AH1N1 - Will Swine Flu Mimic the Spanish Flu of 1918?
Mon, May 4, 2009 at 02:00AM At this moment, the big anxiety is that the “swine” subtype of the flu virus H1N1 will become a worldwide pandemic, wiping out millions, as did the “Spanish” flu of 1918. So far the mortality rate – about 6% in Mexico but much lower elsewhere – has allowed a certain complacency to develop. But it must be remembered that the case-fatality rate of young adults during the 1918 pandemic ranged from only 1% to 3%; it was so devastating due to the sheer numbers of people infected. And the 1918 influenza came in three waves in a 1-year period, the first of which was relatively mild.
A review of present thinking on this is presented in the online Medical Journal of Australia. We certainly have a more robust public health system, with widespread global networks and the ability to communicate rapidly. Vaccines can now be developed within about 3months, although clinical testing will add on to this period. And antiviral medications exist, such as oseltamivir (Tamiflu®) and zanamivir (Relenza®), to which the swine influenza A(H1N1) virus is sensitive; however, it’s recently been shown that the “standard” seasonal H1N1 virus is becoming highly resistant to oseltamivir.
Antibacterial antibiotics can play a major part in battling the complications in a flu pandemic. Pneumonia due to secondary bacterial infection can fatally complicate the primary viral infection, but the value of antibiotics, which were not available in 1918, cannot be fully estimated yet.
Finally, there’s the possibility that certain people may have a less severe illness with swine flu due to exposure of their immune systems to various H1strains of influenza A over the years. Swine flu is not a new phenomenon. It was first noticed in pigs during the pandemic of 1918, and rare human infections with swine strains have been documented at intervals since then. The major epidemic in 1976 in the USA led to some deaths, and the development of a vaccine that was not well tolerated. It remains to be seen if previous infections provide any sort of immunity.
Reader Comments (2)
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