One part of the answer is that the Spanish flu virus passed from birds to pigs and then to humans, a mode of transmission that is thought to produce the most dangerous strains of influenza viruses.

The 1918 influenza pandemic was the most devastating outbreak of infectious disease in human history....It killed 2.5 percent of victims

three genes -- called PA, PB1, and PB2 -- along with a 1918 version of the nucleoprotein or NP gene, made modern seasonal flu kill ferrets in much the same way as the original 1918 flu, Kawaoka's team found

"The virus caused three waves of disease. The second of these, between September and December 1918, resulting in the heaviest loss of life...Although most people who were infected with the virus recovered within a week following bed rest, some died within 24 hours of infection."

Children have immune responses that are still developing, while the elderly tend to lose some immune function with the aging process. However, the middle age group--roughly age 15 to 50, give or take--tend to have an active, vigorous immune response upon invasion by a pathogen. Most of the time, this keeps us relatively free of disease from microbes, but some organisms tend to trigger this type of hyper-response that actually ends up harming the host--in some cases, fatally. This is what we've seen in some cases of H5N1 infection, and what's been induced in mouse models with the 1918 H1N1 strain.

Third, regarding the cytokine storm:
Some research has been posted in another flu thread about natural remedies and cytokines. This research was done regarding H5N1 and may not be important to H1N1.
It is most interesting to note that a common herb for colds/flu could be one of the worst things to take:

Echinacea - AVOID - Increases production of cytokines TNF-a and IL-6. Although it is often used for normal flu, research shows that it may increase the chance of cytokine storms for H5N1.

www.the-health-gazette.com...

For those new to cytokine storms, I offer this, also posted elsewhere in the flu forum:

Children have immune responses that are still developing, while the elderly tend to lose some immune function with the aging process. However, the middle age group--roughly age 15 to 50, give or take--tend to have an active, vigorous immune response upon invasion by a pathogen. Most of the time, this keeps us relatively free of disease from microbes, but some organisms tend to trigger this type of hyper-response that actually ends up harming the host--in some cases, fatally. This is what we've seen in some cases of H5N1 infection, and what's been induced in mouse models with the 1918 H1N1 strain.

scienceblogs.com...

Background. Triple-reassortant swine influenza A (H1) viruses — containing genes from avian, human, and swine influenza viruses — emerged and became enzootic among pig herds in North America during the late 1990s.

Methods. We report the clinical features of the first 11 sporadic cases of infection of humans with triple-reassortant swine influenza A (H1) viruses, occurring from December 2005 through February 2009, until just before the current epidemic of swine-origin influenza A (H1N1) among humans. These data were obtained from routine national influenza surveillance reports and from joint case investigations by public and animal health agencies. ...

Conclusions. From December 2005 until just before the current human epidemic of swine-origin influenza viruses, there was sporadic infection with triple-reassortant swine influenza A (H1) viruses in persons with exposure to pigs in the United States. Although all the patients recovered, severe illness of the lower respiratory tract and unusual influenza signs such as diarrhea were observed in some patients, including those who had been previously healthy.


Source: New England Journal of Medicine. "Triple-Reassortant Swine Influenza A (H1) in Humans in the United States, 2005-2009." NEJM

The United States has reported the most number of cases with 3,352, while Mexico has reported 2,446 cases and Canada 389 cases.

Swine flu cases reported from 33 countries: WHO

4th U.S. Death Linked to H1N1 Flu; Number of Sickened Nationwide Nears 5,000

US now has 4,700 cases of new swine flu - CDC

In the first of what could be a landslide of similar lawsuits stemming from the deadly outbreak of the H1N1 influenza virus, a Texas man whose wife was the first confirmed death in the United States from the so-called “swine flu” is considering suing a hog processing company for causing his wife’s death.

Attorneys for Steven Trunnell, whose wife, Judy, died of the H1N1 influenza strain last month, has asked a district court to grant a discovery request to allow him to investigate the possible role of Smithfield Foods Inc. in the outbreak. Smithfield owns and operates a massive pig processing plant in the same region of Mexico where the first cases of the deadly influenza were reported.

Trunnell’s attorneys accuse Smithfield of operating a filthy food-processing facility where viruses were allowed to grow and be transmitted to humans.

H usband Considers Suit Against Hog Processor for Causing Wife’s ‘Swine Flu’ Death

Emergency Preparedness and You

The possibility of public health emergencies arising in the United States concerns many people in the wake of recent hurricanes, tsunamis, acts of terrorism, and the threat of pandemic influenza. Though some people feel it is impossible to be prepared for unexpected events, the truth is that taking preparedness actions helps people deal with disasters of all sorts much more effectively when they do occur.

To help, Centers for Disease Control and Prevention (CDC) and the American Red Cross have teamed up to answer common questions and provide step by step guidance you can take now to protect you and your loved ones.
Step 1Get a Kit

* Emergency SuppliesGather Emergency Supplies
By taking time now to prepare emergency water supplies, food supplies and disaster supplies kit, you can provide for your entire family.

Step 2Make a Plan

* Family Disaster PlanDevelop a Family Disaster Plan
Families can cope with disaster by preparing in advance and working together as a team.

Step 3Be Informed

* Shelter in PlaceLearn How to Shelter in Place
Centers for Disease Control and Prevention (CDC) and the American Red Cross have teamed up to answer common questions and provide step by step guidance you can take now.
* Quarantine and IsolationUnderstand Quarantine and Isolation
When quarantine and isolation may be called for, what they are, and how they work.
* Healthy State of MindMaintain a Healthy State of Mind
Tools for coping with disaster for adults, parents, children, students, and seniors.

www.bt.cdc.gov...

The Egyptian government has been looking for a reason to wipe out the hog population since 2008, because there was and is growing concern that Egyptian pigs had become reservoirs for H5N1.

...The Egyptian government is scared to death that H1N1 will come around and reassort with H5N1, which they believe to possibly be endemic in their pig population. And if you look at the continuing increase in suspected and confirmed Egyptian H5N1 human bird flu cases, I think you'd agree there is much to be concerned about.

Likewise, the situation in Indonesia and in China also involoves informed speculation on behalf of animal and human influenza researchers that H5N1 may have made a small foothold in the hog populations there. Especially Indonesia, which remains Bird Flu Central for human cases and potential pandemic explosion, despite the competition from ongoing Egyptian human infections. Researchers already know that some 20% of the stray cat population in Indonesia has H5N1 antibodies. Likewise, some hogs in Indonesia have tested positive for H5N! antibodies.

From the Website FluWiki, from2006:

Cat H5N1 sequences in Indonesia are apparently more similar to H5N1 sequences from humans than either are to H5N1 sequences from birds. What is the most logical interpretation of these results? I submit that there may be a mammalian reservoir for H5N1 in Indonesia and other countries and that H5N1 is under selection to adapt to mammals in this reservoir. Further, at least some of the human cases may be due to mammal-to-human infections. (See also Dr. Jeremijenko’s post at 23:14 in this thread, and here and here). In the recent large cluster of human cases in Indonesia, no infections of poultry were found in close proximity to the village where the outbreak occured. However, pigs with antibodies to H5N1 were found in this region reference. H5N1 infections in pigs would be particularly worrisome as these animals could serve as mixing vessels for the formation of a human-adapted H5N1 strain. (bold mine)

That is what everyone is worried about. That is the Elephant in the Room. That is why no one in Geneva, Atlanta or anywhere else is overreacting about this swH1H1 epidemic.
allnurses

Of interest, the 1918 pandemic began with a relatively mild "herald" wave in the spring of 1918. During that time, outbreaks were reported in Europe and in the United States (particularly in military training camps for new recruits headed to the war in Europe) (see References: Reid 2001, Glezen 1996). This first wave was followed by two additional waves in the fall and winter of 1918-19 that were much more severe (see References: Taubenberger 2006). The second, highly virulent, wave spread rapidly around the world in the fall of 1918; it took only 2 months for the pandemic to circle the globe at that time.

Of the three pandemics that occurred in the 1900s, two involved reassorted viruses, but none were reassortants with swine viruses. [Ed. note: reassortments involving swine viruses may be considered more dangerous.]

...
Phase 6


This pandemic phase is characterized by community-level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in phase 5. Designation of this phase will indicate that a global pandemic is under way.

Post-Peak Period


During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur, and countries will need to be prepared for a second wave. Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months, and an immediate “at-ease” signal may be premature.

Post-pandemic period


In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required.

Novel H1N1 Influenza (Swine Flu) URL

Influenza A was first recognized as a clinical illness in pigs in 1918, which coincided with the 1918-19 influenza pandemic in humans. H1N1 influenza A virus was first isolated from pigs in the United States in 1930.

Swine influenza is considered endemic in pigs in the United States, and animal outbreaks occur with regular frequency (usually in the fall and winter months). ...

* From 1930 through 1998 swine influenza in North America was primarily caused by viruses of the classical H1N1 lineage.
* Since 1998, H3N2 viruses with genes derived from human, swine, and avian viruses (triple reassortant viruses) have become an important cause of swine influenza in North America, along with classical H1N1.
* H1N2 viruses that resulted from reassortment between the triple reassortant H3N2 viruses and classical H1N1 swine viruses also have been isolated in the United States.
* Avian H4N6 virus was recognized in pigs in Canada in 1999, but spread beyond the original farm of detection was not identified.
* A novel H3N1 influenza virus was isolated from pigs in the United States in the mid 2000s; this virus may have risen from reassortment of an H3N2 turkey isolate, a human H1N1 isolate, and currently circulating swine influenza viruses (see References: Lekcharoensuk 2006).

...A 2007 report identified 37 civilian swine-origin influenza cases reported in the medical literature between 1958 and 2005 (see References: Myers 2007). Of these cases, 19 occurred in the United States, six in Czechoslovakia, four in the Netherlands, three in Russia, three in Switzerland, one in Canada, and one in Hong Kong. Twenty-two (61%) reported recent exposure to pigs. The overall case fatality rate was 17%. Possible or probably limited human-to human transmission was reported in several situations.

Between December 2005 and February 2009, 11 sporadic cases of infection in humans with triple-reassortant swine influenza A H1 viruses were reported to the Centers for Disease Control and Prevention (CDC) (see References: Shinde 2009, Newman 2008). Ten of the infections were caused by triple reassortant H1N1 viruses and one by triple reassortant H1N2 virus.

...An additional swine-origin influenza case occurred in Spain in 2008 (see References: Adiego 2009, Van Reeth 2009).

On May 11, 2009, the WHO released a preliminary assessment of the novel H1N1 global situation as of that date. Key observations include the following (see References: WHO 2009: Assessing the severity of an influenza pandemic):
* In the two largest and best documented outbreaks to date, in Mexico and the United States, a younger age-group has been affected than seen during seasonal epidemics of influenza. Although cases have been confirmed in all age-groups, the youth of patients with severe or lethal infections is a striking feature of early outbreaks.
* In terms of population vulnerability, the tendency of the H1N1 virus to cause more severe and lethal infections in people with underlying conditions is of particular concern.
* For several reasons, the prevalence of chronic diseases has risen dramatically since 1968, when the last pandemic of the previous century occurred. The geographic distribution of these diseases, once considered the close companions of affluent societies, has likewise shifted dramatically. Today, WHO estimates that 85% of the burden of chronic diseases is now concentrated in low- and middle-income countries. In these countries, chronic diseases show an earlier average age of onset than seen in more affluent parts of the world.
* The full clinical spectrum of disease caused by H1N1 will not become apparent until the virus is more widespread.
* Apart from the intrinsic mutability of influenza viruses, other factors could alter the severity of current disease patterns, if the virus continues to spread.
* Scientists are concerned about possible changes that could take place as the virus spreads to the southern hemisphere and encounters currently circulating human viruses as the normal influenza season in that hemisphere begins.
* The fact that the H5N1 avian influenza virus is firmly established in poultry in some parts of the world is another cause for concern. No one can predict how the H5N1 virus will behave under the pressure of a pandemic.
* The H1N1 virus strain causing the current outbreaks is a new virus that has not been seen previously in either humans or animals. Although firm conclusions cannot be reached at present, scientists anticipate that preexisting immunity to the virus will be low or nonexistent, or largely confined to older population groups.
* H1N1 appears to be more contagious than seasonal influenza. The secondary attack rate of seasonal influenza ranges from 5% to 15%. Current estimates of the secondary attack rate of H1N1 range from 22% to 33%.

Pandemic Perspective

Scientists and public health officials have long been concerned that a reassorted influenza A virus could emerge in pigs and become a pandemic strain.

* Pigs can be infected with influenza A viruses from avian, human, or swine origin; therefore, pigs have been considered a "mixing vessel" for new viruses that can occur as a result of reassortment between viruses of diverse origins (see References: Webster 1992). Triple reassorted viruses (containing genetic material from human, avian, and swine strains) have been transmitted from pigs to humans (see References: Newman 2008), and the current H1N1 strain appears to be a reassorted virus.
* Because this novel H1N1 virus is of swine origin, it is substantially different from human influenza A H1N1 viruses; therefore, a large proportion of the population might be susceptible to infection and the seasonal influenza vaccine H1N1 strain likely will not provide protection (see References: CDC 2009: Swine influenza A [H1N1] infection in two children—Southern California, March-April 2009). These features enhance the pandemic potential of the new strain.

The funding will be used to produce bulk supplies of two key components of a vaccine and to test them in humans. The most critical of the two is the vaccine's active ingredient, a protein from the new flu virus designed to trigger an immune response. The second is a booster, called an adjuvant, that might be added to the vaccine to ramp up its potency if it doesn't appear to work in early human trials.

Waiting in long lines at schools and clinics, more than 40 million Americans — almost 25% of the population — received the swine flu vaccine before the program was halted in December after 10 weeks.

More than 500 people are thought to have developed Guillain-Barre syndrome after receiving the vaccine and 25 died. No one completely understands what causes Guillain-Barre in certain people, but the condition can develop after a bout with infection or following surgery or vaccination. The federal government paid millions in damages to people who developed the condition or their families.

However, the pandemic, which some experts estimated at the time could infect 50 million to 60 million Americans, never unfolded. Only about 200 cases of swine flu and one death were ultimately reported in the U.S., the CDC said.

The public viewed the entire episode as political farce, said Sencer, instead of a dedicated, science-based effort to protect public health. He said the government chose to err on the side of caution and risk scorn — something that experts working on the current outbreak may also face.

Immunologists have a special name for substances used to boost feeble vaccines. They are called adjuvants. Adjuvants are arguably the most extensively researched pharmaceutical product in the last quarter century that you never heard of. I have used the word adjuvant three times in this paragraph so far and that is probably three times more than you have ever seen it in print before. This is partly because the most effective adjuvants, those formulated with oils, are too dangerous for human use. That is squalene's other proven ability, causing incurable disease, which is why it is such a touchy subject with the Department of Defense.

ADJUVANTS, PRESERVATIVES AND TISSUE FIXATIVES IN VACCINES

Vaccines contain a number of substances which can be divided into the following groups:

1. Micro-organisms, either bacteria or viruses, thought to be causing certain infectious diseases and which the vaccine is supposed to prevent. These are whole-cell proteins or just the broken-cell protein envelopes, and are called antigens.

2. Chemical substances which are supposed to enhance the immune response to the vaccine, called adjuvants.

3. Chemical substances which act as preservatives and tissue fixatives, which are supposed to halt any further chemical reactions and putrefaction (decomposition or multiplication) of the live or attenuated (or killed) biological constituents of the vaccine.

All these constituents of vaccines are toxic, and their toxicity may vary, as a rule, from one batch of vaccine to another.

In this article, the first of a two-part series, we shall deal with adjuvants, their expects role and the reactions (side effects).

ADJUVANTS

The desired immune response to vaccines is the production of antibodies, and this is enhanced by adding certain substances to the vaccines. These are called adjuvants (from the Latin adjuvare, meaning "to help").

The chemical nature of adjuvants, their mode of action and their reactions (side effect) are highly variable. According to Gupta et al. (1993), some of the side effects can be ascribed to an unintentional stimulation of different mechanisms of the immune system whereas others may reflect general adverse pharmacological reactions which are more less expected.

There are several types of adjuvants. Today the most common adjuvants for human use are aluminium hydroxide, aluminium phosphate and calcium phosphate. However, there are a number of other adjuvants based on oil emulsions, products from bacteria (their synthetic derivatives as well as liposomes) or gram-negative bacteria, endotoxins, cholesterol, fatty acids, aliphatic amines, paraffinic and vegetable oils. Recently, monophosphoryl lipid A, ISCOMs with Quil-A, and Syntex adjuvant formulations (SAFs) containing the threonyl derivative or muramyl dipeptide have been under consideration for use in human vaccines.

Chemically, the adjuvants are a highly heterogenous group of compounds with only one thing in common: their ability to enhance the immune response-their adjuvanticity. They are highly variable in terms of how they affect the immune system and how serious their adverse effects are due to the resultant hyperactivation of the immune system.

Dr. Sherri Tenpenny, DO
May 1, 2006
NewsWithViews.com

Vaccination of “every man, woman and child” has been in the planning for at least the last several years. The current concept, originated by former Health and Human Services (HHS) Secretary, Tommy Thompson,[1] is being advanced by his successor, Mike Leavitt.[2] Of course, Thompson envisioned mass vaccination using the smallpox vaccine. But times have changed, and the flu shot now appears to be the instrument of choice for those pursuing the universal vaccination agenda.

The fact that the flu shots are ineffective in every age group hardly seems to matter to those who continually promote their use. Multiple studies published in highly reputable publications have documented that flu shots are ineffective in all ages. For example, The Cochrane Collaboration produced a series of articles in 2005 reviewing the published literature to determine the effectiveness of the flu shot. Nothing substantiating its usefulness was found. .........

........During the week of April 17, 2006, The Washington Post ran a story that not only extolled the use of the influenza vaccines but pushed for a new and improved version by saying, “Why wait for the pandemic to benefit from better flu vaccines?”[7] The story went on to say that the National Institutes of Health (NIH) is planning to strengthen the flu shot “destined for the elderly” by adding an immune-boosting compound to the shot called an adjuvant.

An adjuvant is a substance added to produce a high antibody response using the smallest amount of virus (antigen) possible. By definition adjuvants are considered to be “pharmacologically active drugs.” They are designed to be “inert without inherent activity or toxicity” and yet they are required to “potently augment effects of the other compounds” in the vaccines.[8] It is difficult to explain how a substance can be defined as “pharmacologically active” and at the same time be described as “inert and have no activity or toxicity.”

The limiting factor for approval of new adjuvants has been that most are far too toxic for use in humans. However, one adjuvant has been approved in Europe and its approval is on the way for use in the U.S. It is an oil-based adjuvant called MF-59, a compound primarily composed of squalene. On first blush, squalene seems like a good choice for an adjuvant. Manufactured naturally in the liver, squalene is a precursor for cholesterol. In addition, squalene can be purchased at health food stores in its more commonly known form, “shark liver oil.” However, ingested squalene has a completely different effect on the body than injected squalene. When molecules of squalene enter the body through an injection, even at concentrations as small as 10 to 20 parts per billion, it can lead to self-destructive immune responses, such as autoimmune arthritis and lupus.[9]
Several mechanisms have been proposed to explain this reaction.