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Spanish flu - history, causes and symptoms
The Spanish flu was the worst epidemic of the 20th century in Europe and a warning against considering the flu as harmless. Science comes to between 25 and 50 million deaths between 1918 and 1920. That's roughly equivalent to the plague of 1348, which killed one in three people in Europe.
contents
- Spanish flu?
- Three deaths
- Where did the "Spanish" flu come from??
- A new form of the flu
- "Knock me down fever"
- How did the flu spread??
- Dying in America, Africa and Europe
- Native hardest hit
- Symptoms of the Spanish flu
- Blue skin
- Doctors grope in the dark
- A biological weapon?
- Spitting prohibited
- What was the cause?
- Bird and human flu
- Older not prepared
- Not aggressiveness, but immune system
- Teaching for today
- New vaccination strategies
- A warning
- A deadly disease
"In 1337 (1918) a devastating epidemic hit the Najd, plaguing the townsfolk and the Bedouins. So many people died that only God alone could count them. " Abdallah al-Bassam
Above all, people died between 20 and 40 years. This is unusual in that influenza usually rages particularly hard on infants and the elderly. There is an indication of what we need to look out for in terms of flu prevention.
Spanish flu?
The term "Spanish flu" is due to the fact that the first reports of the disease came from Spain. In May of the last year of the war, news went through Europe, after which eight million people fell ill with the still unknown epidemic.
The Spanish flu killed countless people. Image: abhijith3747 - fotolia The disease probably did not originate in Spain, but the active belligerents repressed the reports. In Germany, reports of civilian victims of the epidemic came to public attention in June, and the soldiers knew long ago about the plague called "Blitzkartarrh" or "Flanders Fever".
Names of the disease in the various languages indicate that it was cross-border: Americans spoke of "three-day-fever" and "purple death", English soldiers generally of "flu", Frenchmen of "la flu" and the Italians suspected sandflies as a carrier.
Three deaths
In the spring of 1918, the outbreak was rather mild. Foreign media reported that most infected people recovered in Spain. The situation was quite different in autumn: in Prussia and Switzerland, every second citizen became ill, and in 1919 the effects of the third wave were less serious, but still considerable.
How many people died in this second and third wave will never be accurately determined. The war had just ended, the Bolsheviks were in power in Russia, civil war was raging, and few reports reached Europe.
The situation was clear with the Americans: they lost almost as many soldiers as they did during the war. Far away from Europe, in India, probably at least 16 million died of it, probably Indian Army soldiers of the British Army brought them into the country.
Spanish influenza was probably fatal in 2.5% of those infected - with only a maximum of 0.1% of other influenza patients.
Where did the "Spanish" flu come from??
The origin of the epidemic is still unclear. This is mainly due to the conditions of mass extinction in the First World War. Soldiers of all nations involved in the war died daily at the front, civilians starved and lost their lives through various diseases - from typhoid fever to tuberculosis. Firstly, the influenza patients in May 1918 received little attention, and secondly, it did not occur when people died of fever somewhere in the ditch.
Frank Macfarlane Burnet, a Nobel Laureate in Medicine, saw the source of the flu far from Spain - in rural Coutnty Haskell in the southwestern United States in the state of Kansas.
A new form of the flu
There, the doctor Loring Miner reported on a new form of the flu, which was often fatal. He even contacted the US Public Health Service, but did not get an answer. However, the magazine belonging to the service published its article in the spring of 1918.
At least three patients were therefore in Camp Fuston of the US Army. The first infected person was a cook in the camp on 4 March, and three weeks later there were 1100 sick and 38 dead - 56,000 soldiers. Those affected found the apt name "knock-me-down-fever". On March 18, the first occupied soldiers fell ill in Georgia.
"Knock me down fever"
The American soldiers described graphically that the flu was very intense. Strong fever, severe pain in the head and limbs are relatively abrupt, increased rapidly and usually improved after a few days. The death did not start with the affected soldiers in the US because of the flu itself, but because of a subsequent pneumonia.
In the camps, nearly 90% of the soldiers fell ill in prisons and factories: 1,000 Ford workers in Detroit and 25% of prisoners in San Quentin. Of these, "only" three died.
The flu spread quickly, but the death toll was so low that they did not recognize the health authorities as a threat.
How did the flu spread??
So it really should be called "American flu". Medical historians assume that American soldiers brought them into France, where there were already in April 1918 the first sufferers. By the end of the month, the epidemic had arrived in Paris, and at the beginning of April more than 10,000 people had been affected by the virus.
In June, the flu broke out worldwide: in Germany, China, India and the Philippines.
The flu epidemic also affected the world war. Thus, in July 1918, the German troops presumably lost their summer offensive in Champagne because the plague was rampant.
Denmark and Norway sought the flu in July, Holland and Sweden in August, and in September they reached Australia.
The disease was still thought to be harmless, but in Louisville in Kentucky many victims already died - and 40% of the dead belonged to the actually most immunoesthetic age between 20 and 35.
Dying in America, Africa and Europe
The relatively mild wave in the spring provided a false security: In August, the crew of the British ship HMS Mantua spread the disease in Freetown, Sierra Leone. Two-thirds of the locals fell ill and 3% of them died.
Soldiers in Boston have been down since the end of August, civilians since September. On September 23, Camp Stevens had 2,604 out of 35,000 soldiers, and 63 died in a single day.
The catastrophic conditions in the military camps caused a rapid spread. Dirty hospital beds stood in each of the hospitals in the hospitals, and in the corridors the dead piled up. Elementary hygiene standards could not be met.
A quarantine of US-expiring ships failed because the US Army did not allow any delay to bring soldiers to the front in Europe. The death rate among ship crews was even twice as high as on land. In September, at least 12,000 Americans had died from the flu.
India, Tanzania, Zambia, Mozambique, the Americas, and the Pacific also deplored dead in numbers, and in November, when the victorious soldiers returned, New Zealand also. 8600 New Zealanders died, in Samoa one in five died.
In Saudi Arabia it is remembered as an apocalyptic event as well as the plague.
Native hardest hit
Not only the natives in New Zealand and Samoa, but also Inuit were the most affected by the flu. In Cartwright in Labrador, 96 out of 100 Inuit people died and 26 of them died, 207 out of 266 died in the indigenous settlement of Ohak. Many survivors starved to death or froze to death.
Symptoms of the Spanish flu
The fall flu had some symptoms that they highlighted from other flu illnesses: it was extremely fast, the fever started suddenly and rose sharply within a few hours, with chills and severe pain in the head and joints. The throat and throat were severely irritated, coughing the episode. Some people bleed their nose.
Some patients died after a few hours of severe bleeding pneumonia, others developed conventional pneumonia after days. They too often died.
Blue skin
The skin turned bluish, very unusual for a flu. This was due to lack of oxygen.
Most sufferers died of pneumonia. Picture: Bilderzwerg - Fotolia Those who did not develop pneumonia usually did not die. However, they suffered several weeks of being beaten down and heavy tiredness. Depression was also widespread.
The third wave was weaker overall, and there were further "aftershocks" in various parts of the world, but this was due to the seasonal course of the usual flu epidemic and was not equally fatal.
Doctors grope in the dark
So typical of the "Spanish flu" was their fast and violent course as well as the bloody pneumonia in the episode and the high rate of deaths. That's why some doctors initially thought it was not flu at all.
Some scientists saw a new form of pulmonary plague at work, and the bloody pneumonia spoke in favor as well as the mass extinction. Only in 1933, however, were influenza viruses isolated and recognized as pathogens.
A biological weapon?
Conspiracy fantasies spread, most of which suspected the war opponents of spreading the plague. For example, Germans should have poisoned Spanish canned food and spread the flu. Americans believed that German agents had contaminated fish that American soldiers would have eaten.
Philipp Doane of the Health and Sanitation Section of the Emergency Fleet Corporation said: "For German agents it would be easy to release the pathogen in a theater or other place where many people are gathered. The Germans started epidemics in Europe. There is no reason why they should treat America more cautiously. "
Such theories were less audacious than the fantasies of today's esoterics, who believe that the contrails from planes are chemtrails to poison humans: mustard gas had claimed countless deaths, and the German army leadership had used biological weapons.
She even wanted to use Pesterreger against the British, and German agents committed attacks with anthrax against horses, sheep and cattle, and in animal feed in Romania, Spain, Argentina, the US, Norway and Iraq.
Spitting prohibited
In Canada, the recommendation was to avoid crowds, to thoroughly wash the mouth and skin, and to clean the clothes. Towels, cutlery and other items that other people had used, should be avoided.
These useful advice from today's perspective was accompanied by rather helpless hints. So you should not wear tight shoes, gloves and shirts, drink a glass of water in the morning and chew the food well.
In the US, eucalyptus and figs were a remedy, and in New York it was forbidden to spit on the streets.
In Europe, the Spanish flu was considered a disease that would have spread in the war, such as typhus, but that was a misinterpretation: Because not only by the conditions weakened soldiers were affected, but particularly well-nourished people in the prime of their years.
What was the cause?
Among the peculiarities of the Spanish flu was that in particular 25 to 29 years old people were affected, and in another circle 20 to 40 years old.
The evolutionary biologist Worobey explored this fact at the University of Arizona. The scientist from Tucson wrote in the "Proceedings of the National Academy of Sciences": The course and the severity of a flu episode essentially depends on which pathogens people had contact with as children. "
Influenza viruses change very quickly, and there are many variants.
Bird and human flu
Worobey and his team reconstructed how the H1N1 pathogen mutated at the time of death and compared it to later H1N1 viruses as well as to swine flu 200. Their conclusion: In the winter of 1917, Spanish influenza arose from a combination of an avian influenza virus with a human H1N1 virus. virus.
Older not prepared
Worobey concluded: Older and younger people had come in contact with the H1-type, but not the young adults. Instead, they would have been infected as children with another influenza virus, H3N8.
Anyone who has antibodies against the protein H 3, therefore has no defense against H 1N1 for a long time.
Not aggressiveness, but immune system
Decisive for the lethal course was therefore not a particular aggressiveness of the virus, but the lack of immune defense had been. According to Vorobey, many patients also died because of the following pneumonia.
And, it can be said, it also explains the high mortality rate among Inuit and Maoris: they had never come into contact with this variant of the flu virus.
Teaching for today
In influenza waves of our time, especially young people died at H5N1, especially old people at H7N9. Both were (partially) immunized against certain influenza strains, but not against others. So it's about immunity developed in the early days.
New vaccination strategies
Worobeys conclusion is: Influenza vaccine alone is not enough to avoid deaths. The vaccines would have to include which generation came into contact with which pathogen.
That was the relevant aspects of how devastating flu outbreaks could spread. Worobey writes, "Vaccination strategies that mimic the seemingly powerful lifetime protection of a contact in early childhood could dramatically reduce mortality from both seasonal and new strains."
A warning
The Spanish flu is not only a lesson for the development of vaccines, but also a warning. Influenza often causes "normal citizens" with a flu infection that almost goes along with it in autumn and winter, and that is unpleasant, but after a few days of fever, headaches and bed rest, it is over again.
A deadly disease
However, flu variants are fast-acting killers and no less dangerous than large-scale diseases such as typhus or cholera.
The victims of the Spanish flu probably did not die because the war had wiped them out, the hygienic conditions were pathetic, they did not wash, etc., but because they had developed no immune bodies against a specific mutation of a flu pathogen.
This means that a new variant of a flu pathogen could hit us alive today just like our ancestors did. Not only new vaccines are needed, but also to protect themselves from the epidemic with these vaccines. (Dr. Utz Anhalt)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)