The report Thursday that the Northern Command of the US “Military planning for possible H1N1 outbreak” will no doubt be viewed as a significant development, depending on whether you’re a tinfoil hat type, a conspiracy theorist, or someone with a good handle on the legal meaning of the Posse Comitatus Act.
At this juncture, the plan is more like ‘a plan to study a plan’ since the SecDef needs to sign off on it and if you Google Robert Gates, you’ll notice that he’s been on a road a fair bit of late. In Turkey, for example, he’s reported planning a possible speed-up in the US Iraq withdrawal. Not that his travels may not be connected to nu flu. So depleted is the stock of US domestic Reservists that the extraction of US forces from Iraq could be necessary to staff up the Northern Command’s flu plan should it come (like it won’t?), in the administration’s and in the military brass’s view, later on this year.
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The astute reader of the predictive linguistics out of HalfPastHuman.com might now stitch together how multiple purposes for federal forces could arrive almost simultaneously by late fall. The three main linguistic features of the fall and into mid 2010 seem to include attacks on banks, ATM’s, establishment institutions and such, the possibility of radiation/fallout so bad that it changes our eating habits (driving people to become vegetarian because of risks from meat), and then there’s the flu issue.
Nothing says we can’t get a sampler/smorgasbord of all three in different proportions; such is the outlook for the next six months and beyond.
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Also related on the flu front, I told you yesterday that I would inquire of our consulting PhD microbiologist at the request of a reader who said her doctor said not to overlook the common (not to mention cheap) gout preventative “Allupurinol” in your questions to ask your own doc about when you’re preplanning your personal flu response for this fall. A person would have to be a bit daft not to be prepared with all the lead-time available.
Before his answer though, as a new practitioner, I need to review three things with you: 1) This is not medical advice – it’s a discussion for informational purposes only. See your own doctor (or get one) before the flu season ramps up. 2) The mechanism of death in extreme flu is cytokine storming of the body’s defense mechanism, which you can read about here. 3) Talk with your doctor about the role and advisability of H1 and H2 blockers to reduce ’storming’ potential. Many over-the-counter drugs may be useful.
Now, having disclaimed any responsibility for your actions, here’s what our ’staff microbiologist had to say, paying particular attention to his last paragraph in response to the Allupurinol question…
“Good call. I never thought of that.
In short, your reader’s doctor is correct; allopurinol might slow/inhibit cytokine storming. Allopurinol inhibits the enzyme xanthine oxidase an can lead to reduced levels of uric acid. Hence, the use to prevent gout (won’t help to end a gout attack, but can help prevent one). It also reduces the release TNF-?, and might, therefore, interrupt the chain of events enough to prevent cytokine storm. It is a cheap & relatively safe drug. Note the use of “relatively”. While quite rare, allopurinol is one of the drugs that can trigger Stevens-Johnson Syndrome (SJS). This is a potentially life-threatening syndrome where the epidermis separates from the dermis (if you don’t go “ouch”, think about it for a while). Symptoms often start with painful rashes in the mouth. SJS is an emergency. That said, allopurinol might well be a drug in the arsenal to tone down the inflammatory response.
Other things that may or may not have been previously mentioned:
Loratadine (Claritin) & cetirizine (Zyrtek) also inhibit the inflammatory pathway by more than just the histamine blocking. Cetirizine inhibits the release of IL-8 (interleukin-8) a pro-inflammatory signaling molecule, and it stimulates the release of PGE-2 (prostaglandin-E2; among other things stimulates a fever). PGE-2 inhibits elements of the immune system/ inflammation, so cetirizine may work in 3 ways to help interrupt the chain of events. Loratadine, in addition to the histamine blocking effects, reduces the production of leukotriene-B4; also reducing the likelihood of a runaway inflammatory event. Both of these drugs have peak effects within a couple of hours. Normally a person takes one OR the other, once a day. I wonder if it would be safe to take both, but spaced 12 hours apart? That was a question and not a suggestion as I don’t know what would happen. In the UK cetirizine & diphenhydramine (Benadryl) are teamed together.
Cannabinoids also inhibit IL-2 & TNF-?. It is well documented that heavy pot users are more prone to viral infections and this is due to the inhibition of the immune/inflammatory pathways. Now in all probability, in addition to the illegality, smoking marijuana while in the throes of influenza is not too good an idea (same applies to smoking anything as that really stresses the damaged alveolar cells of the lungs!). Hmmm, I wonder if there are any of those brownies that were widely available at the old Grateful Dead concerts still around-LOL! But, if one were hypothetically looking at agents that can temporarily impair the pro-inflammatory response, cannabinoids likely do fall into that category.
So, to add to the discussion of how to treat one’s self (a potentially risky proposition), include: allupurinol, diphenhydramine, loratidine, cetirizine and cannabinoids. Keep in mind that the very things that can potentially reduce the likelihood of cytokine storm, will INCREASE the probability of pneumonia, so one must weigh the risks of dying from cytokine storm with the risk of dying from pneumonia. Assuming that there are still functioning hospitals if a major H1N1 (in a possibly more virulent form) outbreak occurs, it will be good to gets one’s sick butt there ASAP if the typical symptoms of flu seem to worsen in the lungs. After all, dead is dead, regardless of the specific mechanism of death. Also, FWIW, word released this week suggests that pregnant women are at a greater risk of death than non-pregnant women with regard to H1N1.
As a side note, the above drugs/agents have been suggested as a possible treatment for psoriasis, and by logical extension, some types of eczema. None of the above paragraphs are a recommendation. Merely a discussion of data points.
OK, I’m good with that. But, I got to thinking “Hey! If allupurinol (spelled variously, BTW) is good, what about the sudden onset gout attack medication colchicine?
“Ok, colchicine interrupts microtubule formation. Microtubules are necessary for transport along the axons of nerves and in cell reproduction; think of them as part of the tiny skeletal elements of cells. In low doses colchicine prevents uric acid from forming crystals- which is why it is used for acute gout attacks. In high doses it leads to death in a way that resembles radiation poisoning or overdose on chemotherapy: bleeding from mouth, stomach, intestines and then eventually shock from all of the bleeding, leading to loss of all organ systems. Lower toxic doses can cause kidney failure.
On the other hand, it is an immune suppressant and has anti-inflammatory properties. It is a bit overly powerful at inhibiting the immune system, so caution would be necessary if one had influenza while taking colchicine. So, bottom line is, yes, it could be considered in the discussion of ways to inhibit cytokine storming. The main problem is that while on colchicine, alveolar cells in the lungs that die from influenza will be replaced at a slower than normal rate. A potential bummer.
— the microbiologist
More than you may ever want to know about the flu, but some of us who are seriously allergic (as in anaphylactic shock allergic, to some preservatives, certain egg proteins, and dog proteins that may have to activate our back-up flu plans. If (heaven forbid) I were to get the flu, my personal response would include H1 blocking with Benadryl, H2 blocking with Pepcid or Zyrtec, and sweat like heck to ‘burn it out’.
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The quote today that “A whole industry is waiting for a pandemic” makes the timing of the nu flu just as suspicious as those falling down buildings in NYC…
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Current flu publicity seems to be going to headlines like “Pregnant women fsirst to get swine flu vaccine” and “Volunteer swarm for shot at swine flu vaccine“, however words like ’swarm’ sound a bit….oh…hive-like or herd-like to me. The headline in the Budapest (Hungary) this morning that “Swine flu hysteria yet to grip nation, but politicians are doing their best…”
Mind you, they’re talking about Hungary, but seems to me that the US MainStreamMedia (MSM) caught in the grip of declining ad sales revenue from almost everything else (did I say ‘Especially auto advertising”?) is no doubt salivating at the prospect of flu adverting and maybe some of that new health care plan advertising too.
If I sound a bit overly skeptical of all this…the coincident timing of the ‘discovery’ (release?) of the novel flu which arguably seems statistically unlikely at the time and place of the outbreak, you’re right!
On Again, Off Again
Flipping faster than a strobe light down at the disco, the healthcare bill is back on hold until October. Pardon my healthy skepticism even then. What? Too young to remember disco? Your loss, kid…
Dollar’s Demise
We’ve been mentioning for several years that one of the largest events in your lifetime is likely to be the demise of the (current) US dollar and its succession by something else. In what could be a precursor (besides the Chinese showing up in DC to ask WTF?) there’s a headline today that “Weak Treasury auctions raise worries about US debt burden.“ Glad it’s being noticed and yep, a heads up for the aware…
Unemployment Numbers
From the Labor Department:
“In the week ending July 25, the advance figure for seasonally adjusted initial claims was 584,000, an increase of 25,000 from the previous week’s revised figure of 559,000. The 4-week moving average was 559,000, a decrease of 8,250 from the previous week’s revised average of 567,250.
The advance seasonally adjusted insured unemployment rate was 4.7 percent for the week ending July 18, unchanged from the prior week’s unrevised rate of 4.7 percent.
The advance number for seasonally adjusted insured unemployment during the week ending July 18 was 6,197,000, a decrease of 54,000 from the preceding week’s revised level of 6,251,000. The 4-week moving average was 6,416,250, a decrease of 131,750 from the preceding week’s revised average of 6,548,000.
The fiscal year-to-date average for seasonally adjusted insured unemployment for all programs is 5.497 million. “
About as expected. The markets are poised to head higher at the open. Say, is that a bottle of nitrous there beside your level 3 trading machine? No? Helium, you say?
Not Worth Saving
While Dan Rather may be well intentioned in his suggestion that the administration somehow become involved in ’saving the news’ business, my own feeling runs more to the idea of citizen-journalists and independent reporting on the ‘net is a good thing. Concentration of power has been, again in my view, abused.
If I hear one more “Tell your doctor” I’m gonna puke.
Sometimes I feel like I should post a disclaimer for this website like those pill-pusher ads on TV: WARNING: Use of UrbanSurvival may produce side effects such as mental clarity, independent thinking, skeptical viewpoints and a rash of new ideas. Read only as directed. Daily.