Let’s hold our noses – flu caused the worst disaster in human history

On October 6 the city reported a record 289 deaths in a single day, but it soon got more than twice as bad. The following week one of the victims was my grandmother – who was in Pennsylvania on holidays at the time.

She was pregnant; the flu had a horrendous mortality rate among pregnant women. My father was only two years old at the time

THERE is considerable fear about swine flu at present, especially now that our health authorities are dealing with a probable first case here.

Some people are dismissing swine flu as another scare, like the avian flu of a few years ago. That is now being dismissed as a kind of hysteria because humans only got it from birds. It was not passed from human to human.

About 300 people around the world were infected by that strain of avian flu (H5N1) and more than half of them died. If the virus mutated so that it could be transmitted between humans, the outcome could have been catastrophic.

Any time there is talk of a flu pandemic it gives rise to fears of the Spanish flu of 1918-’19, which was the deadliest pandemic in recorded history. It killed more people in one year than the bubonic plague killed in its four years in the middle of the 14th century.

There is no knowing how many people died in the pandemic because estimates range from 15 million to 60 million, and even higher.

As many as 16 million people may have died in India alone. Some argue that flu originated in China, but the first recorded case was in the United States, at a military camp in Kansas in March 1918. Within two days there were 522 cases.

The First World War is sometimes blamed for the spread of the flu. American soldiers brought the highly infectious flu to France in April 1918, but it was moderate at that stage. It was called the “three days fever”, but the strain apparently mutated because a much more virulent form developed during May and June in neutral Spain where it was known as La Grippe.

Eight million people caught it and there were 270,000 Spanish deaths. Hence it became known elsewhere as the Spanish flu. It spread to other neutral countries like Sweden and Switzerland where 53,000 people died in July 1918.

The first case of a second wave of the disease in the United States was reported in Boston on August 27, 1918, when sailors on board a ship in the harbour became sick. In the next couple of days more than 60 sailors reported they ached as if they “had been beaten all over with a club”.

Dr Victor Vaughn, the acting surgeon general of the US army, was called to Camp Devens near Boston, where he was horrified.

“I saw hundreds of young stalwart men in uniform coming into the wards of the hospital. Every bed was full, yet others crowded in,” he reported. “The faces wore a bluish cast; a cough brought up the bloodstained sputum.” That day 63 soldiers died of the flu in the camp.

The Massachusetts department of health alerted the Boston press on September 5. “Unless precautions are taken, the disease in all probability will spread to the civilian population of the city,” one of the doctors warned.

Many municipal officials from New York to San Francisco dismissed the danger of an epidemic.

“The city is in no danger of an epidemic,” the New York health commissioner announced. He added there was “no need for our people to worry.”

At the end of the month, some 200,000 people gathered for a parade in Philadelphia. Within days there were more than 600 cases of influenza in the city and an epidemic was proclaimed, causing all schools, theatres and churches to be shut. On October 6 the city reported a record 289 deaths in a single day, but it soon got more than twice as bad.

The following week one of the victims was my grandmother – who was in Pennsylvania on holidays at the time. She was pregnant; the flu had a horrendous mortality rate among pregnant women. My father was only two years old at the time. In the third week of October some 4,300 people died in Philadelphia.

The total number of influenza deaths for the month of October across the United States was 195,000, up from 12,000 in September.

By the end of December more than 450,000 would be dead, and that total for the country grew to 675,000 by the following summer. The mortality rate was a frightening 2.5%, which was 25 times higher than the 0.1% death rate in other influenza outbreaks.

The Spanish flu killed a total of 10,651 people in Ireland during 1918. But this was considered secondary in comparison with the epidemics that swept the country as a result of the Great Famine 70 years earlier.

The Asian flu (H2N2) pandemic of 1957-’58 killed 69,800 people in the US and two million worldwide. This was a form of avian flu and it was followed in 1968-’69 by another avian strain (H3N2), known as the Hong Kong flu. It killed 33,800 people in the US and 700,000 worldwide, with the result that it was classified as the mildest pandemic of the 20th century.

Part of the reason it was not deadlier was that so many people had developed a degree of resistance as a result of having suffered from the earlier Asian flu.

But there was another major scare in 1976 when a swine flu pandemic was forecast. This led to a degree of panic in the US, which engaged in a major vaccination drive. Forty million Americans were immunised in the panic and the pandemic never developed. But 500 people suffered nerve damage linked to the vaccine and 25 of those died before the programme was abandoned.

Swine flu had first been identified in 1958, but there had only been 62 cases worldwide between then and the current epidemic in Mexico.

NOW that it is threatening to become an international pandemic there are moves to rename it because Jewish and Muslim people are pretty touchy when it comes to pigs and the idea that they could suffer from swine flu is anathema. In addition, the American pork industry asked for a name change to minimise the damage to the industry.

Vice-President Joe Biden added to the alarm in the US this week when he was asked on NBC television what advice he would give to a member of his family who was thinking of flying to Mexico.

“I would tell members of my family – and I have – I wouldn’t go anywhere in confined places now,” Biden replied. “It’s not that it’s going to Mexico. It’s you’re in a confined aircraft. When one person sneezes, it goes all the way through the aircraft.”

Biden went on to say he wouldn’t suggest that they ride the subway either. His advice could have enormous implications, but only time will tell whether he was being alarmist or prudent.

One of the big problems is determining the severity of the flu. As of Thursday, 170 people had died in Mexico, but only one in the United States – a little boy just short of his second birthday. But many others are seriously ill and this flu seems to be spreading rapidly.

The authorities were complacent initially about the Spanish flu of 1918, but it became the greatest human disaster in recorded history.

People may have exaggerated the dangers of other pandemics, but surely one could not be too careful.

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