Flu Again

Among the unnumbered Americans who suffered last week from sniffles and fevers caused by a variety of viruses, tens of thousands had influenza. The outbreaks skipped across the map from Florida to Missouri and Illinois, over the Continental Divide to the southwestern mountain states, and up the Pacific Coast to remote island villages in Alaska.

So far. all the flu viruses isolated from selected patients and identified by complicated laboratory techniques have proved to be type B. instead of the Asian mutant of the type A group that caused the last notable epidemic two years ago. Though both virus types cause disease outbreaks in cycles, their peaks occur at different intervals and almost never co incide. Outbreaks of Asian, or A2, flu (which has supplanted the older plain A and A1, or "A prime") run in two-or three-year cycles; they may flare up again later this winter or w?ait until next. Type B flu runs in four-to six-year cycles. The U.S. has had none to speak of since 1955, so an outbreak was due this winter. The virus was ready and waiting. As a Public Health Service spokesman put it: "Type B virus was reported sporadically all through 1961--smoking away, rarely breaking out, but never extinguished."

"Herd Immunity." Bedside doctors say that there is no consistent difference be tween cases of flu caused by A and B viruses. Only in the laboratory can the offending particles be identified, by minute differences in the antibodies they provoke. But broad patterns appear. Type B is generally reported to be causing a milder than average illness, usually with four days of fever and malaise and four more days needed for recovery.

In the current outbreaks, most of the victims are children, who escaped previous exposure to type B flu and lacked immunity. As a result, absenteeism in some areas has been high enough to force the closing of schools. But industrial absenteeism has been negligible. Said Washington State's Dr. Ernest A. Ager: "The disease has been so common in past years that there is a fair degree of herd immunity."

"Excess Deaths." But immunity is valid only against strains of flu previously contracted. So flu vaccine is a shotgun prescription containing three strains of type A and one of type B. It is rated 60%-75% effective against flu of any kind. PHS recommends vaccination for pregnant women, for diabetics, for all people over 65. and for those of any age with known disease of the heart, lungs or kidneys.

Flu itself is rarely the direct cause of death, but it may damage the lungs so that pneumonia develops. In an already weakened patient, this may prove incurable. In plotting flu's ravages, PHS tallies all "excess deaths" (above normal for the city and season) in 108 U.S. cities, and checks to see whether the peaks coincide with a rash of "influenza-pneumonia" entries on death certificates. So far, throughout the U.S.. there have been few reports of such "excess deaths."

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