Throughout the history of its existence humanity has encountered endless disasters which are impossible to either predict or prevent: natural calamities, such as earthquakes, floods, and fires, wiped whole settlements off the face of the earth. One of the most vehement catastrophes befalling humankind consists in the outbreaks of pandemic diseases that may spread over the planet and take the lives of millions. Since antiquity, documentary sources have been reporting plague as the social evil killing whole cities; but due to achievements of medicine, this bacterial infection has been stopped from mass manifestations by the early twentieth century. The situation is much more complex and underdeveloped in respect of viral epidemics, with influenza being the most urgent issue of modern virology. During the twentieth century, the population of the Earth experienced several deadly influenza pandemics, with no solution being found and with new influenza pandemics threatening humankind nowadays. This situation makes the objective of efficient resistance to the disease a primary task for specialists to solve. In their search for the cure, medics are investigating the historical development of the virus and tracing its existence back to the tragic events of 1918, when humankind was struck with the deadliest pandemic ever seen, the Spanish flu.
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The pandemic of Spanish flu
Exhausted by the stress of the First World War, the whole world was looking forward to peaceful existence when it was overcome by a catastrophe no less deadly than the war itself. At first, the illness was not recognized as anything more than a seasonal cold; moreover, the armies involved in military action acted as one of the most mass nidi of infection, since ambitions would not let the generals admit the cause of multiple casualties to be an epidemic disease of unprecedented force. Among the most serious symptoms, obstruction of lungs was observed, which caused coughing blood and often resulted in the patients rapid death occurring literally the next day after contagion. The specific feature of the pandemic was that it caused mortality in an untypical age group: while common flu mostly affects young children and elderly people, the epidemic that lasted from March 1918 to June 1920 killed a large number of adults from twenty to forty years old. Due to political reasons, the most open and informative coverage of the pandemic was carried out by the Spanish mass media, and consequently, the disease got a corresponding name. However, it did not affect solely the Iberian Peninsula, nor did it originate therefrom. Infecting nearly one-fifth of the world population, the Spanish flu killed more than fifty million people, with the death rate estimated as high as two and a half percent, by far exceeding that of the common flu. The origins of the Spanish flu were initially believed to lie in China and arrive at the rest of the world as a result of a rare mutation in a common flu virus; but later research has shown that it was transmitted from poultry, either directly or through swine. The possibility of direct transmission between poultry and human is the main cause of the panic terror of the avian flu nowadays. (Diacu 151–152)
The pandemic of swine flu
Despite all the efforts of medical science, influenza continues its triumphant and deadly procession all over the planet. Recently the world has been struck by another pandemic: the so-called ‘swine flu’ being a new strain ofH1N1 influenza virus. Registered in April 2009 in Mexico, swine flu is admitted to be a virus that has never before circulated among humans (World Health Organization, “Pandemic (H1N1) 2009”). Swine flu is especially difficult to detect immediately since its symptoms closely resemble those of common influenza: sore throat, cough, headache, fever, joint and muscle pains are the typical signs of a seasonal cold or flu. Therefore a complex of specialized tests is applied to patients allegedly suffering swine flu; however, specialists advise to start preventive treatment without waiting for test results, since any delays might turn out to be fatal. According to WHO information of 29 November 2009,
“… worldwide more than 207 countries and overseas territories or communities have reported laboratory-confirmed cases of pandemic influenza H1N1 2009, including at least 8768 deaths.” (“Pandemic (H1N1) 2009”)
The situation update is carried out on a regular basis and shows that have peaked in the United States and Canada, the disease activity is now declining, while in Europe it has reached or is reaching its peak, with over ninety-nine percent of influenza cases being diagnosed as H1N1/2009 (World Health Organization, “Pandemic (H1N1) 2009”). Western and Central Asia remain centers of the virus activity, while in East Asia a decline has been reported in diseases of this kind. In Central and South America, the virus activity is observed as declining; Africa has reported isolated occasions of H1N1/2009 scattered throughout the continent; and the temperate southern hemisphere reports low rates of pandemic activity (World Health Organization, “Pandemic (H1N1) 2009”).
Comparison and contrast of the two types of flu based on the type of treatment applicable to them
With such an alarming situation, it appears vital to find a way of taking the events under control, and one of the most efficient ways until now has been seen in that of research and analysis of the past identical situations. Already in 2007 studies were published dedicated to discussion of the 1918 Spanish flu pandemic in the context of the impending threat of a new pandemic disaster. Medical history has shown that vaccination is the most efficient way of treating influenza in patients. And yet the problem with vaccines is that the influenza virus mutates at an alarming rate and in a rather unpredictable way; developing an efficient and safe vaccine in short terms appears an impracticable task so far. Therefore solutions should be sought for in other strategies of action. In the case of pandemics, such strategies involve, along with vaccination, the so-called ‘non-pharmaceutical interventions’ that are possible to apply efficiently in order to at least prevent the mass spread of the infection among the population.
In this case, the epidemics of Spanish flu and swine flu appear to be identical, as the non-pharmaceutical interventions applied in both instances appear to be quite the same. According to Stephen S. Morse, in 1918 measures were introduces varying “from wearing surgical masks to ‘social distancing’ measures (as we call them today) that ranged from closing schools and prohibiting public gatherings to isolating sick people in hospitals or encouraging them to stay home” (7313). To a certain degree, those measures appeared efficient in their combination: as Morse claims, some interventions are more effective than the other, but none of them can be considered universally applicable (7313). This idea is supported nowadays by the World Health Organization that recognizes the low degree of significance born by vaccines and antivirals in the current pandemic situation; WHO remarks on the necessity to concentrate efforts in the sphere of public measures that would reduce the severity of the pandemic (“Mathematical Modelling of the Pandemic H1N1 2009” 344).
The most important aspect in the application of the non-pharmaceutical interventions in 1918 and nowadays is the correct timing and distribution of measures. Morse analyses the Spanish flu situation and arrives at the conclusion that lower peak death rates were observed in the cities where, firstly, several measures were introduced at once, and secondly, those measures were enacted for a longer time period (7313). Taking into account the nature of the influenza epidemic that is estimated to be coming in waves, it is vital to maintain the measures once taken for sufficient time, since in 1918 influenza returned to the cities when the interventions were canceled (Morse 7313). In the current situation, specialists voice a consideration in support of precise timing necessary for the interventions: cases may occur when those interventions are “too effective”, and not enough population is infected with the virus to achieve “herd immunity” (World Health Organization, “Mathematical Modelling of the Pandemic H1N1 2009” 344).
In the situation of the modern pandemic of influenza, it becomes of vital importance to estimate the necessary balance of non-pharmaceutical interventions in terms of their effect on the health of the world population, as well as on the global economy. The present pandemic of swine flu appears similar to the Spanish flu pandemic of 1918, as scientists observe the same rapidness of contagion, high death rate, the animal origin of the virus, and limitedness of vaccination that makes non-pharmaceutical interventions the main efficient way to meet the challenge of the pandemic. Therefore, it is indisputably significant to study the lessons of the past epidemics and apply them wisely to the modern situation, assisting the world population at least by social if not by medical means before the medical cure is discovered.
Diacu, Florin. Megadisasters: The Science of Predicting the Next Catastrophe. Princeton, NJ: Princeton University Press, 2009. Print.
Morse, Stephen S. “Pandemic Influenza: Studying the Lessons of History.” PNAS 104.18 (2007): 7313–7314. Print.
World Health Organization. “Mathematical Modelling of the Pandemic H1N1 2009.” Weekly Epidemiological Record 84.34 (2009): 341–352. Print.
“Pandemic (H1N1) 2009.” Update 77. who.int. WHO, 2009.