Spanish Flu: historical event or precursor of H5N1 Bird Flu?
The 1918 Spanish Flu pandemic killed between 25 and 50 million people between 1918 and 1920. This was out of a total world population estimated at the time of approximately a billion.
It was an illness that, unusually, appeared to kill healthy young adults more often and more quickly than the usual victims of infectious disease, the young, disabled, immunosurpressed or elderly.
More than half the deaths caused by the Spanish Flu epidemic occurred in adults aged 20 to 40 years old H5N1
Two American Presidents, Franklyn Roosevelt and Woodrow Wilson, and a British Prime Minister, David Lloyd George, and the Emperor of Ethiopia, Haile Selassie, are all known to have been infected by the Spanish Flu and to have recovered from it.
There were some odd facts about the Spanish Flu epidemic. It came apparently out of nowhere, and even now no-one has any idea exactly where it arose, or how the strain mutated to infect humans.
Similarly, it vanished almost as suddenly in mid 1920. Spanish Flu has not been seen as an illness in humans since.
Books about the Spanish Flu
Pale Horse, Pale Rider, a mystical story of the narrow ledge between life and death, set at the time of the flu epidemic in 1918.
A novel. "It is the autumn of 1918 and a world war and an influenza epidemic rage outside the isolated utopian logging community of Commonwealth, Wash. In an eerily familiar climate of fear, rumor and patriotic hysteria, the town enacts a strict quarantine, posting guards at the only road into town. A weary soldier approaches the gate on foot and refuses to stop."
From Publishers Weekly
History of the epidemic
Non-fiction account of the Spanish Flu pandemic
Brief history of the Spanish Flu
Spanish Flu is a bit of misnomer. It’s also known as the Great Influenza Pandemic, the 1918 Flu Epidemic, and La Grippe. There’s nothing to suggest it originated in Spain at all.
The name Spanish Flu seems to have arisen because the early stages of the illness received a lot more attention and media coverage in Spain than in the rest of the world because Spain had been neutral during the war, there were no other distracting major new stories, and no wartime censorship. The Spanish called it the French Flu.
The first outbreaks of Spanish Flu noted as being definitely this illness were in America, rather than anywhere else. In early March 1918, cases were observed in Fort Riley, a military base in Kansas, and Queens, a borough in New York.
The strain at that time seems not to have been quite as dangerous as one which later emerged. In August 1918, a more infectious and dangerous strain appears to have appeared simultaneously in France, Sierra Leone, and Boston, America.
Neither the exact world population at the time nor the exact number of people who died from the Spanish Flu is known. An estimated 2.5 to 5% of the world’s population may well have died of the illness, and over 20% of the world’s human beings caught the illness.
The Spanish Flu appears to have killed about 25 million people in the first six months after breaking into the human population, an interesting comparison with Aids, which killed 25 million people in its first 25 years after identification.
It struck some places much more viciously than others. The countries thought to have had the highest infection and death rates are in the Pacific, with Western Samoa having 90% of the population catching the virus, 25% of adults and 10% of children dying from the illness. The island territory of Nauru also suffered a death toll of 16% of the population.
Japan had a particularly low death rate, at about 0.5% of the population.
American Samoa and New Caledonia, in the Pacific, prevented any deaths whatsoever from Influenza by imposing quarantines and block aids which prevented infected people from arriving on the islands.
Far more people died from the Spanish Flu than died in all the theatres of war in the First World War put together.
For example, an estimated 650 to 700,000 American citizens died of the Spanish Flu, which is ten times as many as died in the First World War.
Half the American soldiers who died in the European war theatres died of the Flu rather than of fighting.
- Influenza A virus subtype H5N1
A detailed Wikipedia article setting out the structure of the H5NI virus.
Influenza, or the Flu, is an infectious viral disease.
A lot of people say that they have suffered from Flu, when in fact they’ve had a bad or feverish cold.
Even a “normal” Flu infection is not much fun, and is usually the cause of a high temperature, muscle pains, aches in the bones, bad headaches, coughing, and a general feeling of illness.
Secondary bacterial infections are common after Flu, including chest infections, pneumonia, bronchitis, ear infections, tonsillitis and other associated respiratory infections.
The Flu viruses mutate regularly, and that is why developing a permanent vaccine against it is extremely difficult. Different strains of Influenza become dominant or dormant from year to year and the virus structure evolves rapidly.
Clearly types of Flu have been around for a long time, and were described by Greek physicians 2,500 years ago.
There have been other serious outbreaks of Flu worldwide since the Spanish Flu, including the Asian Flu in 1958 which killed over a million people, and the Hong Kong Flu in the late 1960s which killed up to a million.
Flu can easily be transmitted from person to person, via
either contamination of surfaces such as doorknobs or similar, or by
aerosol when a person coughs or sneezes.
People with Flu are advised to sleep as much as they can (superfluous advice, as most of them can’t get out of bed for a while anyway) drink lots of water, and take medicines such Aspirin, Ibuprofen or Paracetamol to reduce the symptoms.
Antibiotics are useless because Flu is a viral not a bacterial infection. On the other hand, antibiotics are useful for treating secondary bacterial infections.
There are two types of antiviral drugs which can be used in severe cases. They are not a cure, but might reduce symptoms and possibly complications from Flu. They work differently and with different effectiveness against different strains of Influenza.
Spanish Flu symptoms
The illness was unusual among Flu infections in being very sudden. People could be healthy one minute, and extremely ill suddenly while they were out at work, walking home, or at a social occasion.
More than most Flu illnesses, there were haemorrhagic features to the Spanish Flu. It was common for the membranes on the inside of the nose, throat and lungs to haemorrhage blood, and there was also a frequent noting of mental disturbances in the acute phase.
One of the reasons why young adults were thought to have died in such high numbers is that the virus seemed to trigger a particularly brutal immune response which caused a shortage of oxygen.
A blue-ish tinge to the skin was seen by many observers, indicating an acute lack of oxygen.
It was also the case that a very significant percentage of patients developed severe secondary infections, including both viral and bacterial pneumonia.
- BBC NEWS | Health | 1918 killer flu secrets revealed
Scientists have worked out how the virus which caused the world's worst flu epidemic infected man.
Suffering from Spanish Flu
"...case after case of leucopenia--a kind of leukaemia in reverse, where
the white corpuscles of the blood are strangely reduced in numbers... lost
her sight within six days... gangrene of the sexual organs... afflicted by
diarrhoea so intense he endured twenty movements a day.... On one factor, at
least, all doctors were agreed: only in Cholera did the collapse come so
suddenly that most victims could fix the precise moment when they fell...a
man staggering home at a run, handkerchief clapped to a bleeding nose--but
most often this killer-virus struck like a lightning-bolt."
THE PLAGUE OF THE SPANISH LADY: The Influenza Pandemic of 1918-1919
by Richard Collier
Medicine - how the Spanish flu was treated
There was little that could be done to treat Influenza in 1918 once people had caught it.
The most common remedies were Aspirin, Cinnamon in hot milk, and oxygen in the case of people suffering cyanosis (shortage of oxygen in the system).
In many countries, therefore, the emphasis was on prevention rather than a cure. Large scale public health rules were put into effect in many countries.
For example, in Britain, almost all state schools were closed down, theatres, cinemas, and concert halls were all restricted in terms of the length of performance and the need for the halls to be ventilated between performances. In addition, people were encouraged to wear masks while out and about.
Many public health bodies in America undertook such measures as limiting the length of church services and funerals, and often banning all public entertainment altogether.
The varying of opening and closing hours of shops and places of work was encouraged, and in many parts of the United States, people could only board public transport if they were wearing a mask.
A lot of doctors also encouraged people who might have come into contact with Flu germs to disinfect their upper respiratory system by gargling and sniffing unpleasant mixtures such as warm water mixed with weak carbolic acid and quinine, or boric acid and sodium bicarbonate.
It was suggested that these liquids be sniffed, gargled, rinsed and spat out.
Flu in animals
Humans aren’t the only species to get infected with Flu.
In fact, this is one of the problems, as not only can other animals get Flu, mutations can pass between species and birds and pigs,in particular, act as an animal reservoir.
Birds, dogs, horses, pigs, camels, ferrets, seals, mink, whales, and dolphins are all thought to suffer from various type of Flu. Not all of these can be caught by humans.
Although there is a nasty feline illness called "cat Flu", this is just a name - the illness is not in fact Flu at all, and it's a disease only cats suffer from, not humans
- Avian influenza (" bird flu")
The World Health Organisation's information page on H5N1
H5N1 Bird Flu
Most strains of Bird Flu are not a risk for humans. The H5N1 strain is different in that it can jump the species barrier and infect humans.
H5N1 has spread from Asia to bird populations across the world.
Birds which have H5N1 can pass it to other birds through respiratory secretions, dung and urine, and saliva. Other birds can pick it up not only from direct contact with excretions but also from surfaces contaminated with viral material from such secretions.
of the reasons why H5N1 has spread across the world despite strenuous
efforts to prevent it is because migratory birds suffer from it as
well as domestic birds.
- Scottish public health exercise in relation to future flu pandemics
OFFICIALS in Tayside will play a major role in an emergency exercise designed to make sure Scotland is prepared for a flu pandemic. The month-long exercise, due to start next week, will test government agencies on their readiness to respond to a maj
Risks to humans from Bird Flu, H5N1
There is a real awareness at the moment that various types of Bird Flu could cause worldwide serious epidemics which could infect and kill a significant percentage of the world’s population.
One which particularly has scientists’ attention is known as Bird Flu, or H5N1.
For example, H5N1 Bird Flu spread to the human population in Hong Kong in 1997.
Of the 18 confirmed cases, a third died of the illness, despite modern medicine. In order to counter the perceived risk in Hong Kong, the authorities ordered the slaughter of every bird in the territory.
The Hong Kong infections of 1997 were, extremely fortunately, not able to transmit from one human host to another one in aerosol form.
The risk is that H5N1 might mutate and become transmissible in aerosol form from one person to another. In that case, there would be a serious worldwide pandemic.
The World Health Organisation suggests that a strain of H5N1 transmissible from person to person has the potential to cause up to 10 million people to die worldwide.
It’s still the case that it’s far better not to catch Flu than to be treated for it. The American Centre for Disease Control and Prevention advises a disposable type of mask in the case of potentially airborne infections such as Flu or Sars.
There have been a few isolated occurrences of human to human transmission of H5N1, particularly in 2006 and 2007.
In more recent cases of H5N1 in humans, there appears to be a mortality rate of about 50%, although it may very well be the case that milder infections aren’t reported to the authorities and therefore the mortality rate is lower.
There is a significant level of Cytokines, or oxygen shortage, and tissue destruction in infected people, similar to the Spanish Flu.
At the moment, there is no need to panic. H5N1 is clearly very bad for birds, and easily transmitted between different species of birds.
On occasion, the virus has mutated and infected people. However the virus has never mutated in a way which caused easy infection between humans. This is what would have to happen for a pandemic to occur.
It’s not wise to be complacent, because it is quite possible for such a mutation to occur.
The Spanish Flu epidemic of 1918 is therefore far from being
purely a historical event. It is a warning of the possible
consequences should H5N1, or another species of Flu in the future,
mutate to cause a high-mortality pandemic.
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