Soundings : Intelligence test
In October, our attention shifts from one of the biggest threats to our health and safety to one of the smallest. Hurricane season is winding down. Meanwhile, according to the Centers for Disease Control, influenza season officially begins this Sunday, Oct. 4.
It's a common conceit in science writing to arrange teensy things on the head of a pin. If your pinhead measured 1.5 millimeters in diameter, and if your teensy things were the flu virus, members of the family Orthomyxoviridae, you could fit about 360 million of them. That's more than one virion for every man, woman and child in the United States.
These germs are small, but they can be lethal: The global pandemic of 1918, caused by an H1N1 strain of the influenza A virus, killed 50 to 100 million people. To put this in perspective, consider that the world's population in 1918 was about a quarter of today's. Now, an epidemic of 1918 proportions could kill 350 million people.
Our national hero in the field of virology, Dr. Jonas Salk, was the son of poor Russian immigrants and had to work twice as hard as his peers to overcome harsh medical school quotas that limited entry to Jewish students. Dr. Salk fought the Nazis in World War II from the labs at the University of Michigan, developing the first flu vaccine. Administered to American troops, it saved thousands of lives.
After the war, Dr. Salk led the battle against polio, which then was infecting some 60,000 people each year and killing more children than any other disease. If you were a parent in the early 1950s, polio was the most terrifying thing in your world. Today, most schoolchildren can't tell you what polio is. That's a testimony both to our short memory as a species, and to the stunning effectiveness of the vaccine Dr. Salk's team created.
On April 12, 1955 - ten years to the day after the death of our nation's most famous polio victim, Franklin Delano Roosevelt - the University of Michigan announced that Dr. Salk's polio vaccine had been proven safe and effective. Church bells rang across the nation; businesses closed to celebrate; politicians fell over themselves looking for ways to congratulate Dr. Salk. "It was," said one observer, "as if a war had ended."
Now, fast forward to 2009. The media is making a fuss over a new strain of type A, H1N1 influenza - too much fuss, some medical authorities think, because if anything this new strain seems slightly milder than the average flu.
But novel strains of influenza A are worrisome because the influenza A virus lacks a proofreading mechanism to repair errors in its DNA, and thus is prone to mutate. So there was a real basis for concern in the medical community that a more harmful strain, perhaps like that of 1918, might emerge.
The good news is that in an important sense, flu is flu, and that the practice of making vaccine from dead viruses has been proven now by more than a half-century of experience. Each year the World Health Organization designates three viral strains deemed most likely to be prevalent during the next influenza season, and a trivalent vaccine is prepared for distribution in the fall.
This trivalent vaccine will be administered at the Martha's Vineyard Regional High School from 8 am to noon on Veterans Day, November 11. The Island town boards of health are working on plans for a separate day of inoculations against the new H1N1 strain, also known as swine flu.
Some people will shun these Island flu clinics because they don't like needle-sticks. Others will stay away out of fear and ignorance. After all, the word "flu" is fully half of the phrase, "flu vaccine" - seriously now, can that be a coincidence?
Health care providers say the most frequent concern they hear is, "Can I get the flu from a flu shot?" Never mind that thanks to the medical miracle of vaccination, polio has been unknown in the Western Hemisphere since 1991. Never mind that the flu vaccine is made from killed virus - and that you have as much risk of catching flu from a vaccine injection as you have of being devoured by a dead lion.
If you troll the Internet, you can find plenty of websites proclaiming the dangers of flu vaccinations. Of course, you can also find sites declaring that cigarettes are good for you and that the American moon landings were faked on a Hollywood set. If you're looking for information online, please remember that this is the largest unedited environment in the history of civilization, and vet your sources accordingly.
In a sense, this fall's round of flu vaccinations represents a sort of intelligence test for the Island community. Can we get over our fears and weigh the minuscule risks of the vaccine against the real and far larger threat of influenza, which annually hospitalizes 200,000 Americans and kills 36,000?
Dr. Salk put it well: "Life is an error-making and an error-correcting process, and nature in marking man's papers will grade him for wisdom as measured both by survival and by the quality of life of those who survive."