Catching Up With The Flu: 20th Century Pandemics

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As panic mounts over the increasing number of swine flu cases, it looks like the world is ending, with a sniffle and sneeze. But this certainly isn't the first time humanity has had to gird itself against the threat of pandemic and, luckily for all of us, lived to tell about it. Here's a little background on four 20th century outbreaks.

1. The Spanish Flu of 1918: Don't Blame the Spanish

The absolute worst flu pandemic in recent memory was the so-called Spanish flu outbreak of 1918. Somewhere between 20 and 50 million people died from the Spanish Flu "“ more than the number of people who died in World War I.

But don't blame the Spanish. In fact, the virus was likely spread by US soldiers shipped off to fight in World War I "“ the first recorded case of the flu came on March 11, 1918, at Fort Riley, Kansas. Within a week, the virus had made the rounds through the unsanitary military base "“ 522 men reported to the camp infirmary, all suffering from the same illness. The flu moved on from there, primarily through military channels, popping up all over the southern Eastern Seaboard, in California, and other states throughout the Union, infecting 28 percent of Americans. Military transport ships then became floating Petri dishes, incubating the disease and then releasing it on arrival in France. From there, the flu ravaged the rest of Europe, already in a weakened state after years of devastating war. And this particular strain of the flu was terrifying "“ sufferers often succumbed to total respiration failure within hours, essentially suffocating to death in the fluid that filled their lungs.

It was also puzzling "“ where most flu strains affected the weakest members of the population, the elderly, the very young, and people already ill of health, this flu largely affected healthy young people. The fact that a war was on also contributed to the rapid spread of the virus, in part due to the fact that affected countries didn't acknowledge the pandemic.

The Spanish flu got its name from the fact that Spanish papers were the first ones to report that millions of their people were dying from the flu; other countries, on both sides of the Allied and Central Powers lines and though similarly affected by the virus, kept mum for fear of revealing a weakness to the enemy.

Moreover, the war effort left the US and other countries without sufficient medical care "“ many trained doctors and nurses had gone to the front.

Waves of the virus broke on US shores, each time killing more and more people and prompting drastic measures. In Philadelphia, according to a contemporary New York Times article, courts were adjourned, theaters were closed, churches asked to suspend services, football games cancelled, even the sale of liquor prohibited. But other communities were less stringent in their attempts to curtail the illness and more people died.

The flu also inspired, much in the same way the plague allegedly inspired that "pocket full of posies" rhyme, a creepy schoolgirl jump rope rhyme:

"I had a little bird
And its name was Enza
I opened the window
And in-flew-Enza"

After spending several long months exhausting the population, the virus disappeared before it could even be isolated. It's been since identified as a "pure" avian virus, meaning that it adapted from a bird-based illness to possess the necessary features for easy human to human transmission.

2. The Asian Flu of 1957: Science in Action

flu.jpgBy 1957, scientists had a better handle on the whole vaccine, immunology, epidemiology thing, so when the first cases of Asian Flu popped up in China in February 1957, they identified it quickly. But vaccines for the virus weren't available until August 1957, giving the disease several months to spread across the globe. By fall, every continent, every region had seen cases of the virus.

The virus killed more than 2 million people worldwide, 70,000 people in the US alone. In the first wave of the disease, which crossed the globe in the summer and fall of 1957, the illness also proved particularly virulent among school children, young adults, and pregnant women. In the second wave, which hit in the early part of 1958, elderly people were its victims.

Unlike during the Spanish flu pandemic, US medical personnel were somewhat more proactive in clamping down on the Asian flu outbreak. Several major networks used the relatively new medium of television to quickly distribute information on how to deal with the flu: One program featured actors demonstrating symptoms of the flu, animated cartoons explaining how vaccinations work, and sober discussions of where the Asian flu came from and what could and could not be done about it ("the new miracle or wonder drugs," antibiotics, the program cautions, could not be used to treat the flu).

Elsewhere, communities jumped into action: At the University of Illinois, for example, health officers set up 336 hospital cots in an ice rink to prepare for the "worst case scenario."

This virus petered out within a year, and while deadly, had little of the devastating effect of the Spanish flu.

3. Hong Kong Flu-ey of 1968

This pandemic was considered more mild than the two that preceded it; around 1 million people are estimated to have died as a result to the pandemic, however, this flu spread more slowly than the previous two, perhaps owing to a resistance built up from the previous pandemic. The virus was first noticed in China in mid-July; by August, more than 500,000 cases in Hong Kong alone were reported.

The Hong Kong flu was also one of the many unfortunate side effects of the war in Vietnam: Though the virus was first spotted in China, soldiers returning from the Vietnamese front brought the disease home. In three months, the Hong Kong flu had made its way from California across America, proving lethal primarily for the elderly and young children. Europe and the UK were hit by the pandemic, but were largely unfazed: In the UK, for example, death from flu and flu-related illness was actually lower that year than it had been the previous year.

4. Swine Flu the First, 1976: The Pandemic That Wasn't

Scary as it is now, the first time swine flu appeared in the States was more of a whimper than a bang.

The virus first popped up in early February 1976, when a 19-year-old private at Fort Dix, New Jersey, reported to his superior that he felt ill and tired, although not so bad as to skip the training hike later that day. He died within 24 hours. It was echoes of the 1918 Spanish flu epidemic all over again.

An autopsy revealed that the young soldier had contracted swine flu; shortly after, other soldiers were admitted to the hospital with the same symptoms and officials soon found that 500 people at the base were infected with the virus, though they hadn't become ill.

ford_getting_swine_flu_shot.jpgUpon hearing about the potential pandemic, President Gerald Ford ordered the mobilization of a nationwide vaccination program, at a cost of $135 million in 1976 dollars "“ that'd be roughly $505 million now. After the first reported infection in February, the virus pretty much laid low for the next few months.

In October 1976, health officials, armed with a vaccination and a healthy dose of scaremongering, took to the streets. Propaganda about the potential pandemic was more frightening than the actual thing and possibly even more frightening than the news reports this time around.

Health officials tried hard to terrify the populace into getting flu shots with an ominous voice intoning "a swine flu epidemic may be coming" over images of people lying in hospital sickbeds. It worked: More than 40 million Americans, a quarter of the population, got their flu shots.

However, that may have not been the best idea "“ while the flu itself only killed one person, the vaccine killed more than 30. Within two months after the mass inoculations began, 500 people came down with Guillain-Barré syndrome, a paralyzing nerve disease.

This, combined with the fact that the prophesied epidemic never really materialized, didn't exactly help Ford's flagging political career: While the dismal economic state probably had more to do with it, Ford lost re-election that year.

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April 29, 2009 - 9:40am
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