The Middletown Press (Middletown, CT)
FLU AN EVER-PRESENT THREAT
Could 1918 pandemic happen again?
Tearing through the globe like wildfire, the 1918 pandemic known as the Spanish flu killed roughly 50 million people.
Many of those were healthy adults in their 20s and 30s, and the outbreak is said to have slaughtered more people than World War I, which was still raging that year.
“The 1918 flu pandemic was one of the great public health tragedies in history,” said Daniel Weinberger, assistant professor of epidemiology at the Yale School of Public Health. “It hit around the world.”
Now, as the 100th anniversary of the pandemic nears, the world is struggling with a robust flu season that has taken a huge toll in Australia and is threatening to do the same on this half of the globe. This might leave some wondering: Could a worldwide disaster like the one in 1918 happen today?
The answer, according to Weinberger and other health experts, is a flu pandemic is possible, but the circumstances would have to be just right.
“There’s certainly always the potential of a new influenza pandemic,” Weinberger said.
If certain strains of bird flu gained the ability to spread easily among humans, the viruses could “really take off,” he said.
A pandemic is defined as a global disease outbreak, whereas an epidemic is the spread of a disease over a smaller area.
Dr. Zane Saul, chief of infectious disease at Bridgeport Hospital, said a
new pandemic is possible — in theory.
“Theoretically, with all the mutations and genetic shifts that are possible, (a new pandemic) is plausible,” he said. “But with all the technology we have today, I don’t think it could happen,” he said.
Flu is on the public’s mind right now. On Friday, the state Department of Public Health “strongly” recommended Connecticut residents get a flu shot if they have not yet this year, emphasizing it is not too late.
Overall, the most prevalent strain found in Connecticut this season has been Influenza A (H3N2), which typically causes more severe illness than other flu strains, according to the health department. As of the week ending Jan. 6, a total of 1,015 patients have tested positive for influenza, with 456 hospitalized.
Fifteen flu-related deaths have been reported in individuals ages 65 and older in Connecticut this season.
100 years ago
The 1918 Spanish flu pandemic spread across the globe, infecting about 500 million people — about one-third of the world’s population at the time.
Compare that to today, when the Centers for Disease Control and Prevention report between 291,000 and 646,000 people worldwide die from seasonal flu-related illnesses each year.
It’s still not entirely clear where the 1918 flu started, although theories are plentiful. France, China, Vietnam and even Haskell County, Kan., have all been named as potential ground zero for the pandemic. Though it is not thought to have started in Spain, the Spanish press was the first to widely report on the outbreak, which is why it was known popularly as the Spanish flu.
In Connecticut, it seems the virus popped up at the start of September 1918, when several cases of the flu were reported at the naval hospital in New London, according to a report compiled in 1919 by staff from Yale’s School of Medicine. The report stated “these cases came primarily from the Experimental Station and Fort Trumbull, where vessels from foreign ports had discharged patients.”
Within the first 10 days of September, about 100 cases were sent to the New London naval hospital. The illness began to spread north and then west, hitting New Haven County, then Hartford County and eventually Fairfield and Litchfield counties.
In Connecticut, about 8,500 died in the outbreak, according to ConnecticutHistory.org, a program of Connecticut Humanities, which provides grants to historical societies for exhibitions and programs exploring the state’s history.
Amy Brenner-Fricke, of Montville, said she grew up in North Haven hearing stories from her great-grandmother about surviving the 1918 flu as a young woman in Orange. One such story involved a trolley car ride in which droves of passengers reportedly died between the time she boarded and the time she arrived at her destination.
“She literally stepped over bodies on her way off the trolley car,” Brenner-Fricke said. “We thought she was exaggerating, and I later learned that she wasn’t — that the flu was really that bad.”
Past pandemics
Since the 1918 outbreak, there have been three more flu pandemics — in 1957, 1968 and 2009.
None has been as bad as the Spanish flu, but some took a massive toll. The latest pandemic took place when the H1N1 virus emerged in 2009.
It was detected in the U.S., then spread rapidly through the nation and the rest of the world, according to the CDC; it is estimated roughly 60.8 million cases and 12,469 deaths in the U.S. were due to the virus.
When the H1N1 pandemic hit, “initially, people were very concerned” it could be another 1918 flu, Weinberger said. Though the outbreak never reached that level, Weinberger said the threat is always there. He pointed to two strains of bird flu — H5N1 and H7N9 — that have gained traction in recent years. Infections with both illnesses are typically linked to contact with infected birds.
Weinberger said if either of these illnesses were to mutate and become easily transmissible among humans, a pandemic would be possible. But he isn’t sure when or even if that will happen. “It’s almost impossible to predict,” Weinberger said.
The state Department of Public Health echoed that statement. “Influenza pandemics are unpredictable, so we can’t speculate as to whether something of this magnitude could happen today,” said agency spokeswoman Maura Downes.
As for whether the virus that caused the 1918 pandemic could re-emerge from a natural source, the CDC argued in a 2014 statement it was unlikely. “Influenza experts believe that a pandemic is most likely to be caused by an influenza subtype to which there is little, or no, pre-existing immunity in the human population,” the CDC statement said.
The report states today’s antiviral medicines and vaccines would be effective against the 1918 virus.
That’s partly why Saul is not concerned about an imminent modern pandemic. He said there are more ways of tracking, preventing and treating flu than there were 100 years ago. That doesn’t mean the flu should be dismissed. This year’s flu season has been more intense than normal nationwide, and Saul said the hospital has seen moderate to severe activity.
Though he doesn’t think it’s the second coming of the 1918 pandemic, Saul did have some advice.
“Just get a flu shot,” he said.