by Gordon Pedersen Ph.D.
Introduction
Influenza viruses are the respiratory viruses of greatest public health importance, particularly Influenza A (2). Every year 36,000 people die from Influenza making it the 6th leading cause of death in America (2). The CDC estimates that it would cost America 71 – 166 billion dollars if we have an Influenza epidemic today. Approximately 1 out of every 1,000 swine flu patients die from the infection. This is approximately the same rate we have been seeing the past few years but antigenic drift and antigenic shift may create a new and fatal form of Influenza that humans have no immunity against (3). Antigenic drift is a variation within the HN sub-type. Antigenic shift is a variation between different HN sub-types. Changes in the Heamagluttinin (H) and Neuraminiadase (N) makes large portions of the population immunologically naïve on a regular basis (2). The problem with Type A is that it undergoes both antigenic drift and antigenic shift making it more dangerous and unpredictable (2). The World Health Organization declared the H1N1 Swine Flu a pandemic in June of 2009 (4). What this means is that vaccinations have not and will not provide protection because there is continuous change in the virus. In addition, many people have been injured or died from receiving vaccinations. While viruses will continue to mutate, there will never be a totally effective vaccine. With these facts, the patient should always have the freedom to choose to be vaccinated or not.
The annual average U.S. winter epidemics affect 5% to 20% of the population.
The Centers for Disease Control (2) reports the following pandemic death histories:
Influenza Review
The Influenza virus is a member of the Orthomyxoviridae family. The genome consists of 8 segmented, negative-sense RNA strands made up of 15,000 nucleotides each. The influenza virus species is subdivided into three types; A, B and C. Types A and B have 8 RNA segments and encode 11 proteins. Subtype C has 7 RNA segments and encodes 9 proteins. (1). According to the CDC, the current Swine Flu is characterized as Influenza type A and has 8 Single RNA strands made up of 6 human H1N1 strands with one strand of swine flu and one strand of bird flu. This genetic combination makes it very weak to pigs and birds but may recombine during the replication process producing a new virus that could be fatal to as much as half the world’s population.
Influenza Type A is the most dangerous type. The virus can evolve quickly and produce an epidemic in weeks (19,22,23,24). It is affected by antigenic drift and antigenic shift making it the most dangerous and likely type of influenza to mutate into a new and more fatal form (2).
Influenza Type B Produces less serious disease than does Influenza type A and is not categorized by H or N sub types as is Influenza A (2).
Influenza Type C was first isolated in 1949 and is not known to be responsible for epidemics (2).
Influenza Mechanism of Action
The life cycle of the Influenza viruses may be broken down into the following different stages (1).
Binding to the host
Internalization
Fusion and un-coating
Nuclear import of ribonucleoproteins
Transcription
Replication and viral protein synthesis
Nuclear export of ribonucleoproteins
Virus assembly and release
Neuraminidase Inhibitors are a class of antiviral drug that blocks the viral neuraminidase protein, thus preventing the virus from budding (reproducing). Oseltamivir (Tamiflu) a pro-drug and Zanamivir (Relenza) and Peramivir belong to this class (2). These drugs work against Influenza type A and Influenza Type B. The Adamantidines Amantadine and Rimantidine only work on influenza type A. Currently the Adamantidines are not recommended and Tamiflu has developed resistance. Relenza has some CNS concerns. Both Tamiflu and Relenza have been given prophylactic use directions where they can be taken for prevention in single doses (i.e. 75mg once a day) instead of the therapeutic dose (75 mg twice a day). This is to be continued for a period of only ten days or a period of 7 days beyond exposure (2).
People over 45 yrs of age seem to be less at risk from the current swine flu and suffer less severe symptoms because they have some immunity from previous H1N1 exposure. Young adults have little or no immunity according to reports from the CDC (2).
Every winter, epidemics of human influenza recur in the United States, and are associated with an annual average of 226,000 hospitalizations and 36,000 deaths, mainly caused by secondary bacterial pneumonia in the elderly and young children (30, 31). In addition, US influenza epidemics tend to originate in California, which may reflect this region’s interconnectivity to Asia and Australia (14).
February is the month with the most illness from influenza (CDC, 2009).
During the past 26 flu seasons, the peak of the Influenza season has occurred in:
Since the 1968 pandemic, A/H3N2 viruses typically dominate most influenza seasons, including 16 of the past 20 US epidemics (25), and are associated with higher levels of morbidity and mortality (26), higher rates of evolutionary change (19), and greater synchrony in the timing of local epidemics across the United States than A/H1N1 viruses (14). However, during the 2006–2007 US influenza epidemic, more viruses reported by the CDC were of the A/H1N1 (62.3%) than the A/H3N2 subtype (37.7%) (25).
Doctors, nurses and other health care provides are at the highest risk of becoming infected with Influenza. Because doctors are exposed to the virus most frequently it is significant to recognize the survivability of the Influenza virus in open environments.
Mammalian Influenza A survives 1 hour in mucous, while Avian Influenza survives 100 days in water, 200 days @ 63 F, 1 day in feces and indefinitely when frozen. Influenza is easily transmitted from human to human as indicated in the following table.
Health Care Practitioners Are At the Highest Risk
Doctors have the obligation to protect themselves and their patients from the potentially pandemic Influenza viruses. This protection could come from many different sources including Vaccination, Hygiene, Anti viral drugs, Antibiotic drugs, Nutritional supplements, Air filters, Water purifiers, Masks, Topical gels and Silver Sol.
Past epidemics provide important insights into what might happen in the potential spread of the current Swine Flu (5,6,7,8,9,10,11,12,13,14). The most persistent viruses survive and the most diverse seem to go extinct within a few years (15,16). This is most likely the result of strong host-mediated selection pressure, resulting in continual evolution at key antigenic sites, a process termed ‘antigenic drift’ (16,17). This antigenic evolution is observed with major changes in antigenicity occurring periodically in patterns of approximately 3 years between episodes (18).
According to reports from the Department of the Army Medical records, (from the 1918 Spanish Flu, H1N1 epidemic) 24% of the people died from the virus and 76% died form a secondary bacterial infection that produced pneumonia in the lungs. There is a high probability that the swine flu will have similar death rates, and if this is the case, then preventing and treating the secondary bacterial infection will be as important if not more important. The conclusion is that the influenza virus will need to be treated by multiple or combination therapies crossing viral and bacterial lines.
Recommendations For Influenza Prevention and Treatment (2)
Vaccination: Results indicate that U.S. children are largely serologically naïve to the novel influenza A (H1N1) virus and that vaccination with seasonal TIV or LAIV does not elicit any measurable level of cross-reactive antibody to the novel virus. This means vaccination with recent (2005–2009) seasonal influenza vaccines is unlikely to provide protection against the novel influenza A (H1N1) virus. Results among adults suggest that some degree of preexisting immunity to the novel H1N1 strains exists, especially among adults aged >60 years. It takes approximately 5 months to develop and produce a vaccine and during that time it is likely that the virus will mutate and the vaccine will be ineffective. The CDC recommends all health care practitioners be vaccinated each year. This means that a vaccination cannot be successful and won’t provide protection due to the rapid changes resulting from antigenic drift and shift.
Past epidemics provide important insights into what might happen in in the potential spread of the current Swine Flu (32,33,34,35,36,37,38,39,40). The strongest viruses survive and the most diverse seem to go extinct within a few years (41,42). This is most likely the result of strong host-mediated selection pressure, resulting in continual evolution at key antigenic sites, a process termed ‘antigenic drift’ (42,43). This antigenic evolution is observed with major changes in antigenicity occurring periodically in patterns of approximately 3 years between episodes (44). A variety of epidemiological and evolutionary models have been developed to explain this phylogenetic pattern (45,46) and how it relates to the viral genome (47). Although antigenic drift is clearly a key determinant of influenza A virus evolution, this process has rarely been observed in a single locality over a single epidemic season (48,49). Instead, multiple viral introductions appear to drive evolution at the scale of local epidemics, allowing for the co-circulation of multiple clades of the same subtype (47,49). East and South-East Asia, appears to be important in determining large-scale epidemiological patterns (50,51,52). In addition, re-assortment events between viruses of the same subtype occur frequently, and are sometimes associated with major antigenic changes in both the A/H3N2 (53) and A/H1N1 subtypes (54,55).
Every winter, epidemics of human influenza recur in the United States, and are associated with an annual average of 226,000 hospitalizations and 36,000 deaths, mainly caused by secondary bacterial pneumonia in the elderly and young children (56,57). In addition, US influenza epidemics tend to originate in California, which may reflect this region’s interconnectivity to Asia and Australia (40). Influenza A virus can evolve quickly an produce an epidemic in weeks (45, 58,59,60).
Since the 1968 pandemic, A/H3N2 viruses typically dominate most influenza seasons, including 16 of the past 20 US epidemics (61), and are associated with higher levels of morbidity and mortality (62), higher rates of evolutionary change (45), and greater synchrony in the timing of local epidemics across the United States than A/H1N1 viruses (46). However, during the 2006–2007 US influenza epidemic, more viruses reported by the CDC were of the A/H1N1 (62.3%) than the A/H3N2 subtype (37.7%) (61).
The evolutionary dynamics of this epidemic were particularly complex, including a late-season switch in dominance from the A/H1N1 to the A/H3N2 subtype, the co-circulation of multiple antigenically distinct lineages within both A/H1N1 and A/H3N2, an A/H3N2 vaccine mismatch, and the co-circulation of adamantane resistant and sensitive viral lineages in both subtypes (61, 62). This demonstrates how multiple risk factors combine with rapidly evolving viruses stay ahead of vaccines and drugs producing increasing potentials for pandemic events.
Since the development of vaccines cannot keep up with the changes in influenza, and antiviral drugs are producing resistant viruses and bacterial infections are killing three times as many people than the viral infection, we are in need of additional proven methods of prevention if we intend to save more lives and reduce sufferings from influenza.
Hygiene: The CDC recommends washing the hands after any exposure because most influenza is transferred by hand contact. Masks and gloves can help but the mask must fit tightly with no leaks to be effective. A surgical mask helps protect the persons exposed and the wearer, so if you have a fever, cough or sneeze, wear a surgical mask to protect the patients.
Hand washing stations in public buildings, churches, waiting rooms and homes need to be implemented because approximately 70% of influenza is transferred by hand contact.
People that are infected should stay home, stay hydrated, use hand disinfectants and get well before exposing healthy people to the virus.
People should use tissues when they cough or sneeze to contain the virus.
Cloth surgical masks help protect the spread of virus when worn by the infected patient , but the masks do not provide very much protection to the wearer because they leak around the sides.
Nurse stations should be active in airports, bus terminals and other public areas where people travel. Theses stations should include a rapid detection device, thermometer, hand disinfectants, preventive agents and the ability to sequester people who are ill to a safe area.
Air Filters: CDC recommends one in every room. HEPA air filters use silver to inactivate viruses and can effectively kill 99% of all bacteria, and viruses in minutes.
Water Purifiers: Proper hygiene, and a water purifier are recommended by the CDC because the influenza virus can survive 100 hours in water. Get one that has a silver filter that can actually destroy the virus. Carbon, filtration, reverse osmosis do not destroy or remove the virus.
Topical Disinfectants: Topical disinfectants are recommended by the CDC for use between each patient and can kill germs for 4-6 hours. Hand disinfectants should be used by patients and well and doctors and nurses. Patients and health care professionals should use these 4 times a day or as needed. Chlorox kills viruses and can be used sparingly because it is toxic and the gas can irritate the respiratory system. Silver Sol gel demonstrates effectiveness against some of the worst pathogens including: Bird Flu, MRSA, VRE, Strep and the other bacteria that cause pneumonia.
Silver Sol: Prescription drugs and vaccines treat and help prevent viral infection and disease but are not capable of totally controlling a dangerous new or novel virus (20). Nutritional supplements such as Vitamins, Minerals, Echinacea, Ginseng, Probiotics and many others have the ability to help boost immune function and improve natural defenses which results in some defense against disease causing viruses and the associated secondary infections
Silver Sol provides proven prevention and treatment against viral and bacterial infections, while there is nothing else with such broad-spectrum benefits (29). In addition, Silver Sol can be safely taken every day for prevention where it has been shown to provide protection against the very dangerous Bird flu H5N1. The combination of antibiotics with Silver Sol has been shown to enhance antibiotic function by as much as ten fold due to the fact that Silver Sol kills the residual pathogens that the antibiotics cannot (29). Results of the combination of 19 different prescription antibiotics and silver sol demonstrate safe additive and or synergistic benefits across 7 different pathogenic strains (Staphyloccocus, MRSA, E coli, Pseudomonas arugenosa, Salmonella and Streptococcus). The results of this combination therapy result in significant pathogenic destruction while helping to reduce bacterial resistance (29). This can be attributed to the fact that Silver Sol does not produce resistance, nor does it destroy the benefitcial intestinal probiotic bacteria (20).
Silver Sol For Prevention, Treatment, and Combination Therapy:
Different forms of silver have been used for centuries to combat viral , bacterial and fungal infections (26). Silver Sol has demonstrated significant antiviral benefits. These include prevention against Influenza A H5N1 (Bird Flu), where the animals demonstrated a 100% increase in the ability to survive a fatal H5N1 infection (27). Hepatitis B virus has been significantly inhibited by silver sol in humans and animal models. (28). There are numerous forms of silver used medicinally including ionic, colloidal and metallic forms. The colloidal silvers of the past had mediocre benefits but suffered from the problem of tissue accumulation called Argyria. The newly patented form of silver called silver sol, presents a safer, and newer generation of silver that has numerous publications demonstrating its unique, improvements in destroying viruses. These peer reveiwed publications include in-vitro studies, animal studies and human research publications. Silver Sol is newly patented, EPA certified, and a Gel is FDA Approved. There are numerous benefits that should be seriously considered in the prevention and treatment of viral infections including Swine Flu. The following is a summary or studies demonstrating the benefits of Silver Sol as they apply to Influenza and the secondary bacterial infections.
Silver Sol; Studies Prove Antiviral and Anti-bacterial Benefits
Silver sol destroys bacteria viruses and mold.
Destroys all forms of viruses, H5N1, H1N1, H3N2, hepatitis B, Aids, SARS. (Utah State University, 2006).
Silver Sol Prevents Avian Influenza A H5N1 In Mice. Taken orally twice a day,
Silver Sol prevented H5N1 Bird Flu from killing mice. A double-blind placebo controlled study demonstrating a100% improvement in the survival rates of mice. (Pedersen, G., Utah State University, 2008).
Silver Sol Reduced H5N1 virus to below detectable levels in 5 hours. (Utah State University, 2006).
Silver Sol Destroys Beijing Influenza A H1N1 (ATS-Nov 2005)
Silver Sol destroys 98.2% of Influenza A H1N1 in 2 hours. No virus found 12 hours later (ATS-Nov 2005).
During the Spanish Flu of 1918, 76% of H1N1 patients died from a secondary bacterial infection of Haemophillus influenza, Streptococcus influenza, Mycoplasma and Enterococcus (US Dept of Army)
Antiviral drugs are not going to be effective against the bacteria that cause most of the deaths but Silver Sol destroys the virus and the secondary bacterial infection.
Silver Sol can be taken every day as a liquid (two teaspoons twice a day). It can be taken every day for prevention because it passes through the intestines un changed. (US Patent 7135195)
It does not destroy the good pro-biotic bacteria (31).
Delivery systems include: intranasal sprayer, gel and liquid, inhaled as a mist
Works synergistically with antibiotics (26)
Silver Sol destroyed the following pathogens in 10 minutes:
Streptococcus pneumonia, Haemophillus influenza, Staph/MRSA, aureus, Klebsiella pneumonia, Meningitis, Enterobacter, H. Influenza and hundreds more.
All pathogens were killed at 5 ppm or less in ten minutes. (BYU, 1999).
Silver Sol destroys the Influenza virus, and the secondary bacterial infections
Silver Sol destroyed 97.2% of the mycobacterium in 45 minutes. (Nelson Labs,2004).
Silver Sol killed SARS Virus 99% in 60 minutes. (In Vitro, U.S. National Institute of Allergy and Infectious Disease-SARS Kill Test 11/5/2003).
Silver Sol destroys Influenza H3N2 10 ppm killed 96.8% in 2 hours. No virus found 12 hours later. (ATS-Nov 4, 2005).
Recommendations for Silver Sol (Prevention)
Swallow two teaspoons twice a day orally
Gel on hands twice a day – Gel in nostrils twice a day
Silver Sol Treatment of Flu
Swallow two tablespoons twice a day
Gel in nostrils 4 times a day – Gel on hands 4 times a day
Inhale liquid mist through a nebulizer 15 minutes twice a day for respiratory system
Use of Silver Sol During An Epidemic
Swallow two tablespoons twice a day
Gel on hands 4 times a day – Gel in nose 4 times a day
Inhale liquid mist through a nebulizer 15 minutes twice a day
Anti Viral Drugs:
These drugs have the ability to destroy virus but cannot be taken for an extended period of time. They produce side effects that mimic the flu making it difficult to diagnose the severity of the disease. If taken for prevention Tamiflu produces resistance. 18% of the influenza virus is resistant to tamiflu already (2). It is suspected that the health care professionals who were taking it for four months as a preventive agent were the persons that developed resistance. This indicates that we cannot use the antiviral drugs for long periods of time. In addidtion, some drugs cannot be used in children under 13 years of age (tamiflu). Relenza cannot be used in children under one or in adults over 65. The antivirals must be given within 48 hours of the onset of illness or the virus will run its course. Combine this with the fact that 76% of H1N1 subjects in the Spanish flu 1918, died from a bacterial infection that produced pneumonia and you have an incomplete solution to the influenza problem. Because the taifu has developed resistance relenza may be a better choice as long as you monitor the bronchospasms.
Antibiotic Drugs: Antibiotic drugs provide no solution against the virus but can be very beneficial for pneumonia that develops later. Use a broad spectrum antibiotic because there are numerous bacteria that can produce pneumonia. According to a Viridis BioPharma publication, Silver Sol can be given with the antibiotics and produce up to ten fold increase in antibiotic activity against bacterial infections that can cause pneumonia (20).
Nutritional Supplements: There are hundreds of supplements that can be of significant benefit for the immune system and even on some that claim to have antiviral activity. The best proven choices for nutritional supplements come in the form of immune stimulants and wellness products. The best choices include: Antioxidants, Vitamin C, B complex, folic acid, Vitamin D (prevention), pro-biotics, expectorants and silver sol.
Protection From the Cytokine Storm:
The majority of deaths from the 1918 influenza pandemic were caused by a secondary bacterial infection. This means that the virus entered the lungs triggering an immune response against the invading pathogen. This immune response triggered a cascade of cytokines, which are hormones responsible for cellular communication through chemical means. This is has been characterized as a cytokine storm. Cytokines spread chemical messages that result in an activated immune system characterized by a highly mobilized immune force that results in the rapid accumulation of fluids in the lungs. This fluid retention and tissue inflammation creates a situation where the lungs have a more difficult time transferring needed oxygen putting added pressure on the respiratory and circulatory system. It also becomes the perfect breeding ground for bacteria to grow. This means the inflammation and fluid can cause asphyxiation and the bacteria causes pneumonia.
A cytokine storm (hypercytokinemia) is the systemic expression of a healthy exaggerated immune response against pathogens. Cytokines signal immune cells such as T-cells and macrophages through intracellular communication. The activated immune cells respond by traveling to the site of infection. Normally the immune cells maintain a healthy balance of mobilization and activation, but on occasion, activated immune cells send signals that stimulate the production of more cytokines resulting in an uncontrolled mobilization and activation of too many immune cells in one location. The exact cause is not fully understood but may be caused by an exaggerated response when the immune system encounters a new and highly pathogenic invader like H1N1 Influenza. The primary symptoms of a cytokine storm are high fever, swelling and redness, extreme fatigue and nausea. In the case of H1N1 Influenza the immune response may cause death.
Research suggests that cytokine storms were responsible for many of the deaths during the 1918 Influenza Pandemic (63,65,66,67,74). Research from Hong Kong (SARS) also indicated that this exaggerated immune reaction could have been the main reason for the deaths in so many young people (68). Human deaths from Bird Flu H5N1 usually involve the cytokine storm as well (69). Recent research on the latest flu epidemic (2009) suggest that cytokine storms could be responsible for the latest deaths (70). The CDC reports that there is insufficient information about clinical complications to determine cause (71).
The researchers at Imperial College of London published data in the Journal of Experimental Medicine, which demonstrates the possibility of preventing a cytokine storm by inhibiting or disabling T-cell response (72). When the OX40 receptor on the T-cell is blocked, flu symptoms were prevented (73).
ACE Inhibitors and Angiotensin II Receptor Blockers:
The Renin Angiotensin system (RAS) has been implicated in the mediation of the cytokine storm (75). This suggests that there is a potential benefit derived from Angiotensin Converting Enzyme (ACE) Inhibitors and Angiotensin II Receptor blockers (ARB’s). ACE has been implicated in inflammatory lung pathologies (76), and has been confirmed as a useful marker for disease activity in cytokine-mediated inflammatory lung disease (77). Marshall flound that angiotensin II was associated with cytokine mediated lung injury (78) and suggested a role for ACE inhibitors. Wang published data that cytokine mediated pulmonary damage (apoptosis of the epithelial cells) in response to the pro-inflammatory cytokine TNF-alpha requires the presence of angiotensin II. This suggests that ARB’s might have clinical utility against cytokine storms (79). It is suggested that ACE and ARB’s have benefit in down regulating the cytokine storm (80).
Corticosteroids and non-steroidal anti-inflammatory (NSAIDS) have been evaluated in clinical trials and have shown no effect on lung mechanics, gas exchange or biological outcome (64).
Free radical scavengers (antioxidants) have shown a reduction in organ damage and a trend toward improvement in survival (60%) after administering a variety of free radical scavengers called antioxidants (64).
TNF-alpha blockers (arthritis medications) reduce inflammation by inhibiting the tumor necrosis factor-alpha pathway to immune cell activation. These TNF-alpha blockers afforded a slight reduction in antibody presentation after vaccination against influenza (81). It, however it did not significantly affect the patients protective abilities gained from inoculation (81).
Normalizing the Cytokine Storm:
Prevent exposure to the virus.
Vitamin D supplements or Vit D from sunshine, were reported by the US Dept of ARMY (1918 Flu) to be one of the best deterrents of the virus and helped modulate the cytokine storm.
Folic acid 400 mg per day helped modulate cytokine hyper response
Pro-biotics 10 billion active cultures a day help with the over secretion of prostaglandins and histamine. This helps modulate adverse swelling and inflammation.
Ginseng, Echinacea and Garlic have demonstrated antiviral activity but they stimulate the immune system which means they could aggravate the cytokine storm.
Vitamins and minerals can help support basic nutritional needs during the flu.
Antioxidant herbs and fruits help reduce inflammation preventively and during a viral attack. Take them every four hours at double doses.
Antiviral drugs like Tamiflu and Relenza help reduce the viral load that causes the cytokine storm
Broad spectrum drugs help reduce the secondary infection which means less inflammation and fluid retention
ACE inhibitors help reduce inflammation and improve gas exchange, and may be a little better than ARBs which also work on the RAS system.
TNF-alpha may have some benefit but be careful mixing them with other drugs like ACE.
Silver Sol has been shown to destroy the virus in vitro and help prevent death in fatal bird flu infection. It can be used as a liquid or gel. The liquid should be taken two teaspoons three times a day and the gel used topically on the hands, nose and mouth twice a day.
Discussion:
H1N1 is a serious threat to our health and way of life. The best way to treat it influenza is to prevent it and employ healthy hygiene. Drugs have serious side effects and cannot be used by the entire population and should not be used for long periods of time. Another problem is that approximately three fourths of the people who have died from H1N1 influenza have succumbed to a secondary bacterial infection and cytokine storm in the lungs where no antiviral drug can successfully treat this situation.
In order to control an epidemic all types of treatment should be employed including prescription drugs (ACE, ARB’s, TNF-alpha blockers, anti-viral and anti-bacterial) vitamins, mineral, antioxidant herbs, proper hygiene, air filtration, water filtration and the proper use of diet and nutritional supplements, especially the newly patented, FDA approved Silver Sol technology. Silver Sol destroys bacteria, viruses, and mold so it demonstrates broader spectrum of activity than any antibiotic or antiviral drug. It can be taken daily due the fact that it passes through the body unchanged, and can prevent viral infections, treat them and work synergistically with antibiotics to produce as much as a ten fold increase in activity against the bacteria that cause death in influenza. It is evident that the newly patented EPA certified and FDA approved Silver Sol technology provides tremendous treatment options for prevention and combination therapies. Silver Sol gel can help stop the spread of virus on the body’s vulnerable and contagious areas like, hands, nose, mouth and skin. It is sufficiently documented and demonstrated to be a first line of defense against Influenza and a significant companion to antiviral and antibacterial drug regimens topically and orally. Vaccinations will not work long-term because the virus will continue to change due to antigenic shift and antigenic drift. This is why a new flu vaccine is developed every year. Evidence suggests that mandatory vaccination for an Influenza type A virus like H1N1 is not going to contain the virus and it may kill, cause disease or recombine with another flu to develop into a novel virus capable of pandemic death.
References
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32. Laver WG, Webster RG. Selection of antigenic mutants of influenza viruses. Isolation and peptide mapping of their hemagglutination proteins. Virology. 1968;34:193–202.
33. Sleigh MJ, Both GW, Underwood PA, Bender VJ. Antigenic drift in the hemagglutinin of the Hong Kong influenza subtype: correlation of amino acid changes with alterations in viral antigenicity. J Virol. 1981;37:845–853.
34. Fitch WM, Leiter JMF, Li X, Palese P. Positive Darwinian evolution in human influenza A viruses. Proc Natl Acad Sci. 1991;88:4270–4272.
35. Bush RM, Fitch WM, Bender CA, Cox NJ. Positive selection on the H3 hemagglutinin gene of human influenza virus A. Mol Biol Evol. 1999;16:1457–1465.
36. Rvachev LA. Computer modeling experiment on large-scale epidemic. Dokl USSR Acad Sci. 1968;2:294–296.
37. Longini IM, Fine PE, Thacker SB. Predicting the global spread of new infectious agents. Am J Epidemiol. 1986;123:383–391.
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