Swine Flu, in historical context

by Jen on May 4, 2009

in Everyone is entitled to my opinion,Fact of the Day,Worlds' Goodest Teecher

We now interrupt my scheduled post to bring you this little history lesson, because, hell, it’s been too damn long since I’ve done that, hasn’t it?

Swine Flu.* To freak out or not to freak out, that is the question. Mashable reports that there are 10,000 tweets an hour with the #swineflu hashtag. Let’s cut through the crap. (Let’s also remember that I’m a History Goddess, not a Science one. But I’ll do my best.)

Why are some people scared and others dismissive of Swine Flu? No one seems certain whether it’s a health threat worth the hype. Pandemic? Maybe. Probably. But remember, the term pandemic refers only to the spread of the disease, not to the deadliness.

To my understanding, the main issues are 1) that no one is immune to Swine Flu (no one has been vaccinated and no one has acquired immunity) and 2) it can be spread from person to person. The New York Times reports:

In the United States, Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said the outbreak had caused such concern because officials had never seen this particular strain of the flu passing among humans.

“There is no background immunity in the population, and it is spreading from human to human — all of which has the potential for a pandemic,” Dr. Fauci said.

In the regular old Flu that people catch every winter the virus evolves. It shifts antigens every year. (Hey, that much I remember from reading The Stand.) That’s why we can’t develop just one vaccine and be done with it. The Flu usually mutates in birds (often chickens) and spreads to humans, who then spread it to each other. It’s transmissible between animals and people and is transmissible from person to person. The Avian Flu that was so feared a few years ago mutated in birds and spread to humans, but could not be spread from human to human. Deadly, yes. But as a pandemic? A bust.

According to the CDC, the FDA, and Wikipedia (who, frankly, don’t really agree with each other on a lot of things), in the United States each season nearly 150 million people get vaccinated against the regular ol’ Flu. The vaccine has a 57-77% efficacy rate, depending on age, health, the particular strain or strains that emerge that season (whether the vaccine accurately targets it) and the fact that it takes about two weeks for the vaccine to take effect, so it is possible to get vaccinated and still catch the Flu during that period. Each season anywhere from 5 – 20% of the population contract the flu; more than 200,000 people are hospitalized for complications from the flu and 36,000 die.

Historically, the pandemics that made the history books are the ones that were the deadliest. Possibly the most famous pandemic of all was the Black Plague in the mid 1300s. I was going to go into a big lesson about it, but instead I’ll just say neither transmission nor treatment was understood at the time. Today, we treat it with antibiotics and no longer do we suffer its 30 – 50% death rate. (But it’s still out there.)

The much-feared “Sweating Sickness” of late 15th/early 16th century England is believed to have possibly been a strain of the Flu. Starting as a fever and body aches, it moved to the lungs and often caused death in short course. If it hadn’t struck in 1502 (in April to be exact), Henry VII’s son Arthur would have been King of England, Arthur’s good looking younger brother Harry would have been merely a lovable roguish player and the world would have been denied a visually-wonderful, but historically-bastardized, sexed-up Showtime series. Among other things.**

Of course, the “Spanish Flu” pandemic of 1918 is much discussed these days. It was also a variant of the H1N1 strain. No one really agrees as to how deadly it was, but it’s believed it infected about 30% of the world’s population. Depending on your source, probably less than 6% of those infected died; about 2% of the world, I think. God, I suck at math. And the seven thousand differing accounts of the deadliness of this disease don’t help. What was significant about the disease was not only that it was widespread, but that it was particularly deadly. If you’re a history buff at all, it’s worth doing some local history research about the 1918 Flu. Since diseases don’t spread evenly across the planet and do not wreak their devastation levelly, many communities were disproportionally ravaged by this illness and never recovered.

One last historical thought: Because they had no acquired or genetic immunity, Native Americans who contracted Old World diseases during Post-Columbian contact suffered a 90% fatality rate. Of course, they didn’t have penicillin, either. Or vaccines. Or running water, for that matter.

Today? We’re both lucky and cursed. We have antivirals. We have knowledge. (And as we know, “knowledge is power.”) We have running water and skilled health care providers. But we also have the ability to circumnavigate the globe in 24 hours. Our technology is a mixed blessing. It’s easier to spread diseases, but it can be easier to cure them, too.

What’s the upshot of all this? Honestly, I don’t know for sure. Historical experience isn’t always the fortune cookie we’d like it to be. (Oh, wow… did I just say that?) This Flu, although it is spreading, doesn’t seem to stand out as unusually deadly, now that we know what we’re dealing with and are reacting appropriately. If irrationally.***

When the first case of H1N1 was finally, just today, announced in my state, the reaction was along the lines of “Well, if this disease has finally had the guts to cross state borders, then I guess we’d better do something about it here, too. En garde!” Like it’s coming for us. With premeditated, evil intent. Mwah-ha-ha. But consider this: One reason the 1918 Flu was so deadly was because, after the initial outbreak in the spring, it returned in the fall after having mutated in response to increased human antibodies, seemingly with a vengeance and even more deadly. Mwah-ha-ha, indeed.

*Okay. Fine. H1N1. (Whatever, spin doctors.)
**Like the English Reformation being delayed by several decades, if not longer. Among other, other things.
***During the Black Death, Europeans killed cats who were mistakenly thought to be spreading the disease. But nothing like that would happen today, right?

{ 2 comments… read them below or add one }

1 Jen May 4, 2009 at 2:56 pm

I love these history lessons. So this fall is when I should be freaking out then? Just wanted to get that on my schedule…

2 jen @ negative lane May 7, 2009 at 12:55 pm

Well, who can say for sure? In fact, my point was sort of that I’m a little tired of half of the internet totally freaking out while the other half freaks out that everyone is freaking out too much. Chill everyone. No one knows what the hell is going on, so use common sense.

Although, I have to say I’m glad I already decided long before this that I was getting a flu shot next year. That way I don’t feel like a paranoid freak when I do.

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