Monday, May 4, 2009
Health reporter, BBC News
Preliminary analysis of the swine flu virus suggests it is a fairly mild strain, scientists say.
It is believed that a further mutation would be needed in order for the H1N1 virus to cause the mass deaths that have been estimated by some.
But at this point, it is impossible to predict with any accuracy how the virus will continue to evolve.
UK experts at the National Institute for Medical Research outlined on Friday the work they are due to start on samples of the virus sent from the US.
The research, being done at the World Influenza Centre in Mill Hill, will be vital for working out the structure of the virus, where it came from, how quickly it is capable of spreading and its potential to cause illness.
Analysis done so far suggests what they are dealing with is a mild virus and nowhere near as dangerous as the H5N1 avian flu strain that has caused scientists so much concern over the past decade.
Influenza A viruses are classified according to two proteins on the outer surface of the virus - hemagglutinin (H) and neuraminidase (N).
The swine flu strain is a H1N1 virus, the same type as seasonal flu which circulates throughout the world every year, and kills roughly 0.1% of those infected or higher in an epidemic year.
Professor Wendy Barclay, chair in influenza virology at Imperial College London says initial indications suggest there is nothing about the genetic make-up of the new virus which is a cause for particular concern.
The key to its potential lies largely in the H1 protein.
"There are two aspects - one is which receptors the virus tends to bind to and what we see is that it is binding to the upper respiratory tract rather than deep in the lungs."
Can spread between humans
Attaches to receptors in the upper respiratory tract causing mild illness
A pandemic is thought to be imminent
When a flu virus binds to the upper respiratory tract, it tends to cause mild illness but can be easily spread as people cough and sneeze, Professor Barclay explains.
If a virus binds further down in the lungs, it tends to cause much more severe illness, as in the case of the H5N1 avian flu virus which has caused concern in recent years.
"With the H1 gene we also look at the cleavage site," she adds.
"The virus has to be cut into two pieces to be active and it uses an enzyme in the host to do that.
"Most influenza viruses are restricted to the respiratory tract because they use enzymes in the lungs.
"But some, like H5 viruses can evolve to cut into two pieces outside the lungs, so they can replicate outside the respiratory tract."
These initial indications are largely guesswork from looking at the genetic sequence of the virus and comparing that to what is known from work on other influenza viruses.
It will take weeks and months of biological analysis to properly get a handle on the potential of the H1N1 virus.
The team at Mill Hill, one of four World Health Organisation's centres for influenza research will be working in close collaboration with the Health Protection Agency who are carrying out testing in the UK, and their findings will also feed into the development of a potential vaccine.
What this outbreak does highlight is how difficult it is to predict new pandemic strains
Professor Jonathan Ball, Nottingham University
Soon, the Wellcome Trust Sanger Institute in Cambridge will begin the genetic sequencing of the virus and will also be monitoring any mutations or changes in how virulent it is.
However, there is one other reassuring aspect about what is known so far.
That is there seems to be nothing unusual as yet in another protein in the centre of the virus, called NS1, which is linked to the strength of the immune response the virus produces.
In some more pathogenic viruses, it is this NS1 protein which initiates a "cytokine storm", a particularly severe immune reaction that can be fatal in even healthy young people.
Scientists have also played down concerns that the milder H1N1 virus, could combine with the more dangerous H5N1 avian flu virus, causing a super virus that has the ability to both spread easily between humans and cause severe illness.
This is unlikely - or at least just as unlikely as it ever was and the H5N1 virus has been around for a decade without combining with normal seasonal flu.
Professor Jonathan Ball, an expert in molecular virology at the University of Nottingham said: "The chance of swine H1N1 combining with H5N1 is as likely as any other strain recombining.
"What this outbreak does highlight is how difficult it is to predict new pandemic strains.
"Many people suspected that H5N1 was the most likely candidate for the next pandemic strain, but now it appears that this was a mistake - but that's not to say H5N1 or another reassortment containing parts of H5N1 may not happen in the future.
"That's the trouble - you can't predict."
In the 16th, 17th, 18th and 19th centuries, a litany of Christian travelers - Siebald Rieter and Johann Tucker, Arnold Van Harff and Father Michael Nuad, Martin Kabatnik and Felix Fabri, Count Constantine Francois Volney and Alphonse de Lamartine, Mark Twain and Sir George Gawler, Sir George Adam Smith and Edward Robinson - found Palestine virtually empty, except for Jewish communities in Jerusalem, Safed, Shechem, Hebron, Gaza, Ramleh, Acre, Sidon, Tyre, Haifa, Irsuf, Caesarea, and El Arish, and throughout Galilee towns - Kfar Alma, Ein Zeitim, Biria, Pekiin, Kfar Hanania, Kfar Kana and Kfar Yassif. To stay, these Jews had submitted to innumerable conquerors, taxes, pogroms and degradation. But they stayed. In 1799, Palestine was still so much in need of people that Napoleon Bonaparte championed a full-scale return of Jews.
In the early 19th century, Palestine was a backward, neglected province of the Ottoman Empire. Travelers to Palestine from the Western world left records of what they saw there. The theme throughout their reports is dismal: The land was empty, neglected, abandoned, desolate, fallen into ruins.
In Jerusalem, all reports and journals of travelers, pilgrims and government representatives during these years, repeatedly record the poverty, filth and neglect and the desolate nature of the countryside. Early photographs show lepers in rags and dilapidated buildings. Jerusalem was surrounded by marauding bands of Bedouin Arabs and had to close her gates at nightfall and reopen them at first light, a practice that was similar in Biblical times.
Some quotes from the writings of these visitors before modern times:
Nothing there [Jerusalem] to be seen but a little of the old walls which is yet remaining and all the rest is grass, moss and weeds. [English pilgrim in 1590]
The country is in a considerable degree empty of inhabitants and therefore its greatest need is of a body of population. [British consul in 1857]
There is not a solitary village throughout its whole extent [valley of Jezreel] -- not for 30 miles in either direction... One may ride ten miles hereabouts and not see ten human beings. ... For the sort of solitude to make one dreary, come to Galilee ... Nazareth is forlorn ... Jericho lies a moldering ruin ... Bethlehem and Bethany, in their poverty and humiliation... untenanted by any living creature... A desolate country whose soil is rich enough, but is given over wholly to weeds ... a silent, mournful expanse ... a desolation ... We never saw a human being on the whole route ... Hardly a tree or shrub anywhere. Even the olive tree and the cactus, those fast friends of a worthless soil had almost deserted the country ... Of all the lands there are for dismal scenery Palestine must be the prince. The hills barren and dull, the valleys unsightly deserts [inhabited by] swarms of beggars with ghastly sores and malformations. Palestine sits in sackcloth and ashes ... desolate and unlovely ... [Mark Twain, The Innocents Abroad, 1867]
Remarkably, there are photographs dating to the 19th century and early 20th century that document the development of Palestine from the desolate, pre-Zionist landscape reported by travelers to the green and productive land that Jewish immigrants created there. This web site has 460 photographs and lithographs of the period, some never before available to the public. They show how the industrious Zionists made the lightly-populated land productive and able to support the great increases in Jewish and Arab numbers that came to Palestine in the following decades.
Winston Churchill was British Colonial Secretary when he visited the Middle East in the winter of 1920-1921. Anti-Semitic elements in the British government tried to assert that the Jews were not needed to develop Palestine. Churchill replied:
Left to themselves, the Arabs of Palestine would not in a thousand years have taken effective steps towards the irrigation and electrification of Palestine. They would have been quite content to dwell—a handful of philosophic people—in wasted sun-drenched plains, letting the waters of the Jordan flow unbridled and unharnessed into the Dead Sea."
In 1924, a few months after becoming Commissioner of the U.S. Bureau of Reclamation, Elwood Mead (namesake of Lake Mead behind Hoover Dam) published a highly favorable review of Jewish settlements in Palestine based on his visits there in 1923. His article, "New Palestine," praised the Zionists accomplishments and plans, a publicity coup. Mead blamed Islam, Ottoman governance, and Arab culture for the demise of Roman irrigation systems that, according to Mead, once supported "lands flowing with milk and honey." Mead was a consultant to Chiam Weizman offering his expertise to maximize the return on investment of the extensive investments in irrigation, land reclamation, and water supplies in the Zionist areas based on Mead's extensive experience in the American West.
After the Arab riots in 1929, Mead wrote to the British High Commissioner that Jewish colonists had produced "a marvelous transformation" in the Palestinian landscape. Mead noted that in his visits to Palestine he had seen nothing "to indicate that the Arab was injured." Moreover, the Jewish example of "what modern finance and equipment can do, coupled with the sympathetic interest of the government is bringing him out of the hopeless inertia that misgovernment and oppression of centuries past have created .... " Jewish settlers in Palestine were not only reclaiming the land, they were elevating living standards for the Arab population and assisting the British government.
In his report to the League of Nations on the Administration of Palestine and Transjordan for the year 1925, the British High Commissioner wrote:
Fuel-power stations for the generation of electrical light and energy have been established at Haifa and Tiberias by the [Jewish] Palestine Electric Corporation, Limited. This increase in commercial activity, in building enterprise and new industrial developments is due almost entirely to Jewish capital and the entry during the year of an immigrant class with money to invest.
During this period a significant shift of population took place as Arabs and others from all over the Middle East moved to the areas of Zionist cultivation and development. The organizational and technical skills of the Jewish settlers, their access to outside capital, and their sheer hard work created an economic boom that created opportunity for Arab workers, particularly in contrast to the stagnant conditions elsewhere in the region. This has been documented by many, following the much-criticized but basically sound work of Joan Peters in her book From Time Immemorial: The Origins of the Arab–Jewish Conflict Over Palestine. The central findings are that:
1.As far back as 1893, the Jews not only were already far from being a small minority in the areas where they had settled, but were the largest single group there (if one divides the non-Jewish population into Muslim and Christian), and
2.Substantial immigration of Arabs to Palestine took place during the first half of the twentieth century; from 1893 to 1947 while the Palestinian Arab population slightly more than doubled in areas where no Jews were settled, it quintupled in the main areas of Jewish settlement.
These findings are supported with an array of demographic statistics and contemporary accounts, the bulk of which have not been questioned by any reviewer.
Sources and additional reading on this topic:
•First Photos of the Holy Land
•The History and Meaning Of "Palestine" and "Palestinians"
•From Time Immemorial: Table of Contents and Excerpts
•Selected Texts: From Time Immemorial
•New York Review of Books, From Time Immemorial
•Letters Regarding New York Review of Books review of From Time Immemorial
•Book review: Peters, J. From Time Immemorial (Gellner)
•Revisiting A Mideast Must-Read, From Time Immemorial
•Finding truth in the Mideast: Interview with Joan Peters
•Book review: Peters, J. From Time Immemorial (Vanyukov)
•An American In Palestine: Elwood Mead and Zionist Water Resource Planning, 1923-1936
•British High Commissioner's Report to the League of Nations, 1925
•The Myth Of The Palestinian People
•Roots of the Water Conflict in the Middle East