Deadly Flu Outbreak: Is History Repeating Itself?

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http://www.newsmax.com/archives/articles/2002/8/29/153639.shtml

Deadly Flu Outbreak: Is History Repeating Itself?

Phil Brennan, NewsMax.com

Friday, Aug. 30, 2002

An out-of-control outbreak of influenza which has killed as many as 700

people and felled almost 23,000 victims is ravaging Madagascar and health

authorities fear that if the disease is not confined to the huge island it

could spread around the world.

Madagascar which is larger than France and has a population of 16 million

people is located off southeast Africa. World Health Organization (WHO)

officials have said that samples taken from victims of the illness have

shown it to be Type A influenza, a strain of flu believed to have devastated

the world in the horrendous 1918 Spanish Flu epidemic that killed more than

21 million people, a half-million in the U.S. alone.

In the latest outbreak the illness has swept across five out of the island's

six provinces which is larger than France -- since it first appeared in

June, hitting malnourished villagers the hardest. " The province of

Antananarivo has also been affected by the severe flu, which has hit other

regions in Madagascar since June, killing more than 700 people as of

Monday, " Andriamparany, a top government health official, told

reporters.

Health officials say the illness -- known as " raporapo " on the island --

claims 95 percent of its victims from among impoverished peasants with no

access to modern medical care. The infectious illness causes severe

headaches, followed by neck and chest pains.

WHO spokesman Ian Simpson told reporters that a team of international health

specialists is working closely with the Madagascar government in an effort

to contain the disease and prevent its spread. He says the international and

government experts have set up mobile health teams to respond to reports of

large numbers of new cases in new places.

" They are able to send the mobile team out to help people to understand what

is happening, to also help treat people where necessary, " he said.

" Particularly if they have secondary infections, which are what people are

actually killed by. Those who are particularly elderly, have low immunity,

or the very young are at risk of death from secondary infections. And the

key is to get the right drugs to them at the right time and that can now be

done. "

Ominously, Dr. Doyle who has been tracking the epidemic told

NewsMax.com that " Spanish flu comes to mind in this case ... it is spreading

wildly and people are dying. . If this bug gets off the island, and hits

Asia, the UK, Europe, US etc, the death toll will be staggering. "

As already noted, in 1918-19 it was. What follows is a brief history of that

terrifying epidemic.

The GREAT DYING - THE 1918 INFLUENZA EPIDEMIC By Philip St. Brennan

How it all Began

It was still dark when Mess Sgt. Albert Gitchell woke up. He felt terrible,

and the thought of making breakfast for hundreds of hungry soldiers at Fort

Reilly's Camp Funston in the pre-dawn hours made him feel even worse.

He hadn't slept well. He'd gone to bed feeling miserable. He thought he was

coming down with a cold and hoped a good night's sleep would make him feel

better. It hadn't.

After a night of tossing and turning, he felt worse than he had the night

before. His head throbbed, he was burning with fever, he had the mother of

all sore throats and every muscle in his body ached.

He wouldn't be cooking breakfast for anybody this Monday morning, Gitchell

thought, as he struggled out of his bunk and put on his fatigues. His

tortured muscles protested every movement. His head pounded every time he

took a step. He felt as if he hadn't slept in a week, and his body was on

fire.

Without stopping to shave or shower, he left his barracks on this damp cold

March morning headed for the camp hospital-and walked into the pages of

medical history.

Chaos

At Hospital Building 91, part of a sprawling army medical complex that

predated the Spanish American War, the duty sergeant took Gitchell's

temperature, noted it was an alpine 103 degrees, listened to the cook

describe his symptoms, and, as a precaution, ordered him to bed in the ward

reserved for men suffering from any ailment that might prove contagious.

With Gitchell out of the way, the medic turned his attention to Cpl. Lee W.

Drake, the next man in line. Drake, a truck driver assigned to the

Headquarters Transportation Detachment's First Battalion reported the same

symptoms Gitchell described. The duty medic sent him to the same ward.

Right behind Drake came Sgt. Adolph Hurby. He was coughing, and his

temperature was sky-high. His complaints echoed those of the two previous

soldiers. His temperature hovered around 104 degrees, his pulse was low, he

was drowsy, and he winced with pain every time his eyes were exposed to

bright light. His throat, nasal passages and bronchial tubes were inflamed

and badly congested with mucous. He was one sick soldier.

The medic was alarmed. Three men with identical symptoms arriving at the

hospital within minutes of each other spelled trouble on any military base.

But on a base jam-packed with 26, 000 men it could mean disaster. The last

thing anyone on this huge army base wanted in these waning days of World War

I was an outbreak of contagious disease, and here was a clear warning that

something very unpleasant might be loose and rapidly spreading. It was more

than the harried medic could deal with. He picked up the phone and alerted

Lt. Harding, the chief nurse.

Within minutes Harding arrived at the building, one of a series of aging

limestone structures with a combined capacity of 3,068 beds. She was

immediately confronted with two more soldiers with symptoms matching

Gitchell's.

Harding wasted no time. She grabbed the wall phone and called her commanding

officer, Col. R. Schreiner, a 45-year-old army surgeon, rousing the

sleeping doctor from his bed.

Schreiner listened to Harding with growing alarm. He had been dreading an

outbreak of infectious disease at the overcrowded army base, and what he was

hearing from Harding sounded ominous.

He put the phone down, jumped out of bed, dressed hurriedly, and raced to

the hospital in the sidecar of a motorcycle driven by his orderly.

Within minutes he saw his worst nightmares coming true. Soldiers were

arriving in droves, all of them suffering from what he recognized as some

form of flu that appeared to be highly contagious.

By noon, the list of men stricken with the mysterious illness had grown to

107. Before the week was over, 522 men had been felled by it.

Albert Gitchell, army cook, had served as the advance guard for one of the

deadliest epidemics in recorded history.

The Spanish Influenza had made its 20th Century debut.

In a mere eight months it would kill 21 million people world wide. In the

United States alone, it would hit 20 million Americans, and kill a

staggering 500,000, as many as died on both sides in America's bloody Civil

War.

It would sweep across continents, leap over vast oceans, ravish whole

villages, wiping out every single inhabitant in some of them. In the U.S.,

few families escaped its fury. Steadily mutating into more deadly forms as

it spread, it would reach its zenith in October, killing with a fury that

outmatched the worst of the war's carnage.

During the first week of November, it would kill 14,000 Londoners. Then, a

week later, the war was over. And along with it, the worst of the epidemic.

An Ancient Enemy

History is filled with epidemics and plagues-outbreaks of disease that sweep

across nations and continents leaving hordes of dead in their wake and then

vanish as quickly as they appeared.

The more exotic are the best remembered-bubonic plague, smallpox, cholera,

typhus, polio, and the latest scourge, Ebola Zaire-mainly because they are

exotic.

Influenza -the flu virus- seems commonplace and less frightening than

something as horrific as the Ebola Zaire virus. The flu bug hits everybody

at one time or another. And some winters, mini-epidemics cut a wide swath

across whole areas of the nation. We get it, we suffer its symptoms,

sometimes for no more than a day or two, and then we recover.

It seems just too prosaic to qualify as a menace.

But in its more robust forms, it's a killer, as deadly as anything lurking

in the swamps and jungles of equatorial Africa, and far more contagious.

The Spanish Influenza (the word means influence in Spanish) is one of the

lethal flu viruses. It's appearance in 1918 was a rerun.-it has appeared and

disappeared throughout recorded history under other names, or under no names

at all. And every hundred years or so it has swept through large areas of

the world, leaving piles of corpses behind, and the world's population

markedly depleted.

More than 400 years before the birth of Christ Hippocrates described an

epidemic of a disease strikingly similar in its symptoms to the 1918

influenza strain. He wrote that it slaughtered an entire Athenian army.

Writing in the late 17th Century Noah Webster identified 44 instances of

deadly flu epidemics that hit Europe in the past 500 years.

In 1852, Dr. Theophilus , a London, England, physician noted that

the deadly variety of flu virus never seems far away:

" Influenza, " he wrote, " does not, like the plague, desert for ages a country

that which it has once afflicted. "

Time and again the common flu bug has proven that it is capable of mutating

into more violent forms. The bugs we're most familiar with-those that make

us miserable for brief periods-are perfectly capable of turning into wildly

contagious homicidal monsters. And that's what makes them far more

frightening than the more exotic forms of contagion.

Coming seemingly out of nowhere, they can emerge as full-blown epidemics, do

their deadly worst, and then go into hiding, sometimes for a century or

more.

In the 1950s, the director of the World Influenza Center in London, Dr.

es said: " I believe that the virus goes underground and perhaps does

so all over the world ... " It is, he warned, still possible that a pandemic

could return at any time " and kill its millions as happened in 1918-19. "

Added Australian microbiologist Sir Burnet: " Of all the virus

diseases, influenza is probably that in which mutational changes in the

virus are of greatest human importance. We can only guess what type of virus

was responsible in 1918-19 and what changes took place during the pandemic. "

Burnet noted that since the human flu virus was first isolated in 1933 and

two strains, Influenza A and Influenza B identified, both have undergone

striking changes in makeup. " Some of us believe that the influenza virus

chief means of survival is its constant mutation to new serological patterns

.... " he wrote.

In 1918, the flu virus that felled Albert Gitchell and his fellow doughboys

perfectly illustrated Dr. Burnet's point.

In five weeks it hit 1,127 soldiers at Fort Reillly. It killed a mere 46 of

its victims and then seemed to burn itself out.

But it wasn't finished. It was just lying low. It next struck in early May,

ravaging soldiers in two divisions that had just arrived in Europe from Fort

Reilly. In a matter of days it had spread to AEF Headquarters and in a mere

12 days infected 132 soldiers stationed there. By July it was rampaging

across the globe, slowly mutating into a more lethal form and killing more

and more of its victims.

By October it had become an homicidal maniac, butchering its victims by the

millions in every corner of the globe.

And then it gradually crept away and went into seclusion, waiting patiently

for its next opportunity to kill a few million people.

In 1960, a virus similar to the 1918 Spanish flu made a brief appearance in

Canada, perhaps to remind us that it's still out there, waiting patiently

for another Albert Gitchell to come along.

Hopefully, it is not making it's overdue appearance in Madagascar.