Spanish flu
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Template:Flu The Spanish Flu Pandemic, also known as Template:Lang, or Template:Lang, was a pandemic caused by an unusually severe and deadly strain of the subtype H1N1 of the species Influenza A virus. In that pandemic, 50 million to 100 million people worldwide were killed during about a year in 1918 and 1919 <ref>NAP</ref>. It is thought to have been one of the most deadly pandemics so far in human history.
The Allies of World War I called it the "Spanish Flu". This was mainly because the pandemic received greater press attention in Spain than in the rest of the world, because Spain was not involved in the war and there was no wartime censorship in Spain. Although the virus certainly did not originate in Spain, the country did have one of the worst early outbreaks of the disease, with some 8 million people infected in May 1918. It was also described as only "the flu" or "la grippe" by public health officials seeking to prevent panic.
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Origin
Image:Reconstructed Spanish Flu Virus.jpg
One theory is that the virus strain originated at Fort Riley, Kansas, by two genetic mechanisms — genetic drift and antigenic shift — in viruses in poultry and swine which the fort bred for local consumption.
But evidence from a recent reconstruction of the virus (see Recent research below) suggests that it jumped directly from birds to humans, without traveling through swine. This does not challenge the idea that the pandemic started with a Fort Riley cook. Indeed, the cook may have been preparing chickens when he contracted the virus.
Effects
The social effects were intense due to the fast spread of the pandemic. Global mortality rate from the flu was estimated at 2.5% – 5% of the human population, and 20% of world population suffering from the disease to some extent. It spread across the world killing 25 million during six months; some estimates put the total killed at over twice that number, possibly even 100 million.
An estimated 17 million died in India, about 5% of India's population at the time. In the Indian Army, almost 22% of troops who caught the disease died of it. In US, about 28% of the population suffered, and 500,000 to 675,000 died. In Britain 200,000 died; in France more than 400,000. The death rate was especially high for indigenous peoples; entire villages perished in Alaska and southern Africa. In the Fiji Islands, 14% of population died during only two weeks, and in Western Samoa 22%. In Japan, 257,363 deaths were attributed to influenza by July 1919, giving an estimated 0.425% mortality rate, much lower than nearly all other Asian countries for which data are available.
The strain was unusual in killing many young and healthy victims, unlike common influenzas which killed mostly newborns and the old and infirm. People without symptoms could be struck suddenly and within hours be too feeble to walk; many died the next day. Symptoms included a blue tint to the face and coughing up blood caused by severe obstruction of the lungs. In later stages, the virus caused an uncontrollable hemorrhaging that filled the lungs, and patients drowned in their body fluids.
In fast-progressing cases, mortality was primarily from pneumonia, by virus-induced consolidation. Slower-progressing cases featured secondary bacterial pneumonias, while some suspect neural involvement led to psychiatric disorders in a minority of cases. Some deaths resulted from malnourishment and even animal attacks in overwhelmed communities.
While in most places, less than one-third of the population was infected and a fraction of that died, in a number of towns in several countries the entire population was wiped out. The only sizeable inhabited place with no documented outbreak of the flu in 1918–1919 was the island of Marajó at the mouth of the Amazon River in Brazil.
Many cities, states, and countries enforced restrictions on public gatherings and travel to try to stop the pandemic. In many places theaters, dance halls, churches and other public gathering places were closed for over a year. Quarantines were enforced with little success. Some communities placed armed guards at the borders and turned back or quarantined any travellers. One U.S. town even outlawed shaking hands.
Even in areas where mortality was low, those incapacitated by the illness were often so many as to bring much of everyday life to a stop. Some communities closed all stores or required customers not to enter the store but place their orders outside the store for filling. There were many reports of places with no health care workers to tend the sick because of their own ill health and no able bodied grave diggers to inter the dead. Mass graves were dug by steam shovel and bodies buried without coffins in many places.
The Spanish Flu vanished within 18 months. The illness left as abruptly as it came.
Social facts
Most of the contemporary effort was spent in an unsuccessful search for a vaccine to the supposed bacterial cause of the disease, Bacillus influenzae. In fact, this was only one of several causes of secondary pneumonia associated with the pandemic.
Two much milder influenza pandemics followed the Spanish Flu: the Asian Flu in 1957 and the Hong Kong Flu in 1968.
CNN.com reported that historian John Barry wrote in his book "The Great Influenza" that Bayer aspirin was just hitting the market in the US at the time of the Spanish flu, but because Bayer was a German company and World War I was happening, many Americans distrusted it and thought that it was a form of germ warfare. It was reported that Barry further related in his book that this theory was even suggested by US government officials <ref>CNN</ref>.
Recent research
In February 1998, The Molecular Pathology Division of the US Armed Forces Institute of Pathology (AFIP) recovered samples of the 1918 influenza from the frozen corpse of a Native Alaskan woman buried for nearly eight decades in permafrost near Brevig Mission, Alaska. Brevig Mission lost approximately 85% of its population to the Spanish flu in November 1918. One of the four recovered samples contained viable genetic material of the virus. This sample provided scientists a first-hand opportunity to study the virus, which was inactivated with guanidinium thiocyanate before transport. This sample and others found in AFIP archives allowed researchers to completely analyze the critical gene structures of the 1918 virus.
"We have now identified three cases: the Brevig Mission case and two archival cases that represent the only known sources of genetic material of the 1918 influenza virus", said Jeffery K.Taubenberger, MD, PhD, chief of the institute's molecular pathology division and principal investigator on the project.
In September 2000, Noymer and Garenne published a study that poses an etiological theory explaining the unusual W-shaped mortality age profile of the virus. This profile is characterized by a mode in the 25 – 34 year age group. Usually, influenza has a U-shaped profile, being most deadly to the young and the old. Additionally, after the pandemic the difference in life expectancy between men and women decreased (women had a historically longer life expectancy). Noymer and Garenne have causally linked these two anomalies to an interaction with tuberculosis, a predominantly male disease of young adulthood.
In October 2002, the AFIP together with a microbiologist from the Mount Sinai School of Medicine in New York started to reconstruct the Spanish Flu. In an experiment, published in October 2002, they created a virus with two 1918 genes. This virus was much more deadly to mice than other constructs containing genes from contemporary influenza virus. The experiments were conducted under high biosafety conditions at a laboratory of the US Department of Agriculture in Athens, Georgia.
The February 6 2004 edition of Science magazine reported that two research teams, one led by Sir John Skehel, director of the National Institute for Medical Research in London, another by Professor Ian Wilson of The Scripps Research Institute in San Diego, had managed to synthesize the hemagglutinin protein responsible for the 1918 outbreak of Spanish Flu. They did this by piecing together DNA from a lung sample from an Inuit woman buried in the Alaskan tundra and a number of preserved samples from American soldiers of the First World War. The teams had analyzed the structure of the gene and discovered how subtle alterations to the shape of a protein molecule had allowed it to move from birds to humans with such devastating effects.
On October 5, 2005 researchers announced that the genetic sequence of the 1918 flu strain had been reconstructed using historic tissue samples. <ref> Special report at Nature News: The 1918 flu virus is resurrected, Published online: 5 October 2005; Template:Doi. See: "Characterization of the 1918 influenza virus polymerase genes" by Jeffery K. Taubenberger, Ann H. Reid, Raina M. Lourens, Ruixue Wang, Guozhong Jin and Thomas G. Fanning in Nature (2005) volume 437 pages 889–893 Template:Doi. Also: "Characterization of the Reconstructed 1918 Spanish Influenza Pandemic Virus" by Terrence M. Tumpey, Christopher F. Basler, Patricia V. Aguilar, Hui Zeng, Alicia Solórzano, David E. Swayne, Nancy J. Cox, Jacqueline M. Katz, Jeffery K. Taubenberger, Peter Palese and Adolfo García-Sastre in Science (2005) volume 310 pages 77–80 Template:Doi.</ref>
See also
References
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- Terrence M. Tumpey, Adolfo García-Sastre, Andrea Mikulasova, Jeffery K. Taubenberger, David E. Swayne, Peter Palese, and Christopher F. Basler (2002) "Existing antivirals are effective against influenza viruses with genes from the 1918 pandemic virus". Proceedings of the National Academy of Sciences 99, 13849–13854.
- Alfred W. Crosby (1990). America's Forgotten Pandemic: The Influenza of 1918. Cambridge University Press. ISBN 0521386950.
- John M. Barry, (2004). The Great Influenza: The Epic Story of the Greatest Plague in History. Viking Penguin. ISBN 0670894737.
- Leonard Crane, (2000). Ninth Day of Creation. Connection Books. ISBN 0967571294.
- Andrew Noymer and Michel Garenne (2000). "The 1918 Influenza Epidemic's Effects on Sex Differentials in Mortality in the United States". Population and Development Review, 26(3):565–581.
- Geoffrey W. Rice and Edwina Palmer (1993). "Pandemic Influenza in Japan, 1918–19: Mortality Patterns and Official Responses". Journal of Japanese Studies, 19(2):389–420.
Further reading
- Nature "Web Focus" on 1918 flu, including new research
- Influenza Pandemic on stanford.edu
- Article: The Deadliest Fall
- Influenza 1918 in the United States on pbs.org
- Secrets of the Dead: Killer Flu (PBS)
- Flu by Eileen A. Lynch. The devestating effect of the Spanish flu in the city of Philadelphia, PA, USA
- Dialog: An Interview with Dr. Jeffery Taubenberger on Reconstructing the Spanish Flu
- The 1918 Influenza Pandemic in New Zealand - includes recorded recollections of people who lived through it
- Experts Unlock Clues to Spread of 1918 Flu Virus - The New York Times
- PBS - recovery of flu samples from Alaskan flu victims
- Alaska Science Forum - Permafrost Preserves Clues to Deadly 1918 Fluca:Grip espanyola
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