Don't Worry, Brownie's in Charge! (Of the Cytokine Storm)

"Brownie, you're doing a heck of a job!"

I guess I had never thought too much on why the flu epidemic in 1918 caused so many deaths. After all, the flu comes around every year. Many of us made it through the Hong Kong flu (H3N2) of 1968-69 (the late 50's Asian flu) and, every year, most of us survive the more mundane strains. What is it about Bird Flu (H5N1) that makes it so lethal?

Well, the answer, according to Flu Wiki, is that H5N1 (which is similar to the influenza that cause the 1918 epidemic) can cause a cytokine storm in otherwise healthy people. Thus it is not just the old and the very young that may die. It is anyone, even a 300 pound linebacker for the Green Bay Packers!

Our source has the following to say:

The occurrence of a “cytokine storm” has been suggested as an explanation for the devastating nature of the 1918 flu and perhaps H5N1. So what is a cytokine storm? From a clinical perspective, a cytokine storm describes an immune system that has over-reacted and is damaging the body, causing failure of multiple organ systems. Ordinarily a cytokine storm is a rare event, which means there are few opportunities to study them, so we do not fully understand how they happen. The term “cytokine storm” is not precisely defined, referring particular kind of uncontrolled immune response. Cytokine storms can happen rapidly and patients who suffer them have high mortality. Because we lack knowledge, we don’t know the best way to treat the condition. Influenza is thought to be one of the rare conditions able to cause a cytokine storm. (emphasis added)

This is very discouraging. It is possible that Tamiflu, which simply inhibits viral reproduction, might dampen down a cytokine storm enough to allow survival. But who is going to take care of the patients during the "surviving" part?

Alternatively, I've use VP-16, an anticancer drug, to damp down an unusual proliferative disorder called hemophagocytic syndrome. This, also, is probably related to a type of cytokine storm.

You know, I think we knew about this a long time ago. I wonder who is in charge of the response. Whose going to clean up after the storm. Brownie??