Whenever talk of an influenza pandemic arises, invariably the 1918 Spanish Flu outbreak is mentioned. The current H1N1 flu pandemic or Swine Flu virus is actually a strain or offshoot of the 1918 Spanish Flu virus, which increases the concern among health care workers about the virus' ability to spread, infect, and kill people. Swine flu or H1N1 is a mix of four viral strains into a new, unique type. Yet there are critical differences between the 1918 outbreak and the 2009 outbreak that may calm the public's fears.
The 1918 Spanish Flu Epidemic
The 1918 Spanish Flu epidemic killed approximately 100 million people worldwide. It lasted from March 1918 to June 1920. Unlike other influenza epidemics, this particular strain caused 10-20% mortality as compared to less than .1% mortality and appeared to kill healthy young adults more so than infants and the elderly, the typical victims of flu. Researchers estimate that one third of the entire world's population contracted Spanish Flu.
Critical Differences Between H1N1 and the 1918 Spanish Flu Outbreak
Scientists have long feared a second influenza pandemic. The last significant pandemic was the 1968 Hong Kong flu. Many critical differences between the 1918 outbreak and the 2009 H1N1 strain should put people's fears to rest.
These differences include the following:
- Spanish Flu was so deadly because it caused a cytokine storm. A cytokine storm is when the virus hijacks the body's immune system and overwhelms it, thus negating the body's natural defense.
- Spanish Flu targeted the young and healthy. The Swine flu virus affects a mixed group of people.
- Secondary infections such as bacterial pneumonia accounted for a huge number of deaths from Spanish Flu. Today, antibiotics combat bacteria pneumonia. Antibiotic medications did not exist in 1918.
- Antiviral medications such as Tamiflu can be used to shorten the severity and duration of Swine Flu. These medications did not exist in 1918.
- Breathing difficulties due to congestion and bleeding in the lungs also caused deaths from the Spanish Flu. Today, medical equipment such as ventilators (breathing machines) can assist breathing in severely ill patients.
World War I and Its Effects Upon the Spread of Spanish Flu
Another important consideration is the effects of World War I on the spread of the 1918 Spanish Flu pandemic. During times of war, several factors coalesce to create the "perfect storm" for a pandemic.
- Men are housed in close quarters such as barracks, creating an ideal environment for infection to spread.
- Medical supplies during World War I may have been harder to obtain, with many supplies going to the war effort. What was available was primitive compared with modern medications and treatments.
- Food shortages, rationing and poor quality food weakened the population of countries at war.
The only factor affecting today's Swine flu outbreak is when people live in close quarters. Outbreaks of Swine flu have been reported in September 2009 on college campuses, especially in dormitories. But most Swine flu victims are ill for only about three days before feeling better. If complications arise, they can be treated in the hospital.
H1N1 Flu Pandemic No Cause for Panic
Dr. Jorge Parada, associate professor of medicine at Loyola University Chicago Stritch School of Medicine says that H1N1 is no cause for panic. "It was the pre-antibiotic age. If you had post-influenza pneumonia, the likelihood of doing poorly and dying were much higher,” Parada said. “We’re in the antibiotic age now and we do a much better job of treating and preventing post-influenza pneumonia.”
Parada also points out that antiviral medications such as Tamiflu and Relenza, if used in the early stages of infection, shorten the severity and duration.
“The earlier treatment is started, the more effective it is,” Parada said. “If treatment is started after 72 hours of symptoms, it has very limited effect. It has a greater effect if it’s started after 48 hours and an even better effect if it’s started within 24 hours of symptoms.”
Other weapons to fight H1N1 include flu vaccines and simple hygienic practices such as frequent hand washing or using hand sanitizers, staying at home if feeling ill, and avoiding crowds during known outbreaks. For those who do not wish to receive a flu vaccine, following natural and alternative methods to boost immune system response, such as avoiding sugar and increasing intake of fruits, vegetables and healthy foods, using herbs and homeopathic remedies might help.
Parada and other scientists caution that while H1N1flu pandemic is no laughing matter, it's not time to panic yet. The world is a long way from the millions of deaths experienced during the 1918 pandemic. Hopefully, H1N1 will be a typical influenza virus and will disappear as quickly as it appeared.
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