...and speaking of HIV and influenza...

Yesterday, the New York Times op-ed by John Moore and Nicoli Nattrass discussing denial of HIV. They also featured an article suggesting that more human-to-human transmission of H5N1 has occurred than previously thought.

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I've been hearing some odd things around, by people who mean well, but are not as informed as they might be. One suggestion was that should some sort of Bird Flu break out, that there would be a limited supply of vaccine, and the question would be who gets it? Ethical considerations then fly all over, such as "Who decides life and death issues?".

I'd imagine that no such vaccine currently exists (the strain is unkown, but there are some general anti-virals). When one is created, it will unlikely to provide 100% protection, or even close. The distribution of any such vaccine would be aimed at minimizing the spread of the disease at large. I don't know the facts. Perhaps young healthy people take to such vaccines more effectively than others... or are more involved in typical spread patterns.

Rumor has it that in the 1918 event, the highest death toll was in the 15 to 34 year old range. That seems odd. Was the general life span really short?

Stephen, there has been some work done on a vaccine for H5N1, but they've been far from ideal. Additionally, they're based on current circulating viruses, and as you note, may not be a close enough match to provide adequate protection to the hypothetical H5N1 pandemic strain (should that occur). But there are definitely a lot of issues surrounding vaccination--not only who'd get the limited supply, but also how to even distribute it and other rather mundane--but critically important--details.

Regarding 1918, it's thought that those in that age group--which are often the least afflicted by serious influenza complications--were hit hard due to the very factor that usually protects them from infectious disease: a robust immune system. The flu wiki has a nice article on it here.

Thanks for the flu wiki link. The Cytokine storm is easy enough to understand, and seems hype free. It's going to take some time to wade through the rest of the site.

Readers may wish to know that, in response to Dr. Moore's hysterical editorial regarding the hypothesis so fervently, yet ignorantly, endorsed by a certain junior epidemiology prof. with many fawning cardboard cutouts, Harvey "Tryptophan" Bialy challenged Dr. Moore to a moderated debate at the AIDS Wiki...

http://www.reviewingaids.org/awiki/index.php/Document:Bialy/Moore_debate

...Moore's response?"

"Participating in any public forum with the likes of Bialy would give him a credibility that he does not merit. The science community does not 'debate' with the AIDS denialists, it treats them with the utter contempt that they deserve and exposes them for the charlatans that they are. Kindly do not send me any further communications on this or any related matter. -- John Moore"

One would think a scientist worthy of the name would jump at such an opportunity to "expose" his opponents for the "charlatans that they are". Especially considering the US government apparently, according to a recent release sent to all US embassies, gives Dr. Bialy's viewpoint a great deal more credence than Dr. Moore does. Maybe the US government is also comprised of "charlatans" who deserve to be "exposed"?