Spanish Flu — May It Never Return
November 13, 2017 at 4:07 p.m.
By Max [email protected]
Influenza is nothing to fool with, especially for pregnant women, the very young, the elderly or any whose immune systems are suppressed.
Flu is one of the most common infectious airborne (spread by sneezing, coughing or talking) viral diseases that occurs in seasonal epidemics and can cause variable degrees of symptoms, ranging from fatigue to respiratory failure, including red and watery eyes, high fever, sore throat, headache, nasal discharge, weakness, cough, bloody sputum, and, in the worst case, mortality when bacteria swarm into the injured lungs, causing pneumonia. The Centers for Disease Control and Prevention estimates that seasonal influenza is responsible for more than 20,000 deaths annually.
While 20,000 deaths is something to be alarmed about, it pales in comparison to those who died in the great Spanish influenza pandemic of 1918-19. (It was called "Spanish" flu because more than 8 million Spaniards were ill, including King Alfonso XIII, and the cases were widely reported.) This was the disease responsible for the deaths of approximately 50 million to 100 million people worldwide, many between 20 and 40 years of age, and it stands out as the deadliest single event in recorded human history. The disease has plagued mankind through centuries, and the word "influenza" started being used toward the end of the Middle Ages.
One-fifth of the world’s population in 1918-19 suffered from the flu, which killed 2.5 percent of its victims. So many died that the average life span in the United States fell by more than 12 years in 1918. In comparison, AIDS killed 11.7 million through 1997, World War I was responsible for 9.2 million combat deaths and around 15 million total deaths. World War II accounted for 15.9 million combat deaths.
The cause of the pandemic and the reasons for its severity remained one of the most discussed medical mysteries throughout most of the 20th century. Influenza viruses were finally isolated about 15 years after the pandemic, but scientists of the early 20th century were not capable of understanding the emergence, pathology (aspects of the disease), or disappearance, let alone determining a means of prevention. Many years passed until 1996, when with new techniques it became possible to recover and sequence fragments of the viral ribonucleic acid (RNA) retained in preserved tissues from several 1918 victims. The full genome sequence is now available, and this information may provide the ability to prevent and control future pandemics.
Of note: Several different strains of pandemic viruses (1946, 1956, 1968 and 2009) since 1918 contain gene segments derived from the 1918 virus but none approach its lethality.
Molecular biologists know that the simple influenza virus has only eight genes, each made of RNA, and that the viruses die in hours if left alone with no cells to infect. They even know what the flu viruses look like under an electron microscope — they are egg-shaped particles, which sometimes form long filaments. The flu virus particles are wrapped in a slippery fatty membrane, held in place by a protein scaffold.
Biologists also understand how viruses burrow into a human cell and burst out again by using hundreds of sharp edges that poke out of the virus's membrane. They even know why human influenza viruses infect only cells of the lungs, the only human cells with an enzyme the virus needs to split one of its proteins during the manufacture of new virus particles.
Flu viruses depend upon two sorts of proteins to enter and exit the cells; one, hemagglutinin, is used to hoist itself into a cell; and the other, known as neuraminidase, is used by newly made viruses to burst the cell open so it can escape in a spray and infect new cells. The hemagglutinin and neuraminidase proteins also define the flu strain. The 1918 and 1946 strains were H1N1, the next genetic change was in 1956, with strain H2N2. The one that arrived in 1968 involved a virus whose hemagglutinin had changed from the 1956 virus but whose neuraminidase had not, it was thus named H3N2. Even more confusing is that there are actually four types of influenza viruses: A, B, C and D.
Influenza A (H1N1 and H3N2) and one or two Influenza B viruses are included in each year's vaccine. Vaccines are updated annually to keep up with changing viruses. But it can take days for the body to develop enough antibodies to stop a flu infection, unless that flu strain has invaded the body before. In that case, the immune system can quickly marshal its forces and block the virus before the infection occurs.
The annual recommended flu shot contains the strains most likely to occur. Last year's flu vaccine, however, was only 20 to 30 percent effective due to a mutation in the H3N2 strain. No matter; it is better to get a flu shot than suffer from the flu.
Max Sherman is a medical writer and pharmacist retired from the medical device industry. He has taught college courses on regulatory and compliance issues at Ivy Tech, Grace College and Butler University. Sherman has an unquenchable thirst for knowledge on all levels. Eclectic Science, the title of his column, will touch on famed doctors and scientists, human senses, aging, various diseases, and little-known facts about many species, including their contributions to scientific research. He can be reached by email at maxsherman [email protected].
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Influenza is nothing to fool with, especially for pregnant women, the very young, the elderly or any whose immune systems are suppressed.
Flu is one of the most common infectious airborne (spread by sneezing, coughing or talking) viral diseases that occurs in seasonal epidemics and can cause variable degrees of symptoms, ranging from fatigue to respiratory failure, including red and watery eyes, high fever, sore throat, headache, nasal discharge, weakness, cough, bloody sputum, and, in the worst case, mortality when bacteria swarm into the injured lungs, causing pneumonia. The Centers for Disease Control and Prevention estimates that seasonal influenza is responsible for more than 20,000 deaths annually.
While 20,000 deaths is something to be alarmed about, it pales in comparison to those who died in the great Spanish influenza pandemic of 1918-19. (It was called "Spanish" flu because more than 8 million Spaniards were ill, including King Alfonso XIII, and the cases were widely reported.) This was the disease responsible for the deaths of approximately 50 million to 100 million people worldwide, many between 20 and 40 years of age, and it stands out as the deadliest single event in recorded human history. The disease has plagued mankind through centuries, and the word "influenza" started being used toward the end of the Middle Ages.
One-fifth of the world’s population in 1918-19 suffered from the flu, which killed 2.5 percent of its victims. So many died that the average life span in the United States fell by more than 12 years in 1918. In comparison, AIDS killed 11.7 million through 1997, World War I was responsible for 9.2 million combat deaths and around 15 million total deaths. World War II accounted for 15.9 million combat deaths.
The cause of the pandemic and the reasons for its severity remained one of the most discussed medical mysteries throughout most of the 20th century. Influenza viruses were finally isolated about 15 years after the pandemic, but scientists of the early 20th century were not capable of understanding the emergence, pathology (aspects of the disease), or disappearance, let alone determining a means of prevention. Many years passed until 1996, when with new techniques it became possible to recover and sequence fragments of the viral ribonucleic acid (RNA) retained in preserved tissues from several 1918 victims. The full genome sequence is now available, and this information may provide the ability to prevent and control future pandemics.
Of note: Several different strains of pandemic viruses (1946, 1956, 1968 and 2009) since 1918 contain gene segments derived from the 1918 virus but none approach its lethality.
Molecular biologists know that the simple influenza virus has only eight genes, each made of RNA, and that the viruses die in hours if left alone with no cells to infect. They even know what the flu viruses look like under an electron microscope — they are egg-shaped particles, which sometimes form long filaments. The flu virus particles are wrapped in a slippery fatty membrane, held in place by a protein scaffold.
Biologists also understand how viruses burrow into a human cell and burst out again by using hundreds of sharp edges that poke out of the virus's membrane. They even know why human influenza viruses infect only cells of the lungs, the only human cells with an enzyme the virus needs to split one of its proteins during the manufacture of new virus particles.
Flu viruses depend upon two sorts of proteins to enter and exit the cells; one, hemagglutinin, is used to hoist itself into a cell; and the other, known as neuraminidase, is used by newly made viruses to burst the cell open so it can escape in a spray and infect new cells. The hemagglutinin and neuraminidase proteins also define the flu strain. The 1918 and 1946 strains were H1N1, the next genetic change was in 1956, with strain H2N2. The one that arrived in 1968 involved a virus whose hemagglutinin had changed from the 1956 virus but whose neuraminidase had not, it was thus named H3N2. Even more confusing is that there are actually four types of influenza viruses: A, B, C and D.
Influenza A (H1N1 and H3N2) and one or two Influenza B viruses are included in each year's vaccine. Vaccines are updated annually to keep up with changing viruses. But it can take days for the body to develop enough antibodies to stop a flu infection, unless that flu strain has invaded the body before. In that case, the immune system can quickly marshal its forces and block the virus before the infection occurs.
The annual recommended flu shot contains the strains most likely to occur. Last year's flu vaccine, however, was only 20 to 30 percent effective due to a mutation in the H3N2 strain. No matter; it is better to get a flu shot than suffer from the flu.
Max Sherman is a medical writer and pharmacist retired from the medical device industry. He has taught college courses on regulatory and compliance issues at Ivy Tech, Grace College and Butler University. Sherman has an unquenchable thirst for knowledge on all levels. Eclectic Science, the title of his column, will touch on famed doctors and scientists, human senses, aging, various diseases, and little-known facts about many species, including their contributions to scientific research. He can be reached by email at maxsherman [email protected].
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