The other day I finished re-reading The Great Influenza, which I originally read early in the century when I was still teaching. I had used influenza, the virus as a critical part of explaining the relationship between evolution, genetics and disease. This book addresses all of those issues.
Influenza is an RNA virus, as is HIV and coronaviruses which cause both the common cold and SARS which pandemics in 2004 and most recently in 2020 when SARS-CoV-2, which most people know as COVID ravaged the planet. The importance of understanding RNA viruses is in how they are constantly mutating, thus causing more problems.
When the pandemic influenza first appeared in March, 1918 it was in Kansas. So, why is it called the Spanish flu? Spain, since it was neutral in World War One did not have press censorship and freely reported on the disease. Anyway, the disease first appears in Kansas at a small farming community. The influenza probably jumped from birds to humans, which normally would only affect the people who catch it from a bird. However, if a person has a human influenza the genes from the bird influenza can re-assort with those of the human influenza and become a hybrid new human influenza. This is most likely what happened in February, 1918. Regardless, a couple of young men enlisted in the army and went off to crowded camps to train. In the process they carried the flu to thousands of other trainees. In March 30,784 soldiers developed pneumonia, with 5,741 dying. And this was at one military base in Kansas.
By the end of 1919 over 675,000 American would die of influenza, world-wide that number would be between 50 and 100 million. The number is had to calculate world-wide because countries didn’t keep the best of medical records. We do know that at least 20 million died in India, and more than that in China, so the world-wide number is probably closer to 100 million, or approximately 3-6% of the human population at the time.
The 1918 influenza killed people “mostly” by becoming pneumonia. People literally died with lungs filled with their own fluids. This was referred to as ARDS – Acute Respiratory Distress Syndrome (SARS is Severe Acute Respiratory Syndrome). At the time there was no treatment for this disease. Calling it a disease is because they would know it was a virus until years later. The only treatment at the time was isolation and face masks.
The author goes through lenghthy discussions about the men in charge of learning about and fighting the disease. This included nice discussions of Yellow Fever, a tropical that now has a vaccine. During the Spanish-American War in the late 1890s American soldiers in Cuba was getting and dying from Yellow Fever. A military officer was put in charge of controlling mosquitoes near and on military bases. At the time he thought it was useless, but as cases dropped to near zero he learned the importance of controlling mosquitoes. He took this lesson to Panama during the construction of the Panama Canal where ultimately it was controlling mosquitoes that lead to completing the project. By 1918 he has a military commander and was completely frustrated by influenza.
Then there was the story of the influenza researcher who survived the war only to die of Yellow Fever in the 1920s while studying the disease in Brazil. It’s believed that a mosquito escaped in his lab and lead to his death.
In the early 1920s the human Influenza was transmitted to pigs resulting in the entire pig population in the midwest being killed. In the early 2000s there was an influenza strain going around that was 1/4 bird, 1/4 European swine, 1/4 American swine and 1/4 human. Talk about a hybrid disease. I was vaccinated and encouraged all of my students to get vaccinated.
The author ties everything together nicely and at some point comments that if there was a similar disease in the early 2000s nearly 1.75 million Americans would die and 300-600 million world-wide. We fast forward to 2020 and the SARS-CoV-2 pandemic. At least 1.2 million Americans died, but only 7.4 world-wide. The response in the USA was pathetic and world-wide amazing. Isolation and masking still worked and world-wide it was taken seriously. In the USA it wasn’t. Looking back at the 2004 SARS-CoV-1 pandemic the disease was stopped almost immediately with masks and isolation.
Now there are vaccinations for COVID, Influenza and Yellow Fever. I had them all. Yellow Fever is a one time vaccination, while the others are annual vaccinations. Since I’ve traveled in both Panama and Brazil the Yellow Fever vaccination was a must. I even have a Yellow Fever vaccination card that I travel with proving that I’ve been vaccinated.
That’s all for now, more later…
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