World remains at peril of pandemic
Flu killed 50M in 1918, and we’re still vulnerable
One hundred years ago, death came with astonishing speed and horrifying agony.
Some influenza patients admitted to a Boston hospital on the morning of October 1918 were dead by the evening, their bodies turning blue from lack of oxygen. Hospitals reported an average
100 deaths a day, overwhelming morgues.
“For several days, there were no coffins, and the bodies piled up something fierce,” said Roy Grist, a physician at Fort Devens, according to Smithsonian magazine.
Up to 500 million people – about one-third of the world’s population – became infected with the influenza virus, according to the Centers for Disease Control and Prevention. As many as 50 million died, or one out of every
30 human beings on the planet. The virus killed more American troops than died on World War I battlefields.
The intensity and speed with which the flu struck were almost unimaginable. It was the worst global pandemic in modern history.
It’s chilling to think that such a calamity could occur again.
“A global influenza pandemic is No. 1, 2, 3 and 4 on our list of the most-feared public health crises,” according to Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy.
Vanderbilt University infectious disease specialist William Schaffner said: “We fear flu. We know how serious it is.”
Top health and science groups, such as the World Health Organization, the National Academy of Sciences and the CDC, predict influenza pandemics are nearly certain to recur.
“Influenza viruses, with the vast silent reservoir in aquatic birds, are impossible to eradicate,” the World Health Organization warned. “With the growth of global travel, a pandemic can spread rapidly globally with little time to prepare a public health response.”
A pandemic could arise if a strain mutated or developed directly from animal flu viruses, the CDC said. The main contributors to the potential for a pandemic are the lack of a global vaccine and humans’ lack of immunity.
“The threat of a future flu pandemic remains,” the CDC said. “A pandemic flu virus could emerge anywhere and spread globally.”
If the death ratio from a modern pandemic matched the outbreak in
1918, the virus would claim 2 million Americans. That’s the population of the Las Vegas metropolitan area.
In a near worst-case scenario, a new, lethal and highly infectious flu virus would break out in a crowded, unprepared megacity that lacked public health infrastructure, according to Johns Hopkins’ Bloomberg School of Public Heath.
Such a fast-moving virus could burst from a city and catch a ride with international travelers before public health officials realized what was happening.
Avian influenza viruses such as
H7N9 top pandemic threat lists, according to Johns Hopkins. Though these strains are mostly harmless in chickens, they could evolve into much deadlier strains for humans.
“In terms of pandemic potential, an avian influenza virus is thought to be a likely candidate, based on prior pandemics,” said Amesh Adalja of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health.
There are safeguards that did not exist 100 years ago to detect and counteract influenza outbreaks.
These include systems to detect signs of potential outbreaks around the world, Schaffner said. He said scientists have the capacity to make vaccines more rapidly and have better antiviral drugs that could be used to treat those who contract the disease.
Still, influenza and the potential for a pandemic are concerns that are always at the top of the list for experts who work with infectious diseases and public health, he said.
Pandemics ignore national borders, social class, economic status and even age.
The pandemic of 1918 killed more people in 24 months than AIDS killed in 24 years, more in a year than the Black Death killed in a century, according to the book “The Great Influenza.”
The dead included about 675,000 people in the USA.
Although every flu season is different and influenza infection can affect people differently, millions of people get the flu every year, according to the CDC. Hundreds of thousands of people are hospitalized, and thousands or tens of thousands of people die from flu-related causes every year.
An annual seasonal flu vaccine is the best way to help protect against flu, the CDC said. People 6 months old and up should get a flu vaccine every season.
Even if it’s only 40 percent effective, that’s better odds than doing nothing at all, said Paul Offit, director of the vaccine education center at the Children’s Hospital of Philadelphia. “Influenza knocks you out.”
Vaccination has been shown to have many benefits, including reducing the risk of flu illnesses, hospitalizations and even the risk of flu-related death in children. Osterholm recommended getting the shot as close to the heart of flu season as possible, since the duration of protection is limited.
He said citizens should reach out to the government and tell it to start working on new vaccines for influenza.
“There are potentially new pandemic strains out there,” he said. “But we’ve invested very little in influenza vaccines.”