I heard someone say today they were suffering through the worst flu they could remember for more than 20 years. While there was little I could do to help, I did wonder why such things seem to be getting worse.

Tonight I learned that influenza is an especially tricky virus to fend off because it mutates regularly, and there have been at least 24 varieties observed by modern scientists.1 Some viruses and bacteria might change over time, but the flu virus seems to do this every year now, making antibodies obsolete when a new strain invades. Worse, the 15 versions of H and 9 versions of N can combine into a multitude of unique variations, although the body seems to recognize them primarily by those two proteins, so perhaps 24 is the greatest number that humans must face (at once!) for now.

We have all heard for years that nothing can treat a virus except time and a natural immune response, but there is now a trio of antiviral treatments that all seem to function in the same manner as one another. Zanamivir (commonly called Relenza)2, Oseltamivir (known as Tamiflu)3, and Peramivir (trade name Rapivab)4 all inhibit the chemical action of neuraminidase, an enzyme the viruses produce to enable them to escape from infected cells and spread into healthy cells. As inhibitors, they do not attack the virus directly and do little against a full-blown infection. But taken very early after exposure, they can help to limit the virus’s activity and thus shorten the time required for the immune system to eliminate it from the body.

As any informed shopper knows these days, overuse of antibiotics (which only work against bacteria) can allow resistant strains to rise when their competitors are pushed back. These antivirals can be overused in the same way, blocking some of the flu viruses and allowing any new mutation to spread like wildfire. Even this limited line of defense can quickly fall apart if it is abused. A healthy immune system really is the best defense against the flu, and not everyone has that anymore. Still, people are working on solutions.5 6 7 Please share any more that you find in the comments below!


References / further reading:

  1. Book: “Gasping For Air” by Kevin Glynn, MD; published 8/3/2017 by Rowman & Littlefield
  2. Zanamivir: https://www.medicinenet.com/zanamivir/article.htm#what_is_zanamivir_and_how_does_it_work_mechanism_of_action
  3. Oseltamivir: http://www.chm.bris.ac.uk/motm/tamiflu/how_work.htm
  4. Peramivir: https://en.wikipedia.org/wiki/Peramivir
  5. Urumin is effective against strains of the virus that resist the three antivirals above. https://en.wikipedia.org/wiki/Urumin
  6. Scytovirin https://en.wikipedia.org/wiki/Scytovirin must be cultivated from bacteria at present but is topically protective against flu virus and HIV, among other deadly pathogens.
  7. One promising step toward a universal flu vaccine was announced in 2010 http://mbio.asm.org/content/1/1/e00018-10.abstract and seems to have begun development by several more teams.

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