Can We Hide From Plague, Flu, And The Spectre Of Death?

Welcome back to Dose of Reality, where we see whether the week’s health news is really worth worrying — or celebrating — about. Today we’re facing down death and disease, and the news is actually mostly good!

The Plague Isn’t “Back” — It Never Left

The headline: The Plague Is Back, This Time in New Mexico

The story: Three people in New Mexico came down with the plague. Yes, that plague.

Hello, I wrote a book with five chapters about the plague, so I’m going to tell you a little bit about it. It’s caused by a bacterium, Yersinia pestis, that lives in several species of fleas and in the animals those fleas bite. Rats were likely the main host and carrier during the medieval pandemic you’re thinking of, but the disease likely got its start in Siberian marmots. And nowadays, it’s common in prairie dogs in the western US.

Plague won’t kill us all, because today we can cure it with antibiotics. That said, it’s a very serious and still lethal infection, so if you think you have plague you should get immediate medical help. Plague is most famous in its bubonic form, where the infection turns your lymph nodes into painfully swollen germ factories (such a node is called a bubo) but if it infects your lungs, you get pneumonic plague, which you can spread to others through coughing.

In the early 1900s, there were a few major outbreaks of plague in San Francisco, and that’s probably when it first arrived in the US from Asia. The plague spread to local squirrels and other rodents in addition to humans, and now we have a steady population of plague germs in animals. They end up causing a few human cases a year.

The take-away: There will not be a wave of plague sweeping the country, so put down your smelling apples. But plague is real and it’s here to stay. Go to the doctor if you’re sick, and don’t touch dead squirrels.

The Flu Shot of the Future May Be a Patch

The headline: Needle-Free Flu Vaccine Patch Works as Well as a Shot (NBC News)

The story: This is exciting! But let’s clear a few things up. First of all, the patch is not needle-free; it delivers your flu vaccine through 100 tiny needles. (“100-Needle Flu Vaccine Patch” probably didn’t have the same ring to it.) One of the people who tried it told NBC News:

If I had to describe it is maybe like pressing down on the hard side of Velcro. It is like a bunch of little teeny tiny stick things that you can feel but it’s not painful.

It’s not totally painless, though: More than half of people who got the patch said they had tenderness or itching afterwards.

A flu patch is a great idea for a few reasons. First, it’s less intimidating than a traditional needle, which probably means more people will sign up for it. There used to be a nasal spray version of the vaccine available in the US, and I always insisted on it for my kids, but last year the CDC said the nasal spray hasn’t provided enough protection in recent years, and they don’t recommend it.

Second, the patch doesn’t need to be refrigerated, and you don’t need a trained doctor or pharmacist to apply it. That means you could buy a few at the pharmacy and bring them home to vaccinate your family. Or if there’s an outbreak of flu, the health department could mail vaccine patches to everyone in the affected area. And health workers in remote areas of the world could carry vaccine patches in their backpacks rather than having to schlep coolers full of ice and syringes.

So this is for real, but it only cleared a phase 1 trial, so we don’t really know yet if it works well enough to replace a traditional flu shot. Phase 1 trials are designed to find out if there are any safety issues with a treatment, and to just get a sense of whether a thing could work in humans after it’s been tested in animals. They’re also only done in a small number of people: In this case, 100. It’s not until phase 2 and 3 trials that we learn whether something really works on a large scale.

The take-away: We don’t know yet if this can replace a flu shot, but it’s a pretty exciting possibility.

Let’s All Live Forever

The headline: How Long Can a Person Live? There Is No Limit, Study Says (Newsweek)

The story: This is, to be frank, a much less interesting story than the headlines suggest. Two groups of academics are arguing over whether very old people die because they can’t live any longer, or because they didn’t happen to live any longer.

It’s a tale of two studies. The first, written by a group of scientists at Albert Einstein College of Medicine in New York and published last October, noted that when we hear those “oldest person dies at age X” headlines, that age hasn’t been steadily increasing. The authors concluded that there must be a limit to how old we can get, and that it’s probably in the neighbourhood of 115 years.

The second, written by biologists at McGill University in Toronto and published this week, argues that there aren’t enough “world’s oldest living person” data points to draw any such conclusion. Maybe we’re reaching a plateau, or maybe we’re just seeing ups and downs in a trend that is, on average, still increasing.

Here’s a side point that we need to clear up: Both the first paper, and a press release announcing the second paper, tried to link this debate to the well-established phenomenon of life expectancy increasing. But that’s a totally different issue! If you went back to medieval times, and added up the ages of everybody who died in a given year, you might come to the conclusion that life expectancy was 40 or so. But that’s an average that is way skewed by infant mortality. Life expectancy has risen over time, but that’s less because old people are living longer and more because we manage to save a lot of babies from early deaths. (Thank vaccines, antibiotics and clean water.) Play around with these charts for an illustration of what I mean.

The take-away: We don’t know if there’s a biological limit to how old we can get. Enjoy your time while it lasts!