Why was the 1918 flu so deadly?

Factual Questions
1

If I understand this right, the flu at that time was killing millions of people, many healthy young adults in the prime of their lives.

Were people more susceptible to flus then because of lack of medical care or the access to a healthy diet? Did it have anything to do with the First World War soldiers returning home from far off places and bringing weird new viruses with them? Could this happen again right now?

I am currently still housebound from a flu that I picked up in the British isles over my Christams holidays, so the flu has been on my mind a lot in these last three weeks.

2

This may be begging the question, but the deadliness was precisely because it killed healthy people. The flu usually kills in a U-shaped pattern – the old and the very young are at risk. The Spanish Influenza killed in a W-shaped pattern, with a large number of healty adults succumbing.

I don’t think medical care or diet had much to do with it. Even back then there were influenza epidemics that weren’t as virulent. One major difference nowadays is that the flu spreads much faster due to air travel.

Could it happen right now? Certainly. People scoff at the Swine Flu scare of the 1970s, but doctors at the time thought Swine Flu was the same as the Spanish Influenza. They were wrong, but given the virulence of the epidemic (which killed more people in a shorter period of time than any other epidemic in history), they were playing it safe.

“East is east and west is west and if you take cranberries and stew them like applesauce they taste much more like prunes than rhubarb does.” – Marx

Read “Sundials” in the new issue of Aboriginal Science Fiction. www.sff.net/people/rothman

3

i seem to recall the 1918 flu took some 20 million lives, maybe in europe the war contributed to that; breakdown of social services, available medical care, general knowledge, sanitation, migrant populations. i guess the death toll was bad here in the states also. i know one thing; ive only had it twice and it takes you down in a matter of hours. i came down with it 3 days before xmas and i didnt ignore it and try to carry on with the holiday; i went to bed and stayed in bed. i hope your getting better.

4

Somebody send this thread to JillGat, it’s right in her area of expertise. I tried, but she’s blocking email from me.

-Melin

5

how do you send a thread?

6

Above the first post is a blue line that says “Email this page to someone.” JillGat is the moderator in Comments About Cecil’s columns. She works for CDC, and this is exactly her sort of question.

-Melin

7

OK, I’m not the Gat, but my department chief is one of the most senior influenza researchers in the world. I can shed at least little light on the subject.

AFAIK, it is still very much unknown was made that 1918 flu so deadly. Not too long ago, someone found infected lung tissue (IIRC) from a US Army private who died of the disease. The man died early enough in the progression of the disease meaning the influenza virus was still present in his lungs.

Currently, the virus’ RNA is being sequenced to determine how it differs genetically from the flus that tend to pop up today.

We gladly devour those who would subdue us.

8

There are several reasons why the 1918 “Spanish” flu pandemic caused so many deaths:

#1 - The main reason is the virus strain that year was much more virulent than others before & after it. IIRC, the protein that allows the virus to remain atached to the cell membrane was much more effective than usual, so that the virus was more efficient at getting it’s nucleic acid inside cells where it can make more virus particles. I’m not sure whether this same protein or some other factor caused Staph pneumonia (and secondary bacterial infection) to occur with MUCH higher frequency than usual.

#2 - It occurred during WW I, meaning that people were rapidly moving around the world (well in North America & Europe, anyway) & more rapid spread of the flu occurred than if the same virus had struck a few years later.

#3 - when people did get Staph pneumonia, there were no antibiotics available. Either they got better on their own, or they didn’t. Usually, they didn’t.

Sue from El Paso

Experience is what you get when you didn’t get what you wanted.

9

The Flu is deadly. Most people who say they have the flu do not have it. It is just a bad cold.

I had the flu once and it was worse than pneumonia. Just like I hate how the media portrays our old friend the measles as a mild disease. It is NOT. The Brady kids had it. I don’t think if they were sick they would be actin like they were portrayed.

The media makes us think these diseases aren’t so bad.

I recall my first recollection with the 1918 flu was after my dad died and we were in the cemetary and I asked my mother why so many people died in 1918. That was in a cemetary in Hibbing MN. So you know if a little kid can notice things like that it must’ve been bad.

10

Alphagene and others have answered the question pretty well. We don’t have a culture of the 1918 flu, and for all we know, it could still come back and hit us again. It was 25 times more deadly than ordinary influenzas and killed more people than any other epidemic in the history of the world, including the “Black Plague” that descimated in Europe. And yet, amazingly, it is often left out of history books and accounts of that period. It was incredibly virulent; more than 25% of the US population became ill with it. It killed 2.5% of its victims. Deaths worldwide aren’t known for sure, but estimates range from 20 million to 100 million. The Centers for Disease Control and Prevention and local health departments take the threat of another deadly flu pandemic very seriously. Meetings are held on a regular basis to discuss strategies to prepare for what is considered by many to be an inevitability… an outbreak of either that virus or another one like it. Scientists are searching arctic tundra for flu vicims who may have remained frozen since that time, hoping to recover the virus to study. Some say that if Hong Kong hadn’t responded quickly (by killing all their chickens) to that avian flu that hit a few years ago, something similar might have happened, but we’ll never know.

I’m not a flu expert - I’m an HIV/AIDS epidemiologist. If you’re interested in knowing more about the 1918 flu, there is a very readable, interesting book that has just come out called “Flu” by Gina Kolata. It’s quite a story.

I didn’t realize that Melin was still blocked from my account. Sorry.
Jill

11

Hopefully, we won’t have to worry so much about influenza pandemics, based on the rather interesting news story yesterday about the drug Pleconaril, which apparently does a wonderful job of negating the effects of various picornaviruses. This drug is an example of the new tailor-made drugs that aren’t discovered through organized serendipity, but instead are fashioned to specifically fit onto certain sites of three-dimensionally mapped viruses. If this drug works as it appears to so far, then the creation process would imply that ANY virus can be neutralized once properly mapped and understood as to how it works.

Information for this reply was obtained from The Blade (Toledo), the 1/15/00 issue, which pulled the story from the Associated Press.

12

Just to be pendantic, that’s not strictly true. The Black Death killed 75-100. In 1347-1351, it reached 25 million (Spanish flu is generally credited with around 20-22 million), and there were many other breakouts.

However, Spanish Influenza killed all its victims in just a few months (March 1918 - December 1918).

“East is east and west is west and if you take cranberries and stew them like applesauce they taste much more like prunes than rhubarb does.” – Marx

Read “Sundials” in the new issue of Aboriginal Science Fiction. www.sff.net/people/rothman

13

Another pandemic is expected by CDC and NIH in the next 50-100 years. That is not to say that I might not occure tomorrow.

The level of travel now is greater than ever, and any drugs that are developed may not be available to all.

No doubt such an epidemic will open eyes to the danger of ignoring the world wide health situation, as having a nice PPO may not help when that stuff hits. I hope it doesn’t turn out that way.

14

Agent: Virus - unidentified even today

Just imagine a flu that quickly infects one half the population of the world. Killed a mininum of 25 million people, many within hours of exposure becoming ill.

Plague of the past…No it was the 1918 flu. WWI had just ended claiming 10 million lives in 4 years. In the USA alone almost a million people fell ill. The high risk group for this illness…everyone on the planet.

It was history’s greatest plague…At least for the greatest number of people dead in the shortest time. And it all began with a relatively mild flu bug going beserk. Even more mind blowing when you realize it could happen again.

All influenzas are viruses, and tend to be seasonal, visiting us year to year in slightly altered form. They owe their name to Italian scientists who named them based on the INFLUENCE of heavenly bodies.

In the year 1918, according to insurance acuaralists dropped the life expectancy of the average American by 25%.

So where did this come from? From Camp Funston, KS and a low grade cook named Albert Mitchell. On March 11, 1918 he reported to sick bay with a low grade fever, mild sore throat, muscle aches, typical flu like symptoms. The nurse on duty, seeing these symptoms a hundred time before didn’t rush him to bed. She let him wait.

While waiting Mitchell struck up a conversation with Corp. Lee Drake. He had less symptoms but a higher fever. But before the two could be put to bed yet ANOTHER soldier was ill.

It appeared a flu outbreak was upon the camp. By noon 107 very very ill soldiers were being treated. Within two days 522 beds were filled. These men were not mearly sick they were desperately ill. Most by now were in stages of pneumonia.

Suddenly by the end of the week this scene was played out in CA, FL, VA, AL, SC and GA. What’s more naval ships throughout the east were docked with thousands of ill sailors. Even in places like Alcatraz, isolated areas, the flu was invading.

Oceans were no match. By April, in France, the military as well as civilians were falling ill. The US military was blamed for causing and spreading the outbreak. But by Mid April China and Japan were overwehlmed. By May Africa was in deep. By June Australia and South America fell. No disease in history conquered so quickly. In all likelyhood it was the birds, the troops, the shipment of fruits the air currents that were spreading this killer.

So how did people react. In Boston the editors of the paper put a small not alarming notice in the paper announcing the flus arrial. Four months later 15,000 people were dead. And what did the miliary do. To protect their soldiers they moved them to bases in the Midwest. Thereby infecting popluations there as well as not saving a single life.

This flu took a mere 6 days to be reported in every single state.

WORLDWIDE DEATH TOLL

It is hard to imagine the swiftness of this killer. You would wake up on a Monday with a sore throat and be dead on Friday.

But what killed these people?

The actual cause of the deaths was a pneumonia that ravaged the lungs of those ill. The two germs traveled in tandem. Here are death tolls in some cities:

Philly 158 of every 1000 people
Baltimore 148 of every 1000
Washington 109 of every 1000
Boston 100 of every 1000.

Worldwide the disease followed its predictable pattern. It came quickly killed faster and left the recovering very weak for a long time. This along with the 1916 TB epidemic and WWI left the problem of caring for so many sick people.

In Somoa and Nome, AK where respitory disease was then, uncommon, it took 80% of the population.

In Spain the virus turned so deadly the epidemic was infamously named “The Spanish Flu.” even though it most likely started in the USA.

Luxury liners that docked in NYC from Europe were arrving with 10% fewer passengers than when they left.

Worldwide the death toll is put at 25 million. Though indirectly it is as high as 37 million.

Then as mysteriously as it came the virus vanished. And it vanished so well no one could find it. Scientist spent years looking in humans, birds, and swine.

Flu viruses are notorious for rapid mutations and this in all probability is what happend to this guy. (As a side note AIDS can mutate 1000 times faster than a flu virus)

The above condensed from Extraordinary Ending to Everything and Everybody

15

The above was condensed? :smiley:

Not entirely true. As of now, we know it is what is called an “H1N1 influenza virus” the H1N1 refers to the type of spikes that stick out of the surface of the virus.

Some flu viruses that are around today are also H1N1s, but what made the 1918 H1N1 flu virus biochemically different from the H1N1s that are going around today is what is currently being determined.

We gladly devour those who would subdue us.

16

[[ The Black Death killed 75-100. In 1347-1351, it reached 25 million]]

The other way to look at it, too, is the rate per population. The plague killed a third of the population of Europe, so one could argue that its impact was greater than the flu. But I believe that most experts believe that the 1918 flu killed more individuals than the plague did… though plague also wiped out quite a few in China, and we don’t really have numbers.

A few of the points in Markxxx’s excerpted piece are inaccurate, just ftr.
Jill

17

Geeze, Jill, which points are inaccurate? Don’t leave us hanging. Or is this an assignment for the class to dig em all out?

“You can be smart or pleasant. For years I was smart.
I recommend pleasant.”
Elwood P. Dowd

18

Almost everything you wanted to know about flu:

http://www.ultranet.com/~jkimball/BiologyPages/I/Influenza.html

and, efforts to dig it up again:

http://www.medicalpost.com/mdlink/english/members/medpost/data/3512/09A.HTM

Launcher may train without warning.

19

The November 1999 issue of National Geographic includes a small (three paragraph) article about the 1918 flu epidemic. Most of what they state has been covered by others, but they do comment that they have extracted the virus from three different victims (geographically spread), and have sequenced three of the virus’s eight genes. Stillo not known what made this one so lethal.

20

Sorry, I should have referenced the Armed Forces Institute for Pathology in my comment about the National Geographic article.