The largest plague in human history is also the one most forgotten. The Spanish Flu of 1918 killed one-fifth of the world’s population. The scary part is, this flu is similar to the one brewing in Asia right now. The Spanish flu, or Influenza type A, is caused by a virus. Viruses aren’t living organisms like germs, but are strands of RNA (ribonucleic acid), a substance that is composed of four separate chemicals, wrapped in protein. The only way viruses can live and reproduce is to attach to a living cell (known as a host), and use chemicals and enzymes in cells to reproduce. The virus becomes part of its host. What separates the flu from most viruses is that is can mutate and change its chemical composition. This makes immunity very difficult. It is possible to be immune to one strain of a virus but not another.
Viruses become better at infecting their hosts through a process known as progression. The first animal infected with a viral strain may not get very sick. The virus then changes its chemical composition so that the next animal infected becomes sicker, or needs less exposure in order to get sick. After a number of progressions, humans or animals may only need to be exposed to a small amount of virus in order to get sick. Flu virus spreads from person to person primarily through the air (coughing and sneezing). Using tools that an infected person has used and may have contaminated with saliva or nasal discharge can also spread it. Flu can even be transmitted by shaking hands. Flu itself is usually not deadly, but the damage that the virus does to human lungs makes it easy for disease-causing bacteria to enter and create another infection. One physician described patients in the 1918 plague as having “died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth.” The flu virus ended quietly in 1920, after killing between 20 and 40 million people. Scientists believe the virus self-destructed, mutating from a lethal form into a mild form that was easily defeated in healthy people.
Last year a scientist unearthed a piece of tissue from a victim with plague. He concluded, “The polymerase protein sequences from the 1918 human influenza virus differ from avian consensus sequences at only a small number of amino acids, consistent with the hypothesis that they were derived from an avian source shortly before the pandemic” and that therefore the genetic material of that virus parallels the H5N1 avian influenza virus. The virus tends to mutate from wild birds to domesticated ones, from those to humans, and then from human to human. So far, the virus cannot spread from person to person, and is therefore not considered a ‘pandemic flu’- better known as plague. There has only been one such case. The people most likely to be infected are those raising poultry. However, a mutation can erupt anywhere. The cases of bird flu tend to follow the migratory patterns of wild birds. The cases started in China, moved up through Serbia, and there is a high possibility that they can spread to Alaska. However, in today’s global arena, it is hard to prevent the virus from spreading globally. Most countries are taking strong measures to prevent the spread of the virus. However, poorer areas, such as Vietnam, cannot take the measure they need. There’s debate centering on the improper treatment of animals as reasons for the growing number of animal infections, such as Mad Cow disease. However, this hasn’t been proven to be the case for this flu.
Since the virus is primarily for birds, humans do not have immunity from it. There is a limited amount of TamiFlu, the vaccine to guard from this virus. A vaccine works by exposing your body to a similar, harmless strain of a virus, so your body can build up its own immunity. However in the case of a flu, the virus changes so often that the vaccine may not be able to keep up with the mutation. The creation of a new vaccine requires around 5-6 months. The larger picture of this issue is the pharmaceutical industry. The sector has largely replaced curing and preventing disease in favor of treating and searching for ongoing symptoms such as Attention Deficiency Disorder, Depression, and Restless Leg Syndrome. We are not prepared in the case that a plague does hit. With planes taking off every second from all corners of the globe, one cannot stop the spread of an airborne infection once it starts, according to the World Health Organization. There has been some initial production of a vaccine, however, it is far from enough for everyone. Further, if industrialized countries do not make vaccine for the third world, which cannot afford it, the repercussions of mass mortality will lead to greater public health issues.
For further information on this and other issues of international public health, watch a brilliant documentary by PBS called “RX for Survival.” It can be found sparingly from video rental places. Clips can be found at the PBS website. Part 1 is also re-airing April 12th.
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