Health Spectator

In a previous post, we noted the recently published research of Yoshihiro Kawaoka, the eminent Japanse virologist, in which he recorded the fact that he had infected miniature pigs with H1N1 swine flu, and they were asymptomatic, though readily infected. He also pointed out that other mammals (and apparently humans) suffer significantly more lung damage from swine flu than from seasonal flus, in stark contrast to the lack of symptoms in his pigs.

We also commented in that previous article that everyone’s worst nightmare about the swine flu A(H1N1) was that it might turn into something more virulent but just as contagious by merging with bird flu:

Certainly the worst fear of all concerned is that the H1N1 virus could mutate into something resembling one of the current strains of avian flu such as H5N1, which has killed 50-60% of the humans it infected. Currently, H5N1 shows none of the infectious ability of H1N1 in human populations, but were that to change—as through a genetic recombination that combines the worst of both pathogens—the nightmares of those who fear the worst could be realized.

Scott McPherson’s blog points out that just such a situation could be emerging in Vietnam, possibly to be replicated shortly in China and Indonesia:

The deputy director of the Department of Preventive Health in the central province of Ha Tinh, Nguyen Luong Tam, confirmed on 26 Jul 2009 that a 30-year-old man died of bird flu at the General Hospital. The man had been rushed to hospital the previous day with pneumonia, high fever, headache, muscular and joint pain, cough, breathing difficulty, and vomiting. Doctors diagnosed him as having avian influenza and isolated him. They found his lung to be seriously damaged. He died on 26 Jul 2009. Health workers later found diseased poultry at the man’s house. He also had contact with a female relative, a teacher at Ngo Thoi Nhiem private High School in District 9, where 73 students and 5 teachers have contracted swine flu [that is, influenza pandemic (H1N1) 2009 virus infection].¹

So the human population in Indonesia has brought both avian flu and swine flu into close proximity, to the point where members of the same family may be infected with each type of virus. An isolated incident such as this does not guarantee there will be crossover between the two strains because they have come into close contact, but once this scenario has been repeated enough times, the odds mount.

Recombination typically occurs when the same cell becomes infected with two different strains of virus. Then the genetic materials have the opportunity to rearrange at will, resulting in mutations.² Accordingly, the Vietnamese health authorities are watching that situation closely.

Why Egypt slaughtered all the pigs

Something we haven’t yet mentioned, and which we also owe to McPherson’s website is the explanation of why the Eqyptians slaughtered all those pigs. (Swine flu: Why Egypt wants to kill all the pigs.) It’s worth a read on McPherson’s blog, as he does a good job of elaborating the story. We’ll try to give the short version here.

Those who follow influenza outbreaks are well aware that the dreaded avian flu (H5N1 virus) has made a home in Indonesia, where it has been jumping from birds to humans often enough to put a dent of 57 or so deaths in the human population. But less known to most Americans is that Egypt has also had problems with the bug. In fact, Egypt has the highest avian flu prevalance outside of Asia.

Avian flu infections in Egypt have appeared steadily since 2006 and have killed at least 26 people there. Meanwhile, as of August 19 there have been 509 cases of swine flu reported in Egypt.³ So, for those who fear the combination of H1N1 and H5N1 virus strains, Egypt is as likely a melting pot as Vietnam or Indonesia. And, like Vietnam, it has both outbreaks occurring in the human population.

What Egypt also had until recently was a large pig population—300,000 give or take a few—despite being a Muslim country where eating pork is forbidden to all but the occasional stray Christian. As Thacker and Janke note,

pigs would be the ideal mixing vessel for the creation of new avian/mammalian influenza viruses capable of causing novel diseases with the potential for producing pandemics in the human population. Whether this will happen easily, however, is less clear, although it is apparent that, in the US swine industry, transmission of influenza viruses between swine and humans is fairly common and is bidirectional. The pandemics of the past appear to have involved the introduction of whole or partial avian influenza viruses into a human population directly, rather than through swine.^{4 5}

So the World Health Organization (WHO) and many Egyptians had been worried for some time that the strains of swine flu and bird flu already present in that country might take advantage of the pig population—which in Egypt, apparently, lives not only in close proximity to humans, but within the cities rather than in the country—to recombine into something very contagious and very, very deadly.⁶

The pigs had to go.

Meanwhile, the event WHO and other health organizations around the world had been preparing for was the next big avian flu outbreak. This seemed likely to arise in Asia, given the high dependence on poultry for food there and the close proximity of human and poultry populations, since many Asians still raise and slaughter their own birds.

Avian flu a killer

Speaking of poultry, we should examine briefly one of the reasons why humans currently do not catch avian flu all that easily. Hemagglutinin is the portion of the virus’s outer coat that enables it to attach to a host cell and gain entry. The substance gets its name from its ability to cause red blood cells to clump and is often a primary source of the virus’s toxicity. Avian flu incorporates one type of hemagglutinin and human flu another.

Why does that matter? Because human and avian cell surface receptors differ significantly. Think of these receptors as functioning like locks on the exterior of the cells. Each takes a different shape of key (the hemagglutinin). But unlike birds or humans, pigs have both types of hemagglutinin receptors, so their cells open to both types of keys; they seem to catch avian, swine and human flu with almost equal ease.

In this country, the population doesn’t pay much attention to avian flu, presumably because it hasn’t been a problem here. The rest of the world is not so naive. Studies performed on the 1918 pandemic flu, moreover, show that it was an avian flu that jumped to humans.

Indeed, the 1918 influenza pandemic is generally considered to be the worst viral outbreak the world has ever seen. It killed millions, probably more than the Black Death (bubonic plague, a bacterial infection) of the Middle Ages. What public health officials fear the most is just another such outbreak.

So, if you were going to design your own influenza virus and you wanted it to be as virulent as possible, you might take some avian flu genes and put them in a swine flu package. That way, you would get maximum transmissibility from the swine flu and maximum killing power from the avain flu.

Resurrection

In February 1997 or 1998, depending on the account,⁷ a forensic pathologist named Johan Hultin recovered samples of the 1918 influenza from the frozen corpse of a Native Alaskan woman buried near Brevig Mission, AK.⁸ Hultin took his samples to the CDC and the Armed Forces Institute of Pathology (AFIP). There they were reconstituted and injected into mice.

The 1918 pandemic flu resurrected in 1997 bears an uncanny resemblence to the avian flu that first appeared in Asia in 1998. (Were it equally contagious among humans, we’ll venture to guess, it would bear an even stronger resemblence.)

While Asia was having problems with avian flu, in the United States a new version of swine flu emerged in a herd of pigs in North Carolina. This H3N2 virus was composed of avian, human, and swine influenza virus genes—just the sort of mix we have been talking about. This new swine flu quickly became the predominant strain within U.S. swine. It was the precursor to the current pandemic swine flu.

Swine flu in pigs?

Meanwhile, three recent outbreaks of pandemic swine flu have been reported—of all strange places—in pigs. (We hope you can see the irony.) The first incident, in Alberta, CA, we reported on May 6 and May 8. Initial reports were that a Mexican worker returning from a vacation in Mexico had infected the pigs. Subsequently, the Mexican worker and other humans on the farm tested negative for H1N1 flu virus, apparently ruling out that immediate human source of the pig infection.

In that particular incident, the infected pigs were eventually culled (slaughtered) because they were being kept in quarantine and were part of a larger population of 2200.

This left, of course, the question of how the pigs became infected in the first place. It would appear, as we suggested in our previous article, that the novel H1N1 virus was quietly making the rounds in pig populations, aided by the growing tendency of the American food industry toward a set of techniques known as factory farming.

Flash forward to July 24 of this year when authorities in Canada confirmed another outbreak of pandemic H1N1 influenza in pigs on a Quebec farm. In this case, the pigs have “completely recovered.” Pathologist Dr Alain Laperle of the Quebec Agriculture, Food and Fisheries Ministry (MAPAQ) states that the first clinical symptoms in the pigs began the end of June. Meanwhile, no symptoms of swine flu have been detected in any of the humans living on or visiting the farm.

Further denials

Nevertheless, Laperle told the Quebec farmers’ newspaper La Terre de Chez Nous on July 28 that the “most probable hypothesis” is that the H1N1 reached the farm through a human carrier.

Now we change hemispheres. On July 17, Argentina announced a nationwide animal health emergency when a herd of pigs was found to be infected with H1N1. At that point, the H1N1 epidemic had killed 137 people in Argentina. Once again, we are told that the pigs in question must have been infected by humans.

But why is it more logical to assume that humans have spread the infection to pigs rather than to assume the pigs have been spreading it among themselves all along? Or at least, as is most likely, that the human carriers were carrying the infection on their boots or other clothing, rather than spreading it because they themselves were infected? And doesn’t it seem strange that when referring to a disease known as swine flu, the official sources react with apparent disbelief—even outright denial—that it could actually occur in pigs?

We agree that humans are far more likely than pigs to hop on a plane to travel long distances, so the notion of spread by humans has some innate appeal. But it clearly is unlikely that anyone would be searching for H1N1 virus in pigs were it not already wreaking havoc in the human population. For the past 10 years its presence in pigs has been ignored by everyone who doesn’t make a living studying such things.

Indeed, it is not the policy of any agency within the United States to keep track of the flu infections in swine populations. But that doesn’t mean H1N1 wasn’t spreading through hog herds all along.

Factory-farmed hogs get to travel

And it turns out that pigs raised on factory farms get to travel long distances. In 2001, 27% of U.S. pigs traveled across state lines. At that time, 72% of them were raised on factory farms. And that figure was up from 10% factory-farm raised in 1994. We can only guess how high that percentage has risen since. But we do know that in 2005, more than 25 million live pigs were traded internationally. That’s more than 2 million pigs every month.⁹

CDC’s current chief virologist, Ruben Donis, has confirmed that the pandemic strain of flu virus was first detected in the Midwest in 1998 in swine. Although it does have avian and human flu components, it has existed among pigs for more than a decade. “One little detail,” Donis told his interviewer, “is [that] these Midwestern viruses were exported to Asia. Korea and many countries import from the U.S. Swine flu is economically not such a big deal, [so] many countries don’t check for it.”¹⁰

The problem with the official story that all these pigs are being infected by humans is that no one has yet confirmed that any human has infected any pig. It’s really just a denial by the pork industry trying to portray a flu of swine origin as a human flu. Nor have we forgotten that the initial outbreak of novel H1N1 in humans occurred in Mexico in February next to a huge hog farm.¹¹ Local press reports at the time detailed how massive swarms of flies were believed to have caused a local respiratory outbreak in La Gloria, in which two babies died and about 60% of the population was infected. Town folk later recognized the symptoms they had as being the same symptoms attributed to swine flu once its existence was announced.

Then a blood sample that had been taken from a four-year-old boy involved in the La Gloria outbreak came back positive for swine flu.

True, two children in California had been infected with what was later determined to be swine flu in March, but that was well after the outbreak in La Gloria.¹² So that puts ground zero in La Gloria right next to the Granjas Carroll (Smithfield) pig farm.

Smithfield factory farms

And Smithfield has not had a sterling record even here in the United States:

Smithfield, which is led by pork baron Joseph W Luter III, has previously been fined for environmental damage in the US. In October 2000 the supreme court upheld a $12.6m (£8.6m) fine levied by the US environmental protection agency which found that the company had violated its pollution permits in the Pagan River in Virginia which runs towards Chesapeake Bay. The company faced accusations that faecal and other bodily waste from slaughtered pigs had been dumped directly into the river since the 1970s.¹³

Mexico is almost certainly more lax in its environmental requirements—at least at the local level—than the United States.

So accounts local to the Smithfield Granjas Carroll plant in Mexico, just 12 miles from La Gloria, about the swarms of flies that bred in the pig waste lagoons until local officials came and sprayed are quite believable.

“According to state agents of the Mexican social security institute, the vector of this outbreak are the clouds of flies that come out of the hog barns, and the waste lagoons into which the Mexican-US company spews tons of excrement,” reported Mexico City newspaper La Jornada.¹⁴

Why deny it?

Why, you might ask, if it is indeed a swine flu, does the pork industry go to such pains to claim it is not? Why perpetuate this shell game in which industry and governments alike pretend to be astonished that the pigs have infections everyone knew they had all along? Well, initial liability might be one issue. If the strain did jump from hogs to humans at the Smithfield plant because of poor sanitary conditions, there might be legal ramifications. Two children died in that outbreak, and many have died since.

But if you owned a large hog farm with tens of thousands of hogs, what would be your worst nightmare? Probably that a situation such as that in Egypt would arise—that you might be forced to slaughter all your hogs in the name of protecting the human population from swine flu. Even more so if your holdings included numerous such farms, as it does for the major producers today.

Cottoning to the Egyptians

But that particular genie is already out of the bottle. It no longer does any good to slaughter hogs to save humans, because the flu has already spread to humans. Unless—but wait—could it be? Contrary to what we have been told, could the Egyptian thinking really make sense?

Could it be that pigs, which have not shown much reaction to swine flu all along because they have been its home for more than a decade, might become the breeding ground for the much-feared combination of avian, human and swine flu, a blend of H5N1 and H1N1 with all the worst features of both?

Smithfield and local authorities have maintained all along that the Granjas Carroll pigs have not had swine flu, but local press accounts report that the specimens delivered for testing from farm pigs were delivered by farm personnel. Local Mexican authorities never have been known for their incorruptibility and candor.

And Smithfield has tried to cover up similar swine flu outbreaks in Romania, where the local officials are not so easily bought:

“Our doctors have not had access to the American farms to effect routine inspections,” deplores Csaba Daroczi, assistant director at the Timisoara Hygiene and Veterinary Authority. “Every time they tried, they were pushed away by the guards. Smithfield proposed that we sign an agreement that obliged us to warn them three days before each inspection. These people have never known how to communicate with the public authorities.”

The swine plague epidemic, discovered August 3, [2008] revealed an embarrassing situation for the American company. Of its 33 farms, 11 had no authorization from the sanitary authorities and had to close their doors. Moreover, Smithfield lacks manpower because of its low salary policy. Four of the nine Romanian employees at the Cenei farm have left, their 500 lei (160 euros) salary inadequate to assure their everyday needs.

Cenei’s inhabitants are shocked by the American company’s methods. In mid-July, hundreds of carcasses of pigs killed by the heat wave were left lying around for about ten days. “We couldn’t breathe any more,” relates Gheorghe Olarov, an adviser at the Cenei town hall. “I live a kilometer away from the farm, and at night I had to close the windows to sleep. The Americans have made our village a hotbed of infection.”

….

“We’ve established a crisis center to confront the problem,” declared Timisoara Sub-Prefect Zoltan Marrosy. “The Smithfield farms are quarantined. The police are assuring this region’s security, so as to prevent the transport of animals and stop transmission of the virus. Smithfield has behaved aggressively: we asked them to stop breeding pigs and transferring them from one farm to another, but they paid no attention to our instructions.” The fine of 130,000 euros to which the American company was sentenced had no impact.¹⁵

With the scales of production involved, this is no surprise. The Granjas Carroll plant alone produces approximately one million hogs for slaughter annually. The income from that will support a high level of corporate arrogance. The swine population in the United States is on the order of 60 million. Most of these are raised in lots of 10,000 or more. The amounts of money to be made dwarf the impact of fines that would bankrupt a smaller operation.

The use of factory farming techniques has been accelerating rapidly. Those familiar with the issues believe it is just this rise of intensive farming that is causing the spread of increasingly virulent forms of disease.

And while fear of the loss of livestock to an emergency slaughter may haunt industry mavens, there is yet another aspect of the saga we have yet to mention: the fall from favor of pork as a food because of the bad publicity presented by swine flu. The U.S. is involved in a vast marketing effort to export pork to other parts of the world. So long as there is the merest suspicion among foreign consumers that pork might not be safe, sales are going to suffer.

The industry has preferred to keep a lid on such information, though, and scarce press has emerged detailing the extent of the market decline.

On May 1, 2009, the New York Times reported that

as more cases of the new influenza emerged on Tuesday, deepening worries about a possible pandemic, several nations slammed their borders shut to pork from the United States and Mexico. Wall Street analysts predicted a sharp decline of pork sales in grocery stores, and some consumers began steering clear of pork chops.

Several countries on Tuesday announced that they were banning some or all pork products from the United States, angering trade negotiators and hog farmers. To date, countries including the Philippines, Kazakhstan, Ukraine and Ecuador have banned pork from the United States, with Mexican pork exports also covered by most of those bans.

China banned pork from certain states, and Russia banned all meat imports, not just pork, from certain states.¹⁶

So the pork industry is taking a big hit by association with the swine flu, which is ironic because they do appear to be to blame for breeding the flu in the first place and then for permitting its outbreak to humans. Yet no source we have seen whatsoever alleges that you can actually get swine flu from eating pork.

Heard a lot on the news about that lately?

Not so much?

We just can’t think of a bigger irony.

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