Spanish flu

Spanish flu
Soldiers from Fort Riley, Kansas, ill with Spanish flu at a hospital ward at Camp Funston
Soldiers from Fort Riley, Kansas, ill with Spanish flu at a hospital ward at Camp Funston
DiseaseInfluenza
Virus strainStrains of A/H1N1
LocationWorldwide
First outbreakUnknown
DateFebruary 1918 – April 1920[1]
Suspected cases500 million (estimate)[2]
Deaths
17–100 million (estimates)
Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out.

The Spanish flu, also known as the 1918 influenza pandemic, was an unusually deadly influenza pandemic caused by the H1N1 influenza A virus. Lasting from February 1918 to April 1920, it infected 500 million people – about a third of the world's population at the time – in four successive waves. The death toll is typically estimated to have been somewhere between 20 million and 50 million, although estimates range from a conservative 17 million to a possible high of 100 million, making it one of the deadliest pandemics in human history.[3][4][5]

The first observations of illness and mortality were documented in the United States (in Kansas) in March 1918 and then in April in France, Germany and the United Kingdom. To maintain morale, World War I censors minimized these early reports. Newspapers were free to report the epidemic's effects in neutral Spain, such as the grave illness of King Alfonso XIII, and these stories created a false impression of Spain as especially hard hit. This gave rise to the name "Spanish" flu. Historical and epidemiological data are inadequate to identify with certainty the pandemic's geographic origin, with varying views as to its location.[2]

Most influenza outbreaks disproportionately kill the very young and the very old, with a higher survival rate for those in between, but the Spanish flu pandemic resulted in a higher-than-expected mortality rate for young adults.[6] Scientists offer several possible explanations for the high mortality rate of the 1918 influenza pandemic, including a severe 6-year climate anomaly that affected the migration of disease vectors and increased the likelihood of the spread of the disease through bodies of water.[7] Some analyses have shown the virus to be particularly deadly because it triggers a cytokine storm, which ravages the stronger immune system of young adults.[8] In contrast, a 2007 analysis of medical journals from the period of the pandemic found that the viral infection was no more aggressive than previous influenza strains.[9][10] Instead, malnourishment, overcrowded medical camps and hospitals, and poor hygiene, all exacerbated by the recent war, promoted bacterial superinfection. This superinfection killed most of the victims, typically after a somewhat prolonged death bed.[11][12]

The 1918 Spanish flu was the first of two pandemics caused by H1N1 influenza A virus; the second was the 2009 swine flu pandemic.[13]

  1. ^ Yang W, Petkova E, Shaman J (March 2014). "The 1918 influenza pandemic in New York City: age-specific timing, mortality, and transmission dynamics". Influenza and Other Respiratory Viruses. 8 (2): 177–88. doi:10.1111/irv.12217. PMC 4082668. PMID 24299150.
  2. ^ a b Taubenberger & Morens 2006.
  3. ^ "Pandemic Influenza Risk Management WHO Interim Guidance" (PDF). World Health Organization. 2013. p. 19. Archived (PDF) from the original on 21 January 2021. Retrieved 7 December 2020.
  4. ^ Cite error: The named reference pmid30202996 was invoked but never defined (see the help page).
  5. ^ Rosenwald MS (7 April 2020). "History's deadliest pandemics, from ancient Rome to modern America". The Washington Post. Archived from the original on 7 April 2020. Retrieved 11 April 2020.
  6. ^ Gagnon A, Miller MS, Hallman SA, Bourbeau R, Herring DA, Earn DJ, Madrenas J (2013). "Age-specific mortality during the 1918 influenza pandemic: unravelling the mystery of high young adult mortality". PLOS ONE. 8 (8): e69586. Bibcode:2013PLoSO...869586G. doi:10.1371/journal.pone.0069586. PMC 3734171. PMID 23940526.
  7. ^ More AF, Loveluck CP, Clifford H, Handley MJ, Korotkikh EV, Kurbatov AV, et al. (September 2020). "The Impact of a Six-Year Climate Anomaly on the "Spanish Flu" Pandemic and WWI". GeoHealth. 4 (9): e2020GH000277. doi:10.1029/2020GH000277. PMC 7513628. PMID 33005839.
  8. ^ Barry 2004b.
  9. ^ MacCallum WG (1919). "Pathology of the pneumonia following influenza". JAMA: The Journal of the American Medical Association. 72 (10): 720–23. doi:10.1001/jama.1919.02610100028012. Archived from the original on 25 January 2020. Retrieved 16 August 2019.
  10. ^ Hirsch EF, McKinney M (1919). "An epidemic of pneumococcus broncho-pneumonia". Journal of Infectious Diseases. 24 (6): 594–617. doi:10.1093/infdis/24.6.594. JSTOR 30080493.
  11. ^ Brundage JF, Shanks GD (December 2007). "What really happened during the 1918 influenza pandemic? The importance of bacterial secondary infections". The Journal of Infectious Diseases. 196 (11): 1717–8, author reply 1718–9. doi:10.1086/522355. PMID 18008258.
  12. ^ Morens DM, Fauci AS (April 2007). "The 1918 influenza pandemic: insights for the 21st century". The Journal of Infectious Diseases. 195 (7): 1018–28. doi:10.1086/511989. PMID 17330793.
  13. ^ "La Grippe Espagnole de 1918" (in French). Institut Pasteur. Archived from the original (Powerpoint) on 17 November 2015. (also here, requires Flash player)

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