Spanish Flu: 100th Anniversary

Some families in the United States have a special anniversary: remembering an ancestor who, facing dire circumstances, showed courage and resilience, and found a way to create the conditions for a better life for his or her descendants. When we recall that day it reminds us of who we are and where we come from. Also, when facing a difficult moment in our life we can better put it in perspective and find the strength to deal with it. For me and my family it is 1918: the end of World War I and the beginning of the 1918-1919 Spanish Flu pandemic. 

My maternal grandfather was a young military officer who died in the first few days of World War I (WWI). My grandmother, from that point on, had to raise their two young daughters and support them. My grandmother became a nurse and a role model for her grandchildren, especially for my sister, who became a nurse, as well as for me, now a medical doctor.  

My paternal grandfather was buried alive in a trench on the Western Front, and was rescued by a comrade. He was sent home just before the cease fire and the November 11, 1918, armistice that ended the war. His father, like other members of the family, was happy to welcome him back home. He was hoping that my grandfather would recover from his wounds and resume helping to run the family business. He thought, like most people around him, that humankind would never again allow nations to engage in such massacre (20 million people killed and twice as many wounded), and was convinced that this had been ‘the war to end all wars.’ Also, impressed by the progress of medicine in the previous 50 years (immunizations against Rabies, Diphtheria, Typhoid fever, for instance), he thought that no natural disaster could cause as much damage as WWI.

Unfortunately, my great-grandfather was wrong on both counts: 

1. World War II (twenty years later) caused three times as many casualties as WWI.
2. He died in 1919 from the Spanish Flu pandemic (epidemic touching all corners of the world) of 1918-19. That pandemic killed twice as many people as WWI (more people than in any other epidemic in recorded history), including 750,000 people in the US alone. 

His wounded son was so diminished that his wife, my grandmother, had to raise 2 boys by herself and also run the family business. Again, she became a model for us, always optimistic and telling us funny stories about her life until, just before her death at age 96, when she confessed to me that she had had a really tough life. 

Looking at what has happened in the last 100 years, we can observe that mankind has not been able to prevent wars nor eliminate deadly infectious disease, but has been successful in decreasing the mortality from one of the deadliest infectious diseases in the US: the influenza, or ‘flu.’   

It took a long time to figure out what causes the flu. In the 18th century Miasma, or “Bad Air” was thought to be the cause. In the 19th and early 20th centuries a bacteria was suspected. It was only in 1933 that the influenza virus was isolated after many studies done on animals.  The first flu vaccines were used in 1945. The Center for Disease Control (CDC) was created in 1946, and started tracking flu activities each year. The number of deaths from the flu varies from 3,000 to 50,000 each year in the US. 

Last year, one of the worst flu seasons in many years, 80,000 people died from the flu in the US. 90% were people over the age of 65, but 180 young children and teenagers died.  According to the CDC, 80% of children who died from the flu had not been vaccinated (the percentage in adults is not exactly known, because it is not mandatory to report deaths from the flu in adults as it is in children).  

So, the message is: “flu” is a deadly disease, especially if you do not get the flu shot.

Now is a good time to get your flu shot before this year’s epidemic starts, and get into the habit of repeating it every year. It will boost your immunity against the flu virus and, if you are exposed to the virus, will not only protect you from a deadly disease but also decrease the spread of the virus and protect the vulnerable people around you (young infants and children, immunocompromised people, and older adults). If your child is older than 6 months, he can receive it in any of our five clinics. For adults 24 years and older, we administer the flu shot at the Washington Neighborhood Clinic. There are many other places to get the flu shot, as well: (https://www.sccgov.org/sites/phd/services/izclinic/pages/flu.aspx)

Unfortunately, there is no way to predict if the flu epidemic will be mild or severe, if it will cause deaths mainly in young children and older adults like most years, or if it will affect even young people, like during the Spanish Flu pandemic, when the average age of death from the flu was 28.

The flu virus is transmitted from one individual to another by droplets that infected people send into the air as far as 6 feet by breathing, coughing or sneezing. Following the basic hygienic recommendations like covering your face when coughing or sneezing and frequent hand washing can help prevent the spread of the virus.

If you or your child develop a fever, with congestion, cough and body aches, it is better to stay home as long as fever is present. You may want to contact your health care provider at one of our clinics in the early stages of the disease to find out if a medication like Tamiflu could shorten or reduce your symptoms. Usually candidates for Tamiflu are people at high risk, like young children, older adults, and patients with chronic medical conditions.

If you want more details about the flu you can ask one of our medical providers, or consult the CDC website: https://www.cdc.gov/flu/index.htm