Friday, January 11, 2013

Worst Flu Outbreaks in World History

It seems to happen every year in the fall and winter months here in the United States, sickness. The realization that the common cold effects everyone this time of year is obvious, and we do everything humanly possible to prevent our cold from getting worse. The flu seems to break itself open at some point every year and no matter how affordable or easily accessible the flu vaccine is the outbreak still seems to occur. Typical years we hear very little about the flu outside our local school systems and neighbors commenting on how it's "getting around." Then, every once in a while the news reports on a major outbreak spreading throughout the country; the death toll in young children and the elderly climbing, and doctors offices and hospitals inundated with visits for medication and treatment. National Flu Outbreak 2013

These pandemics historically occur three to five times every century since around the sixteenth century with some of them fairly mild and others far more severe. Many people claim the first ever flu epidemic was recorded by Hippocrates in the fifth century B.C. "According to Chamseru however, a French physician in the eighteenth century, the 'Cough of Perinthus', as Hippocrates called it, could have encompassed several diseases." (Martin and Martin-Grenel, Emerging Infectious Diseases, Vol 12, No 6, June 2006, p 978) Which means that it probably was not an influenza breakout but rather multiple types of diseases spreading through the region. The next recorded instance of influenza, or simply called the flu, occurred in 212 B.C. by the historian Livy, who claimed an infectious disease spread through the Roman Army. A famous sixteenth century doctor known as John Keys was the first to create a detailed description of flu, which he called 'Sweating Sickness.' (Avian Birds Flu, http://pandemic.avianbirdsflu.com/article.aspx?pageId=93) As the definition of influenza and its known symptoms become public knowledge we can begin to examine our first ever truly recorded pandemic of the flu. This list was compiled based on a full list of flu pandemics that have occurred in history. Based on various lists that were found from various sources I narrowed it down to simply 7 of the Worst Flu Outbreaks in History.

1) The First Recorded Flu Epidemic of 1580 - The word Influenza comes the Italian phrase "influenze del freddo" or "Influence of the Cold" in English. This phrase was first developed during the outbreak that occurred in 1580. There is not a lot of reliable information available on this flu epidemic other than to say that is started somewhere in Asia Minor and spread to Africa, Europe and eventually the New World. The spread of the virus however can possibly be attributed to Spanish troops sent by Philip II to fight the Dutch. (Pyle, The Diffusion of Influenza, p. 24). It is believed that only about one twentieth of the population avoided infection.

2) The Westward Moving Flu of 1781-1782 - The emergence of Russia in European affairs thanks to Peter I is believed to have been one of the leading reasons why this flu spread so quickly in the eighteenth century. It is believed the flu originated there or possibly in Far East Asia around early 1781, however because of Peter I efforts to expand relations, communication, and transportation to Europe the flu found a quick route to the rest of the world. It is believed that nearly three fourths of Europe was infected within the first eight months of 1782. Some historians believe that although the sickness was minor those with respiratory problems had greater difficultly and the death toll is therefore possibly in the hundreds of thousands. (Hays, Epidemics and Pandemics, p. 171) 

3) The Russian Flu of 1889 - As the transportation revolution spread throughout the world and railroads stretch across continents the speed by which influenza spread grew faster as well. In the spring of 1889 a new influenza virus began around central Asia or Ruusia. By the fall and winter of 1889-1890 it moved quickly through Russia, into Germany and the rest of Europe and the first reported cases of influenza hit the United States in December 1889. The virus continued to circle the globe reaching South America by early 1890 and Australia by mid 1890. In all it is estimated that nearly 1 million people died and with the origin yet again coming from the Far East it added to the misnomer that foreigners, specially those from that region, are filthy people in need of being civilized. 

4) The Spanish Flu of 1918 - "1918 has gone: a year momentous as the termination of the most cruel war in the annals of the human race; a year which marked, the end at least for a time, of man's destruction of man; unfortunately a year in which developed a most fatal infectious disease causing the death of hundreds of thousands of human beings. Medical science for four and one-half years devoted itself to putting men on the firing line and keeping them there. Now it must turn with its whole might to combating the greatest enemy of all--infectious disease." (Journal of American Medical Association, Dec 1918) Soldiers from around the world were returning home at the end of 1918 after going through the deadliest war in human history. Nearly 16 million lives were lost as a result of this four year conflict and everyone, on both sides, was overwhelmed with too much death. Sadly as they returned home hoping for peace all they were to find was more death, in fact more than the entire Great War ever produced. A modern day British team of researchers believed they have nailed down the source of the virus to a military hospital in Etaples, France in 1917. From there the virus easily spread through the ranks of different military groups from around the world who transported the virus back to their home countries when returning from war. Since newspapers in Europe and the United States had been reporting death and destruction for years they were hesitant to report the initial death tolls of the flu. However in Spain the papers freely published how the flu was effecting their people which gave way to the pandemic being deemed the "Spanish Flu." The first cases of the virus in the United States have been traced back to Haskell County, Kansas in January 1918, within only a matter of months the virus had made it to New York City. The virus affected the United States so badly that the life expectancy of the average individual dropped by nearly 10 years. What made this influenza pandemic unique to all others before and since was who was affected by it. Typically the first and only casualties during flu epidemics were children and the elderly, those with weaker immune systems, however the Spanish Flu did the opposite. The greatest amount of deaths were seen by those between the ages of 20-40, healthier individuals. To this day no one completely understands why this occurred. There is so much history and so many books dedicated to this flu pandemic that killed nearly 50 million people, close to 3% of the worlds population. I encourage you, if your interest in this pandemic is peaked, to check out www.influenzaarchive.org and check out their twitter account @1918FluArchive. 

5) The Asian Flu of 1957 - As this flu outbreak began many recognized that a pandemic was possible because of how devastating it was to those over the age of 65. Based on the name alone it's clear that the virus found its origins in Asia. Overlooked by many in the government and the medical profession Dr. Maurice Hilleman, a microbiologist at Walter Reed Hospital, played a crucial role in preventing the Asian Flu from doing extensive damage here in the United States. Watch this clip on the History of Vaccines website and hear Dr Hilleman explain how he discovered that a pandemic was coming. Although the vaccine was only available in limited supply by the end of 1957, his quick action probably saved hundreds if not thousands of lives. As Hilleman predicted the virus found its path in the United States when children returned to school. It spread so rapidly that health officials saw little need to quarantine individuals. Although the effect of this virus was no where close to that of 1918 outbreak it infected close to 25% of the U.S. population and killed nearly 2 million globally.   

6) The Hong Kong Flu of 1968 - Little improvement had been in made since 1957 in handling influenza epidemics. In mid-July of 1968 the first signs of the flu were spotted in Hong Kong. By the end of the month the virus popped up in Vietnam and Singapore. Over the next two months it spread to India, Australia, Europe, and the shores of California. Unlike other fast moving flu pandemics this virus had a low mortality rate. Overlooked by many around the world, the first source to break the possibility of an influenza pandemic was The Times in Great Britain. Similar to the virus seen in the 1957 outbreak where it mostly effected the elderly, it was a milder version, The death toll however still reached nearly 1 million people. Another reason many attribute a reduction in mortality rates from this pandemic than we saw in previous ones, is the vast improvements in medical care and antibiotics. 

7) The Swine Flu of 2009 - As medicine and medical treatment improved over the next 40 years the expectation that one would die from a flu virus diminished dramatically. Localized epidemics had always been reported in the media every so often however a true pandemic of influenza had thought to be impossible in this day and age. I remember this year well when the term "swine flu" spread throughout the country. The government quickly tried to get health officials to term it an H1N1 virus to prevent pork prices from bottoming out but the term stuck, if you were sick you had the swine flu. I even remember that year my mother-in-law getting very ill for a couple days and whether she officially had it or not we all kept saying that's what she had. The first flu case was reported in April of 2009. Within days the CDC was working on a vaccine and by the end of April the U.S. government declared it a public health emergency. A total of 74 countries reported being affected by the virus and the vaccine at first was in limited supply available only to those at high risk, however because of modern medical advances and the quick response of government officials the mortality rate was very low. It is estimated between 43 and 89 million people were infected globally but only around 250-500 thousand died.   

Many more influenza outbreaks occurred throughout world history and some could have arguably been added to this list yet I limited it to Simply 7. I found it interesting while looking through the various flu pandemics that the virus typically found its way from Asia in the spring time and worked its way around the world throughout the summer but the real danger began during those fall and winter months. I'm sure every few years, similar in some ways to this year, we will hear about how the flu is spreading quickly and is a danger to the public. All we can do however is pray that we never seen one like the Spanish Flu of 1918 that wiped out tens of millions of people.  

2 comments:

  1. Influenza in Bangladesh & LVPEF can help to Solve it

    International center for diarrheal disease research institute has been working for the last 40 years to provide training about common diseases. CDC and IEDCR both are taking immediate steps to control the disease.

    The main cause of the Influenza disease is RNA virus. Its most common disease in Bangladesh. Sometimes influenza makes children develop vomiting and fever. Adult people also feel physical discomfort , runny nose, muscle pain . This virus spreads around the world.

    U.S centers and Government of Bangladesh recently published hospital based surveillance report , about 20 month influenza prevention and control efforts. This virus is two types type A and type B. National representative published data , from May 2007 to December 2008 3698 influenza affected people which 386 were positive. Among themselves 51% A type and 49% B type. Children are mostly affected by the disease.

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