Flu not the big killer in 1918 pandemic?

[RamboLiberal]

Source: MSNBC/Reuters

Strep infections and not the flu virus itself may have killed most people during the 1918 influenza pandemic, which suggests some of the most dire predictions about a new pandemic may be exaggerated, U.S. researchers said.

The findings suggest that amassing antibiotics to fight bacterial infections may be at least as important as stockpiling antiviral drugs to battle flu, they said.

In the report released Thursday, Keith Klugman of Emory University in Atlanta and colleagues looked at what information is available about the 1918 flu pandemic, which killed anywhere between 50 million and 100 million people globally in the space of about 18 months.

Some research has shown that on average it took a week to 11 days for people to die — which fits in more with the known pattern of a bacterial infection than a viral infection, Klugman's group wrote in a letter to the journal Emerging Infectious Diseases.

"We observed a similar 10-day median time to death among soldiers dying of influenza in 1918," they wrote.



Read more: http://www.msnbc.msn.com/id/29038301/

[MineralMan]

1. Pneumonia is a common sequal to viral influenza.

Remember that the 1918 epidemic came before penicillin was discovered. Bacterial pneumonia was a much more serious disease then than it is now.

The flu virus runs its course, but leaves the patient's immune system weakened, allowing bacteria to thrive.

This has been known for years about the 1918 epidemic.

[donco6]

8. Yes. Read the Great Influenza.

It's all in there.

[Critters2]

26. Even with antibiotics, this can happen.

Happened to me just this past November. First, the flu. Closely followed by pneumonia. Happily, I took my anti-b's and got well pretty quickly. I can see how this would have been a killer in 1918.

[Mojorabbit]

2. In John Barrys book

about the pandemic he talks of people being fine in the morning and dropping dead on the street in the evening. I can't see pneumonia doing that having had pneumonia myself. Still it is a new piece of the puzzle.

[RamboLiberal]

4. I don't think they are saying this wasn't one deadly flu bug

and that some dropped dead quickly but are speculating if the flu killed those that lasted over a week.

[olddad56]

7. my grandfather died in less than 24 hours.

He was a volunter fire figter, got wet fighting a fire, got sick during the night and was dead by 4pm the following day.This was in a small town. The next day an article on the front page of the local paper simpy read "Four more die of the flu" and listed thier names. It was 3 days before my dad's 4th birthday. His only sibling was born 16 days later. Tough time for a widowed woman with a 4 year old and a newborn to get by.

[goclark]

18. So sad

:cry:

[hedgehog]

3. Still doesn't take into account the people who went to work or school healthy,

and then dropped dead before arriving home again. Nor does strep typically turn the lungs into bags of blood. Some infection or infections got loose worldwide and took out a bunch of people. Even with knowledge of antibiotics, would we have enough antibiotics, enough nurses, enough people just to change bed linens if there was another pandemic? (Or should I say, when the next pandemic comes?)

[Mugweed]

5. I've always contended

that the "epidemic" back then was mostly due to poor hygenic conditions, shitty medical knowledge, no real vaccines. Not just the flu killing people. It just doesn't translate into modern times. The bird flu is another scare tactic hoax.

[kimmerspixelated]

9. True,

Also, I've read reports that actually linked the 1918 flu vaccine that they used on the soldiers b4 battle to the pandemic itself,(causing it to flourish) but everytime I put links up like that, the pharma shrills and the "woo-chasers" jump my ass, so I'm not going there. I don't know why they can't just respectfully disagree.

[LeftishBrit]

33. Perhaps because being called 'pharma shrills' doesn't lend itself much to respectful disagreement?

And there was no flu vaccine in 1918 - as I understand, doctors responded to the epidemic by *trying*, among other things, to develop a vaccine , but no flu vaccine was actually in use until the 1940s.

[No Elephants]

14. George Bush kept us safe from the bird flu, too. Remember--he told us he

had read a book about it and was really worried about it? What the blank was that all about?

[DirtFrmr]

19. Only 14 posts before someone drags Bush into this.

Dude, this was 80 years ago. Bush is gone. Get over it already.

[Stellabella]

20. Bush may be 'gone', but his disastrous policies are going to

affect us for decades. We're not going to 'get over it', especially since I'll bet people like you were still blaming President Clinton for the Repuke mess as late as last year.

Oh, and here's another thought. We'll 'get over' stolen election 2000 and the Bush debacle years as soon as Repukes 'get over' Roe v. Wade and let that go.

[4dsc]

21. That's telling him...

Conservative policies have ruined this country and people need to know about it every day.. That would include naming names.. ITS BUSH'S FAULT!!

[DirtFrmr]

22. Obsessing over things that happened 8 years ago

is ignorant and pointless. It helps nothing and only makes our side look like fanatics. Which we would be if we all thought like you.

Just because I'm not obsessed with Bush and feel the need to tie him to the 1918 pandemic I must be a closet Republican? :crazy:

[eowyn_of_rohan]

23. our country is ruined and we should hold accountable the man responsible

you are in lala land or denial if you think otherwise, IMO

[Stellabella]

24. The very fact that you don't hold Bush accountable for the disaster

that is our economy, not to mention the country and the world, BESIDES the fact that his administration didn't do enough to prevent flu deaths (the original point), not the stupid leap YOU made, is suspect.

Also, the fact that you suggest we should 'get over' a stolen election and the death of democracy is unAmerican. Buh-bye.

[DirtFrmr]

25. Good grief, did you even read my post?

All I did was point out how how obsessive it is to drag Bush into a discussion about the 1918 pandemic and YOU brought up the stolen election, wrecked economy and Roe v Wade and accused me of being a Clinton hater. WTF? Then you accuse me of not holding Bush responsible for the economy when I never once mentioned it. What is wrong with you?

[Stellabella]

28. What is wrong with YOU?

YOU count down how many posts it took to bring that asshole Bush into a discussion and tell us to get over the last eight years.

Buzz off, creep.

[Sheets of Easter]

38. Mr. Scalia, is that you?

:hi:

[struggle4progress]

16. The idea of vaccination was well known at the time but vaccines are difficult to

develop and only a few existed, none for influenza. When the influenza pandemic occurred, the industrialized world was not scientifically primitive. The germ theory of disease was well-established, and for a number of diseases (such as yellow fever or typhoid fever) the infectious agent and route of transmission was understood. Successful brain tumor surgery was performed with anesthesia under aseptic conditions. In the US, there was an active movement to ensure the quality of drinking water, and Chicago had been chlorinating its drinking water for a decade

http://virus.stanford.edu.nyud.net:8090/uda/images/flumap.jpg
http://virus.stanford.edu/uda/flustat.html

The pandemic in the US after WWI can be traced first to the port cities through which soldiers returned home, and subsequently to various military bases, before it spread across the country. The natural hypothesis, therefore, is that infected soldiers distributed it. Considerable effort was made to avoid transmission, once the threat was taken seriously, though such efforts were necessarily based on some guesswork:

http://www.fic.nih.gov.nyud.net:8090/images/flu_masks.jpg
http://www.lifelikecharm.com.nyud.net:8090/flu_masks_1918_19.jpg
http://www.panflusouthidaho.org.nyud.net:8090/Images/Closed_Assemblages.jpg

[Mojorabbit]

17. The people who are getting it now

are dying even with the very best of care. I think it is around 60 percent case fatality rate.

[Fire_Medic_Dave]

29. 63% of the confirmed cases have died as a result.

[Mojorabbit]

31. Thanks

I was close. :) From what I read it is taking about a week to ten days till they die which is why I wonder about the article. The fellow that made it in China recently was released from the hospital after 22 days of intense care which will not be available to the masses if we have a pandemic.

[byeya]

6. Pandemic

I am also a little disturbed because it's been handed down in respected circles that many people in their primes - late teens to early thirties - died very suddenly like above posters have noted.
I also think that strep throat, which nearly killed me in 1955, would have been widely recognized because it has been common for centuries. As a matter of fact, only the 2nd generation antibiotics regularly cured people in a severe case.
I am happy to see scientists still keeping an open mind on the problem however.

[ConcernedCanuk]

10. We are overdue for a culling - it's only a matter of time, and who knows whether

.
.
.

it will be Momma Nature or our human evil devices that take us down

but we are overdue . . .

and overpopulating . .

depleting resources

I am not proud

to be a human

we SUCK!

[originalpckelly]

12. I agree, the earth is behaving in accordance with the same laws...

that cause self-regulation in life, it may or may not be "alive" but it does self-regulate. There have been computer simulations, going a while back, that have played around with variation and how it relates to planetary self-regulation. I remember seeing this neat simulation of black/white daisies from the '80s, when the simulated planet became too warm, the white daisies would thrive and cool it down. When it was too cold, the black daisies would warm it up. That idea has motivated me to continue down this line of thinking, and I have concluded from my little experience that this is so.

[NashVegas]

34. On My Most Cynical Days

I think the massive layoffs/economy are being utilized to determine how many can be culled and we still keep the trains running.

[originalpckelly]

11. Cytokine storm, or at least that's what I heard.

Hence the reason it supposedly attacked 18-25 people worse than other age groups.

[brentspeak]

13. Were animals affected by the pandemic?

[Fire_Medic_Dave]

30. The strains that are transmissible by humans don't usually affect animals.

[Uben]

15. Untreated strep often turns into Scarlet Fever

After my wife's breast reconstruction surgery a few years ago, she woke up on Christmas morning red from her waist to her neck. We went to the hospital ER and they admitted her immediately saying she had had a strep infection that had turned into Scarlet Fever.
She was put on Cipro (I believe) and the infection had attached itself to her implants, so they had to be removed, as well! After a years wait, she had reconstruction again, and this time the job was done much better, so it really turned out okay.

[du_grad]

37. Different types of strep and their diseases

I am a medical microbiologist, and have been since 1974. There are many different types of streptococcus infections. Uben, I have no doubt your wife was infected with Group A Beta strep (see below). However, it is not called scarlet fever when it is invasive like that. Scarlet fever is a sequel to pharyngitis (sore throat) and presents as a rash (see below). Sometimes invasive Group A infections coexist with Staphylococcus aureus/MRSA infections. That's a much too complicated topic to approach in this message.

Streptococcus pneumonia can cause bacterial pneumonia (as can other organisms). It can be lethal very quickly. It can cause a consolidated mass in the lung. It can be treated with antibiotics. This organism used to be universally sensitive to Penicillin, but nowadays there are more resistant strains around. When one gets a pneumonia vaccine, this is the organism you are hopefully protected against. This bug is the most common cause of bacterial pneumonia and, in patients over the age of 60, it can kill 20% of its victims. If you rapidly spike a high temp and/or cough up blood from an upper respiratory infection, get your butt to an ER quickly. Waiting does NOT improve your chances of a good outcome. You can end up in ICU with this one. It can also migrate to your spinal fluid and cause meningitis. It can kill you quickly from there. Antibiotics can help IF you get them fast. These bacteria produce toxins. If the toxins get ahold of you, all the antibiotics in the world will not help.

http://www.textbookofbacteriology.net/S.pneumoniae.html

Streptococcus pyogenes (also known as Group A Beta strep) can cause many infections. It is the organism one worries about when you get strep throat, but is also the organism referred to in cases of "flesh-eating" infections.

http://www.textbookofbacteriology.net/streptococcus.html

"In the last century, infections by S. pyogenes claimed many lives especially since the organism was the most important cause of puerperal fever (sepsis after childbirth). Scarlet fever was formerly a severe complication of streptococcal infection, but now, because of antibiotic therapy, it is little more than streptococcal pharyngitis accompanied by rash. Similarly, erysipelas (a form of cellulitis accompanied by fever and systemic toxicity) is less common today. However, there has been a recent increase in variety, severity and sequelae of Streptococcus pyogenes infections, and a resurgence of severe invasive infections, prompting descriptions of "flesh eating bacteria" in the news media. A complete explanation for the decline and resurgence is not known. Today, the pathogen is of major concern because of the occasional cases of rapidly progressive disease and because of the small risk of serious sequelae in untreated infections. These diseases remain a major worldwide health concern, and effort is being directed toward clarifying the risk and mechanisms of these sequelae and identifying rheumatogenic and nephritogenic strains of streptococci.

Acute Streptococcus pyogenes infections may present as pharyngitis (strep throat), scarlet fever (rash), impetigo (infection of the superficial layers of the skin) or cellulitis (infection of the deep layers of the skin). Invasive, toxigenic infections can result in necrotizing fasciitis, myositis and streptococcal toxic shock syndrome. Patients may also develop immune-mediated post-streptococcal sequelae, such as acute rheumatic fever and acute glomerulonephritis, following acute infections caused by Streptococcus pyogenes."

There are other types of strep infections also but these are the two biggies. I wish, when news media make these blanket statements about strep possibly causing the 1918 pandemic, they would be clearer in telling us what KIND of strep they are referring to. There are lots of them. Strains of these bugs have different virulence factors. Systemic infections (blood, spinal fluid) from these organisms are reported to state Health departments and ultimately the CDC.

Anyone wishing to track the country's infections can go to the MMWR report from the CDC. You can enter your email address and get a weekly report by state and county for free. This is something your tax dollars pay for that's NOT a tax boondoggle and IS a good thing.

http://www.cdc.gov/mmwr/

Lots of statistics available too, if you're into those:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5804md.htm

I will be glad to explain any microbiology questions any time. Unfortunately, micro is a difficult subject to understand, and there are lots of myths and untruths out there. I have been reporting out microbiology lab reports my entire adult career. I and my colleagues in labs across the country SEND OUT the lab report your docs get when you are sick and have a culture submitted. We do this 365 days a year.

[The abyss]

27. 1918 Pandemic

Nice to read a DU discussion on this topic and this latest report!

"We observed a similar 10-day median time to death among soldiers dying of influenza in 1918," they wrote.

I found very interesting, as did many other posters. Various reports I have read over the years do differ from this statement wildly. I also recall reading about the decimation of individuals in their mid 20s to mid 30s and comments about people “waking up fine, going to work, returning home at noon feeling sick, their body loaded into a wagon the next morning”. Those statements have always bugged me, were their several disease vectors at work here? I should clarify my quote… I am paraphrasing.

My grandfather related to me long ago about the number of railcars pulling out the dead from different military facilities within Mississippi, Missouri and Arkansas.

What has perplexed me for some time now is the “why” of these on-going studies and reports? All of us alive today are descended from survivors of this event. Reality check, if they want to study the chromosomes and active DNA, it still lives in us all around. There was never a need to go about digging up bodies buried in the permafrost of people that perished in 1918, examining lung tissues still preserved, etc….

From what I remember of my limited reading on this subject is that the first diagnosed cases were actually located at Fort Riley Kansas. Was Fort Riley an induction facility in those years? Were soldiers being jabbed with a “new” inoculation? Did they just happen to hit one or more individuals that were down with the sniffles with the wrong combination? That has been my theory for sometime.

Any “educators” out here? I would like to learn more.

[Mojorabbit]

32. There is an alternate theory

that it may have started in France.
http://www.npr.org/templates/story/story.php?storyId=5222069

[The abyss]

35. Thanks for the link.

I had not read this one.

[ronnie624]

36. A good audio link at that site:

<http://www.npr.org/templates/story/story.php?storyId=93747214>