26-04-2009, 12:04 PM
1918 flu pandemic
From Wikipedia, the free encyclopedia
The 1918 flu pandemic (commonly referred to as the Spanish flu) was an influenza pandemic that spread to nearly every part of the world. It was caused by an unusually virulent and deadly Influenza A virus strain of subtype H1N1. Historical and epidemiologic data are inadequate to identify the geographic origin of the virus.[1] Most of its victims were healthy young adults, in contrast to most influenza outbreaks which predominantly affect juvenile, elderly, or otherwise weakened patients. The pandemic lasted from March 1918 to June 1920,[2] spreading even to the Arctic and remote Pacific islands. It is estimated that anywhere from 20 to 100 million people were killed worldwide,[3] or the approximate equivalent of one third of the population of Europe,[4][5][6] more than double the number killed in World War I.[7] This extraordinary toll resulted from the extremely high illness rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms. The pandemic is estimated to have infected up to one billion people: half the world's population at the time.[8]
The flu probably originated in the Far East.[9] The disease was first observed at Fort Riley, Kansas, United States, on March 4, 1918,[10] and Queens, New York, on March 11, 1918. In August 1918, a more virulent strain appeared simultaneously in Brest, France, in Freetown, Sierra Leone, and in the U.S. at Boston, Massachusetts. The Allies of World War I came to call it the Spanish flu, primarily because the pandemic received greater press attention after it moved from France to Spain in November 1918. Spain was not involved in the war and had not imposed wartime censorship.[11]
Scientists have used tissue samples from frozen victims to reproduce the virus for study. Given the strain's extreme virulence there has been controversy regarding the wisdom of such research. Among the conclusions of this research is that the virus kills via a cytokine storm (overreaction of the body's immune system) which explains its unusually severe nature and the concentrated age profile of its victims. The strong immune systems of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults caused fewer deaths.Contents [hide]
1 Mortality
2 History
2.1 Patterns of fatality
2.2 Devastated communities
2.3 Less affected areas
2.4 Government response
2.5 Cultural impact
3 Spanish flu research
4 Victims
4.1 Notable fatalities
4.2 Notable survivors
4.3 Fictional
5 See also
6 References
7 Further reading
8 External links
[edit]
Mortality
The difference between the influenza mortality age-distributions of the 1918 epidemic and normal epidemics. Deaths per 100,000 persons in each age group, United States, for the interpandemic years 1911–1917 (dashed line) and the pandemic year 1918 (solid line).[12]
Chart of deaths in major cities
The global mortality rate from the 1918/1919 pandemic is not known, but is estimated at 2.5 to 5% of the human population, with 20% or more of the world population suffering from the disease to some extent. Influenza may have killed as many as 25 million in its first 25 weeks (in contrast, AIDS killed 25 million in its first 25 years)[citation needed]. Older estimates say it killed 40–50 million people[3] while current estimates say 50 million to 100 million people worldwide were killed.[13] This pandemic has been described as "the greatest medical holocaust in history" and may have killed more people than the Black Death.[14]
An estimated 7 million died in India, about 2.78% of India's population at the time. In the Indian Army, almost 22% of troops who caught the disease died of it[citation needed]. In the U.S., about 28% of the population suffered, and 500,000 to 675,000 died.[15] In Britain as many as 250,000 died; in France more than 400,000. In Canada approximately 50,000 died. Entire villages perished in Alaska and southern Africa. Ras Tafari (the future Haile Selassie) was one of the first Ethiopians who contracted influenza but survived,[16] although many of his subjects did not; estimates for the fatalities in the capital city, Addis Ababa, range from 5,000 to 10,000, with some experts opining that the number was even higher,[17] while in British Somaliland one official there estimated that 7% of the native population died from influenza.[18] In Australia an estimated 12,000 people died and in the Fiji Islands, 14% of the population died during only two weeks, and in Western Samoa 22%.
This huge death toll was caused by an extremely high infection rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms.[3] Indeed, symptoms in 1918 were so unusual that initially influenza was misdiagnosed as dengue, cholera, or typhoid. One observer wrote, "One of the most striking of the complications was hemorrhage from mucous membranes, especially from the nose, stomach, and intestine. Bleeding from the ears and petechial hemorrhages in the skin also occurred."[13] The majority of deaths were from bacterial pneumonia, a secondary infection caused by influenza, but the virus also killed people directly, causing massive hemorrhages and edema in the lung.[12]
The unusually severe disease killed between 2 and 20% of those infected, as opposed to the more usual flu epidemic mortality rate of 0.1%.[12][13] Another unusual feature of this pandemic was that it mostly killed young adults, with 99% of pandemic influenza deaths occurring in people under 65, and more than half in young adults 20 to 40 years old.[19] This is unusual since influenza is normally most deadly to the very young (under age 2) and the very old (over age 70), and may have been due to partial protection caused by exposure to a previous Russian flu pandemic of 1889.[20]
[edit]
History
While World War I did not cause the flu, the close troop quarters and massive troop movements hastened the pandemic. Some researchers speculate that the soldiers' immune systems were weakened by the stresses of combat and chemical attacks, increasing their susceptibility to the disease.[21]
A large factor of worldwide flu occurrence was increased travel. Modern transportation systems made it easier for soldiers, sailors, and civilian travelers to spread the disease quickly to communities worldwide.
American Red Cross nurses tend to flu patients in temporary wards set up inside Oakland Municipal Auditorium, 1918
Two poems, dedicated to the Spanish flu, were popular in those days[citation needed]:
I had a little bird,
Its name was Enza,
I opened the window,
And in-flew-enza.
-American Skipping Rhyme circa 1918
Obey the laws
And wear the gauze.
Protect your jaws
From septic paws.
[edit]
Patterns of fatality
The influenza strain was unusual in that this pandemic killed many young adults and otherwise healthy victims; typical influenzas kill mostly infants (aged 0–2 years), the elderly, and the immunocompromised. Another oddity was that this influenza outbreak was widespread in summer and fall (in the Northern Hemisphere). Typically, influenza is worse in the winter months.
People without symptoms could be stricken suddenly and within hours be too weak to walk; many died the next day. Symptoms included a blue tint to the face and coughing up blood caused by severe obstruction of the lungs. In some cases, the virus caused an uncontrollable hemorrhaging that filled the lungs, and patients drowned in their body fluids (pneumonia). In others, the flu caused frequent loss of bowel control and the victim would die from losing critical intestinal lining and blood loss.[citation needed]
In fast-progressing cases, mortality was primarily from pneumonia, by virus-induced consolidation. Slower-progressing cases featured secondary bacterial pneumonias, and there may have been neural involvement that led to mental disorders in a minority of cases. Some deaths resulted from malnourishment and even animal attacks in overwhelmed communities.[citation needed]
[edit]
Devastated communities
Street car conductor in Seattle not allowing passengers aboard without a mask in 1918.
In most places less than one-third of the population was infected, only a small percentage of whom died. In a number of towns in several countries entire populations were wiped out.[citation needed]
Even in areas where mortality was low, those incapacitated by the illness were often so numerous as to bring much of everyday life to a stop. Some communities closed all stores or required customers not to enter the store but place their orders outside the store for filling. There were many reports of places with no health care workers to tend the sick because of their own ill health and no able-bodied grave diggers to bury the dead. Mass graves were dug by steam shovel and bodies buried without coffins in many places.[citation needed]
Several Pacific island territories were particularly hard-hit. The pandemic reached them from New Zealand, which belatedly implemented measures to prevent ships carrying the flu from leaving its ports. From New Zealand, the flu reached Tonga (killing 8% of the population), Nauru (16%) and Fiji (5%, 9000 people). Worst affected was Western Samoa, a territory then under New Zealand military administration. A crippling 90% of the population was infected; 30% of adult men, 22% of adult women and 10% of children were killed. By contrast, "[t]he flu was excluded from American Samoa by a commander who imposed a blockade".[22] The mortality rate in New Zealand itself was 5%.[23]
[edit]
Less affected areas
In Japan, 257,363 deaths were attributed to influenza by July 1919, giving an estimated 0.425% mortality rate, much lower than nearly all other Asian countries for which data are available. The Japanese government severely restricted maritime travel to and from the home islands when the pandemic struck.
In the Pacific, American Samoa[24] and the French colony of New Caledonia [25] also succeeded in preventing even a single death from influenza through effective quarantines. In Australia, nearly 12,000 perished.[26]
[edit]
Government response
The Great Influenza was the source of much fear in citizens around the world. Further inflaming that fear was the fact that governments and health officials were downplaying the influenza. While the panic from WWI was dwindling, governments attempted to keep morale up by spreading lies and dismissing the influenza. On Sept. 11, 1918, Washington officials reported that the Spanish Influenza had arrived in the city. The following day, roughly thirteen million men across the country lined up to register for the war draft, providing the influenza with an efficient way to spread. However, the influenza had little impact upon institutions and organizations. While medical scientists did rapidly attempt to discover a cure or vaccine, there were virtually no changes in the government or corporations. Additionally, the political and military events were fairly unaffected due to the impartiality of the disease, which affected both sides alike.[27]
[edit]
Cultural impact The examples and perspective in this article may not represent a worldwide view of the subject. Please improve this article or discuss the issue on the talk page.
In the United States, Great Britain and other countries, despite the relatively high morbidity and mortality rates that resulted from the epidemic in 1918-1919, the Spanish flu began to fade from public awareness over the decades until the arrival of frightening news about bird flu and other pandemics in the 1990s and 2000s.[28] This has led some historians to label the Spanish flu a “forgotten pandemic.”[29] Indeed, one of the only major works of American literature written after 1918 that deals directly with the Spanish flu is Katherine Anne Porter’s Pale Horse, Pale Rider. However, in 1937 William Keepers Maxwell, Jr., the American novelist, wrote They Came Like Swallows, a fictional reconstruction of the events surrounding his mother's death from the flu. Mary McCarthy, the American novelist and essayist, also wrote about her parents' deaths in Memories of a Catholic Girlhood. In 1992 Bodie and Brock Thoene's "Shiloh Legacy Series" leads off with an account of the Spanish Flu in New York and Arkansas in their fictional novel, "In My Father's House." More recently (2006), author Thomas Mullen wrote a novel called The Last Town on Earth, about the impact of the Spanish flu on a fictional mill town in Washington and author Myra Goldberg wrote a novel called Wickett's Remedy that is set in Boston during the pandemic.
Several theories have been offered as to why the Spanish flu may have been “forgotten” by historians and the public over so many years. These include the rapid pace of the pandemic (it killed most of its victims in the United States, for example, within a period of less than nine months); previous familiarity with pandemic disease in the late 19th and early 20th centuries; and the distraction of the First World War.[30]
Another explanation involves the age group affected by the disease. The majority of fatalities, in both World War I and in the Spanish Flu epidemic, were young adults. The deaths caused by the flu may have been overlooked due to the large numbers of deaths of young men in the war or as a result of injuries, shortly afterwards. When people read the obituaries of the era, they saw the war or post-war deaths and the deaths from the influenza side by side. Particularly in Europe, where the war's toll was extremely high, the flu may not have had a great, separate, psychological impact, or may have seemed a mere "extension" of the war's tragedies.[31] The fact that the disease would usually only affect a certain area for a month before leaving, left little time for the disease to have a significant impact on the economy. During this time period pandemic outbreaks were not uncommon: typhoid, yellow fever, diphtheria, and cholera all occurred near the same time period. These outbreaks probably lessened the significance of the influenza pandemic for the public.[32]
[edit]
Spanish flu research
Main article: Spanish flu research
Centers for Disease Control and Prevention’s Dr. Terrence Tumpey examining a reconstructed version of the 1918 flu.
One theory is that the virus strain originated at Fort Riley, Kansas, by two genetic mechanisms – genetic drift and antigenic shift – in viruses in poultry and swine which the fort bred for food, but evidence from a recent reconstruction of the virus suggests that it jumped directly from birds to humans, without traveling through swine. The soldiers were then sent from Fort Riley to different places around the world, where they spread the disease.[33]
An effort to recreate the 1918 flu strain (a subtype of avian strain H1N1) was a collaboration among the Armed Forces Institute of Pathology, Southeast Poultry Research Laboratory and Mount Sinai School of Medicine in New York; the effort resulted in the announcement (on October 5, 2005) that the group had successfully determined the virus's genetic sequence, using historic tissue samples recovered from a female flu victim buried in the Alaskan permafrost and samples preserved from American soldiers.[34]
On January 18, 2007, Kobasa et al. reported that monkeys (Macaca fascicularis) infected with the recreated strain exhibited classic symptoms of the 1918 pandemic and died from a cytokine storm[35] – an overreaction of the immune system. This may explain why the 1918 flu had its surprising effect on younger, healthier people, as a person with a stronger immune system would potentially have a stronger overreaction.[36]
On September 16, 2008, the body of Yorkshire landowner Sir Mark Sykes was exhumed to study the RNA of the Spanish flu virus in efforts to understand the genetic structure of modern H5N1 bird flu. Sykes had been buried in 1919 in a lead coffin which scientists hope will have helped preserve the virus.[37]
In December, 2008 research by Yoshihiro Kawaoka of University of Wisconsin linked the presence of three specific genes (termed PA, PB1, and PB2) and a nucleoprotein derived from 1918 flu samples to the ability of the flu virus to invade the lungs and cause pneumonia. The combination triggered similar symptoms in animal testing.[38]
From Wikipedia, the free encyclopedia
The 1918 flu pandemic (commonly referred to as the Spanish flu) was an influenza pandemic that spread to nearly every part of the world. It was caused by an unusually virulent and deadly Influenza A virus strain of subtype H1N1. Historical and epidemiologic data are inadequate to identify the geographic origin of the virus.[1] Most of its victims were healthy young adults, in contrast to most influenza outbreaks which predominantly affect juvenile, elderly, or otherwise weakened patients. The pandemic lasted from March 1918 to June 1920,[2] spreading even to the Arctic and remote Pacific islands. It is estimated that anywhere from 20 to 100 million people were killed worldwide,[3] or the approximate equivalent of one third of the population of Europe,[4][5][6] more than double the number killed in World War I.[7] This extraordinary toll resulted from the extremely high illness rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms. The pandemic is estimated to have infected up to one billion people: half the world's population at the time.[8]
The flu probably originated in the Far East.[9] The disease was first observed at Fort Riley, Kansas, United States, on March 4, 1918,[10] and Queens, New York, on March 11, 1918. In August 1918, a more virulent strain appeared simultaneously in Brest, France, in Freetown, Sierra Leone, and in the U.S. at Boston, Massachusetts. The Allies of World War I came to call it the Spanish flu, primarily because the pandemic received greater press attention after it moved from France to Spain in November 1918. Spain was not involved in the war and had not imposed wartime censorship.[11]
Scientists have used tissue samples from frozen victims to reproduce the virus for study. Given the strain's extreme virulence there has been controversy regarding the wisdom of such research. Among the conclusions of this research is that the virus kills via a cytokine storm (overreaction of the body's immune system) which explains its unusually severe nature and the concentrated age profile of its victims. The strong immune systems of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults caused fewer deaths.Contents [hide]
1 Mortality
2 History
2.1 Patterns of fatality
2.2 Devastated communities
2.3 Less affected areas
2.4 Government response
2.5 Cultural impact
3 Spanish flu research
4 Victims
4.1 Notable fatalities
4.2 Notable survivors
4.3 Fictional
5 See also
6 References
7 Further reading
8 External links
[edit]
Mortality
The difference between the influenza mortality age-distributions of the 1918 epidemic and normal epidemics. Deaths per 100,000 persons in each age group, United States, for the interpandemic years 1911–1917 (dashed line) and the pandemic year 1918 (solid line).[12]
Chart of deaths in major cities
The global mortality rate from the 1918/1919 pandemic is not known, but is estimated at 2.5 to 5% of the human population, with 20% or more of the world population suffering from the disease to some extent. Influenza may have killed as many as 25 million in its first 25 weeks (in contrast, AIDS killed 25 million in its first 25 years)[citation needed]. Older estimates say it killed 40–50 million people[3] while current estimates say 50 million to 100 million people worldwide were killed.[13] This pandemic has been described as "the greatest medical holocaust in history" and may have killed more people than the Black Death.[14]
An estimated 7 million died in India, about 2.78% of India's population at the time. In the Indian Army, almost 22% of troops who caught the disease died of it[citation needed]. In the U.S., about 28% of the population suffered, and 500,000 to 675,000 died.[15] In Britain as many as 250,000 died; in France more than 400,000. In Canada approximately 50,000 died. Entire villages perished in Alaska and southern Africa. Ras Tafari (the future Haile Selassie) was one of the first Ethiopians who contracted influenza but survived,[16] although many of his subjects did not; estimates for the fatalities in the capital city, Addis Ababa, range from 5,000 to 10,000, with some experts opining that the number was even higher,[17] while in British Somaliland one official there estimated that 7% of the native population died from influenza.[18] In Australia an estimated 12,000 people died and in the Fiji Islands, 14% of the population died during only two weeks, and in Western Samoa 22%.
This huge death toll was caused by an extremely high infection rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms.[3] Indeed, symptoms in 1918 were so unusual that initially influenza was misdiagnosed as dengue, cholera, or typhoid. One observer wrote, "One of the most striking of the complications was hemorrhage from mucous membranes, especially from the nose, stomach, and intestine. Bleeding from the ears and petechial hemorrhages in the skin also occurred."[13] The majority of deaths were from bacterial pneumonia, a secondary infection caused by influenza, but the virus also killed people directly, causing massive hemorrhages and edema in the lung.[12]
The unusually severe disease killed between 2 and 20% of those infected, as opposed to the more usual flu epidemic mortality rate of 0.1%.[12][13] Another unusual feature of this pandemic was that it mostly killed young adults, with 99% of pandemic influenza deaths occurring in people under 65, and more than half in young adults 20 to 40 years old.[19] This is unusual since influenza is normally most deadly to the very young (under age 2) and the very old (over age 70), and may have been due to partial protection caused by exposure to a previous Russian flu pandemic of 1889.[20]
[edit]
History
While World War I did not cause the flu, the close troop quarters and massive troop movements hastened the pandemic. Some researchers speculate that the soldiers' immune systems were weakened by the stresses of combat and chemical attacks, increasing their susceptibility to the disease.[21]
A large factor of worldwide flu occurrence was increased travel. Modern transportation systems made it easier for soldiers, sailors, and civilian travelers to spread the disease quickly to communities worldwide.
American Red Cross nurses tend to flu patients in temporary wards set up inside Oakland Municipal Auditorium, 1918
Two poems, dedicated to the Spanish flu, were popular in those days[citation needed]:
I had a little bird,
Its name was Enza,
I opened the window,
And in-flew-enza.
-American Skipping Rhyme circa 1918
Obey the laws
And wear the gauze.
Protect your jaws
From septic paws.
[edit]
Patterns of fatality
The influenza strain was unusual in that this pandemic killed many young adults and otherwise healthy victims; typical influenzas kill mostly infants (aged 0–2 years), the elderly, and the immunocompromised. Another oddity was that this influenza outbreak was widespread in summer and fall (in the Northern Hemisphere). Typically, influenza is worse in the winter months.
People without symptoms could be stricken suddenly and within hours be too weak to walk; many died the next day. Symptoms included a blue tint to the face and coughing up blood caused by severe obstruction of the lungs. In some cases, the virus caused an uncontrollable hemorrhaging that filled the lungs, and patients drowned in their body fluids (pneumonia). In others, the flu caused frequent loss of bowel control and the victim would die from losing critical intestinal lining and blood loss.[citation needed]
In fast-progressing cases, mortality was primarily from pneumonia, by virus-induced consolidation. Slower-progressing cases featured secondary bacterial pneumonias, and there may have been neural involvement that led to mental disorders in a minority of cases. Some deaths resulted from malnourishment and even animal attacks in overwhelmed communities.[citation needed]
[edit]
Devastated communities
Street car conductor in Seattle not allowing passengers aboard without a mask in 1918.
In most places less than one-third of the population was infected, only a small percentage of whom died. In a number of towns in several countries entire populations were wiped out.[citation needed]
Even in areas where mortality was low, those incapacitated by the illness were often so numerous as to bring much of everyday life to a stop. Some communities closed all stores or required customers not to enter the store but place their orders outside the store for filling. There were many reports of places with no health care workers to tend the sick because of their own ill health and no able-bodied grave diggers to bury the dead. Mass graves were dug by steam shovel and bodies buried without coffins in many places.[citation needed]
Several Pacific island territories were particularly hard-hit. The pandemic reached them from New Zealand, which belatedly implemented measures to prevent ships carrying the flu from leaving its ports. From New Zealand, the flu reached Tonga (killing 8% of the population), Nauru (16%) and Fiji (5%, 9000 people). Worst affected was Western Samoa, a territory then under New Zealand military administration. A crippling 90% of the population was infected; 30% of adult men, 22% of adult women and 10% of children were killed. By contrast, "[t]he flu was excluded from American Samoa by a commander who imposed a blockade".[22] The mortality rate in New Zealand itself was 5%.[23]
[edit]
Less affected areas
In Japan, 257,363 deaths were attributed to influenza by July 1919, giving an estimated 0.425% mortality rate, much lower than nearly all other Asian countries for which data are available. The Japanese government severely restricted maritime travel to and from the home islands when the pandemic struck.
In the Pacific, American Samoa[24] and the French colony of New Caledonia [25] also succeeded in preventing even a single death from influenza through effective quarantines. In Australia, nearly 12,000 perished.[26]
[edit]
Government response
The Great Influenza was the source of much fear in citizens around the world. Further inflaming that fear was the fact that governments and health officials were downplaying the influenza. While the panic from WWI was dwindling, governments attempted to keep morale up by spreading lies and dismissing the influenza. On Sept. 11, 1918, Washington officials reported that the Spanish Influenza had arrived in the city. The following day, roughly thirteen million men across the country lined up to register for the war draft, providing the influenza with an efficient way to spread. However, the influenza had little impact upon institutions and organizations. While medical scientists did rapidly attempt to discover a cure or vaccine, there were virtually no changes in the government or corporations. Additionally, the political and military events were fairly unaffected due to the impartiality of the disease, which affected both sides alike.[27]
[edit]
Cultural impact The examples and perspective in this article may not represent a worldwide view of the subject. Please improve this article or discuss the issue on the talk page.
In the United States, Great Britain and other countries, despite the relatively high morbidity and mortality rates that resulted from the epidemic in 1918-1919, the Spanish flu began to fade from public awareness over the decades until the arrival of frightening news about bird flu and other pandemics in the 1990s and 2000s.[28] This has led some historians to label the Spanish flu a “forgotten pandemic.”[29] Indeed, one of the only major works of American literature written after 1918 that deals directly with the Spanish flu is Katherine Anne Porter’s Pale Horse, Pale Rider. However, in 1937 William Keepers Maxwell, Jr., the American novelist, wrote They Came Like Swallows, a fictional reconstruction of the events surrounding his mother's death from the flu. Mary McCarthy, the American novelist and essayist, also wrote about her parents' deaths in Memories of a Catholic Girlhood. In 1992 Bodie and Brock Thoene's "Shiloh Legacy Series" leads off with an account of the Spanish Flu in New York and Arkansas in their fictional novel, "In My Father's House." More recently (2006), author Thomas Mullen wrote a novel called The Last Town on Earth, about the impact of the Spanish flu on a fictional mill town in Washington and author Myra Goldberg wrote a novel called Wickett's Remedy that is set in Boston during the pandemic.
Several theories have been offered as to why the Spanish flu may have been “forgotten” by historians and the public over so many years. These include the rapid pace of the pandemic (it killed most of its victims in the United States, for example, within a period of less than nine months); previous familiarity with pandemic disease in the late 19th and early 20th centuries; and the distraction of the First World War.[30]
Another explanation involves the age group affected by the disease. The majority of fatalities, in both World War I and in the Spanish Flu epidemic, were young adults. The deaths caused by the flu may have been overlooked due to the large numbers of deaths of young men in the war or as a result of injuries, shortly afterwards. When people read the obituaries of the era, they saw the war or post-war deaths and the deaths from the influenza side by side. Particularly in Europe, where the war's toll was extremely high, the flu may not have had a great, separate, psychological impact, or may have seemed a mere "extension" of the war's tragedies.[31] The fact that the disease would usually only affect a certain area for a month before leaving, left little time for the disease to have a significant impact on the economy. During this time period pandemic outbreaks were not uncommon: typhoid, yellow fever, diphtheria, and cholera all occurred near the same time period. These outbreaks probably lessened the significance of the influenza pandemic for the public.[32]
[edit]
Spanish flu research
Main article: Spanish flu research
Centers for Disease Control and Prevention’s Dr. Terrence Tumpey examining a reconstructed version of the 1918 flu.
One theory is that the virus strain originated at Fort Riley, Kansas, by two genetic mechanisms – genetic drift and antigenic shift – in viruses in poultry and swine which the fort bred for food, but evidence from a recent reconstruction of the virus suggests that it jumped directly from birds to humans, without traveling through swine. The soldiers were then sent from Fort Riley to different places around the world, where they spread the disease.[33]
An effort to recreate the 1918 flu strain (a subtype of avian strain H1N1) was a collaboration among the Armed Forces Institute of Pathology, Southeast Poultry Research Laboratory and Mount Sinai School of Medicine in New York; the effort resulted in the announcement (on October 5, 2005) that the group had successfully determined the virus's genetic sequence, using historic tissue samples recovered from a female flu victim buried in the Alaskan permafrost and samples preserved from American soldiers.[34]
On January 18, 2007, Kobasa et al. reported that monkeys (Macaca fascicularis) infected with the recreated strain exhibited classic symptoms of the 1918 pandemic and died from a cytokine storm[35] – an overreaction of the immune system. This may explain why the 1918 flu had its surprising effect on younger, healthier people, as a person with a stronger immune system would potentially have a stronger overreaction.[36]
On September 16, 2008, the body of Yorkshire landowner Sir Mark Sykes was exhumed to study the RNA of the Spanish flu virus in efforts to understand the genetic structure of modern H5N1 bird flu. Sykes had been buried in 1919 in a lead coffin which scientists hope will have helped preserve the virus.[37]
In December, 2008 research by Yoshihiro Kawaoka of University of Wisconsin linked the presence of three specific genes (termed PA, PB1, and PB2) and a nucleoprotein derived from 1918 flu samples to the ability of the flu virus to invade the lungs and cause pneumonia. The combination triggered similar symptoms in animal testing.[38]
"Let me issue and control a nation's money and I care not who writes the laws. - Mayer Rothschild
"Civil disobedience is not our problem. Our problem is civil obedience! People are obedient in the face of poverty, starvation, stupidity, war, and cruelty. Our problem is that grand thieves are running the country. That's our problem!" - Howard Zinn
"If there is no struggle there is no progress. Power concedes nothing without a demand. It never did and never will" - Frederick Douglass
"Civil disobedience is not our problem. Our problem is civil obedience! People are obedient in the face of poverty, starvation, stupidity, war, and cruelty. Our problem is that grand thieves are running the country. That's our problem!" - Howard Zinn
"If there is no struggle there is no progress. Power concedes nothing without a demand. It never did and never will" - Frederick Douglass