An influenza primer, updated for 2012/13

As the flu season gets serious, we revisit our coverage of influenza biology.

Read the whole story

 

[Maxipad]

Last I checked into it (which was about 7 years ago) the flu vaccine only had about a 50% chance of nailing that year's flu. Since that time, have they gotten better at predicting and putting out the correct vaccine?

Generally I'm all in favor of knocking things out as aggressively as possible, but if it is only a 50/50 chance of being the right vaccine, and I'm only about 10% likely to get the flu in the first place, a 5% chance of the vaccine working isn't economically viable for me.

Couple that with less than 100% effectiveness of the vaccine, and any sideeffects of it (and having to be more careful than average on the timing of the vaccination due to my blood donation cycle) it just didn't seem to make sense for me to get one.

I think the effectiveness is now substantially higher than 50%. Prediction methodology has advanced in the last few years. Anyone have any recent figures? I thought I read something closer to 80% recently, and even higher for those vaccinated most years. (I may be conflating two articles. Old memory. )

 

[heftysmurf]

I watched a documentary on viruses fairly recently, and one of the areas that really caught my attention was the segment on viral replication and how it varies between viruses.

For example, the smallpox virus tends to replicate very accurately. From what the documentary was saying, most smallpox infections involve a single very consistent strain. A very welcome trait for the purposes of vaccination, and the proof is in the pudding; it has been basically eradicated within the human species.

The HIV virus is not in the same boat at all. One of its key "properties" is relatively inaccurate reproduction; you can almost guarantee that it will mutate over a short period of time, thus providing it with all sorts of advantages against the immune system and vaccinations.

Does anyone know if the mechanism by which HIV encourages mutation is similar in influenza?

 

[FrankM]

Last I checked into it (which was about 7 years ago) the flu vaccine only had about a 50% chance of nailing that year's flu. Since that time, have they gotten better at predicting and putting out the correct vaccine?

Generally I'm all in favor of knocking things out as aggressively as possible, but if it is only a 50/50 chance of being the right vaccine, and I'm only about 10% likely to get the flu in the first place, a 5% chance of the vaccine working isn't economically viable for me.

Suppose the shot costs $30. Taken as insurance, this is worth it if you would demand at least $600 ($30 / 5%) as payment to suffer two weeks of flu symptoms.

Couple that with less than 100% effectiveness of the vaccine, and any sideeffects of it (and having to be more careful than average on the timing of the vaccination due to my blood donation cycle) it just didn't seem to make sense for me to get one.

Now this is where the cost of the shot gets subjective. Maybe the expectation of side-effects or the worry of the shot including unannounced drugs raises the cost. To the tinfoil hat brigade, this subjective cost could be staggering. In your case, it seems just enough to keep you out of the drugstore. If it helps, they give you a preservative-free shot if you tell them you suspect/know that you are pregnant.

Also, remember that the immunity doesn't fade immediately. Your effective immunization is really cumulative with your last few shots, which is probably what increased the 50/50 chances.

 

[AcheronEHJ]

I largely assume the exact same companies that are manufacturing the anti-flu shots are the same ones that manufacture the flus each year.

What, a new virus shows up exactly once a year that creates a massive market for our drugs? How immensely convenient.

Gee, we only need to make some relatively small modifications to a previous virus so that we can sell another round of product? Imagine that.

Giant pharmaceuticals tend to be a hugely profitably and evil to the core business. I've known a guy who died because the drugs that could have saved him weren't profitable enough to mass-produce.

I see the massive profits being made off lifetime diseases like juvenile diabetes and am well aware that these people are just being farmed for money.

Or the example of the fellow who designed a better inhaler - causing better product absorbtion and correspondingly less drug to be needed for the same results. That inhaler concepts gets instantly bought and dissapears from the light of day.

Anyways, random internet posting accomplishes nothing. But the world is so damn evil these days.

 

[Evolution]

The article describes the virus like a group of militants under the commands of an experienced military general (which military general did not have the military experiences? LOL) who drew an elaborate plan of attack. Carry out a specific movement on who should be the target. How to attack. First covered the healthy cells with protein. Where and when to attack the cells. And don't forget reproductions and multiplication for more of their kinds.

"When you killed one of us, we will get some more help." Like the virus reservoir. Human have this stubborn behavior and the virus the same? With all that going on with these virus I have one comment here to say and that is, " We're dealing with a group of intelligent microorganism."

 

[Deleted member 1]

I have never ever had seasonal shots of any kind of any joke. I simply don't trust these manufactured "virus" sprees by upper corrupted corps in conjunction with governments. If your not sick, why get a shot in the first place? Oh wait... to prevent it, sure.

As a person in an "at risk group" this thinking is quite silly. Preventing anyone around me from getting the flu lowers my chances of getting it signifigantly.

Getting this shot has likely saved me (or significantly helped my chances ) from getting sick this year.

I hate drug companies as much as the next person, but these are pretty well tested, and pretty well researched. If you are going to hate them, go for something more legitimate like their horrible marketing / "education" or patent practices.

Not to mention group immunity. Other people not getting their shots and thereby causing other people harm is... Insidious.

 

[Deleted member 1]

Edit: damn phone, double post

 

[Fentras]

Last I checked into it (which was about 7 years ago) the flu vaccine only had about a 50% chance of nailing that year's flu. Since that time, have they gotten better at predicting and putting out the correct vaccine?

It's a year to year thing. Occasionally they screw up and mis-predict the emerging strain(s) that will be big that year. A year or two ago, IIRC, there was a big mis-call and they had to get out another vaccine after initial batches went out, so there was a strain on supplies. It happens.

 

[Zorro]

Herd immunity!

The Romans didn't know about viruses but they did know one thing.

The Best way to not be sick is for your neighbor to not be sick.

If your neighbor never gets the flu you are less likely to get it too.

 

[deas187]

For all those people out there thinking they are like totally immune from getting sick, unless you work at a sewage treatment plant, you are not invincible.

 

[quantum meruit]

I am genuinely astonished by people who ignore informed medical advice and refuse to get a flu shot or to get their kids vaccinated. Why wouldn't you trust the professional consensus of hyper-educated, peer-reviewed modern medicine? And sure, the experts can get it wrong sometimes -- but they are more qualified to give an opinion and less likely to be wrong than anyone else.

 

[StratThinker]

"A study examined the mutations required for an influenza virus to adapt to growing in a new host; it found 14 of them, scattered widely through the viral genome."

Gee, that sounds like macroevolution to me. 14 independent mutations of just the right kind in separate areas of the genome required for the influenza virus to jump species! What are the odds? Therefore by the denialist's reasoning, influenza can never jump species. I guess all those swine and avian flu sufferers are secretly paid shills for the evolution lobby. My tinfoil hat is feeling tight today. ;-)

There are at least flaws in your argument:
1) You say "14 ... required", however if read the very next sentence in the article (emphasis mine)

It's possible to make a rational case that changes in any one of these genes could dramatically change the dynamics of an infection, and thus (potentially) its lethality.

You see, it is highly likely that each of the 14 changes make a difference, (and thus by the proven theory of natural selection the viruses will tend to have all 14 of these changes). I sad that no one, not even the story author pointed out this misquote, nor did any see that you made this major flaw in your argument and down vote you.

2) The second flaw is that you assume that these changes are outside of what creation scientist predict to occur. Creation scientists predict that information creating genes are very infrequent (as in they have never been observed) or they are non-existent. When virus mutate no new genetic information is yet known to be created (as in no new parts/proteins for new purposes), instead they modify the way that the way in which their outer proteins fold, this changes the way that antibodies interact with the proteins which changes whether the antibody would recognize it, it also changes the way that it binds to a cell which changes the whether the cell would pump it into it. In conclusion there is no new parts, only modified shapes.
Take a look at this quote from the article (emphasis mine)

Like most viruses, a spreading swine flu virus has a coat formed of proteins which surround the genetic material that allows the virus to hijack a cell and reproduce. These coat proteins are critical in a variety of ways: they determine which cells the virus can latch onto and infect and, being exposed, they're the things antibodies recognize when your body generates an immune response to the virus

and another ars article

Chemically, the proteins that run most of a cell's functions are little more than a string of amino acids. Their ability to perform structural and catalytic functions is primarily dependent upon the fact that, when in solution, that string adopts a complex, three-dimensional shape.

Wikipedia adds that it also has to do with its chemical composition, (it is mostly dependent on the atoms on the outside)

The chief characteristic of proteins that also allows their diverse set of functions is their ability to bind other molecules specifically and tightly.

edit: corrected some errors of mine.

 

[dragosani]

This year has been rough.

My family and extended family gets the flu vaccine every year. My family hasn't had the flu until this year. That makes the success rate for the vaccine for us far better than 75%. One child came down with the flu this year.

The pediatrician stated that the flu shot hasn't been very successful this year. Far more children testing positive for flu than any other year including the supposed H1N1 pandemic (in our area).

Everyone that has gotten the flu and has had the shot has gotten over it within 3-4 days. That is the complete recovery time with the fever gone in 1-2 days and all other symptoms gone 1-2 days later. Far faster than the typical time.

We will be getting our shots again next year. No flu in our house hold for over a decade. Even with the reduced effectiveness this year the flu vaccine has helped stop the spread of the disease to other members of the family and reduced the severity of those that actually got the flu.

I know some people are against taking the flu shot. I recommend that you reconsider.

The CDC states that less that 35% of the population gets the flu shot in the US. When we can get that number above 85-90% we might actually see the "flu season" go way. People will still get the flu from time to time but it will not effect a large percentage of population all at once.

Remember just because you get the vaccine doesn't mean that your own body will build up sufficient antibodies to completely block you from getting the flu. It will help boost your immune system if you do get the flu so that you will get well faster.

Every person that gets a flu shot will help save the lives of the elderly and small children who are at a higher risk of dieing from influenza.

However, if you cannot get the flu shot because of religious beliefs or your own personal beliefs please do the following to help stop the spread of the disease.

- Wash your hand thoroughly and frequently.
Follow this guide:
http://pediatrics.about.com/od/pediatri ... washng.htm
- Do not shake people's hands. I cannot stress that enough.
- Stay at least 6 feet from anyone that is coughing or sneezing.
- Take the stairs instead of the elevator during flu season when you can. Hospitals and other places my not allow stair usage except in emergencies for security reasons. It is also good exercise which helps the immune system.
- If you are sick stay home until at least 24 hours after your fever goes away.
- Cough and sneeze into the sleeve of your shirt instead of using your hands to cover your nose and mouth. That way you are not spreading the germs from your hands to door handles, keyboards, ect.
- Keep your hands away from your face.
- Do not go work, the pharmacy, or any store when you are sick. Get a healthy person to pickup your medication. Please stay at home and stop spreading disease when you are sick.

There is a lot more but the above will go a long way in preventing the spread of the flu and other diseases.

 

[Nitestorm]

Every time I read things like these it reminds me to get a flu shot, only for me to forget until its too late.

I'm already recovering from a the latest flu it seems. Oh well, there is always next year.

 

[sciencegeek]

Pretty interesting stuff. Also interesting to note that to this day no viral infection/disease has ever been cured. Only prevented with vaccines and treated with antivirals. Only the immune system can remove a viral infection. In the case of some infections it never really does.

A virus really isn't a living organism.

 

[zelannii]

"A study examined the mutations required for an influenza virus to adapt to growing in a new host; it found 14 of them, scattered widely through the viral genome."

Gee, that sounds like macroevolution to me. 14 independent mutations of just the right kind in separate areas of the genome required for the influenza virus to jump species! What are the odds? Therefore by the denialist's reasoning, influenza can never jump species. I guess all those swine and avian flu sufferers are secretly paid shills for the evolution lobby. My tinfoil hat is feeling tight today. ;-)

The odds are actually astronimical, or at least, in terms of direct numbers. Its probably in the 1 in several quadrillion range.

However, since the flu virus replicates hundreds or thousands of times even that many individual viruses in a year, the numberes suddently become far more significantly plausible. Take into account virus "mixing" as they describe, when a single host is infected by multiple concurrent viruses, and the incredible ease with which RNA is modified comparted to DNA, and it becomes more of a "when" and not su much an "if", let alone calling the chance near impossible.

2 rats makes 8 -12 children with a 3 week gestation, after which there's a delay before impregnation (or maturity) can repeat the process. The progination of manals is 2:10 on average. The progination of a virus is 1:100-1000. This occurs every 4-36 hours, and they can immediately infect another cell. In just 4 generations, a virus with a progination of just 100 (very low) can be 10^8th virus cells (100,000,000). Yes, in a time from less than 1 day to about a week, depending on the rate the virus propogates, you can have over 100,000,000 copies of a virus inside of you from a single infeection. Multiply that rate of progress across a 380m people, and streatch that out over a year not just a few days, and suddenly even astonimical muation requirements become extremely likely. In fact, its likely that H1N1 became human-capable through mutation THOUSANDS of times without actually coming in cnntact with and successfully infecting a human host who became infected enough to spread it to others, and even if it did, what's the odds that remote farmer came in contact with enough people to actually spread it before building immunity to it and never being capable of getting that infection again, and eventualyl all the pigs in the farm also became immune and the virus was wiped out ending all trace of the mutation and erradicating it;s ability to spread. Without a siufficient population to maintain the spread, the virus is defeated and the mutation is lost, and farms are not exactly known for large populations that intermix directly.

 

[InfoDav]

I generally try to avoid influenza shots to reduce the risks of getting Guillain-Barré Syndrome. Granted, the risks are very low, but it can so easily destroy a life that I prefer abstaining myself from the vaccine.

I know the flu itself can give GBS, but if I don't take the vaccine, I won't get the flu every seasons anyway, therefore globally I reduce the risks.

Having seen 3 people getting GBS after getting flu vaccines is without a doubt influencing my decision.

 

[dehildum]

Last I checked into it (which was about 7 years ago) the flu vaccine only had about a 50% chance of nailing that year's flu. Since that time, have they gotten better at predicting and putting out the correct vaccine?

Generally I'm all in favor of knocking things out as aggressively as possible, but if it is only a 50/50 chance of being the right vaccine, and I'm only about 10% likely to get the flu in the first place, a 5% chance of the vaccine working isn't economically viable for me.

Couple that with less than 100% effectiveness of the vaccine, and any sideeffects of it (and having to be more careful than average on the timing of the vaccination due to my blood donation cycle) it just didn't seem to make sense for me to get one.

Well, it may be only 60% effective at this year's flu, but the protection does not disappear right away. I will go on to protect you against future exposure as well. In fact, one theory as to why the 1917 pandemic did not affect older persons was that they had previously been exposed to a slightly less virulent version of the virus about forty years previously, thus had significant immunity to the 1917 pathogen.

Given the choice between a two to three weeks of illness and a chance of death (which do occur even in young, healthy individuals with the flu) and at most one or two days of a mild fever and a sore arm, I think the vaccination is the more intelligent choice to get immunity to a strain of influenza.

 

[dehildum]

do you own any sort of modern computer, containing rare earth metals? there's blood all over that -- much of it made by slave labor. how dare you?

MODERATION:This is trolling - stay on topic, stay rational, and stay polite, or stay out of the thread.

i'll make my point more clearly, then: the world is full of horrible problems. they trouble me, but i have a limited capacity to solve them. it's not my responsibility to compulsively get a vaccine that only works 2/3 of the time. donate the cost of a flu shot to the red cross instead; don't make out like my moral position created the flu virus.

Actually, if your moral position results in you getting influenza, then you will be creating, and spreading, the flu virus by the billions to everyone around you, and anyone who goes where you went for the next several days. Note that influenza is infectious well before any symptoms show - the time between being actively infectious and showing symptoms is measured in days.

 

[Tundro Walker]

I come from a social science background, and my concern with the flu usually revolves more around that. Most notably, how the media likes to create scare-mongering, and how some folks will take partial information (and not even research it further...just run with whatever rumor and assumption they have) and start paranoid rampages.

During the swine flu outbreak, I was shocked at how freaked out folks were getting. But, when you compared the amounts of folks dying from swine flu to normal flu, the swine flu seemed pretty benign. Likewise, folks started becoming racist, b/c they felt certain cultural demographics were the carriers. I was annoyed at people using the flu as an excuse to berate and badger others. (Of special note was a lady that I had never seen before at the gym suddenly showing up with a face mask on and gloves to "work out" when in fact all she was really doing was berating folks for not wiping down the equipment between use and looking like a gestapo member while doing it). I was amazed at how folks were paranoid about getting the flu, so they would congregate at hospital waiting rooms -- filled with folks already infected with the flu -- not realizing they were just increasing their chance of getting it.

The sad thing is, a quick 5-minute read of an informative document about the flu, how it travelled, how it worked, how to avoid it, etc, would have resolved a lot of this.

 

[The_Barbarian]

smallpox is still an issue in some parts of the world.

No it isn't.

https://en.wikipedia.org/wiki/Smallpox#Post-eradication
http://www.who.int/features/2010/smallpox/en/index.html

 

[dragosani]

I generally try to avoid influenza shots to reduce the risks of getting Guillain-Barré Syndrome. Granted, the risks are very low, but it can so easily destroy a life that I prefer abstaining myself from the vaccine.

I know the flu itself can give GBS, but if I don't take the vaccine, I won't get the flu every seasons anyway, therefore globally I reduce the risks.

Having seen 3 people getting GBS after getting flu vaccines is without a doubt influencing my decision.

You are extremely lucky (or unlucky as the case may be) to have seen 3 people with GBS.

Your chances of getting GBS from an influenza shot is 1 in 1,000,000. Not to mention 80% of the cases make a complete recovery. Only about 4% of the cases result in death.

versus

Your chances of dying in a car accident is 1 in 10,000 (in 2009). You don't recover from death.
See: http://www-nrd.nhtsa.dot.gov/Pubs/811401.pdf

You are far more likely to get GBS from a bacterial infection than from a flu vaccine.

You may want to stop using a car or being a pedestrian and get the shot. Far better odds with the flu shot than being anywhere near a automobile.

 

[Carbon Fibre]

Let's not compare diseased en-masse along with typical flu's people get seasonally.

So what you're saying is that vaccines don't work, except when they obviously work and save millions of lives.

Yes, true and ethical chemistry involved in that vaccine, not some pre activated hosts for "later-activation" by some future vaccine for God knows what monster comes out of it...

 

[igor.levicki]

"A study examined the mutations required for an influenza virus to adapt to growing in a new host; it found 14 of them, scattered widely through the viral genome."

Gee, that sounds like macroevolution to me. 14 independent mutations of just the right kind in separate areas of the genome required for the influenza virus to jump species! What are the odds? Therefore by the denialist's reasoning, influenza can never jump species. I guess all those swine and avian flu sufferers are secretly paid shills for the evolution lobby. My tinfoil hat is feeling tight today. ;-)

Or maybe some lab helped this "evolution" by injecting virus DNA with those mutations to begin with? You know, just in case that nature doesn't manage to do it on its own?

Also, what happened with "stay at home when you feel under the weather"?

Lets look at vaccination from a different perspective -- nowadays people are so scared of getting poor performance reivews at work if they call in sick too often that they will go to work even when they should have been in bed. They don't want to use vacation days, and claiming sick time results in reduced salary so everyone avoids that by going to work sick. They spread viruses to their colleagues, they spread it to their spouses, children, etc. So, is flu vaccination humane? Or is it just a means of making us all more productive by preventing downtime?

Yes, you will get a shot. You will not get a flu 2 out of 3 times. But your body needs rest, and it needs a way to eliminate accumulated toxins (which is what happens naturally when you have fever). By taking a shot and preventing a flu you may be saving some downtime, but you could also be exposing yourself to more long-term damage to your cells.

 

[sawtoothpaper]

You couldn't pay me to get the flu shot, got it once and never again...

I'm better off taking my chances since I have had the flu only 3 or 4 times my whole life then get a shot and sit on the toilet all week again :S

 

[InfoDav]

You may want to stop using a car or being a pedestrian and get the shot. Far better odds with the flu shot than being anywhere near a automobile.

Putting odds on my side where I can and when I can. Also, the last study on the subject showed an higher rate than 1/1000000.

 

[Carbon Fibre]

Let's no confuse cures for diseases vs. intelligently manufactured widespread "flu's" that governments and corporations do. Many of you are quite exaggerated on posting links towards major diseases created by warfare and poverty spreads and posting quite disturbing images to impose presence on this topic and "smartassery". Since these so called 'deactivated vaccines' for later use are advertised and recommend for children and anybody over 60, is quite obvious who jumps first to insecurely defend their choice of being shot and rant it over with going to the contrary of what I said. None other than scared, government dependent, modern day ignorance (denied) citizens that are spoon fed anything that come in their way are being shot. Now, don't get me wrong. If your on the verge of dying in such sickened state because you decided to not live a healthy and clean life in your home and around you (or some jerk spreads the s*** all over), then by all means head to the doctor and get shot. I hope many of you are listening to news recently on the major amounts of side effects these stupid vaccines are creating all over the world, for what? Prevention? Let's be real here people. Those who still have had reactions are nonetheless "already shot-treated" muppets from previous events in previous years who are only being played with to move corp money on these so called diseases. Big Pharma at work, quite successfully over the ignorant. Vote away all you want, if that's make you feel better, yet again.

 

[Carbon Fibre]

You couldn't pay me to get the flu shot, got it once and never again...

I'm better off taking my chances since I have had the flu only 3 or 4 times my whole life then get a shot and sit on the toilet all week again :S

No! get a shot like us! Else you'll get polio, small pox and everything on wikipedia! Do what the controlled media says!...

 

[FrankM]

Let's no confuse cures for diseases vs. intelligently manufactured widespread "flu's" that governments and corporations do. Many of you are quite exaggerated on posting links towards major diseases created by warfare and poverty spreads and posting quite disturbing images to impose presence on this topic and "smartassery". Since these so called 'deactivated vaccines' for later use are advertised and recommend for children and anybody over 60, is quite obvious who jumps first to insecurely defend their choice of being shot and rant it over with going to the contrary of what I said. None other than scared, government dependent, modern day ignorance (denied) citizens that are spoon fed anything that come in their way are being shot. Now, don't get me wrong. If your on the verge of dying in such sickened state because you decided to not live a healthy and clean life in your home and around you (or some jerk spreads the s*** all over), then by all means head to the doctor and get shot. I hope many of you are listening to news recently on the major amounts of side effects these stupid vaccines are creating all over the world, for what? Prevention? Let's be real here people. Those who still have had reactions are nonetheless "already shot-treated" muppets from previous events in previous years who are only being played with to move corp money on these so called diseases. Big Pharma at work, quite successfully over the ignorant. Vote away all you want, if that's make you feel better, yet again.

It is simply mind-boggling how much damage has been caused by one fraudulent study that squeaked its way in Lancet.