assuming this is accurate, what implications does that have for a regular person? Are we more able to survive pandemics because of antibiotics. What about antibiotic resistance? Will, or could, that have an impact on the death rate?

If it isn't true or accurate, then how did this information spread?

That's largely true. Most influenza deaths aren't due to "primary" infection--that is, they're not due only to the influenza virus. Instead, they're due to "secondary" infections: the bacteria colonize the influenza-damaged lungs, and death is from bacterial pneumonia. This means that sure, it's more treatable now, but as has been mentioned repeatedly about influenza, even in a "normal" year, ~36,000 people succumb to the infection in the United States alone. Antibiotics simply aren't a magic bullet. In some cases, resistance is a problem; in others, treatment begins too late in the infection. And a scary thing about several H5N1 cases--and that was seen in the 1918 flu as well--is that many deaths were due to primary viral infection--the patient died before bacterial pneumonia could even set in. So very long story short, yes, antibiotics are certainly helpful, but they alone aren't enough to save us in the event of a pandemic influenza outbreak.

Is the death rate from primary viral infections caused by a "cytokine storm" reaction and are people of child bearing age more vulnerable to these storms because of a highly tweaked immune system?

http://content.nejm.org/cgi/content/full/352/18/1839

I answered my own question- yes to 18-40 (not 35) and yes to the cytokine storm. They have a lovely interactive on what the proposed mechanism of a cytokine storm is.

MOre on cytokine storms in the Flu Wiki and a whole bunch of other things.

Not much on highly tweaked immune systems in those of childbearing years.