March 2nd, 2006 00:57 EST
Global Pandemic- Overdue?
A pandemic (from Greek pan all + demos people) is an epidemic (an outbreak of an infectious disease) that spreads worldwide, or at least across a large region.
In retrospect, 1918-19 was a time that may have seemed quaint, even appealing. It was a time of horse-drawn carriages, top hats and long trailing skirts. Yet, it was a terrifying time too, on a worldwide scale. Victims died en masse. Millions of healthy young people were suddenly cut down in their most productive time of life. Corpses piled up faster than they could be buried. In some places, entire towns and villages were wiped out. It was a scourge, one that has been called the most destructive in all recorded human history- the Spanish Influenza.
The Spanish Influenza was so named because the non-combatant country of Spain was the one that reported the illnesses and deaths of many civilians amidst a world embroiled in World War 1. Apparently, the pandemic began in March 1918 in the State of Kansas, USA. It spread to France by newly arrived U.S. soldiers. By July 1918, influenza deaths had sharply increased. World War 1 ended on November 11, 1918 but by then the pestilence had broken out earth wide, claiming lives with frightening suddenness.
In his book The Great Influenza John M. Barry quotes a written record of that time: “In Rio de Janeiro, a man asked medical student Ciro Vieira da Cunha, who was waiting for a street car for information in a perfectly clear voice, then fell down dead. In Cape Town, South Africa, Charles Lewis boarded a streetcar for a [five-kilometer] trip home when the conductor collapsed, dead. In the next [five kilometers] six people aboard the streetcar died, including the driver.”
Science had no answer as to the cause of the disease and how it spread. Although public measures were imposed; ports were quarantined, movie theatres, churches and other public meeting places closed, whole populations ordered to wear gauze masks or risk facing a fine or jail, the pestilence spread relentlessly.
The 1918-19 pandemic did not primarily afflict the elderly; it struck healthy young people and killed them. Many of those who died of the Spanish Flu were between 20 and 40 years of age. In a relatively short time, the flu had claimed an estimated 21 million lives worldwide, a figure some experts now judge to be low.
John M. Barry noted in his book The Great Influenza: “Influenza killed more people in a year than the Black Death killed in a century; it killed more people in 24 weeks than AIDS has killed in 24 years.”
Eighty five years later, we must ask; could it come back? If it did, could it be fought successfully?
On May 18, 2005, The Wall Street Journal said, “The bird flu currently active in Asia is known as H5N1 and was first spotted in Hong Kong’s poultry markets in 1997. It is unusual for its virulence- it kills as many as 80% of those who catch it.”The next day, on May 19, 2005, Reuters Alert Net warned of the continuing appearance of new flu viruses adding that these ‘pose a continuing and potentially growing pandemic threat.’
Since then the threat of a pandemic outbreak has become a matter of serious concern on the international level.
Have we learned well from the Spanish Flu of 1918? Historian Alfred W. Crosby writes: “All the physicians of 1918 were participants in the greatest failure of medical science in the 20th Century or, if absolute numbers of dead are measured, of all time.” John M. Barry, however, makes this point: “Back then Scientists fully comprehended the threat’s magnitude, knew how to cure many secondary bacterial pneumonias, and gave public health advice that would have saved tens of thousands of American lives. Politicians ignored that advice.”
What about scientists today? In 1997, scientists exhumed the body of a young woman who had fallen victim to the Spanish flu back in 1918 in the small Eskimo village of Brevig on the frozen tundra of the Seward Peninsula of Alaska. Thanks to the frozen specimen, a team of scientist has been able to identify and sequence most of the genes of the 1918-19 flu virus. However, scientists have still not figured out what caused that flu to be such a killer. One thing they do know is that that strain was a relative of the now active H5N1 flu virus.
Some feel that farming communities where poultry, swine, and people live in close proximity- as is often the case in Asia, and the recently affected African communities, for example- are likely sources of flu strains. This is because flu viruses also affect mammals. The pig, it is believed can be a host for viruses that affect birds. However, it can also be the host for other viruses that infect humans. Therefore, if both types of viruses infect a pig, the genes of the two strains can get mixed together. The result can be a totally new strain of influenza, one to which humans have no immunity.
Taking into consideration that the flu virus reproduces so rapidly [far faster than the HIV virus], a strain of the flu that humans have no immunity to or a developed vaccine against is a very terrifying possibility.The medical journal Vaccine reported in 2003: “It has been 35 years since the last influenza pandemic, and the longest interval between pandemics recorded with certainty is 39 years.” The article continued: “The pandemic virus may emerge in China or a nearby country and could include surface antigens or virulence factors derived from animal influenza viruses.” The Vaccine article predicted: “It [flu virus] will spread rapidly throughout the world. Several waves of infection will occur. Morbidity will be extensive in all age groups, and there will be widespread disruption of social and economic activity in all countries. Excess mortality will be evident in most if not all age groups. It is unlikely that health care systems in even the most economically developed countries will be able to adequately cope with the demand for health care services.”
Since then the bird flu virus H5N1 has spread through Asia into Europe and Africa, claiming birds en masse, and at least 90 human lives. It is no surprise that this time around, world leaders and scientists are reacting with seriousness and urgency. Still, with the world’s socio-economic inadequacies, we cannot ignore the living risk we face everyday. We must be careful to avoid morbid paranoia about the virus, but on the other hand, we must be even more careful not to put ourselves out at even higher risk by negligence and indifference.
We are long overdue for another global pandemic. Have we learned well enough to survive it this time?