Day 174 (#2): H5N1 & Hope-Simpson

The following book report was composed by your humble scholar in a state of excited delirium triggered by close theoretical and historical contemplation of the virus that nearly killed me days ago. R. Edgar Hope-Simpson’s The Transmission of Epidemic Influenza was my ultimate page-turner.

I begin by digressing: Shortly before his death in 2005, vaccine pioneer Maurice Hilleman told his biographer in Vaccinated that only 3 of the 16 (HA) hemagglutinin subtypes transmit flu easily among humans. Each, he said, does this every 68 years, and they do it in order, cycling H1—H2—H3. The H5 subtype, he said, was only for the birds. He’d have us battling a resurgent H2 in 2025 after a long pause between pandemics. Ominously, H2 is the one Missouri pigs share with people and birds.

INFECTION SITES OF H1N1 vs. H5N1: RED IS THE COLOR OF LETHALITY & TRANSMISSION (Tim Vickers)Hilleman was cheating. His chart of outbreaks doesn’t jibe with most others. For one thing, he skips the (non-pandemic) revival that 1918’s H1 staged in 1977, choosing instead to claim a “mini-pandemic” for H1 in 1986. Otherwise he couldn’t claim that flu subtypes follow a 68-year cycle.

Just about everyone in the flu business has pet theories, scientific convictions, and logical holes they try hard to overlook. As I showed months ago, prevailing flu dogma is deeply flawed. In summing up decades of his work in this book, Hope-Simpson effectively undermines preexisting theories as he attempts to establish his own New Concept. He seems admirably open to new data and I find his questions compelling, his arguments fascinating.

How I wish this spunky maverick were here to explain how H5N1 broke out, or at least to pose fresh challenges to the received wisdom that smothers us in useless expert babble.

Hope-Simpson made his name establishing that a virus could long lie dormant and then reemerge ferociously with a new set of symptoms. In assessing influenza, he didn’t much look to the animal world as a source for pandemics. He believed that human beings serve as a repository for what he considered a master viral genome. He thought we carry the entire code in generational waves.

Original Antigenic Sin

The first subtype of Influenza A to which each generation is exposed causes a primal immunity that stamps those carriers forever in a phenomenon called “original antigenic sin.” (Here, I pause to contemplate those kids who quietly came down with very mild H5N1 all over the world.) This subtype goes on to infect people for decades, with each survivor reactivating without symptoms for up to two years to infect others.

Eventually our subtype begins to run into too many specimens with primary immunity to it. In a process that remains mysterious and grand, the subtype vanishes all over the world, to be replaced in a pandemic by another subtype to which only old survivors of that flu carry immunity.

But only the first three listed hemagglutinin subtypes were previously known to transmit easily among people. Like Hilleman, Hope-Simpson believed H1, H2, and H3 comprised humanity’s infectious flu genome, though he ordered their appearances differently (H2-H3-H1…). What would he make of H5N1’s leap into the sequence? How did an upstart flu virus seed the world (all the way to Saskatoon) while the WHO was dogging it with Tamiflu blankets?

In his book, Hope-Simpson cites a 1979 letter to Lancet from China’s Dr. Wang Mau Liang, who suggested that a noninfectious subtype could recombine with another animal- or human-based influenza virus to create a new pathogenic strain. But H5N1 is not a reassorted virus, or even a recombined one. It’s a familiar one, located very close to H2 on an Influenza A family tree in Hope-Simpson’s book. (Could this somehow address why pre-1968 H2 carriers seem to bear some immunity to H5N1?) All we know is that the upstart H5 suddenly turned virulent and crashed the human cycle.

I’m guessing that Hope-Simpson would begin by theorizing that H5 was in us all along, a quiescent part of that genome. (The WHO concluded [in final reference to footnote #6] in 2008 that 15% to 20% of people over 40 bore “baseline” antibodies to H5N1.)

Given that those H2—H3—H1 cycles are known only to have operated since the late 19^th century, our visionary doctor might wonder if H5N1 is an element of a much bigger cycle that runs over a greater stretch of time. Were people long ago dying from H5 strains? Could an H7 (or H16) follow in a new centuries-long cycle? Is there a genomic pattern so big that puny modern mortals can’t yet see it?

He might also ask if human beings have done something revolutionary to vault H5 into the subtype cycle. Did any prepandemic vaccines contain live elements that seeded the world, enabling H5N1 to jump a line it was never meant to be on? China tried plasmapheresis—injecting people with antibodies from survivors in hopes they would acquire immunity. Did some government(s) or corporation(s) try this, too? Did a bird flu correctly dismissed by Hilleman spook us into spreading it ourselves?

Just asking, folks. I don’t have a clue. I’m merely danged glad to be alive. I wish the old doc were, too.

Day 175: Flu York City Blues

I haven’t much to report. New York’s streets are quieter. The government’s food giveaways have gone pretty well. Little further violence has been reported, with no hijackings. On the other hand, bloodshed is rarely recounted, except by bloggers whose credibility you are continually urged to doubt by big media.

Readers who aren’t prodding me for inaccessible details of my personal life have sent tales of their own communities in crisis. Those from places like New Zealand—where the government and private sector prepared contingency plans for just about everything that could arise in a pandemic—tend to revolve around personal tragedy and loss, plus complaints about Big Brother advising people what to eat. (Our government warns people what not to eat of what little is left.)

ALL THE BEST PLACES ARE CLOSEDEuropeans, Canadians, Australians, and such have seen lots of unrest, but governments have kept up fundamental services. National parliaments have been quick to debate and pass new measures as needed. Social democrats will be insufferable after this pandemic! They’re doing pretty well, according to foreign readers transfixed by the spectacle of a National New Orleans in the U.S.A.

The rest of the world seems a mess, though India’s melodramatic press may be exaggerating unrest there. I check Boxun—the shadowy, independent agency that blew the whistle on SARS and claims disorder is endemic in China—but it, too, favors the grimmest reports. (I welcome any insights from China.)

Here, we roam rubble that sprouts like weeds. My ‘hood, long a hive of gentrification, is devolving. Yuppie eateries have been cooked. Armed men staff what remains. The peoples’ gardens are locked.

A friend came home this morning from walking the dog to find two men in his kitchen next to a broken window, devouring his dinner. They beat and robbed him, took his golden retriever. Do they intend to eat the dog? He’s looking for a gun, aims to hunt them down before they can harm his pet. He’ll recognize them because they looked … Hispanic. Like almost everyone just east of here.

Looters, Looters, Everywhere

From what I hear, the death toll in the projects is awful. They weren’t the only looters, though in white neighborhoods it gets reported more as “desperate parents saving their families.” I’ve heard, seen, and read white people boasting about having made the most of a bad situation—including a zealous environmentalist pal who nabbed a pair of energy-conserving air conditioners for her apartment. Two courteous looters carried them for her. (She tipped them well; my friends aren’t cheapskates.)

Three hardcore LES DIY members have died—a loss to our species. I like to think that relatively few people I know caught H5N1 because my friends are informed and have protective gear. Hope-Simpson would probably call it luck.

The Committee of Public Nutrition—as the lawyers have restyled the LES DIY—continues to serve food at the restaurant. The shrine to Ric takes up half the sidewalk. Two white-collar members just quit, however. Their employers let it be known that only groups sanctioned by RAISE should be supported in thought, word, or deed. How did they even know these people were involved with the LES DIY? Who said you need RAISE’s permission to give people food?

Ominously, Tribulation Beat says InfraGard (that FBI-business collaboration controlled by DHS) has turned companies big and small into snoops that spy on their customers. I swear, your secrets are safe with me (and the credit card company you used, UPS, your bank, your ISP)—if not with InfraGard, which got hacked in 2011….

Happily, I’ll dine at Anna’s apartment tomorrow. She predicts my appetite will have recovered by then. This will be our first date.

Hope-Simpson converts are asking if I think she gave me the flu because she had it in Round One. Who knows? Anna gives me fever. She probably saved my life for the second time in two weeks when I caught bird flu. I think I saved hers in the park—just before she saved mine.

Y’all ask so many questions about Anna. I’m not holding back: I don’t understand her myself. Turns out that can be a wonderful thing. Every moment contains surprises. Sometimes I’m doing new things—or old things in new ways. Seeing things freshly. The Month of Living Dangerously has only just begun, paced by this fierce old song she played for me: Isis from the Yeah Yeah Yeahs.

Day 175 (#2): An Unholy Stew

I was awakened after only a few hours by fighting in the street below, but it turned out to be mere fisticuffs. Comforted, I headed to Ric’s Place to mooch leftovers.

While I was chewing, a priest who was a big LES DIY fan three months ago barged in and demanded in Spanish that an elderly woman who was making pasta leave with him. When she looked down and kept working, I saw that her hands were shaking. Then he started yelling that we were doing the devil’s work. I’ve never seen a priest act so medieval. Everyone was speechless.

The priest’s relative youth, unusual accent, and black clerical costume caused two recent LES DIY recruits—kitchen staffers—to think it was a joke. They hooted and tossed stale rolls at him, which provoked the older woman to scream at them in Spanish. (She belongs to the parish in question.) They thought that was funny, too, till she flung boiling water at them. This accidentally scalded a DIYer who was scrubbing an oven. It was a domino run of sociopolitical catastrophe.

By the time Anna came upstairs to reestablish order, the priest wasn’t interested in listening to a younger woman a third his size. In a voice that grew heartier and louder with each syllable, he denounced the LES DIY’s sinful, sinister ways and its lack of standing with the government. (The LES DIY did, in fact, register with RAISE; because the group was not licensed as a charity, it wasn’t taken seriously and never received a response. This was fine with Anna & Co., who sought neither subsidies nor approval, but left them open to the preposterous charge that they are not authorized to help anyone during a national emergency.)

When the priest ran out of rhetoric and paused for air, Anna told him to get out. I was shocked. She pointed to the door. Lifting his own finger to the heavens, then leveling it at Anna as if she intended to abort the Second Coming, the priest called on the Almighty to crush the LES DIY and anyone who sought the group’s help. He was cursing us all—even the families we feed.

Anna stood her ground. She wasn’t raised Catholic. She said he’d said enough. She was right, but I would never have said that to him. It didn’t turn out well.

A dishwasher headed for the door, followed by the cook who had thrown water. Anna took the women’s hands to thank them for all they had done. The older one was crying, The priest watched, expressionless in victory. He used to enjoy joking with Ric. They drank cognac together at least once. How could this have happened?

Day 176-7: My Dinner at Anna’s

Sorry, people, I’m fine. I appreciate your alarm when I fail to post. I apologize.

At Anna’s insistence—even after the priest’s earthly intervention caused so many staffing problems—I kept our dinner date. I hated relying on her to cook after all she does, but she can’t legally (or safely) walk home late, while I can. And I’d been waiting to taste what she’d make just for me, on her turf.

MANHATTAN BRIDGE UNDER CONSTRUCTION, 1909Anna lives near the Manhattan Bridge in a slummy neighborhood that looks like mine did years ago. It’s the last unspoiled nook of downtown Manhattan, where cheap but authentic Chinese eateries still flood the streets with thick, piquant odors that sing dim sum, congee, salted pepper squid….

Hers is a typical rent-stabilized flat, old and small with decrepit fixtures her landlord will never replace until rehabilitation expense accounting can free the apartment of regulation by lifting the monthly rent over $2,500. (My place was liberated shortly before I arrived.) As long as rent is cheap, owners treasure shabbiness.

Why is this ungrateful critter saying this about his dear friend’s home, you ask?

Because her space is a timeless refuge I couldn’t have imagined in that drab walkup. It’s colored in aqua and magnolia and hung with fabrics that suggest a tent in a desert breeze. The vibe is both restful and stimulating. It was a dream to sit there, sampling cognac and herbs amid hushed, wailing chamber music.

I reclined in her dining area while she fetched appetizers she must have conjured: There were two good cheeses and an original dip redolent of garlic and ginger, with strips of celery, avocado, carrot, and asparagus.

We didn’t talk shop, never mentioned the priest after she asked if I thought she’d go to hell. (No way.) I was dazzled by her world and her Hot Black Silk. (Thanks, Jason Molina & Songs Ohia.)

Then I noticed photographs over the stereo—a little girl with a shy smile and wide eyes, dancing in a red fairy outfit. For a moment, I thought it was Anna as a child, and then Anna explained that she and her daughter used to hula-hoop together in this room. She seemed happy to remember.

Anna asked me to open a malbec as soft and intense as her gaze. Wherever he was last night, Ric toasted her. He probably gave her the bottle.

Triumph of Good Will

We sipped wine and ate almonds. I could have imagined we were picnicking as we spoke of how we’d grown up, where and when—and why she waited so long to reveal herself to me. Readers have asked: Is she really so shy? Sadistic? I was curious, too.

We weren’t ready, Anna told me. She thought she was months ago, but I drove upstate the day she was planning to introduce herself. One pandemic wave led to another. I cooped myself up. She decided I had simmered long enough when she read my longings for a partner to join me by the lake in the park. It spurred her own development. Within days, Ric’s death slammed us together in that very spot, fighting for our lives.

Before anyone suggests she be toasted for sorcery, let me add that Anna is one of the most innocent people I’ve ever met, someone who follows her impulses with consummate integrity. If she doesn’t feel like talking, she can’t. But she’s brilliant at anticipating how others will react. When she needs something, she’s like a gifted fullback approaching an alert line: Though her target is clear to everyone, she’ll get there.

She says power is a mirage that helps others accept what you want.

Will Anna mind my posting this? She says she doesn’t care, so long as I tell the truth.

Frankly, dinner turned out to be a ravishing pesto oozing a fine blend of pine nuts and garlic and basil and arugula. I’ve tasted nothing like it since long before the pandemic. Ric taught her some tasty tricks while they were whipping up batches of blander food.

Want me to keep going? Is this too painful to read? I can’t help myself: Dessert was chocolate-covered bananas and espresso. She was sad not to offer lemon peel.

Days ago, I feared I was dying. Now I was in heaven, her world. I’m still there in spirit.

Day 178: A Stimulating Q&A

Mail call!

Hey, I never claimed that our pandemic was propelled by an errant vaccine. I merely suggested it was an interesting possibility if H5N1 was indeed genomally incapable of serially infecting many people. The point I’m always trying to make is not that I know so much, but that we know so little.

WHO NEEDS A VACCINE? ANNA'S GOT CHOCOLATE!A number of hysterical antivaxers (not including Fitch, who protests in person) have written to try to persuade me that the big pharmaceutical companies will turn babies into repurposed drones via the impending H5N1 vaccine. Ladies, you’ll be lucky if your babies see a vaccine this year. (And please note that they no longer use thimerosal in any vaccines for kids under seven years of age.)

Still, I vigorously oppose legislation to force vaccinations not only on health workers, but all public employees. Such measures induce resentment and panic. The fact is that most Americans want to be vaccinated.

Yes, I still wear a mask, gloves, and goggles when I go out, and I disinfect when I come home. Even if I did catch H5N1, the virus may evolve other strains that could come back and bite me. Not to mention that I might infect others, per Hope-Simpson. And track microbes indoors for Sneeky to absorb.

I definitely dread the prospect of emergency legislation that would enable the government to draft Americans who have survived bird flu. If Hope-Simpson was right, flu survivors spread it no less than current victims do—possibly more.

I detest conscription anyway. The LES DIY keeps a list of flu survivors who could help others. (Only Anna has heard of Hope-Simpson; she reads this blog.) The people on the list volunteered, which is what the government and DHS and FEMA and RAISE ought to ask Americans to do—instead of drafting them to work for contractors and subcontractors hired by the government for fat fees.

I hope Congress comes to its senses (it’s tough not to laugh out loud at the thought, but I vowed never to use Web jargon) and chooses to help citizens help themselves.

In the Food for Love

By now, more than a few readers are saying hmmm, what about my question? You know, the culinary one…. One reader put it best: “Young man, I don’t know you, but your hostess wasn’t taking any chances on her menu. By my count, your dinner consisted of nearly 100% aphrodisiac foods. I’m shocked—shocked—that she didn’t serve oysters!”

Prompted to look into this unseemly allegation, I’m astounded to discover that almost everything Anna served is known or rumored to have a libidinous effect. I suspect she couldn’t obtain oysters, which are laden with zinc and dopamine. (Both have an established effect on arousal.)

But she did pretty well. Take our dessert: Bananas have an enzyme called bromelain, chocolate an alkaloid called theobromine and a chemical called phenylethylamine. All have sensual effects. That was just one course. I could go on and on.

I did, but I would have anyway.

Anna provides very well for herself and her chosen beneficiaries. She’s Mother Earth in gauzy fabrics, inspired and inspiring. In return, she needs to be consumed. It turns out we’re exceedingly well-matched. Am I smitten? You bet.

Anna’s world is rich because she imagines it to be, then makes it so. She says she imagined I was pure and ferocious. Reporting for duty, ma’am. I always knew she was ravishing.

Special thanks to the woman who sent the hot tip about celery. It turns out to contain androsterone, an odorless hormone men release when they sweat; it’s said to excite women. If I find some celery, I’ll see what happens. I doubt I could tell the difference.