Our best shot

Flu vaccination season is here. Some people queue up without a prompt, others decline the offer, citing "I never get the flu," or "The flu shot always makes me sick." To the former I'd say "Well don't push your luck," and to the latter "It's an inactivated vaccine, it can't possibly give you the flu."

Influenza viruses are rarely virulent enough to kill a healthy patient. The only patient of mine who ever died primarily of flu was a thirty-something year old severe anorectic who barely had the strength to walk across the room much less battle her final viral load. Indeed, most flu deaths occur in such compromised hosts, or as a result of a secondary bacterial invasion of flu-weakened airways.

A notable exception was the dreadful flu of 1918 that killed tens of millions of people around the world, many of them in the prime of life. Investigators know that not only did this strain of flu cause a fatal primary pneumonia all on its own, it also opened the door for easy bacterial access to the lungs and fatal secondary pneumonia.

Tennessee researchers discovered a deadly viral protein--PB1-F2--that causes such a dreadful inflammatory mess in the lungs of mice that 100% of infected animals either die of primary viral pneumonia or secondary bacterial infections. They induced an otherwise ordinary variety of flu to express this protein, engineered to be identical to the nasty molecule the 1918 strain produced.

Virologist Dr. Jonathan McCullers concluded: "This is one of the big reasons 1918 was so bad, because PB1-F2 allowed bacteria to cause more problems due to lung inflammation and damage." Scientists can use this information to spot super-flus before they spot us.