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The Lancet, Volume 373, Issue 9667, Pages 885 - 886, 14 March 2009
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doi:10.1016/S0140-6736(09)60530-4
Cite or Link Using DOI
Stories of an influenza pandemic
Original Text
Bill Bynum
Living with Enza: the Forgotten Story of Britain and the Great Flu Pandemic of 1918
Mark Honigsbaum
Palgrave Macmillan, 2008
Pp 256. ?16?99. ISBN-978-0-23021-774-4
<script> document.write('
'); </script>
Full-size image (23K)
19th-century doctors used to quip that it was better to have cancer than a common cold. There were dozens of remedies for cancer but none for the cold. Colds and ?flu? are more-or-less interchangeable in much common speech today, even if the old joke is not much bandied about. A touch of ?flu? is still a way to describe some upper-respiratory infection with a bit of fever and chills, the usual home remedy for both colds and ?flu? being rest, fluids, and an antipyretic.
Most winters, influenza ...
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60530-4/fulltext
Traduction machine
Les m?decins de 19?me si?cle utilis?s pour railler qu'il valait mieux d'avoir le cancer qu'un rhume de cerveau. Il y avait des douzaines de rem?des pour le cancer mais aucun pour le froid. Les froids et la ? grippe ? sont plus-ou-moins interchangeable dans beaucoup de discours commun aujourd'hui, m?me si la vieille plaisanterie n'est pas beaucoup ?chang?e environ. Un contact de la ? grippe ? est toujours une mani?re de d?crire une certaine infection sup?rieur-respiratoire avec un peu de fi?vre et froids, le rem?de de maison habituelle pour les deux froids et ? grippe ? ?tant repos, des fluides, et un antipyr?tique.
Vivre avec Enza: L'histoire oubli?e de la Grande-Bretagne et de la pand?mie de grippe de 1918 par Mark Honigsbaum
<!-- END: Module - Main Heading --><!--CMA user Call Diffrenet Variation Of Image --><!-- BEGIN: M24 Article Headline with landscape image (d) --><script type="text/javascript" src="http://entertainment.timesonline.co.uk/tol/js/m24-image-browser.js"></script><script type="text/javascript" src="http://entertainment.timesonline.co.uk/tol/js/tol.js"></script><!-- BEGIN: Module - M24 Article Headline with landscape image (d) --><script type="text/javascript"> <!-- /* Global variables that are used for "image browsing". Used on article pages to rotate the images of a story. */ var sImageBrowserImagePath = ''; var aArticleImages = new Array(); var aImageDescriptions = new Array(); var aImageEnlargeLink = new Array(); var aImageEnlargePopupWidth = '500'; var aImageEnlargePopupHeight = '500'; var aImagePhotographer = new Array(); var nSelectedArticleImage = 0; var aImageAltText= new Array(); var i=0; //--></script><script type="text/javascript"><!-- aArticleImages[i] = '/multimedia/archive/00419/flu_385x185_books_419535a.jpg'; //--></script><!--Don't Display undifined test for credit --><script type="text/javascript"><!-- aImageAltText[i] = "Wearing a surgical mask, a public health worker carries a spray pump filled with a anti-flu spray for use on buses in the UK." ; aImageAltText[i] = aImageAltText[i].replace(/"/g,"\""); //--></script><script type="text/javascript"><!-- aImageEnlargeLink[i] = '/multimedia/archive/00419/flu_385x185_books_419535a.jpg'; i=i+1; //--></script> The Times examen par Joanna Bourke
<!-- END: Module - M24 Article Headline with landscape image (d) --><!-- Article Copy module --><!-- BEGIN: Module - Main Article --><!-- Check the Article Type and display accordingly--><!-- Print Author image associated with the Author--><!-- Print the body of the article--><style type="text/css"> div#related-article-links p a, div#related-article-links p a:visited { color:#06c; } </style><!-- Pagination --> J'ai eu un petit oiseau
Son nom est Enza
J'ai ouvert la fen?tre
Et in-flu-enza ( ne pas traduire !! )
BRITISH ?l?ves de sauter ? cette comptine pendant la Grande pand?mie de grippe de 1918 et de 1919 aurait pu ?tre tout simplement heureux que les ?coles avaient ?t? ferm?es pour r?duire la contagion. Mais beaucoup auraient ?t? au courant de ses plus redoutables sens.
? la fin de 1918, la grippe tue en moyenne 95 enfants par semaine ? Londres seulement. Dans l'ensemble, un tiers de la population britannique ont ?t? infect?s et 228.000 morts. Partout dans le monde, le virus de 1918 a tu? plus de dix fois plus de personnes sont mortes pendant la Premi?re Guerre mondiale. Les victimes ont ?t? tourment?s par des fi?vres et des maux de t?te atroce, et, juste avant de mourir, leur peau se tourner de la couleur de cendres humides et ils se noient dans les fluides de remplissage de leurs poumons. Comme un ?ditorial dans The Times d?plor? le F?vrier 2, 1921, que la grippe a ?t? un "monstre" avec un grand app?tit.
Il est un monstre qui pourrait revenir aujourd'hui.
<!--#include file="m63-article-related-attachements.html"--> Le gouvernement britannique a pris note. Craignant la propagation du virus aviaire de mauvaises appel? H5N1, il a des stocks de m?dicaments antiviraux. En 2007, l'exercice d'hiver de Willow a examin? la pr?paration du Royaume-Uni pour faire face ? une pand?mie de grippe. Si une nouvelle pand?mie est une ?fatalit? biologique", comme l'OCM all?gu?e, alors peut-?tre la catastrophe de 1918-19 nous enseigner des le?ons?
Dans ce livre, Mark Honigsbaum montre comment l'histoire de la m?decine peuvent informer les politiques d'aujourd'hui. En 1918, nous dit-il, des m?decins ont ?t? pr?par?s. Ils ne sont pas permis que les bact?riologistes ? l'?poque ? une perte d'expliquer ce qui a caus? la maladie. Il a fallu attendre 1933 pour les scientifiques de se rendre compte que la grippe a ?t? transmise par un virus.Tout aussi important est que, en 1918, la responsabilit? de g?rer les crises de cette ampleur r?side dans les mains des autorit?s locales. Le Minist?re de la Sant? a ?t? cr?? seulement en 1919. M?me ainsi, les autorit?s ont ?t? lentes ? r?agir. Sir Arthur Newsholme, l'OCM de la Local Government Board, a expliqu? son propre incomp?tence en se r?f?rant ? la guerre. Les "besoins de la guerre sans rel?che", at-il insist?, n?cessaire ? la nation ? ?exercer?, ind?pendamment de tout risque.
Tout le monde n'?tait pas comme d?missionnaire. Population assi?g?e chimistes insistant sur le fait que leur soit donn? la quinine. ?ternuements, crachats, et ?aveugle expectoration" en public ?tait interdit. Certains ont pris de panique, surtout quand pompes fun?bres manqu? de cercueils et les organes sont rest?s sans s?pulture dans le salon avant, parfois pendant des semaines
Mais nous avons oubli?. Que faire si une souche mortelle du virus apparue aujourd'hui? Le gouvernement britannique a pr?vu de stocker 14 millions de doses d'oseltamivir, mais cela ne portent que sur un quart de la population britannique. En cas d'apparition d'un foyer, que la fabrication d'autres doses du m?dicament sont termin?s ? temps? Compte tenu de l'approvisionnement limit? de la drogue, qui devrait donner la priorit?? Seriez gens de panique? Quel serait l'effet sur l'?conomie si entre un quart et la moiti? de tous les travailleurs ont d?cid? de rester ? la maison?
Au cours de l'?pid?mie de SRAS, pr?s d'un tiers des personnes infect?es sont des professionnels de la sant?. Certes, le NHS serait submerg?? En 1918, un quart de la population britannique ont ?t? infect?s: si la m?me proportion a ?t? de tomber malade aujourd'hui, quelque 15 millions de personnes auraient besoin de soins m?dicaux. Si seulement 10 pour cent des personnes infect?es ont ?t? admises ? l'h?pital, Honigsbaum nous rappelle que ce serait de 1,5 millions de patients - mais il n'y a que 111.800 aigus et lits de soins intensifs en Angleterre. Encore plus inqui?tant est que la soci?t? britannique d'aujourd'hui n'a pas les volontariste ?thique et l'esprit de communaut? qui a domin? les premi?res d?cennies du si?cle dernier. Honigsbaum du pronostic est maussade. Le l?gendaire "de la l?vre sup?rieure raide" a ?t? grandement exag?r?e au cours de la guerre 1914-18. Il serait tr?s peu probable au cours d'une pand?mie du 21e si?cle.
Living with Enza: The Forgotten Story of Britain and the Great Flu Pandemic of 1918 by Mark Honigsbaum
<!-- END: Module - Main Heading --><!--CMA user Call Diffrenet Variation Of Image --><!-- BEGIN: M24 Article Headline with landscape image (d) --><script type="text/javascript" src="http://entertainment.timesonline.co.uk/tol/js/m24-image-browser.js"></script><script type="text/javascript" src="http://entertainment.timesonline.co.uk/tol/js/tol.js"></script><!-- BEGIN: Module - M24 Article Headline with landscape image (d) --><script type="text/javascript"> <!-- /* Global variables that are used for "image browsing". Used on article pages to rotate the images of a story. */ var sImageBrowserImagePath = ''; var aArticleImages = new Array(); var aImageDescriptions = new Array(); var aImageEnlargeLink = new Array(); var aImageEnlargePopupWidth = '500'; var aImageEnlargePopupHeight = '500'; var aImagePhotographer = new Array(); var nSelectedArticleImage = 0; var aImageAltText= new Array(); var i=0; //--></script><script type="text/javascript"><!-- aArticleImages[i] = '/multimedia/archive/00419/flu_385x185_books_419535a.jpg'; //--></script><!--Don't Display undifined test for credit --><script type="text/javascript"><!-- aImageAltText[i] = "Wearing a surgical mask, a public health worker carries a spray pump filled with a anti-flu spray for use on buses in the UK." ; aImageAltText[i] = aImageAltText[i].replace(/"/g,"\""); //--></script><script type="text/javascript"><!-- aImageEnlargeLink[i] = '/multimedia/archive/00419/flu_385x185_books_419535a.jpg'; i=i+1; //--></script>
<!-- Remove following to not show photographer information --><!-- Remove following to not show image description --><!-- Remove following to not show enlarge option --><!----><script type="text/javascript"><!-- fCreateImageBrowser(nSelectedArticleImage,'landsca pe',"/tol/"); //--></script>
<!-- Print Author name associated with the article --><!-- Print Author name from By Line associated with the article --> The Times review by Joanna Bourke
<!-- END: Module - M24 Article Headline with landscape image (d) --><!-- Article Copy module --><!-- BEGIN: Module - Main Article --><!-- Check the Article Type and display accordingly--> <!-- Print Author image associated with the Author--><!-- Print the body of the article--><style type="text/css"> div#related-article-links p a, div#related-article-links p a:visited { color:#06c; } </style><!-- Pagination --> I had a little bird
Its name was Enza
I opened the window
And in-flu-enza
BRITISH schoolchildren skipping to this rhyme during the Great Influenza pandemic of 1918 and 1919 might have been simply pleased that schools had been closed to reduce contagion. But many would have been aware of its more ominous meaning.
By the end of 1918, influenza was killing an average of 95 children a week in London alone. In all, one third of the British population were infected and 228,000 died. Around the world, the 1918 virus killed more than ten times as many people as died in the First World War. The victims were tormented by high fevers and excruciating headaches and, just before dying, their skin would turn the colour of wet ashes and they would drown in fluids filling their lungs. As an editorial in The Times lamented on February 2, 1921, that influenza was a ?monster? with a mighty appetite.
It is a monster that could return today. Three years ago, Sir Liam Donaldson, Britain's Chief Medical Officer (CMO) admitted that a new pandemic was a question of ?when, not if?. Avian flu could arrive in the UK by migrating birds, or on any number of commercial airliners. In 2002, public health officials feared the worse when severe acute respiratory syndrome (Sars) was spread via passengers on aircraft from China to 26 countries around the world, causing 8,500 infections and killing 916 people. The microbiologist Malik Peiris was not exaggerating when he said that ?nature remains the greatest bioterrorist of all?.
<!--#include file="m63-article-related-attachements.html"--> The UK Government has taken note. Fearing the spread of the nasty avian virus known as H5N1, it has stockpiled antiviral drugs. In 2007, Exercise Winter Willow reviewed the UK's preparedness for dealing with a flu pandemic. If a new pandemic is a ?biological inevitability?, as the CMO alleged, then might the 1918-19 catastrophe teach us some lessons?
In this book Mark Honigsbaum shows how the history of medicine can inform policymaking today. In 1918, he tells us, medical officers were unprepared. They were not helped that bacteriologists at the time were at a loss to explain what caused the disease. It took until 1933 for scientists to realise that influenza was transmitted by a virus. Equally significant is that in 1918 responsibility for dealing with crises of such magnitude lay in the hands of local authorities. The Ministry of Health was established only in 1919. Even so, the authorities were slow to respond. Sir Arthur Newsholme, the CMO of the Local Government Board, explained his own ineptitude by referring to the war. The ?relentless needs of warfare?, he insisted, required the nation to ?carry on?, regardless of any risk.
Not everyone was as resigned. People besieged chemists insisting that they be given quinine. Sneezing, spitting, and ?indiscriminate expectoration? in public were forbidden. Some people panicked, especially when funeral parlours ran out of coffins and bodies remained unburied in the front parlour, sometimes for weeks. Suicide rates soared. Survivors all agreed that the ?feeling of misery and utter helplessness? was something they would ?never forget?.
But we have forgotten. What if a lethal strain of the virus emerged today? The UK Government has plans to stockpile 14 million doses of oseltamivir, but this would cover only a quarter of the British population. In the event of an outbreak, would the manufacture of further doses of the drug be completed in time? Given lim-ited supplies of the drug, who would be given priority? Would people panic? What would be the effect on the economy if between a quarter and half of all workers decided to stay at home?
During the Sars outbreak, nearly a third of those infected were healthcare professionals. Surely the NHS would be overwhelmed? In 1918, a quarter of people in the UK were infected: if the same proportion were to fall ill today, some 15 million people would need medical attention. If only 10 per cent of these infected people were admitted to hospital, Honigsbaum reminds us that this would total 1.5 million patients - yet there are only 111,800 acute and intensive care beds in England. Even more worrying is that British society today lacks the voluntarist ethic and community spirit that dominated the early decades of last century. Honigsbaum's prognosis is glum. The legendary ?stiff upper lip? was greatly exaggerated during the 1914-18 war. It would be highly unlikely during a 21st-century pandemic.
Living with Enza: The Forgotten Story of Britain and the Great Flu Pandemic of 1918 by Mark Honigsbaum
<Previous Article|Next Article>
doi:10.1016/S0140-6736(09)60530-4
Cite or Link Using DOIStories of an influenza pandemic
Original Text
Bill Bynum
Living with Enza: the Forgotten Story of Britain and the Great Flu Pandemic of 1918
Mark Honigsbaum
Palgrave Macmillan, 2008
Pp 256. ?16?99. ISBN-978-0-23021-774-4
<script> document.write('
'); </script>
Full-size image (23K)
19th-century doctors used to quip that it was better to have cancer than a common cold. There were dozens of remedies for cancer but none for the cold. Colds and ?flu? are more-or-less interchangeable in much common speech today, even if the old joke is not much bandied about. A touch of ?flu? is still a way to describe some upper-respiratory infection with a bit of fever and chills, the usual home remedy for both colds and ?flu? being rest, fluids, and an antipyretic.
Most winters, influenza ...
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60530-4/fulltext
Traduction machine
Les m?decins de 19?me si?cle utilis?s pour railler qu'il valait mieux d'avoir le cancer qu'un rhume de cerveau. Il y avait des douzaines de rem?des pour le cancer mais aucun pour le froid. Les froids et la ? grippe ? sont plus-ou-moins interchangeable dans beaucoup de discours commun aujourd'hui, m?me si la vieille plaisanterie n'est pas beaucoup ?chang?e environ. Un contact de la ? grippe ? est toujours une mani?re de d?crire une certaine infection sup?rieur-respiratoire avec un peu de fi?vre et froids, le rem?de de maison habituelle pour les deux froids et ? grippe ? ?tant repos, des fluides, et un antipyr?tique.
Vivre avec Enza: L'histoire oubli?e de la Grande-Bretagne et de la pand?mie de grippe de 1918 par Mark Honigsbaum
<!-- END: Module - Main Heading --><!--CMA user Call Diffrenet Variation Of Image --><!-- BEGIN: M24 Article Headline with landscape image (d) --><script type="text/javascript" src="http://entertainment.timesonline.co.uk/tol/js/m24-image-browser.js"></script><script type="text/javascript" src="http://entertainment.timesonline.co.uk/tol/js/tol.js"></script><!-- BEGIN: Module - M24 Article Headline with landscape image (d) --><script type="text/javascript"> <!-- /* Global variables that are used for "image browsing". Used on article pages to rotate the images of a story. */ var sImageBrowserImagePath = ''; var aArticleImages = new Array(); var aImageDescriptions = new Array(); var aImageEnlargeLink = new Array(); var aImageEnlargePopupWidth = '500'; var aImageEnlargePopupHeight = '500'; var aImagePhotographer = new Array(); var nSelectedArticleImage = 0; var aImageAltText= new Array(); var i=0; //--></script><script type="text/javascript"><!-- aArticleImages[i] = '/multimedia/archive/00419/flu_385x185_books_419535a.jpg'; //--></script><!--Don't Display undifined test for credit --><script type="text/javascript"><!-- aImageAltText[i] = "Wearing a surgical mask, a public health worker carries a spray pump filled with a anti-flu spray for use on buses in the UK." ; aImageAltText[i] = aImageAltText[i].replace(/"/g,"\""); //--></script><script type="text/javascript"><!-- aImageEnlargeLink[i] = '/multimedia/archive/00419/flu_385x185_books_419535a.jpg'; i=i+1; //--></script> The Times examen par Joanna Bourke
<!-- END: Module - M24 Article Headline with landscape image (d) --><!-- Article Copy module --><!-- BEGIN: Module - Main Article --><!-- Check the Article Type and display accordingly--><!-- Print Author image associated with the Author--><!-- Print the body of the article--><style type="text/css"> div#related-article-links p a, div#related-article-links p a:visited { color:#06c; } </style><!-- Pagination --> J'ai eu un petit oiseau
Son nom est Enza
J'ai ouvert la fen?tre
Et in-flu-enza ( ne pas traduire !! )
BRITISH ?l?ves de sauter ? cette comptine pendant la Grande pand?mie de grippe de 1918 et de 1919 aurait pu ?tre tout simplement heureux que les ?coles avaient ?t? ferm?es pour r?duire la contagion. Mais beaucoup auraient ?t? au courant de ses plus redoutables sens.
? la fin de 1918, la grippe tue en moyenne 95 enfants par semaine ? Londres seulement. Dans l'ensemble, un tiers de la population britannique ont ?t? infect?s et 228.000 morts. Partout dans le monde, le virus de 1918 a tu? plus de dix fois plus de personnes sont mortes pendant la Premi?re Guerre mondiale. Les victimes ont ?t? tourment?s par des fi?vres et des maux de t?te atroce, et, juste avant de mourir, leur peau se tourner de la couleur de cendres humides et ils se noient dans les fluides de remplissage de leurs poumons. Comme un ?ditorial dans The Times d?plor? le F?vrier 2, 1921, que la grippe a ?t? un "monstre" avec un grand app?tit.
Il est un monstre qui pourrait revenir aujourd'hui.
.
Il ya trois ans, Sir Liam Donaldson, Britain's Chief Medical Officer (CMO) a admis que d'une nouvelle pand?mie est une question de "quand, pas si".La grippe aviaire pourrait arriver au Royaume-Uni par les oiseaux migrateurs, ou sur n'importe quel nombre d'avions commerciaux. En 2002, les responsables de la sant? publique craint le pire quand le syndrome respiratoire aigu s?v?re (SRAS), a ?t? propag? par les passagers des avions en provenance de Chine et 26 pays ? travers le monde, provoquant des infections 8.500 personnes et en tuant 916. Le microbiologiste Malik Peiris a ?t? de ne pas exag?rer quand il dit que "la nature reste le plus grand de tous les bioterroristes". <!--#include file="m63-article-related-attachements.html"--> Le gouvernement britannique a pris note. Craignant la propagation du virus aviaire de mauvaises appel? H5N1, il a des stocks de m?dicaments antiviraux. En 2007, l'exercice d'hiver de Willow a examin? la pr?paration du Royaume-Uni pour faire face ? une pand?mie de grippe. Si une nouvelle pand?mie est une ?fatalit? biologique", comme l'OCM all?gu?e, alors peut-?tre la catastrophe de 1918-19 nous enseigner des le?ons?
Dans ce livre, Mark Honigsbaum montre comment l'histoire de la m?decine peuvent informer les politiques d'aujourd'hui. En 1918, nous dit-il, des m?decins ont ?t? pr?par?s. Ils ne sont pas permis que les bact?riologistes ? l'?poque ? une perte d'expliquer ce qui a caus? la maladie. Il a fallu attendre 1933 pour les scientifiques de se rendre compte que la grippe a ?t? transmise par un virus.Tout aussi important est que, en 1918, la responsabilit? de g?rer les crises de cette ampleur r?side dans les mains des autorit?s locales. Le Minist?re de la Sant? a ?t? cr?? seulement en 1919. M?me ainsi, les autorit?s ont ?t? lentes ? r?agir. Sir Arthur Newsholme, l'OCM de la Local Government Board, a expliqu? son propre incomp?tence en se r?f?rant ? la guerre. Les "besoins de la guerre sans rel?che", at-il insist?, n?cessaire ? la nation ? ?exercer?, ind?pendamment de tout risque.
Tout le monde n'?tait pas comme d?missionnaire. Population assi?g?e chimistes insistant sur le fait que leur soit donn? la quinine. ?ternuements, crachats, et ?aveugle expectoration" en public ?tait interdit. Certains ont pris de panique, surtout quand pompes fun?bres manqu? de cercueils et les organes sont rest?s sans s?pulture dans le salon avant, parfois pendant des semaines
.
Les taux de suicide ont grimp?. Les survivants sont tous convenus que le "sentiment d'impuissance totale et la mis?re? est quelque chose qu'ils ne ?jamais oublier?. Mais nous avons oubli?. Que faire si une souche mortelle du virus apparue aujourd'hui? Le gouvernement britannique a pr?vu de stocker 14 millions de doses d'oseltamivir, mais cela ne portent que sur un quart de la population britannique. En cas d'apparition d'un foyer, que la fabrication d'autres doses du m?dicament sont termin?s ? temps? Compte tenu de l'approvisionnement limit? de la drogue, qui devrait donner la priorit?? Seriez gens de panique? Quel serait l'effet sur l'?conomie si entre un quart et la moiti? de tous les travailleurs ont d?cid? de rester ? la maison?
Au cours de l'?pid?mie de SRAS, pr?s d'un tiers des personnes infect?es sont des professionnels de la sant?. Certes, le NHS serait submerg?? En 1918, un quart de la population britannique ont ?t? infect?s: si la m?me proportion a ?t? de tomber malade aujourd'hui, quelque 15 millions de personnes auraient besoin de soins m?dicaux. Si seulement 10 pour cent des personnes infect?es ont ?t? admises ? l'h?pital, Honigsbaum nous rappelle que ce serait de 1,5 millions de patients - mais il n'y a que 111.800 aigus et lits de soins intensifs en Angleterre. Encore plus inqui?tant est que la soci?t? britannique d'aujourd'hui n'a pas les volontariste ?thique et l'esprit de communaut? qui a domin? les premi?res d?cennies du si?cle dernier. Honigsbaum du pronostic est maussade. Le l?gendaire "de la l?vre sup?rieure raide" a ?t? grandement exag?r?e au cours de la guerre 1914-18. Il serait tr?s peu probable au cours d'une pand?mie du 21e si?cle.
Living with Enza: The Forgotten Story of Britain and the Great Flu Pandemic of 1918 by Mark Honigsbaum
Vivre avec Enza: The Forgotten Story de la Grande-Bretagne et en cas de pand?mie de grippe de 1918 par Mark Honigsbaum <!-- END: Module - Main Heading --><!--CMA user Call Diffrenet Variation Of Image --><!-- BEGIN: M24 Article Headline with landscape image (d) --><script type="text/javascript" src="http://entertainment.timesonline.co.uk/tol/js/m24-image-browser.js"></script><script type="text/javascript" src="http://entertainment.timesonline.co.uk/tol/js/tol.js"></script><!-- BEGIN: Module - M24 Article Headline with landscape image (d) --><script type="text/javascript"> <!-- /* Global variables that are used for "image browsing". Used on article pages to rotate the images of a story. */ var sImageBrowserImagePath = ''; var aArticleImages = new Array(); var aImageDescriptions = new Array(); var aImageEnlargeLink = new Array(); var aImageEnlargePopupWidth = '500'; var aImageEnlargePopupHeight = '500'; var aImagePhotographer = new Array(); var nSelectedArticleImage = 0; var aImageAltText= new Array(); var i=0; //--></script><script type="text/javascript"><!-- aArticleImages[i] = '/multimedia/archive/00419/flu_385x185_books_419535a.jpg'; //--></script><!--Don't Display undifined test for credit --><script type="text/javascript"><!-- aImageAltText[i] = "Wearing a surgical mask, a public health worker carries a spray pump filled with a anti-flu spray for use on buses in the UK." ; aImageAltText[i] = aImageAltText[i].replace(/"/g,"\""); //--></script><script type="text/javascript"><!-- aImageEnlargeLink[i] = '/multimedia/archive/00419/flu_385x185_books_419535a.jpg'; i=i+1; //--></script>
<!-- Remove following to not show photographer information --><!-- Remove following to not show image description --><!-- Remove following to not show enlarge option --><!----><script type="text/javascript"><!-- fCreateImageBrowser(nSelectedArticleImage,'landsca pe',"/tol/"); //--></script>
<!-- Print Author name associated with the article --><!-- Print Author name from By Line associated with the article --> The Times review by Joanna Bourke
<!-- END: Module - M24 Article Headline with landscape image (d) --><!-- Article Copy module --><!-- BEGIN: Module - Main Article --><!-- Check the Article Type and display accordingly--> <!-- Print Author image associated with the Author--><!-- Print the body of the article--><style type="text/css"> div#related-article-links p a, div#related-article-links p a:visited { color:#06c; } </style><!-- Pagination --> I had a little bird
Its name was Enza
I opened the window
And in-flu-enza
BRITISH schoolchildren skipping to this rhyme during the Great Influenza pandemic of 1918 and 1919 might have been simply pleased that schools had been closed to reduce contagion. But many would have been aware of its more ominous meaning.
By the end of 1918, influenza was killing an average of 95 children a week in London alone. In all, one third of the British population were infected and 228,000 died. Around the world, the 1918 virus killed more than ten times as many people as died in the First World War. The victims were tormented by high fevers and excruciating headaches and, just before dying, their skin would turn the colour of wet ashes and they would drown in fluids filling their lungs. As an editorial in The Times lamented on February 2, 1921, that influenza was a ?monster? with a mighty appetite.
It is a monster that could return today. Three years ago, Sir Liam Donaldson, Britain's Chief Medical Officer (CMO) admitted that a new pandemic was a question of ?when, not if?. Avian flu could arrive in the UK by migrating birds, or on any number of commercial airliners. In 2002, public health officials feared the worse when severe acute respiratory syndrome (Sars) was spread via passengers on aircraft from China to 26 countries around the world, causing 8,500 infections and killing 916 people. The microbiologist Malik Peiris was not exaggerating when he said that ?nature remains the greatest bioterrorist of all?.
<!--#include file="m63-article-related-attachements.html"--> The UK Government has taken note. Fearing the spread of the nasty avian virus known as H5N1, it has stockpiled antiviral drugs. In 2007, Exercise Winter Willow reviewed the UK's preparedness for dealing with a flu pandemic. If a new pandemic is a ?biological inevitability?, as the CMO alleged, then might the 1918-19 catastrophe teach us some lessons?
In this book Mark Honigsbaum shows how the history of medicine can inform policymaking today. In 1918, he tells us, medical officers were unprepared. They were not helped that bacteriologists at the time were at a loss to explain what caused the disease. It took until 1933 for scientists to realise that influenza was transmitted by a virus. Equally significant is that in 1918 responsibility for dealing with crises of such magnitude lay in the hands of local authorities. The Ministry of Health was established only in 1919. Even so, the authorities were slow to respond. Sir Arthur Newsholme, the CMO of the Local Government Board, explained his own ineptitude by referring to the war. The ?relentless needs of warfare?, he insisted, required the nation to ?carry on?, regardless of any risk.
Not everyone was as resigned. People besieged chemists insisting that they be given quinine. Sneezing, spitting, and ?indiscriminate expectoration? in public were forbidden. Some people panicked, especially when funeral parlours ran out of coffins and bodies remained unburied in the front parlour, sometimes for weeks. Suicide rates soared. Survivors all agreed that the ?feeling of misery and utter helplessness? was something they would ?never forget?.
But we have forgotten. What if a lethal strain of the virus emerged today? The UK Government has plans to stockpile 14 million doses of oseltamivir, but this would cover only a quarter of the British population. In the event of an outbreak, would the manufacture of further doses of the drug be completed in time? Given lim-ited supplies of the drug, who would be given priority? Would people panic? What would be the effect on the economy if between a quarter and half of all workers decided to stay at home?
During the Sars outbreak, nearly a third of those infected were healthcare professionals. Surely the NHS would be overwhelmed? In 1918, a quarter of people in the UK were infected: if the same proportion were to fall ill today, some 15 million people would need medical attention. If only 10 per cent of these infected people were admitted to hospital, Honigsbaum reminds us that this would total 1.5 million patients - yet there are only 111,800 acute and intensive care beds in England. Even more worrying is that British society today lacks the voluntarist ethic and community spirit that dominated the early decades of last century. Honigsbaum's prognosis is glum. The legendary ?stiff upper lip? was greatly exaggerated during the 1914-18 war. It would be highly unlikely during a 21st-century pandemic.
Living with Enza: The Forgotten Story of Britain and the Great Flu Pandemic of 1918 by Mark Honigsbaum
