Pandemics Part 2: Deadly Flu
Corona trivialists like to claim that the currently rampant corona virus is no worse than "ordinary flu". In doing so, they reveal that they have no idea of the current corona pandemic or of influenza viruses: “Common flu” are not only the number 1 candidate for pandemics because they spread very quickly and mutate very quickly - they are also among the diseases that claimed the most lives worldwide.
Kill the flu
The flu doctor was the first to be described by the ancient doctor Hippocrates. There have been more than 30 flu pandemics in the past 500 years. Three of them fell into the 20th century, and it wasn't just the ones that killed most people under the flu outbreak. One of them, the Spanish flu, even together with the 14th century bubonic plague, generally represented the plague of history that left the most dead.
Even in “normal” flu years, an average of 1.5 million people die of flu worldwide. Scientists worldwide are in constant competition with the mutating influenza viruses to develop new vaccines. Because only with these can the pathogens be fought.
"Influenza pandemics are like earthquakes, hurricanes and tsunamis: they occur, and some are much worse than others. The idea that we would not have another 1918-like event is foolish. ” (Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota)
Flu viruses - an overview
- Flu (influenza) is a respiratory disease caused by viruses.
- An “ordinary flu” is by no means harmless, but a serious illness that can threaten life.
- A "flu infection" shows symptoms similar to those of the flu, but the pathogen is different.
- In Germany, especially in winter, there are flu waves that have different degrees of severity and spread to different extents.
- Influenza vaccines need to be adjusted every year.
- Flu is extremely contagious because droplets containing the viruses spread through the air when sneezing, coughing and speaking and are inhaled.
- At the same time, they spread when the virus has come into contact with skin and thus enters the body through the mucous membranes of the mouth, nose or eyes.
- Influenza viruses also stick to objects, so we pass them on to our hands when we hold onto the railing or open a door.
- Influenza pandemics are usually caused by group A flu viruses, which constantly change their surface structure, making it difficult for the body's immune system to recognize and fight them.
Flu - symptoms
With every third flu disease, those affected suddenly feel "typically sick" - they have a fever, a dry cough, and pain in the throat, limbs, muscles, head and back. In some people, often the elderly, these symptoms are not severe and are easily mistaken for a cold.
An uncomplicated flu subsides after about five days, but the dry cough can last for a while. But there is no rule of thumb: A flu infection can show no, slight or the described symptoms. But it can also be very difficult and lead to death.
Flu And Cold - What Are The Differences?
In the vernacular, we often equate "flu" with a "flu infection" and / or a cold. What they all have in common is that they are viral diseases of the respiratory tract. However, a cold starts slowly. It scratches in the throat, we are hoarse, followed by a cold and cough, and often everything is over after two days, but at the latest after four or five days.
However, the flu suddenly breaks out. In a few hours, the feeling of health changes from "everything is OK" to "very sick". In the course of a day, the fever often rises from normal temperature to up to 40 degrees Celsius. Head, neck and body aches, runny nose and cough quickly follow. With a moderate course, flu lasts about a week.
The risk of flu is infection that occurs as a result of the disease. This includes inflammation of the middle ear, and inflammation can also occur in the heart and brain. However, the most common consequence is pneumonia caused by pneumococcal infection. The vast majority of the “flu dead” die from such a lung disease.
Why is the flu called influenza?
In the Middle Ages in Europe, the idea that diseases were influenced by the position of the planets was circulating. The language of scientists and medicine was Latin, and Latin means influence Influenza.
Hippocrates used 400 BC Chr. The term epidemic, which results from "epi" and "demos"For" about "and" people ". So an epidemic is something (an illness) that breaks through the people. "Pan" comes from the Greek adjective pas (in neuter pan), that means "everything". As a preceding word formation element, pan stands for whole, comprehensive or total.
Medical history of the influenza virus
Since the late Middle Ages, influenza has only been known as the flu. In the 8th century, an illness decimated the soldiers of the army of Charlemagne. The symptoms described indicate a flu epidemic. According to Wolfgang Behringer, there were three to six influenza pandemics per century from 1500 to 1800; in the Middle Ages, the insufficient data made no statements possible.
The first pandemic flu was documented in 1580. Wolfgang Behringer, history professor for early modern times at Saarland University, researched this epidemic. It probably spread from Italy to Central Europe, from Germany to Scandinavia and England.
According to Behringer, flu, high fever, chills, back and headache, and a violent cough speak for. These symptoms gave the disease its name.
The French term “la grippe” means to be gripped by something. Suddenly people are lying in bed with pain in the head, limbs and muscles, are “gripped” by the fever and can hardly move. In England, people called the disease “new ache” because of these symptoms. According to the experts, names like “Spanish fips”, “Borstsuke” (breast disease) or “la coqueluche” were also used for the flu at the time.
The usual treatment for such diseases was bloodletting in the early modern period. This is harmful and often fatal for infections in which the immune system is weakened anyway. In the flu pandemic at the time, for example, the queen of Spain, Maria Anna, asked whether she died of the flu - or the bloodletting that was used to treat it.
Horror of modern times
Since this first specifically documented flu pandemic, more than 30 others have followed which have resulted in numerous deaths. The worst of them was the "Spanish flu" from 1918 to 1920, which cost tens of millions of lives - estimates ranged from 25 to 50 million, some historians today estimate 50 million or more victims based on systematically evaluated data. The Spanish flu claimed more deaths than the entire First World War, at the end of which it raged.
The two following flu pandemics of the 20th century, the "Asian flu" from 1957 to 1968 and the "Hong Kong flu" from 1968 to 1970, also killed millions of people. In addition, these pandemics, typical of influenza viruses, subsequently led to regional epidemics, as the viruses spread in the pandemic changed locally. For example, a sprout of the "Hong Kong flu" virus type (influenza A virus subtype H3N2) still walks around today.
Flu is not harmless
But even without a pandemic, influenza epidemics are by no means harmless. For example, more than eight million people fell ill with the flu waves in Germany in 1995/96 and 2012/2013, of which around 20,000 died. 2017/2018 was followed by the worst flu wave of the past 30 years. 25,100 people died in Germany.
“The plague raced through the city. The ambulances of the city medical company whizzed back and forth between the city and the hospital (…) The seriously ill drove to the city hospital.“
(Alfred Döblin in "November 1918").
The American soldier Albert Gitchell fell ill on March 4, 1918 with severe flu at Camp Funston in the US state of Kansas. He was one of the first known victims of a pandemic known as the "Spanish flu" but was the first to be documented in this American military camp. The same day, hundreds of other soldiers in the camp complained of high fever, sore throat and headache, and some came to the military hospital with severe inflammation.
The disease spread extremely quickly among the US soldiers, and the symptoms suddenly set in violently - the soldiers aptly called it "knock-me-down-fever." It was an A / H1N1 subtype influenza virus. However, this first wave was not overly lethal. American soldiers probably brought the flu to Europe.
"Neapolitan flu" from China?
In spring 1918 there was an unusually severe flu wave in Europe. Soldiers were particularly often infected in young adulthood. Then Alfonso XIII, the King of Spain, fell ill and at the end of May the number of those affected in the country was estimated at 200,000. Meanwhile, speculation circulated about where the flu originated. Sometimes military helpers should have brought them in from China, sometimes the Russians should have spread them (presumably also an association with the "Russian flu" in 1889). The right general Ludendorff blamed China.
The epidemic was soon called "Spanish flu" in Europe, although it did not originate in Spain. When the disease raged on the Iberian Peninsula, it had spread to large parts of Europe. However, the war was not yet over and the press in the belligerent states was subject to strict censorship - the war was also at the center of the media. Spain was neutral and that was one of the reasons why the outbreak of the pandemic made headlines here. In Spain itself, the epidemic was called "Neapolitan flu."
Spanish flu circles the world
In reality, the "Spanish flu" had been rife in Portugal, Italy, Greece and the Maghreb states by June 1918 at the latest, and later in the year in England, Scotland and Wales, France and the countries of Eastern Europe. Denmark and Norway reached the epidemic in July, the Netherlands and Sweden in August, and affected Australia in September.
The French called it "la grippe", the British "the flu", the Americans also "three day fever" or "purple death" (presumably because the body of the flu victim swelled dark due to the lack of oxygen). German soldiers spoke of the “lightning catarrh” and the “Flanders fever”.
It soon hit Cuba and the Philippines, as well as India. It is believed that 500 million people, i.e. one in three who lived on Earth at that time, became infected. In the end, the three waves of influenza from 1918 to 1920 killed an estimated two and a half to five percent of the world's population - an estimated 25 to 50 million people.
The worst plague since Black Death
The virus mutated. In late summer 1918, a far more deadly form of Spanish flu appeared than the first wave in three places on three continents on the Atlantic: Freetown in Sierra Leone, Brest in France and Boston in the USA. Seamen on the British ship HMS Mantua had brought the plague into Freetown. Two out of three locals got sick, and three percent of the sick died.
The poet Guillaume Apollinaire died in Paris in November 1918 of lung failure due to the infection. His body was tarnished by the lack of oxygen, victims "drowned" on their own body fluids. The Times wrote about a “plague unmatched since the Black Death”.
From New Zealand to Alaska
In Philadelphia, 5,000 people died in a week, in Kimberley, South Africa, 2,500 diamond mine workers after the flu had come from the Cape on the new rail line. Corpses lined up on the streets in Brazilian slums. The cities of India, which were overcrowded with people in very tight spaces, were hit very hard, but the viruses also reached remote settlements "at the end of the world" like in Alaska.
Half of the population fell ill in Prussia and Switzerland. Tanzania, Zambia, Mozambique, the Americas and the Pacific complained of countless deaths, and in November soldiers spread the plague to New Zealand.
The worst hit was India, estimates range from five to 12 million deaths, the flu ended the lives of around 500,000 in the United States, 147,000 died in Spain and around 500,000 in Italy, the greater part in the south of the country.
The respiratory tract was mostly affected in the deceased, more rarely the middle part of the chest cavity. In the lungs, the inflammation raged particularly in the lower lobes, the spleen was often enlarged, sometimes the liver, and very often the meninges, which also explains why survivors often suffered from nerve disorders for weeks. Bleeding from the kidney was uncommon, inflammation of the kidney less common.
Conspiracy fantasies were rife in which the opponent of the war had spread the disease. Philipp Doane of the Health and Sanitation Section of the Emergency Fleet Corporation said:
“It would be very easy for German agents to release the pathogen in a theater or other place where many people are gathered. The Germans have started epidemics in Europe. There is no reason why they should be more careful with America. ”
Three waves - heavy, murderous and deadly
In the spring of 1918 the outbreak was mostly mild, and according to media reports, many of the sick in Spain soon recovered. The autumn wave, on the other hand, became murderous. The third wave in 1919, which was perhaps already a post-epidemic, was more deadly than the first, but less deadly than the second.
Foreign media reported that in Spain most of the first wave infected got well. The situation was quite different in autumn: in Prussia and Switzerland, every second citizen fell ill, and in 1919 the effects of the third wave were less severe but still significant.
Domestic workers, Inuit and Maoris
Between August and December 1918, in the second wave, the outbreak and course of the disease were very rapid, and many affected people died after a few hours. Survivors often suffered from chronic fatigue, nerve disorders and depression for weeks. Almost all tuberculosis patients who contracted the flu died of lung failure.
In India, a particularly large number of women died who cared for the sick and suffered from immunodeficiency due to iron deficiency. In Paris, a quarter of the women who died from the flu were domestic workers who lived in overcrowded rooms, had no heating and were malnourished, which also meant a lack of vitamins and minerals. If too little vitamins and minerals are taken in, this leads to a severely weakened immune system. The worst hit were the indigenous people in New Zealand, Samoa and America. The mortality rate among affected Inuit was 25 to 90 percent.
Death in the prime of life
Overall, the influenza pandemic fell victim to many young adults between the ages of 20 and 40 - in contrast to other flu, which is particularly severe or fatal among children and the elderly. Today we know why. Evolutionary biologist Worobey and his team conducted a study to investigate how the H1N1 pathogen mutated in Spanish flu, and compared this with other H1N1 viruses and swine flu.
They found that the Spanish flu developed in the winter of 1917 when a bird flu virus mixed with a human H1 virus. The very old and the very young had been in contact with this H1 type, while people between 20 and 40 had become infected with an H3N8 flu virus as children. You would therefore have had no defense against H1N1.
Therefore, the reason for the deadly effect of the virus was the lack of immune defense, which also explains why so many people suffered from pneumonia. The lack of immunity also explains why Maoris and Inuit died of the disease so often: they had never been exposed to this variant of influenza.
The flu spread rapidly in the mass camps of the soldiers, on the ships, in the slums of Brazil and India, and insufficient hygienic conditions and the lack of medication contributed to their severe course. The reason that it was so deadly, however, was that those affected had not developed any immune bodies against this specific, mutated flu virus.
Pneumonia and bacteria?
Influenza viruses were not discovered until 1933, and many scientists doubted that the outbreaks of 1918-1920 were flu. Since most died of pneumonia and turned dark, some doctors thought the disease was a form of pneumonia. After all, there had been a plague epidemic in Manchuria in 1910.
The plague scientist Anton Ghon traveled to Switzerland and examined the symptoms of the plague that was raging there, and assured that it was not the plague but an unusual form of the flu.
In fact, it was not the flu itself, but pneumonia caused by streptococci, pneumococci and other bacteria as a result of the viral infection that was responsible for the majority of the deaths.
Influenza was also considered a bacterial infection when the Spanish flu broke out. In 1892, during the Russian flu, the doctor Richard Pfeiffer had a bacillus "Haemophilus influenzae“Isolated, who even made it into medical science textbooks. This actually occurred in those who died during the flu pandemic in 1889/90 - but it was not the cause of the disease.
Therapy of the Spanish flu
Spanish flu treatments were inadequate everywhere because there was no vaccination. Doctors used quinine, disinfected the throat with boric acid, prescribed inhalation of oils such as camphor, peppermint or eucalyptus. Others tried massive alcohol consumption. The doctors could only alleviate symptoms.
They used caffeine and digitalis to maintain the heart action of the pulmonary, administered codeine and opium for the cough, and used antipyretic drugs. Aspirin was the number one drug.
A warning of history
The Spanish flu teaches: A flu against which there is no vaccination and against which people have not developed basic immunity is anything but a "normal" disease in winter, which means that we lie in bed with a fever for a few days.
The Spanish flu is not only a lesson in the development of vaccines, but also a warning of medical history. "Ordinary people" often equate influenza with a flu-like infection. It is almost a part of it in autumn and winter and is uncomfortable, but after a few days with fever, headache and bed rest it is over.
The Spanish flu, an "ordinary" flu agent, on the other hand, cost the lives of more people than probably all other epidemics before - except for the bubonic plague of the 14th century.
The Asian flu
The second major flu pandemic of the 20th century struck in 1957/58. A lot had changed in medicine since 1918. Science knew that influenza was caused by viruses and had developed vaccines against the disease. However, this also prevented the global spread of the disease and countless deaths.
In February 1957, new types of influenza were reported in Singapore, and in March 1957, the flu epidemic broke out in Canton in China. In April Hong Kong registered the first influenza patients, hundreds of thousands of them; the epidemic became a pandemic, spreading in Southeast Asia in May, then across Asia, waving to the Middle East, Africa and South America.
2.5 million people with flu were officially registered in Japan, half a million in Singapore and Malaysia, 20 percent of the population in Indonesia, and two million in Formosa. In June 1957 she had reached Germany. Authorities warned against dramatizing the danger - they were soon instructed otherwise.
Smaller outbreaks of epidemics emerged in Holland and England, in the USA, Mexico and the Caribbean. Most of these were clearly related to shipping and flight connections to Asia. The sick with the flu brought the disease to California on the "General Daniel I Sultan" troop carrier, and the first case in Europe was introduced in Rotterdam by passengers of a steamer from Djakarta. As the wave subsided in Asia, it sprayed from smaller herds in Europe.
At the end of May, the WHO declared this new type of influenza a pandemic - a global wave of diseases. Vaccinations in the affected areas were unsuccessful. The pathogen did not respond to conventional vaccinations. The clinical picture was similar to the well-known flu epidemic.
Search for the vaccine
After the discovery, virologists injected the virus into incubated chicken eggs and sent the increased pathogens to 57 research institutes worldwide. The flu was still considered a minor illness, and there was no longer a quarantine for air travelers and seafarers. Some scientists believed that there was no flu season in the summer and that the Singapore virus would not spread all over the country.
Asian flu symptoms
The Asian flu started in healthy people with acute and high fever, headache, limb and muscle pain. Those affected felt very sick and chronically exhausted.
The disease only lasted two to five days. The ring of the throat reddened and the nasal and eye mucous membranes became inflamed. Some sufferers suffered from diarrhea. Pneumonia as a result was far less common than the Spanish flu. At an estimated 0.4 percent of those affected, the death rate was significantly lower than in the 1918 pandemic, but around 20 percent of the world's population fell ill, and the death toll was in the millions.
Who was the causative agent?
The causative agent of the Asian influenza was a previously unknown strain of the influenza A virus, unrelated to the B, C and D strains. Vaccines against virus type A did not help against the new strain, which was now called Virus A Singapore. Very old people had raised antibodies against this strain, so it probably appeared before 1900.
The Dutch professor Mulder therefore came to the conclusion that it was not a new pathogen at all, but that the Singapore virus was identical to the influenza virus that caused the Russian flu in 1889. Today we know that the causative agent of Asian flu originated from recombination, in which a flu virus from humans and one of the group of birds infected the same cell.
Hong Kong flu
The Hong Kong flu was the last major flu pandemic. Around a million people worldwide died from it. Today we know that it came from a combination of avian influenza viruses and human influenza viruses. It formed the H3N2 type of flu that is established today.
The virus spread from Hong Kong to the Philippines, Singapore, Vietnam, India, Australia, Africa, South America and Europe. Soldiers who came from the Vietnam War brought the pathogen to the United States. Worldwide, the death toll peaked in December 1968 and January 1969.
Hong Kong infected 500,000 people, 15 percent of the population. The number of people infected there was so high that hospitals and authorities could do little more than advise the infected people to stay at home and lie in bed. The infrastructure in Hong Kong was badly hit. Two hundred out of three hundred workers from the Hong Kong Telephone Company and China Light and Power fell ill.
The death rate remained lower than that of the Spanish flu, but the pathogen was extremely contagious. Symptoms persisted for up to two weeks, including high fever, muscle aches, chills, and weakness. A vaccine was quickly developed, but in many countries where the pandemic struck, it was only available after it claimed the dead.
Why the Hong Kong flu was far less fatal globally than the Asian flu before was probably due to the basic immunity that had developed against it. The "Hong Kong virus" probably evolved from the Asian flu virus. The Hong Kong Influenza A subtype H3N2 presumably originated from an antigen shift in which the surface of the virus changed - towards the new H2 subtype. However, because very many people who were exposed to Asian flu globally in 1957 had developed immune protection against this pathogen, their immune system also withstood the Hong Kong flu to some extent.
Despite around four million people infected in Poland, deaths were not high here - just as little in Bulgaria, Czechoslovakia, Finland, Hungary, the Netherlands, Germany and even Iceland, Sweden and parts of the USSR. The disease was usually mild.
In a second wave there were epidemics in Kenya, Brazil and Ceylon (Sri Lanka), 1969 the flu broke out in March in South Africa, in May in Argentina, Chile, New Zealand and Uruguay. This second wave caused more deaths almost everywhere than the first - until today it is unclear why.
Relatively few people were affected in Japan, it spread widely in the United States, and the death toll was enormous. In contrast to the Spanish flu, most deaths (as is typical for flu) were very old people and children.
The H3N2 virus that triggered the 1968 pandemic is still active and continues to trigger seasonal seasonal flu waves. A similar virus was isolated from pigs in the 1990s. Scientists suspect that the human H3N2 virus spread to pigs - not the other way around.
China - the hotbed of the flu?
Two of the three largest flu pandemics of the 20th century arose in China, the Asian flu as well as the Hong Kong flu. The authorities and scientists in Hong Kong were expressly praised by the WHO in 1970 because their fast and effective cooperation made it possible to isolate the virus and develop a vaccine.
In 2009, the then boss of the WHO warned of a new flu pandemic. A flu A subtype H1N1 was known to be known from pigs. From April to June, the flu affected 74 countries, in Germany the Robert Koch Institute worried because people in this country had neither been vaccinated against the new virus nor developed basic immunity.
But it looked worse as the pandemic eventually developed. When the Mexican scientists first assumed a death rate of 27 percent, it quickly became apparent that the mortality rate was actually less than 1 percent. In Germany there were around 350 deaths from "swine flu", while the normal flu waves claim up to 20,000 deaths per year.
In the end, the number of deaths worldwide was around 18,000, which is why it is controversial in science to call swine flu a pandemic. WHO was particularly accused on social media of having spread panic and a strange definition of pandemic.
The swine flu virus has lost its horror and is one of the annual seasonal flu viruses. The then WHO chief Briand, on the other hand, justified mass vaccinations at the beginning of the swine flu outbreak by saying that nobody could have assessed whether it would not develop much worse.
After the pandemic is before the pandemic
In addition, she warned not to underestimate the risk of a pandemic - in words that came true in February 2020: “It is not a question of“ whether ”but“ when ”a new pandemic is coming.” The WHO appointed the Global Preparedness Monitoring Board , an expert commission of 15 scientists who analyzed the dangers of a pandemic. In September 2019, they warned that the countries of the world and global organizations were insufficiently prepared for a global epidemic.
Not flu, but corona
A pandemic flu virus could spread around the world in 36 hours and kill up to 80 million people. There would be panic, the economy of the nation-states would collapse just like national security. The governments concluded that the governments were not prepared for such a catastrophe.
Half a year later the pandemic is there, not a flu virus but a corona virus, and unfortunately it becomes clear that the scientists are right: there is hardly a country that is able to respond appropriately to the disaster. (Dr. Utz Anhalt)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
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