influenza

Wet Markets and Avian Influenza

Map of Hong Kong by Shawn Smallman, Apple pencil in Procreate

This week I had an article published: “Wet Markets and Avian Influenza: Public Policy Decisions in Hong Kong.” Because the Journal of International and Global Studies is open source, you can read the article by clicking on the link above if you are interested. You can also read the abstract here:

After the emergence of H5N1 avian influenza in 1997 Hong Kong implemented a sophisticated system to regulate live poultry markets. While this system is well designed and thorough, it also has limitations. The rise of H7N9 avian influenza (which is typically acquired through contact with poultry, including in live markets) makes this an appropriate time to revisit the ethical and practical issues related to this trade. Based on data from field observations of live markets in Hong Kong, and interviews with experts in the field, this paper recommends that the government of Hong Kong create a committee to examine the pros and cons of ending live poultry markets in this Special Administrative Region.

Shawn Smallman, 2018

The 1918 Flu Pandemic

“Virus” by ddpavumba at freedigitalphotos.net

The 1918 influenza pandemic was the disease outbreak that took the greatest toll in the twentieth century. Globally, perhaps between fifty and a hundred million people died. There are a wealth of wonderful books on the topic. I particularly recommend both Alfred Crosby, America’s Forgotten Pandemic and John Barry, The Great Influenza. Eileen Pettigrew’s Silent Enemy is an excellent popular account of Canada’s experience of the pandemic.

Years ago I was visiting a graveyard in Portland, Oregon. There were three graves next to each other, a man, a woman, and a child, who had all died within a few days of each other in November, 1918, almost certainly from the flu. It’s hard to imagine now what that lived experience must have been like. So many families have stories of ancestors who fought in World War One and survived, only to die on their way home.

My own grandfather was traveling in the Peace River country of northern Alberta at the time. He had decided that he was bored on the farm in southern Ontario. He and a friend had set out on an adventure to travel to the Yukon. Then his friend came down with the flu that fall in 1918. Although they never did make it to the Yukon, my grandfather helped to get his friend Frank home, where -as far as I know- he had a long and happy life. Of course, this was only one insignificant moment in the global disaster that impacted families from India to Australia, and took tens of millions of lives.

There is a fascinating new podcast series on this outbreak, which is well-researched and thoughtfully presented: Going Viral: the Mother of All Pandemics. The presenters have deep historical knowledge, and have invested an immense amount of time in preparing this engaging work. I enjoyed their trip to the former battlefields of France to try to track down the pandemic’s origin with Dr. John Oxford. One would think that there wasn’t much new left to say on this topic. Yet in their search for the true origins of the pandemic they look at provocative thinking and current debates, such as Mark Osborne Humphries’ idea that perhaps the pandemic actually began in China. They are also engaging speakers; one can imagine listening to them as a student, and being captured by their lecture style. You can find the podcast on iTunes and similar venues. Given the proliferation of H7N9, the diversification of influenza clades, and the fact that we still don’t have a universal influenza vaccine, this history remains sadly relevant. Highly Recommended. If you are interested to learn about more recent debates, you can also read my own work on influenza and pre-pandemic vaccines as well as conspiracy theories. Both of these articles are publicly available for free. You can also find more freely available articles on influenza here.

Shawn Smallman, 2018.

 

Influenza Humans Commons

Colorized transmission electron micrograph of Avian influenza A H5N1 viruses. By Photo Credit: Cynthia Goldsmith Content Providers: CDC/ Courtesy of Cynthia Goldsmith; Jacqueline Katz; Sherif R. Zaki [Public domain], via Wikimedia Commons
The Influenza Humans Commons is a collection of open-access articles on influenza, which is a great resource both for research and for course materials. You can find my own article, “Whom Do You Trust? Doubt And Conspiracy Theories In The 2009 Influenza Pandemic,” at this site, where it was recently among the top ten downloads. This is the paper’s abstract:

The 2009 pandemic of H1N1 influenza led people around the globe to create narratives about the epidemic defined by the question of trust; these narratives ranged from true conspiracy theories to simply accounts in which mistrust and betrayal formed a motif. In particular, most of these narratives reflected a fear of capitalism and globalization, although in specific regions, other issues—such as religion—played a more central role. These stories were not unique to the H1N1 pandemic but rather have appeared with every contemporary outbreak of infectious disease. This paper will examine conspiracy theories and moral panics related to the H1N1 pandemic in different world regions to explore how the disease became associated with economic and social systems in these accounts.

Shawn Smallman, 2018

Flu, Protest and Iran

While many factors are driving the current protests in Iran, Michael Coston has pointed out that a significant outbreak of avian influenza in that country has driven up the cost of poultry and eggs, which has likely contributed to peoples’ food insecurity. His blog post is an interesting attempt to tie influenza to economic factors, which in turn may be connected to politics.

Shawn Smallman, 2018

Conspiracy theories and the 2009 influenza pandemic

The Journal of International and Global Studies is an open access journal, which has just published my article: Whom do you trust: Doubt and Conspiracy theories in the 2009 Influenza Pandemic. The article examines how people in widely separated world regions responded to the pandemic with motifs based around trust and betrayal. While the article focuses on influenza, it also discusses other diseases such as polio and Ebola. Currently the Ebola in West Africa has been waning, and Liberia has finally been declared to be free of the disease. Even now, however, public health workers have to struggle against a powerful narrative of denial, which depicts Ebola as a tool created by the West to sell expensive medications. As I discuss in the article, such narratives have deep roots.

Shawn Smallman

Randall Munroe, XKCD Creative Commons Attribution and non-commercial use 2.5 license

Bird Flu in the United States

As Americans and Canadians follow the threats posed by emerging infectious diseases they are accustomed to hearing news from distant countries such as Saudi Arabia or Liberia. While the threat posed by highly pathogenic avian influenza (HPAI) may move its focus from Indonesia to Egypt, events seem far from our borders. Yet the U.S. is now in the midst of a grave outbreak of HPAI, which is devastating flocks in the Midwest. While this is primarily an avian disease, there is always the risk that it may jump to humans. Even if it remains confined to poultry, the long-term economic effects are serious. The virus is unlikely to disappear or be eradicated at any time in the near future. As always, Maryn McKenna is one of the best observers of issues related to infectious disease. I highly recommend her recent article on this topic here. It’s important to note that there is no evidence that the virus is transmitting from birds to humans at the current time, and that the CDC is preparing a vaccine, just in case. As others have noted, the larger issue is the sheer number of HPAI strains circulating globally, which is very different from even a decade ago.

Update: one of the students in my “Introduction to International Studies” class recommended this article in Time. You can also see my most recent article on conspiracy theories and the 2009 influenza pandemic for free.

Shawn Smallman, Portland State University

Influenza and Respect

The French website Sentiweb tracks disease prevalence in the country. This winter the map of influenza-like illness in France has been a sea of red, which documents a particularly bad year. The situation in Germany is no better. Influenza viruses mutate over time, which means that every year vaccine makers must guess which strain of the virus is most likely to cause illness in the coming season. Sadly, this year’s vaccine was poorly matched with the strain of H3N2 that has caused the most illness. According to a study in the U.S. it was only 23% effective, while one study in Canada found that people were actually more likely to become ill if they had been vaccinated. You can’t have a much worse vaccine that that. This situation has meant that more people in the United States went to the hospital with an influenza-like illness than in most years, particularly amongst the elderly. At least in the United States the influenza season is now waning. In my home state of Oregon, influenza cases peaked last month. This sadly does not seem to be the case in France as this map suggests. As in the United States, the majority of cases in France have been the H3N2 strain.

People tend not to treat influenza with sufficient respect. Years ago I had a phone call from someone who wanted to drive to Portland to meet me in my role as the Director of International Studies. The morning of the meeting I woke up and knew right away that I had the flu.  It felt as though somebody had turned up the gravity in my room. I had a high fever and could barely stand. But not wanting to disappoint them, I dragged myself to the office. They didn’t show up, and after an hour I went home. I consoled myself that it was for the best, because they last thing that they needed was to catch my flu. …

Biopiracy and Vaccines

"Bromo Mountain In East Java, Indonesia" by suwatpo at freedigitalphotos.net
“Bromo Mountain In East Java, Indonesia” by suwatpo at freedigitalphotos.net

Mariah Tso, an undergraduate student, just posted a great summary of my article, “Biopiracy and Vaccines: Indonesia and the WHO Pandemic Influenza Plan” on the blog “Climate Vulture.” This blog is also a great resource for information on climate change. You can view the original article here. I also have a second article on influenza, which examines conspiracy theories and the 2009 pandemic, which is publicly available.

Shawn Smallman, Portland State University

A book review of Dehner’s Global Flu and You

The Spanish Influenza. Chart showing mortality from the 1918 influenza pandemic in the US and Europe. Wikipedia commons.
The Spanish Influenza. Chart showing mortality from the 1918 influenza pandemic in the US and Europe. Wikipedia commons.

In 2009 people globally learned of the appearance of a new strain of influenza named H1N1A or “swine flu” in Mexico. By June the World Health Organization had declared the outbreak to be a pandemic, the U.S. and European governments were spending billions of dollars on vaccines and medications, and the tourism industry in Mexico was devastated. For most Americans, vaccine became available only after influenza had already peaked in their communities. Predictably there was an outburst of anger when the mortality rate proved to be low, as people felt that they had been misled by authorities, and frightened unnecessarily. Conspiracy theories regarding the WHO, pharmaceutical companies, and national governments abounded on Youtube and Twitter. While the mechanisms for communication were new, the problem faced by governments was not. Indeed, the U.S. had faced a similar situation in the 1970s. A historical perspective on influenza can provide some much needed context for policymakers and health authorities. George Dehner’s recent book, Global Flu and You: A History of Influenza, is a concise, well written organized overview of influenza’s history, which can help us to better understand contemporary health issues. …

H7N9 Influenza and the WHO’s Pandemic Influenza Plan

Photo courtesy of hyena reality and freedigitalphotos.net
Photo courtesy of hyena reality and freedigitalphotos.net

Like many of you, I’ve been carefully following the news about H7N9. A few of my favorite blogs or sites for this are Avian Flu Diary, Virology down under, the Center for Infectious Disease Research and Policy, and the Bird Flu Report. A couple of thoughts about what we know so far. First, it is always difficult to make a vaccine for an H7 virus. For this reason, it’s unlikely that sufficient vaccine could be ready in six months, even in the United States. It is true that some newer vaccine technologies are now proving their potential. But we aren’t in a fundamentally different position than in 2009, when most vaccine became available too late for swine flu. …

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