Bacterial Infection the Biggest Killer in 1918 Pandemic Flu

[Cowgirl]

http://www.newscientist.com/article/dn1445...u-pandemic.html

 

 

 

Bacteria were the real killers in 1918 flu pandemic

 

* 14:02 04 August 2008

* NewScientist.com news service

* Ewen Callaway

 

(Image: US National Museum of Health and Medicine)

Enlarge image

(Image: US National Museum of Health and Medicine)

 

Medical and scientific experts now agree that bacteria, not influenza viruses, were the greatest cause of death during the 1918 flu pandemic.

 

Government efforts to gird for the next influenza pandemic – bird flu or otherwise – ought to take notice and stock up on antibiotics, says John Brundage, a medical microbiologist at the Armed Forces Health Surveillance Center in Silver Spring, Maryland.

 

Brundage's team culled first-hand accounts, medical records and infection patterns from 1918 and 1919. Although a nasty strain of flu virus swept around the world, bacterial pneumonia that came on the heels of mostly mild cases of flu killed the majority of the 20 to 100 million victims of the so-called Spanish flu, they conclude.

 

"We agree completely that bacterial pneumonia played a major role in the mortality of the 1918 pandemic," says Anthony Fauci, director of National Institute for Allergy and Infectious Disease in Bethesda, Maryland, and author of another journal article out next month that comes to a similar conclusion.

Double whammy

 

That pneumonia causes most deaths in an influenza outbreak is well known. Late 19th century physicians recognised pneumonia as the cause of death of most flu victims. While doctors limited fatalities in other 20th-century outbreaks with antibiotics such as penicillin, which was discovered in 1928, but did not see use in patients until 1942.

 

This is not to say that flu viruses do nothing, says Jonathan McCullers, an expert on influenza-bacteria co-infections at St Jude Children's Research Hospital in Memphis, Tennessee.

 

McCullers' research suggests that influenza kills cells in the respiratory tract, providing food and a home for invading bacteria. On top of this, an overstressed immune system makes it easier for the bacteria to get a foothold.

 

However, the sheer carnage of 1918 caused many microbiologists to reconsider the role of bacteria, and some pointed their fingers firmly at the virus.

'Unique event'

 

When US government scientists resurrected the 1918 strain in 2005, the virus demolished cells grown in a Petri dish and felled mice by the dozen.

 

"The 1918 pandemic is considered to be – and clearly is – something unique, and it's widely understood to be the most lethal natural event that has occurred in recent human history," Brundage says.

 

But to reassess this conclusion, he and co-author Dennis Shanks, of the Australian Army Malaria Institute in Enoggera, Queensland, scoured literature and medical records from 1918 and 1919.

 

The more they investigated, the more bacteria emerged as the true killers, an idea now supported by most influenza experts.

 

For instance, had a super virus been responsible for most deaths, one might expect people to die fairly rapidly, or at least for most cases to follow a similar progression. However, Shanks and Brundage found that few people died within three days of showing symptoms, while most people lasted more than a week, some survived two – all hallmarks of pneumonia.

Local bugs

 

Military health records for barracks and battleships also painted a different picture. New recruits – men unlikely to have been exposed to resident bacteria – died in droves, while soldiers whose immune systems were accustomed to the local bugs survived.

 

And most compelling, Brundage says, medical experts of the day identified pneumonia as the cause of most deaths.

 

"The bottom line is we think the influenza virus itself was necessary – but not sufficient – to cause most of the deaths," he says.

 

As the world's health experts prepare for the next influenza pandemic, many have looked to 1918 as a guide, planning for a deadly super-virus.

 

The H5N1 bird flu strains jetting around the world seem to kill humans without the aid of bacteria, but those viruses aren't fully adapted to humans, McCullers says. If H5N1 does adapt to humans, bacteria may play a larger role in deaths, he adds.

 

"Everyone is focused exclusively on the virus, and that's probably not the best idea," he says.

 

Antibiotics and vaccines against bacterial pneumonia could limit deaths in the next pandemic. And while an effective influenza vaccine should nip an outbreak in the bud, such a vaccine could take months to prepare and distribute.

 

"The idea of stockpiling [bacterial] vaccines and antibiotics is under serious consideration," says Fauci, who is on a US government taskforce to prepare for the next flu pandemic.

 

At a recent summit on pandemic influenza, McCullers said health authorities were increasingly interested in the role bacteria might play, but there had been little action taken.

 

"There's no preparation yet. They are just starting to get to the recognition stage," he says. "There's this collective amnesia about 1918."

 

Journal reference: Emerging Infectious Disease (DOI: 10.3201/eid1408.071313)

 

Bird Flu – Learn more about the flu pandemic that could kill millions in our continually updated special report.

 

Jonathan McCullers

Related Articles

 

* Virulent 1918 flu genes resurrected

* http://www.newscientist.com/article.ns?id=dn6502

* 06 October 2004

* Down with the flu?

* http://www.newscientist.com/article.ns?id=mg18124365.200

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* Cracking the key to 1918 flu virus

* http://www.newscientist.com/article.ns?id=mg18124342.200

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* 1918 "Spanish" influenza pandemic down to pig flu RNA

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* 07 September 2001

 

Weblinks

 

* Armed Forces Health Surveillance Center

* http://afhsc.army.mil/

* Anthony Fauci, National Institute for Allergy and Infectious Disease

* http://www3.niaid.nih.gov/about/directors/biography/

* Jonathan McCullers, St Jude Children's Research Hospital

* http://www.stjude.org/stjude/v/index.jsp...0000e2015acRCRD

 

 

[Violet]

Won't a pnuemonia shot protect you against this ? I got a pnuemonia shot. They are good for years.

I am also considering asking for a shingles vaccine. It costs about $200 and ins. won't cover it for me. So, I would rather pay the $200 and not get shingles. Would cost more than that if a person got shingles. Not to mention how terribly painful it is to people.

[Mrs B]

Wow, thank you for this information! I'm adding antibiotics to the stockpile list!

[mom11]

Two years ago, I contacted the FDA. I wondered if the high mortality of the H5N1, might be, because it was outbreaking in parts of the world that did not have access to vaccines, such as we commonly do...Most especially the pneumonia vaccine. I asked the FDA, if the pneumonia vaccine would be of any advantage, if H5 broke out here. They told me yes...They said it would help to prevent the secondary pneumonias, that the H5 causes. That afternoon, I went to our local clinic and each one of us, from age 5 to 50, received the vaccine. My insurance did cover it, but we are a high risk family. The next time I went to the pediatrician, I told her what I had done...She said "Good, Good, Good!" Her father is a biologist, at the university here.

 

The pneumonia vaccine doens't prevent all pneumonia strains, but it covers a lot of them...Anything, would be better than nothing, if a severe pandemic breaks out. I wonder how many in these Asian countires, where most of the outbreaks have been...have had the pneumonia vaccine?

[Percysgirl]

Be careful with vaccines. They weaken your immune system by injecting mercury and aluminum into you. And statistically, we know that more people come down with a disease that they are vaccinated against than not. Most disease outbreaks are among the vaccinated, NOT the unvaccinated.

 

We also know that statistically, you're less like to get the flu if you DON'T get the vaccine. And when you get the vaccine, someone who is unvaccinated can get the flu from you.

[mom11]

You cannot catch the disease, from someone, vaccinated with dead virus.

 

You are, also, not more likely to catch flu, if you are vaccinated. The flu virus mutates rapidly and then the vaccine may not match the strain going around and you may catch a new strain. Even then, if it is a variant of the one, you have been vaccinated for, you may become less sick. I have 11 children and not one year, have we had a severe case of flu, when we were vaccinated.

 

My sisters and I, ALL, caught the measles, chicken pox, mumps when we were unvaccinated children. We had two friends that caught these childhhod illnesses and both ended up with encephalitis. I had classmates that had polio and they were left severely affected. All of my children born before the time of chicken pox vaccinations caught the chicken pox, not one of the vaccinated children has. My children have never known a peer to have polio....Not one. Yet it is still rampant in parts of the world, where the polio vaccine is unavailable. Not one of my vaccinated children has caught measles or mumps, nor tetanus, nor whopping cough, nor meningitis, nor polio. Thank you Dear Lord!

 

There are risks with everything. Each mother must weigh what those risks are. If H5 goes pandemic...Your child has virtually NO chance of survival, if the virus keeps it's current mortality rate. Those that do survive, are often left with permanent problems. I haven't seen a single vaccine that kills almost all of it's recipients. I'll take the gamble with a vaccine, can't be worse than THAT virus, nor many others. There is no right or wrong...Each of us has to decide what is right for our own families. However, it's not true, we catch viruses more often if we are vaccinated. Why then do these childhood viruses, not wipe out classrooms ,full of children, each year, now that vaccines are available?

 

 

[CrabGrassAcres]

My Grandfather was a marine in WWI. He was laying in a ward and someone came down the row of beds with a tape measure. They needed to get the coffins ready since the bodies had to be buried quickly in the tropical heat. Made Grandpa so mad that he determined to get well. He came back home and married his childhood sweetheart. (They ran away together when they were 3.) They had 8 children. Mom was the oldest. Grandpa lived to be 94 and Grandma 98.

 

I think a LOT of recovering from any sickness is your attitude and determination and faith in God.

[Crazy4Canning]

Originally Posted By: CrabGrassAcres

I think a LOT of recovering from any sickness is your attitude and determination and faith in God.

Well said! Well said!

[Tracie]

i was vaccinated for measles (a live vaccine, btw) TWICE and *still* caught it as an adult. I was vaccinated as an infant, then, because there was an outbreak of mumps when I was in college, and I couldn't produce documentation fast enough, I got vaccinated a second time at the university health center. When I was 28, I got measles.

 

My son is not vaccinated because I do not trust the CDC more than I trust God. I believe that while vaccines are great for pharmaceutical companies, and for government health agencies, they *may* be quite dangerous to individuals. nobody has been able to pin down why some people have adverse reactions and other's don't. But in theory, if 80% of the "herd" is vaccinated, the unvaccinated should be fairly safe.

 

 

[Percysgirl]

Originally Posted By: mom11

You cannot catch the disease, from someone, vaccinated with dead virus.

But many of the vaccines on the market aren't dead virus. And the flu virus is one of them. Measles and chicken pox are two more.

Quote:

You are, also, not more likely to catch flu, if you are vaccinated.

The CDCs own statistics say differently.

Quote:

My sisters and I, ALL, caught the measles, chicken pox, mumps when we were unvaccinated children. We had two friends that caught these childhhod illnesses and both ended up with encephalitis. I had classmates that had polio and they were left severely affected. All of my children born before the time of chicken pox vaccinations caught the chicken pox, not one of the vaccinated children has. My children have never known a peer to have polio....Not one. Yet it is still rampant in parts of the world, where the polio vaccine is unavailable. Not one of my vaccinated children has caught measles or mumps, nor tetanus, nor whopping cough, nor meningitis, nor polio. Thank you Dear Lord!

Polio was already on the way out when the vaccine was developed. Look at the information available on vaccination and different countries, and you'll find that understanding of sanitation and cleanliness practices have more to do with the decreases in disease outbreaks than vaccinations.

Your children didn't catch more likely from good sanitation and lessened exposure, not vaccination. We know for history that illnesses typically have natural ebbs and surges in exposures.

Quote:

However, it's not true, we catch viruses more often if we are vaccinated. Why then do these childhood viruses, not wipe out classrooms ,full of children, each year, now that vaccines are available?

There's a difference between being killed and catching an illness. Most illnesses that vaccination deals with aren't deadly in an otherwise healthy person.

Take a look at whooping cough. All of the recent outbreaks were in people already vaccinated. Ditto measles. And don't look at the media reports with their spin, take a look at the actual CDC statistics on it. Quite eye opening.

having a strong immune system is a direct predictor of whether you'll get sick or not when you're exposed to ANY illness. Not having known neurotoxins and immune-supporessants in the form of mercury and aluminum in you goes a long ways towards a healthy immune system.

[CrabGrassAcres]

I'm glad I was vaccinated against polio. I went to school with children (some younger than I) who wore braces on their legs because of polio. Those were the ones who survived and were able to walk at all afterwards. Some were not so fortunate. My best friend's MIL was pg with Best Friend's DH when she came down with polio. She survived, but has suffered terribly from the effects of polio for the last 50 years.

[Cowgirl]

There are flu vaccines with live virus (a weakened virus). There are also flu vaccines with DEAD virus. I have had both types. The live virus type made me slightly sick, as though I had a "mild" case of the flu. I prefer to avoid live virus vaccines as a result. The dead virus type does not make me sick at all. I also do not get the flu, though I am often around it, due to having so much interaction with the public. Now, when I get my flu shot, I am sure to ask which type they have, as I will only take the dead virus types.

 

I, for one, am thankful for vaccines. My family is short one member due to a now preventable child hood illness that took him from us. And polio --- what a dreadful disease that was! My dad's best friend died of it. When that vaccine came out, my family lined up to get it - it was a much prayed for miracle.

 

Yes, like anything else in life, there are risks. NOTHING in this world is 100% safe, nor 100% effective, nor 100% good. Life is not about black and white, but about shades of grey. But the protection the vaccines offer as compared to the disease they generally prevent is worth the small risk, in my view.

 

Obviously, some people feel that ANY risk is too much. They don't need to take the vaccines, then. But to tell me, who is missing a family member because of a disease that used to kill but is now largely preventable ... well, don't tell me not to take them.

 

I think this issue is like religion. Some people believe strongly one way. Others believe strongly the opposite way. It is best to just live and let live.