Oddly inspired by the Queer Eye pitting thread of Laurie. The 1918 influenza pandemic was responsible for at least 20 million deaths worldwide, with estimates of morbidity at 1 billion. The strain has yet to be conclusively identified. Annually, 25 to 50 million Americans are infected with mortality rates at ten to forty thousand(depends if you want to count secondary infections, most often pneumonias, for example.) CDC stats. Not astronomical, but as high as AIDS deaths and much higer than the “dreaded” SARS epidemic. In the book Evolution of Infectious Disease by Paul Ewald, he argues the virulence of the 1918 strain was largely due to the horrendous conditions of trench warfare. ( Briefly, high population density of susceptible hosts favors rapid transmission and higher virulence, without the necessity of a mobile host, short incubation and rapid replication can occur, causing greater damage to host cells and higher mortality, morbitity as virus replicates and sheds). Influenza occurs in three major strains, A,B,C all capable of antigenic shift making them unrecognizable to memory T and B lymphs. In other words, we get “new” strains every season. There are now huge populations of immunocompromised hosts and vectors due to AIDS, immunosuppressive therapy for transplantation, autoimmune disorders, etc. TB has already started to re-emerge in this demographic. TB however, is not nearly as able as a virus to tear through a population. Does this large group of immunocompromised patients present just the right resevoir(a much better one, in fact, than healthy young men slogging it out in the trenches) for another pandemic. Is anyone on top of this? The CDC, WHO? Or should I just go in my room and hide now?
Relax. It wasn’t just “trench warfare” that helped along the spread of influenza, but the generally unsanitary conditions that existed in all the major cities at the time. Keep in mind that in 1918, you were also pretty likely to drop dead of cholera or typhoid and other diseases that are largely unknown in modern industrialized nations.
Fact is, with clean hot water on demand in our homes, as well as food preserved by effective refrigeration, and modern sewage systems, dying of any infectious disease is getting pretty rare compared to heart disease and cancer. Pneumonia and influenza still claim plenty of elderly victims, though, but by that age your immune system is probably already weakened and you’ve fulfilled your evolutionary destiny, anyway.
Nasty bugs may rise again, especially since they’ve been hardened to our best antibiotics, but if you make sure to wash your hands after using the toilet, prepare your food properly, use condoms and get plenty of rest and fluids, odds are you’ll live to become even more crotchety than you already are.
Crotchety, eh? You should see me off my medication. 
I think your right on about the risk in industrialized countries with regard to the bacterial pathogens you mentioned and agree Ewald’s theory only partly addresses the the causes of the pandemic, there are other hypotheses(high virulence due to recent zoonosis, for one). However, modern sanitation is not practiced so readily worldwide, and influenza has this nasty mode of airborne transmission…its not like there were no efforts made to quarentine infected individuals during the pandemic…
Oh yeah. Littlle help here, can someone enlighten me as to how to link to other threads?
It works best with two browser windows open, but basically, you simply drop in the url:
http://boards.straightdope.com/sdmb/showthread.php?s=&threadid=103503
To be fancy, you can click on the “http://” button on the Reply page, type in the text or name of the page on the first pop-up, then drop in the url on the second pop-up:
FAQ - technical issues - please read this BEFORE posting a question
To be really fancy, you can link to a specific post within a thread by following the directions, here
(To see the coding for the above examples, click the quote button on the bottom right of my post.)
Much appreciation, Tom.
Like Mexico City? Just a copule of hours drive from the US.
Or Rio? Visited by millions from around the world, yearly, and a virtual pest hole, in many neighborhoods.
There are too many other examples to list.
And what about this–
The prospect of a new disease being brought home seem less than unlikely.
What’s your point? That diseases can rapidly spread among urban populations that have less-than-adequate access to sanitation? That’s pretty much what I said in my first post.
Sure, in individuals. But if channels of communication are kept open, these individuals can be isolated and treated, so it is far far less likely that we’ll see a 1918-style pandemic in a modern industrialized relatively clean city. If I have to take some unPC route and disqualify Mexico City and Rio, so be it.