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Vitamin D's role in the 1918 influenza pandemic

W

wbgrant

Member
Greetings,

I do research on the health benefits of solar ultraviolet-B (UVB) irradiance and vitamin D. One of the benefits is the induction of human cathelicidin, LL-37, which has important antimicrobial and antiendotoxin activities. John Cannell et al. proposed that seasonal variations in solar UVB and vitamin D could explain a good deal of the seasonal variation in epidemic influenza:

Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF, Giovannucci E. Epidemic influenza and vitamin D. Epidemiol Infect. 2006 Dec;134(6):1129-40.
Cannell JJ, Zasloff M, Garland CF, Scragg R, Giovannucci E. On the epidemiology of influenza. Virol J. 2008 Feb 25;5(1):29 [Epub ahead of print]

Support was quickly forthcoming in a post-hoc analysis of a randomized controlled trial:
Aloia JF, Li-Ng M. Re: epidemic influenza and vitamin D. Epidemiol Infect. 2007 Oct;135(7):1095-6; author reply 1097-8.

Bsaed on this paper, which I found through FluTrackers:
Britten RH. The incidence of epidemic influenza, 1918-19. Pub Health Rep. 1932;47:303-39.
http://statelibrary.dcr.state.nc.us/iss/INFLUENZA/PDFfiles/USPHR47All.pdf

I did an ecological analysis of case fatality rates in 12 cities of the United States. The finding was that summertime solar UVB was strongly inversely correlated with case fatality rates, and wintertime UVB was almost as strongly inversely correlated. Looking further at the literature, I realized that most people who died from A/H1N1 influenza actually died from pneumonia, caused by a bacteria. Thus, it seems that in this case, LL-37 had a more important effect on bacteria than the virus. The W-shaped age distribution of the mortality rates seems to be related to immunity for people born prior to 1890 and the outbreak of the Russian flu. However, the seasonality of pandemic influenza indicates that UVB and vitamin D may still play some role in reducing the risk. I will be submitting this manuscript for publication shortly.

Abstracts of published papers are at www.pubmed.gov.
 
Re: Vitamin D's role in the 1918 influenza pandemic

I would direct you to the source of Cannell's work, namely the works of the noted Btirish physician and self-taught researcher R. Edgar Hope-Simpson. He was the first to suggest a corollary between sunlight and influenza. His work has had a huge influenxe on Cannell's work.
 
Re: Vitamin D's role in the 1918 influenza pandemic

hello wbgrant,

I see you are mainly interested in UVB-Vitamin D --> cancer : several papers at pubmed.
I had read about Cannell's flu-experiments in prisons, he also posted at Effectmeasure once.
Seasonality of influenza is still unclear, a recent paper claimed to have solved it by heat --> melting of lipid envelope.
Recent sequence analysis seems to show that flu travels around the globe and rarely
"oversummers" or keeps dormant.
And we have flu all year in the tropes and two peaks in Hongkong : March and July.
Vitamin D may contribute but can't explain everything (IMO).
It may reduce the chance to become infected or -if infected- reduce the severety,
the number of cells involved,apoptosis.
Your study seems to concentrate on the mortality only,
not number of infections (?) :
mortality from P+I in 12 US-cities 1918/9
wrt. estimated UVB - exposure. (at what time prior to infection ?)

There should be much more data available to examine this, not only 1918 !?!
So I assume this can be resolved in the next years ...
You should be able to re-use your weather/UVB data from cancer
studies just for influenza. In USA they have weekly influenza data for 40/50/120 cities
since 1920, but I don't know whether it's available in computer readable form.
Then we have mortality-data from many countries and (excess) pneumonia+influenza-mortality.
And then, of course, ILI-submissions data, number of positive flu samples
etc. for the recent years.
flunet seems to get them from many
countries now.
Simonsen,Vibaud ... should have most of the data in computer-readable form.
 
Flu seasonality less operative

Flu seasonality less operative

As the use of sunscreen increases, the seasonality of flu changes. I follow 25-OH vitamin D blood levels in my patients (family practice). There is a clear relationship to D levels and resistance to influenza and other viruses.

The 1918 pandemic is likely the key to understanding our defense against flu. Given the scope of that event - either the bug was unique, or host defense was uniquely impaired. (opinion) I think it was poor host defense, due to low D levels, resulting from a summation of predictable atmospheric fluctuations in ozone coupled with extraordinary solar events.
 
Re: Vitamin D's role in the 1918 influenza pandemic

why is there influenza during the whole year in the tropes ?
 
Unfamiliar with trope data

Unfamiliar with trope data

I practice in Southern Illinois, USA.

(opinion) I believe relative D deficiency is a permissive precondition - allowing an infection to manifest - or to affect it's severity. Also, I suspect that co-existing intracelluar deficits in magnesium contribute to reduced effectiveness of stored vitamin D hormone in regulating the immune system response.

I don't know how accurate influenza data is, in general. Here in the US, the billing code data from practicing clinicians is GIGO (Garbage in, garbage out).
 
Re: Vitamin D's role in the 1918 influenza pandemic

here
http://www.virologyj.com/content/5/1/29
they suggest that influenza survives in some people
from season to season and is activated by changes in
immunity.

But the sequencing clearly shows that influenza runs around the
globe and is seeded from outside newly each year.

Despite all efforts it there is no case where the infection couldn't
be tracked back to possible human contacts.
 
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