From simple to stupid

Epidemic: from the Greek, epi- (upon) + -demos (the people)

Pandemic: from the Greek, pan- (all) + -demos (the people)

Pandemic (according to the WHO): from external pressure and internal weakness, highly-virulent + "justified" panic + all + the people

The definition of a pandemic used to be simple: a worldwide outbreak of disease in excess of what would normally be expected (a global epidemic).  

The WHO even came out with a definition of worldwide spread (community transmission in 2 or more WHO regions).

But now, apparently, the WHO intends to change the definition of a pandemic from simple to stupid.

Bowing to pressure from member nations, the WHO is (according to the New York Times) going to change the definition to include the severity of disease, and will probably do so in such a way that the current H1N1 outbreak will never count as a pandemic (unless it becomes more virulent, which it very well might).

Now, you may remember that we've had three pandemics in the last century, one in 1918, one in 1957 and one in 1968... or, at least, that used to be true.  If this new definition goes into effect as described, we'll have to erase those last two from the list, because they were no more severe than this new H1N1 strain appears to be right now.

Whether a given outbreak is a pandemic or not is a separate question from how severe that pandemic is.  

If the WHO thinks a severity scale would be useful, then by all means they should create one. There are some good arguments against using a severity scale (flu viruses evolve so quickly, severity varies between and within countries, etc.), but it's possible a severity scale would help countries and communities to better plan for and respond to a pandemic... but the role of a severity scale should be to better describe an existing pandemic, not to determine whether an outbreak is a pandemic.

If the WHO goes through with this, there will be two definitions of a pandemic: One used by epidemiologists and other public health professionals, and one used by the WHO --because the WHO's new idea for a definition doesn't make any rational sense.  By setting up such a situation, the WHO will be undercutting its own credibility in a time when its ability to lead is more important than ever.

Instead of caving to the pressure of politicians from the member nations who feel that declaring a pandemic would cause "unjustified panic," the WHO should be using this as a teachable moment, to educate the public about what a pandemic is, what can be done about it, and why panic is never a justified reaction regardless of severity.

   

Bogus: Bioweapon claims for H1N1 Swine Flu

Some segments of the blogosphere are all atwitter (pun intended) with the theory that the H1N1 Swine Flu must be the work of some nefarious group of bioengineers because the virus contains segments from 4 different progenitor viruses --2 different swine flu viruses, an avian flu virus and a human flu virus.  Some even seem to imply that US government researchers working on the 1918 pandemic flu virus (which was also an H1N1 virus, though very different) might have been involved in weaponizing it.

Much of this seems to be driven by a story written by Wayne Madsen of Online Journal:

It turns up all over the place, at PrisonPlanet.com, Know4Life, InTheseNewTimes, and elsewhere.

Jeff Denmark at Drudge Retort quotes the article:

"According to two mainstream media journalists, one in Mexico City and the other in Jakarta, who spoke to WMR on background, they are convinced that the current outbreak of a new strain of swine flu in Mexico and some parts of the United States is the result of the introduction of a human-engineered pathogen that could result in a widespread global pandemic, with potentially catastrophic consequences for domestic and international travel and commerce." 

And goes on to say: "WMR has been informed that the CDC and U.S. Army dug up the body of an Inuit woman who died in 1918... from an outbreak of Spanish flu. . . . . WMR has been told the genetic material recovered by the U.S. government from the corpse of the Inuit woman provided the basis for the development of the H5N1, or bird (avian), flu strain at the U.S. Army Medical Institute of Infectious Diseases (USAMRIID) laboratory at Fort Detrick, Maryland, the point of origin for the Ames strain of anthrax used in the 2001 bio-war attacks against the U.S. Congress and the media."

This is, as they say in Jolly Olde England, complete rubbish.

"How, then" you may ask "did a brand new virus that's made up of four different viruses suddenly spring into being and spread all over the world? Doesn't it have to be the result of bioengineering?"  

...Actually, no.

This is exactly the sort of thing we've been expecting for years.  

If more than one strain of flu virus infects the same cell, the two strains can mix up their genes, leading to what is called a recombinant virus.  That simply means that the genes from the two (or more) viruses have recombined to create a new strain.  In effect, it's a lot like sexual reproduction in humans; parents mix up their genes with the result that a child might have her mother's hair and her father's eyes.

This recombination happens especially easily in pigs, because they can be infected by swine flu viruses, avian flu viruses and --you guessed it-- human flu viruses.  The pig as a "mixing vessel" scenario is something we've long known to be a threat when it comes to pandemic flu.  In fact, this is believed to be what caused the last two pandemics, in 1957 and 1968, as this figure illustrates.

This is perfectly natural and expected.  That doesn't make it good, of course, but there's no hidden conspiracy behind it.  The virus arose naturally and the epidemiological evidence seems to show pretty clearly that it's spread so quickly because of air travel --something else we knew to expect-- not because it's being used as some kind of very inefficient bioweapon.

We humans are all on the same side on this one.