Links Relating Epidemics of Spanish Flu 1918 and H3N2 Flu 2015

Some farming families in Eastern Ohio were able to survive the Spanish Flu with little medical treatment.
Some farming families in Eastern Ohio were able to survive the Spanish Flu with little medical treatment.

Groups of Farmers Survive in 1918 Flu Disaster

A century ago, the flu called "The Spanish Lady" was swift and deadly, the infected often instantaneously exhibiting symptoms and falling dead in their tracks. This is the stuff of horror films like Outbreak, Contagion, the (fittingly) Spanish REC film series 1-4 and the American remake of REC 1: Quarantine.

The farm families in Guernsey County, Ohio in 1918 suffered from the Spanish Flu epidemic and had few options for treatment, but several victims survived. Why did they survive and what else can we learn from them?

We find one similarity between the flu strains infecting Americans in 1918 and 2015 and a similarity in prevention, but more than one difference between the epidemics.

The film “Contagion” (2011) offers its finale by clearly portraying the specific path of infection around the world, including who infected whom from the first case and where exposure occurred in each instance. We see the infection spreading through individual interactions.

Outbreak and Epidemic

Studying flu pandemics and other epidemics in a preventive medicine program has been useful every year. In addition, paternal family members at the turn of the 20th century were among the survivors of the Spanish flu. These two elements can work together for preventing future flu outbreaks, at least in my own circle.

An outbreak of flu in a greater metropolitan area can be expected to spread and decline within four to six weeks and that is long enough to halt business in a city. For example, during the outbreak of flu in 2012 - 2013, many of the school systems in my Midwestern county closed for several days.

During 2013, mumps and measles outbreaks occurred in a city just north of us, closing down school and social organizations for many days. Those outbreaks were connected to one student at The Ohio State University in Columbus.

Quarantines were widespread in 1918 and 1919 and may occur during 2015 as well.

SIMILARITY: Unlike other pandemics and seasonal flu infections, both the 1918 pandemic and the 2014 - 2015 epidemic resulted in high infection rates for healthy adults, generally 20 to 50 years old.

H3N2 Epidemic High Points by January 2, 2015 [CDC bulletins]

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A markerOhio -
Ohio, USA
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Number of cases already on the decline in the first week of January 2015.

B markerPaducah KY -
Paducah, KY, USA
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C markerCape Girardeau MO -
Cape Girardeau, MO, USA
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D markerHarrisburg and Rockford Il -
Harrisburg, IL, USA
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E markerDallas-Fort Worth -
Fort Worth, TX, USA
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F markerAustin -
Austin, TX, USA
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G markerTennessee: Chattanooga, Knoxville, Nashville, Kingsport, Johnson City and Bristol -
Tennessee, USA
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H markerBristol VA -
Bristol, VA, USA
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I markerColumbia SC -
Columbia, SC, USA
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J markerOklahoma City -
Oklahoma City, OK, USA
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The CDC estimates that 200,000 Americans are hospitalized annually for flu or its complications. Associated deaths number from 3,000 to 49,000 every year. Estimates vary, but the Spanish flu of 1918-1920 killed approximately 50,000,000 worldwide on a population of one billion (5.0% of the world population).

NJ Epidemic Near Philadelphia

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A markerCherry Hill NJ -
Cherry Hill, NJ, USA
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B markerStratford NJ -
Stratford, NJ, USA
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C markerWashington Twonship NJ -
Washington Township, NJ, USA
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November - December 2014

As were some other US States, New Jersey was hard hit with flu during Autumn 2014 and by December 6, the emergency rooms were all consistently full in Cherry Hill, Stratford, and Washington Township, according to Dr. David Condoluci of the Kennedy Health System.

Reports from the New Jersey Department of Health, Communicable Disease Service (see www.nj.gov/health/cd/) indicated that the 2014 - 2015 anti-flu vaccine adequately fought only three or four strains of flu virus, but did not immunize patients from A-H3N2 that sickened people in the epidemic.

Note: Many Americans do not want to accept an anti-flu injection, but the number of patients complying with injection increased in 2014 over 2013, according to the CDC. Further, some individuals are allergic to either eggs or chicken or both, but anti-flu vaccines are now prepared in two media: 1) chicken eggs and 2) a non-chicken product and allergic individuals can request the non-allergen injection.

After careful consideration, the DOH has made a decision to continue to accept egg allergy as a valid medical contraindication for the 2012 - 2013 school year. In other words, if the physician/APN’s written medical exemption states that the child has an egg allergy and cannot receive flu vaccine for that reason, we would encourage schools to accept this as a valid exemption.

— http://www.nj.gov/health/cd/documents/egg_allergie_flu_vaccination.pdf

Largest 2015 Outbreaks: Red Map Areas

Source

Alternatives to Vaccines?

Is it only guesswork when the government and vaccine manufacturers decide which flu strains to include in vaccinations each year? They have a method and a formula, but many of the public do not trust them.

Also not trust-building is the declaration by a number of medical professionals that everyone should receive the yearly anti-flu vaccine, even if it does not prevent flu infections. The vaccine is thought to lessen the severity of symptoms in the sickness caused by several flu strains. Some people do not believe that. Conspiracy theorists feel that vaccines make people sick, not well, and probably provide a pathway for mind control and genetic manipulation. Regardless, not everyone who accepts a "flu shot" avoids the flu and 100% protection is statistically slim.

Precautions Against Flu

Autumn is a time of holiday celebrations, parties, crowded stores, and flu outbreaks. Even though we may enjoy celebratory activities, some precautions against flu infection work. Some seem harsh, but flu can be a life-or-death disease:

  • Do not spit in public! This practice spreads more disease than the flu viruses.
  • Anytime of year, when in stores, if the cashier licks her fingers before opening a bag in which to place groceries, politely refuse it and tell her why. If he/she licks fingers before ringing an item, refuse that item. If the cashier becomes rude, politely report the incident to the store manager and customer relations department - that works well.
  • If you are at high risk for flu infection, wear a medical-type mask in public, especially crowded stores. In 2015, we found that the H3N2 flu strain hit adults first, rather than the very young and the very old and the pregnant, as is typical of most flu strains.
  • Do not visit people who have the flu and especially do not take children to visit them. This is harsh, but if you and your children have accepted flu vaccine, use your own judgement in this matter. Also be careful of taking children who have colds or flu to visit the elderly.
  • Avoid shopping at peak times and avoid holiday parties if you are high-risk for flu infection.
  • Take extra care when eating foods prepared by someone other than yourself. Holiday gits of cookies may not be a good idea during Flu Season. If you are at high risk for catching flu, you may want to avoid the foods at the company Christmas party.
  • Wash hands often and for 30 seconds each time, with liquid anti-bacterial soap. Save the nicely-scented bar and liquid soaps for spring and summer. Carry hand sanitizer with you. The antibacterial soaps may or may not prevent children from building up immune systems, so use your own judgment with your children.
  • Use anti-bacterial hand wipes offered free at grocery stores, schools, libraries, and computer laboratories. Before and after using equipment, wipe down shopping cart handles, computer keyboards and mice, etc.
  • As most medical professionals advise, refrain from touching your eyes, nose, and mouth, because viruses and bacteria can enter through those portals from your fingers.
  • If you exhibit flu symptoms, see a doctor or nurse practitioner (NP) immediately, follow his or her instructions, and stay at home until you are well. NPs provide medical services at most of the mini-clinics found in drug stores and supermarkets.

Flu Epidemics that Affected America

Years
Flu Epidemic
1918 - 1920
The Spanish Lady - 20 to 40% of world population affected; 5% died. US incurred about 675,000 deaths. Pneumonia was a prevalent complication. At least olne component of virus related to Bird Flu.
1957 - 1958
A flu from the Far East. USA cases were highest in October to December 1957 and February to March 1958. About 69,000 US deaths.
1968 - 1969, 1970, 1972
Hong Kong Flu. Americans are thought to have received some immunization from suffering the Far East flu in 1957 - 1958. US incurred 33,800 deaths.
2009 - 2010
Swine Flu H1N1. CDC reports about 18,000 US deaths from April 2009 to April 2010.

Influenza A H3N2 viruses with the matrix (M) gene from the 2009 H1N1 pandemic were first found in American pigs in 2010. The CDC reports related 2009 - 2010 infections resulted largely from prolonged exposure to pigs at agricultural fairs. Pigs cough & sneeze, so avoid them. How many patients in 2014 - 2015 were around pigs? - We do not yet know.

Flu Drugs Used in 1918 vs 2015

Spanish Flu
2014 - 2015 A-H3N2
Aspirin
Oral Oseltamivir (Tamiflu®)
Possible Precursors to Sulfa Drugs - Effective against the complication of pnuemonia.
Inhaled Zanamivir (Relenza®)
Multiple daily enemas, heated blankets, and icepacks, prescribed by Dr. John Kellogg, Battle Creek MI.
Amantadine and Rimantadine for Influenza B only
 
Peramivir (Rapivab®) for adults ony
Reference: CDC. Influenza Antiviral Medications: Summary for Clinicians.

Avian vs. Swine Flu

The 1918 - 1920 virus seems more related to Bird Flu and the 2014 - 1015 virus is a Swine Flu variant. The similarity is that they both target adults from ages 20 to about 50, rather than the very young, the very old, and those with chronic medical conditions or pregnancy. However:

  • US federal official advise that people ages 65 and older should receive a new high-dose injection of the annual flu vaccine.
  • This advice is confusing some folks, because the H3N2 targets younger adults.

Is it possible that, in a survival effect, the 2015 virus strain mutated to affect more active younger adults in order to spread itself more quickly over more of the human population? The CDC warns us of genetic drift (rearrangement of proteins) in these types of viruses to outfox immunizations.

By coincidence, children in 1918 sang this song while they were jumping rope:

I had a little bird,

Its name was Enza.

I opened the window,

And in-flu-enza.

— Family stories

Why Is the 1918 Flu So Deadly?

Open Yale Courses at http://open.yale.edu/courses:

Influenza records since the 1700s show that the world has suffered one major flu pandemic every century. Documentation is the most immense and far reaching for the Spanish Flu. It has a clearly high mortality rate and targets adults in the prime of life.

Christopher Basler, et.al. Toxic Traces: What Made the 1918 Influenza Virus So Deadly? National Institute of Allergy and Infectious Diseases. August 12, 2010.

  • Samples of the 1918 flu virus are in stock at NIH and used in high-level biohazard safety laboratories. Of the eight genes found in the 1918 flu virus, five have been produced by reverse engineering in the laboratory.
  • The 1918 gene for the matrix (M) protein are vulnerable to Amantadine and Rimantadine (these work against B-strains).
  • The 1918 HA and NA antigens are vulnerable to Zanamivir and Oseltamivir.
  • HA and NA genes are high lethal to lab mice.
  • The HA protein in the 1918 flu is similar to that of deadly Bird Flu.

Surviving The Great Pandemic During WWI

The farming families in 1918 Ohio were more isolated from one another and from the Spanish flu than were residents in big cities and probably less likely to pass the disease quickly. Farmers enjoyed well ventilated areas outdoors. Many of them likely avoided influenza..

In addition, many of the farm family members may have enjoyed some immunity gained from previous bouts of similar flu strains in the 1800s. Further, the farming families seemed to favor Dr. Kellogg's techniques of enemas, hot blankets, and cold packs, which seemed to be effective - Kellogg reported 100% cure at his facility, if we can believe that figure.

Health and Human Services tells us that in 1918, life expectancy for men was 53 years and for women, 54 years. My fathers line of several farming families enjoyed lives of 80 to 90 years and more. Their genetic makeup may have defended them against dying when they contracted Spanish Flu.

Dayton, Ohio officials passed out advice from the US Navy and local Division of Sanitation that likely helped farmers a lot across Ohio: Avoid crowded places like streetcars, trains, movie houses, large meetings, poorly ventilated places, packed circus tents, and crowded streets. Farmers had little time for these things back in 1918, but we can use the advice today.

Can any of these things help us now? Certainly, some of them can, but in 2015, listen to your chosen healthcare practitioner.

Scenes from 1918 and 1919

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Iowa State University gymnasium served as a Flu Ward in 1919.Police Officers used masks.
Source
Iowa State University gymnasium served as a Flu Ward in 1919.
Iowa State University gymnasium served as a Flu Ward in 1919.
Police Officers used masks.
Police Officers used masks.
Source

Remembering the Spanish Flu: 56 min.

© 2015 Patty Inglish

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Comments 7 comments

Eiddwen profile image

Eiddwen 20 months ago from Wales

Very interesting and some great research here. Voted up and shared.

Eddy.


Patty Inglish, MS profile image

Patty Inglish, MS 20 months ago from North America Author

I am grateful that you are reading this article, Eddy! It helps a lot to have had relatives in the pandemic who survived. Those first-hand histories are invaluable.

In the future, I pray and hope for a vaccine that can beat many strains of flu at once and not produce any ill side effects. It seems sad and incoherent that so many die from respiratory ailments such as the flu.


BlossomSB profile image

BlossomSB 20 months ago from Victoria, Australia

Thanks for an interesting article. The Spanish flu was a big problem in many countries of the world; it was also here in Australia.


mckbirdbks profile image

mckbirdbks 20 months ago from Emerald Wells, Just off the crossroads,Texas

Hello Patty - startling statistics here in your article. I hear over and over 'do you want the flu shot' and I decline. Everyone I know that gets the shot gets the flu. So likely it is just my superstitions, but there it is.


Patty Inglish, MS profile image

Patty Inglish, MS 20 months ago from North America Author

I have serious reservations about the flu shots as well. They need to be more effective without making people sick.


Jackie Lynnley profile image

Jackie Lynnley 20 months ago from The Beautiful South

I have never had a flu shot either but I stay away from fast foods in flu season and keep my hands washed or sanitized after I have been in a store or anywhere I touch anything someone else may have. I cannot remember the last time I had flu or a cold, but I am guessing ten years at least. I do pay attention to anti-oxidants too so perhaps that helps. ^+


Patty Inglish, MS profile image

Patty Inglish, MS 20 months ago from North America Author

@Jackei Lynnley - Those are good tips. During Christmas week, I became overheated in a crowded store with children sneezing this way and that and I need to remember to avoid those times and places.

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