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Spanish flu pandemic a stark precedent
By Aaron Derfel, Gazette Health Reporter
September 25,
MONTREAL ?
Much of the rationale behind the decision by governments around the world to launch massive flu vaccination campaigns against the H1N1 virus is the fear of a second wave of much deadlier infections.
There is a stark historical precedent for this in the 1918-19 Spanish flu pandemic. Estimates vary, but it?s believed that at least 50 million people died from a swine-flu subtype of H1N1 virus.
That pandemic occurred in three waves over 10 months. The second wave was by far the most lethal. Most people died at the end of October.
Ninety years later, epidemiologists are struck by a number of parallels between the Spanish flu and today?s declared pandemic.
First, the viruses are both H1N1. Second, children, teens and young adults are particularly susceptible to catching the virus today, as they were in 1918. And third, there is already some increased H1N1 flu activity in parts of the world (including the Beecher Bay First Nation reserve on Vancouver Island), signalling a second wave.
But that?s where the similarities end, and the differences might well be more significant.
No one knows for certain what the death rate was from the Spanish flu, but most experts suspect that it was at least two per cent. That means that out of every 1,000 people infected, 20 people died.
During a regular flu season, the mortality rate is less than one-tenth of one per cent. Even at such a low rate, the seasonal flu kills up to half a million people globally every year, mostly the frail and elderly.
Initially, as the H1N1 virus spread from Mexico in late April, figures from the World Health Organization suggested that the death rate was in line with the seasonal flu. This was true for Quebec as well.
But then the mortality rate appears to have crept up as H1N1 swept the globe. A WHO report made public yesterday noted that the cumulative worldwide total of H1N1 infections as of Sept. 20 was 318,925, and of that number 3,917 people have died.
Based on those numbers, the mortality rate is one per cent, which would be 10 times deadlier than the seasonal flu and perhaps half as deadly as the Spanish flu. But the WHO was quick to point out that countries are no longer required to test and report individual cases, so ?the number of cases reported actually understates the real number of cases.?
In other words, the death rate from H1N1 is probably lower than one per cent.
A report last week by the U.S. Centres for Disease Control and Prevention observed that since Sept. 28 of last year, the CDC had confirmed 117 influenza-associated pediatric deaths. Of that number, 49 were blamed on the H1N1 virus.
By comparison, the CDC reported 88 pediatric deaths during the 2007-2008 flu season.
Marc Lipsitch, a professor of epidemiology at Harvard University, told a meeting of flu experts in Washington this month that the H1N1 death rate compares to a moderate year of seasonal influenza.
Richard Schabas, a public health officer in Ontario, noted that the H1N1 activity in Australia, which has just gone through its winter, was no worse than the seasonal flu. And that bodes well for Canada, he said.
He accused the WHO and other public-health authorities ? which have a vested interest in promoting their agendas ? of unnecessarily causing panic.
?There?s no reason to think that the influenza we?re going to see this fall and winter ? which will probably be totally H1N1 ? is going to be more virulent than what we?ve seen,? Schabas said. ?I don?t subscribe to that theory at all. I think that?s unscientific fear-mongering.?
http://www.montrealgazette.com/health/Spanish+pandemic+stark+precedent/2035496/story.html
By Aaron Derfel, Gazette Health Reporter
September 25,
MONTREAL ?
Much of the rationale behind the decision by governments around the world to launch massive flu vaccination campaigns against the H1N1 virus is the fear of a second wave of much deadlier infections.
There is a stark historical precedent for this in the 1918-19 Spanish flu pandemic. Estimates vary, but it?s believed that at least 50 million people died from a swine-flu subtype of H1N1 virus.
That pandemic occurred in three waves over 10 months. The second wave was by far the most lethal. Most people died at the end of October.
Ninety years later, epidemiologists are struck by a number of parallels between the Spanish flu and today?s declared pandemic.
First, the viruses are both H1N1. Second, children, teens and young adults are particularly susceptible to catching the virus today, as they were in 1918. And third, there is already some increased H1N1 flu activity in parts of the world (including the Beecher Bay First Nation reserve on Vancouver Island), signalling a second wave.
But that?s where the similarities end, and the differences might well be more significant.
No one knows for certain what the death rate was from the Spanish flu, but most experts suspect that it was at least two per cent. That means that out of every 1,000 people infected, 20 people died.
During a regular flu season, the mortality rate is less than one-tenth of one per cent. Even at such a low rate, the seasonal flu kills up to half a million people globally every year, mostly the frail and elderly.
Initially, as the H1N1 virus spread from Mexico in late April, figures from the World Health Organization suggested that the death rate was in line with the seasonal flu. This was true for Quebec as well.
But then the mortality rate appears to have crept up as H1N1 swept the globe. A WHO report made public yesterday noted that the cumulative worldwide total of H1N1 infections as of Sept. 20 was 318,925, and of that number 3,917 people have died.
Based on those numbers, the mortality rate is one per cent, which would be 10 times deadlier than the seasonal flu and perhaps half as deadly as the Spanish flu. But the WHO was quick to point out that countries are no longer required to test and report individual cases, so ?the number of cases reported actually understates the real number of cases.?
In other words, the death rate from H1N1 is probably lower than one per cent.
A report last week by the U.S. Centres for Disease Control and Prevention observed that since Sept. 28 of last year, the CDC had confirmed 117 influenza-associated pediatric deaths. Of that number, 49 were blamed on the H1N1 virus.
By comparison, the CDC reported 88 pediatric deaths during the 2007-2008 flu season.
Marc Lipsitch, a professor of epidemiology at Harvard University, told a meeting of flu experts in Washington this month that the H1N1 death rate compares to a moderate year of seasonal influenza.
Richard Schabas, a public health officer in Ontario, noted that the H1N1 activity in Australia, which has just gone through its winter, was no worse than the seasonal flu. And that bodes well for Canada, he said.
He accused the WHO and other public-health authorities ? which have a vested interest in promoting their agendas ? of unnecessarily causing panic.
?There?s no reason to think that the influenza we?re going to see this fall and winter ? which will probably be totally H1N1 ? is going to be more virulent than what we?ve seen,? Schabas said. ?I don?t subscribe to that theory at all. I think that?s unscientific fear-mongering.?
http://www.montrealgazette.com/health/Spanish+pandemic+stark+precedent/2035496/story.html