Saturday, February 9, 2013

H1N1 Flu Virus may cause Narcolepsy via Secondary Infection

One more time...

Flu shot ingredient eyed for narcolepsy link 
 "It's clear that H1N1 is a key ingredient. But it's also clear that if you didn't have the adjuvant you also didn't have this dramatically increased risk (of developing narcolepsy)," said Mignot, who is being funded by GSK to conduct further research into the links.  "So my opinion is that it was a combination of both in Pandemrix that made it very nasty for narcolepsy."

Yes, well he's right about the vaccine.  The flu virus is necessary to provide the right antigen- it seems this result does not occur with other vaccines for other pathogens. And the adjuvant was clearly a factor, because other H1N1 vaccines manufactured without it did not have this high incidence of onset of narcolepsy.  The Pandemrix adjuvant causes a stronger immune response, which implies the immune response is actually responsible for the post inoculation complications.
Recently it has been shown that Chinese individuals often have an extreme immune response to the flu virus. And there was a documented rise in post H1N1 narcolepsy cases in China that were caused by infection, not the vaccine, indicating the adjuvant isn't actually necessary for flu virus to promote narcolepsy onset.  This non-vaccine data suggests an autoimmune reaction to the flu virus may be the trigger for narcolepsy onset.

I propose an alternate explanation for these events:  The immune reaction to the flu virus indirectly causes Narcolepsy by decreasing bacterial immunity and facilitating the development of a Streptococcal infection.  Post-streptococcal autoimmune disorders commonly cause neurological symptoms, and strep is already associated with the onset of narcolepsy.  Encephalitis Lethargica was a post 1918 flu complication with symptoms similar to narcolepsy, and has also been associated with strep infection.

The increased incidence of streptococcal infections after flu exposure is extensively documented.  It seems plausible that an extreme immune response to the flu virus facilitated more virulent bacterial activity, which then triggered the streptococcal autoimmune response causing narcolepsy in susceptible individuals.
An increase in bacterial infections after the H1N1 epidemic was predicted before it happened and confirmed after it did. 

The increased lethality of H1N1 has been shown to be due to more aggressive Streptococcus pneumonia coinfection.

Various oropharyngeal streptococcal infections were reported after H1N1 infection and were characterized by marked increases in invasive S. aureus and S. pyogenes infections among children and adults. Children with allergies seem to have a more extreme reactions to the virus too.     This may even be caused by an interaction with an antibody receptor.   (I personally got an acute oropharyngeal infection after having the US version of the vaccine.)

This additional data indicates that the mechanism for the onset of narcolepsy is more complicated than a flu infection.  Autoimmune and secondary infections must also be considered.  If narcolepsy is caused by an immune response instead of the pathogens themselves- then vaccination probably infers a greater risk of developing narcolepsy, and the proper protocol for immunization of susceptible individuals should be determined for the flu as well as pneumococcal vaccines.