From Flu Wiki 2

Forum: Mild Pandemics

04 September 2006

anonymous – at 11:06

Tom DVM – at 10:23 (News Reports for Sept 4)

I would have put this post into a new thread topic but I am not very good with computers so I will put it here instead and if someone feels it is important enough for a general discussion then they can put it up as a new thread topic. Thanks.

I have been trying to read The Great Influenza by John M. Barry. On page 216 last night, I came across a ‘funny’ piece of information.

“During and after the 1889–90 influenza pandemic-with the exception of 1918–19, the most severe influenza pandemic in the last three centuries-he (Dr. Richard Pfeiffer) had searched for the cause.”

This statement was a two by four up the side of my head…

…because in his May 2005 article in the New England Journal of Medicine, Dr. Osterholm stated that the 1918 pandemic should not be considered an outlier or a fluke because the pandemic of 1830–32 had been as bad or worse than 1918…

…If the above statement is factual then we may have to change our whole mindset about the inherent virulence of influenza pandemics…

…the 1957 and 1968 pandemics may indeed be the exception rather than the rule…and the norm is high virulence pandemics rather than mild pandemics…****!!!!!!

Tom DVM – at 11:14

anonymous. Thanks.

Eccles – at 11:20

Tom -

One thing I would like to mention about going too far back in history is that folks often assumed diseases were what they though, based on the presentation. So, if for instance, a disease presented as a major gastorintestinal illness, I suspect that it would have been called Cholera. On the other hand, we are learning that influenza can present in numerous ways, including some that aren’t normally ascribed to flu.

With that in mind, I point your attention to this site:

1832 Cholera Epidemic

I sugest you look through it, especially the timeline of epidemics the author presents, and see whether some of what has been ascribed to other causes may actually also be pointers to pandemic influenza.

As you know, I’m not a “Med Head”, so I would appreciate feedback from someone more knowledgeable than myself

Tom DVM – at 11:24

Eccles. I agree…a good dose of skepticism is always a good thing…

…but from my reading of John Barry, it appears the scientists were quite sophisticated and more importantly…

…I trust Dr. Osterholm as a source and I am quite sure that if he said the 1983 oubreak was influenza in a ‘peer reviewed’ medical journal of the stature of the New England Journal of Medicine…then I assume he will be right.

Tom DVM – at 11:25

Sorry, should have been 1830 outbreak…it is amazing how easy mistakes can be seen right after hitting the post button…oh well!!

Anon_451 – at 11:27

Eccles – at 11:20 You have said something that I have been thinking about for a while. I think we need History lover and a few others in here on this one. Through out history, wars have ended, civilizatons have fallen and times have gotten really tough all due to “The Plague”. We wost likely could never prove it, but I have been wounder how many of “The Plague” out breaks in history were really influenza, and not the plague.

That would shead a whole new light on the threat and effects.

Eccles – at 11:30

Tom- What I was gettng at was the other way ‘round. I note in the site I referenced a description by Heinrich Heine of the Cholera Epidemic of Paris (1832):

On March 29th, the night of mi-careme, a masked ball was in progress, the chabut in full swing. Suddenly, the gayest of the harlequins collapsed, cold in the limbs, and, underneath his mask, ‘violet-blue’ in the face. Laughter died out, dancing ceased, and in a short while carriage-loads of people were hurried from the redoute to the Hotel Dieu to die, and to prevent a panic among the patients, were thrust into rude graves in their dominoes. Soon the public halls were filled with dead bodies, sewed in sacks for want of coffins. Long lines of hearses stood en queue outside Pere Lachaise. Everybody wore flannel bandages. The rich gathered up their belongings and fled the town. Over 120,000 passports were issued at the Hotel de Ville.

While I’m no medical expert, the collapsing victim cited sounds, to me, more like a 1918 style influenza. Wouldn’t cholera have resulted in violent nausea and diarrhea, not suddenly collapsing dead with a blue face?

Tom DVM – at 11:32

anon 451. I am not sure if you were with us in the winter or not but Clark from New Zealand is our resident expert on plagues and influenza. I believe he has decided to take some time off form flu wiki but when he comes back…grab him and get his opinion.

I agree with you on the importance of these questions and I would welcome the input of History Lover…but it becoming very clear that either John Barry made a mistake or we have to correct our thinking on some things…I am sure Dr. Osterholms and his peer reviewers are not wrong about 1980.

Maybe Dem or annon or Melanie can put the exact quote from the May 2005 article about 1830 on this thread. Thanks.

anonymous – at 12:00

according to
http://www.andypryke.com/pub/InfluenzaPandemic
there were only about 1 million deaths in the 1830 pandemic. Maybe Osterholm had meant USA-only or such, I don’t know. But I did observe Osterholm earlier of manipulating the wording to support his claims. He also sticks on this “not if but when”, probably meaning _any_ pandemic but apparantly enjoying the audience thinking he meant H5N1.

anon_22 – at 12:30

Tom DVM,

Slightly off topic.

If you want to start a new thread, go look up the side bar, click on Discussion Forum. On that page, you will see a box that says (inside the box) create new topic, and a box that says ‘Go’.

Click inside the ‘create new topic’ box, NOT the ‘Go’ box. You will find the content of that box miraculously emptying so you can enter the title of the new thread that you want to start.

AFTER you’ve entered the title, then click Go. You will find yourself looking at a very familiar page like this current one except no one else has posted anything yet and you’re the first one!

Then write your (virgin) post and off you go….

anon_22 – at 12:38

Again slightly off topic, on the subject of the 1889 pandemic, we now have indications that it was an H3 virus, but one which is significantly different from the current circulating H3N2. This is from the work of Taubenberger at NIH who is currently trying to sequence fragments from autopsy samples pre-1918. Last I heard, they found several tissue samples with fragments of which at least 3 are clearly identifiable as H3.

Seeing as there are at least 16 HA subtypes, but only H1 H2 and H3 have infected humans in the last 100+ years, is there any reason why certain subtypes are more likely to infect humans than others? That’s a question that I would like an answer to, among many.

And if an H3 virus was the circulating human strain preceding the pandemic of 1918, just like today, is that a coincidence or is there anything significant about that?

Sure would like to have JKT’s answer or hypothesis about that…..

Tom DVM – at 13:11

anon 22 Thanks. I clicked the go box and wasn’t sure after that. /:0)

Leo7 – at 13:12

Eccles at 11;20:

Thanks for the link. It’s difficult for me to believe a man with cholera could dance all night. The diarrhea is crippling. I think it’s safe to say there is and was a lot of misdiagnosis. Think Chinese soldier diagnosed with SARS instead of H5N1. My personal thoughts are epidemics be they viral or bacterial seem to have combination kick off events in the old days. Now we have antibiotics so it’s only the viral epidemics to worry about, x out the ones covered by effective vaccines and what remains are what I think of as super bugs, HIV, Hep C, MRSA. As soon as we invent a vaccine or medication there is mutation. I don’t think there will ever be a disease free society.

anon_22 – at 13:13

If you click the Go box before you enter the title of your thread, you will have created a new thread called ‘Create New Topic’.

Which is fine. We’ve all done that before.

Just yell for a mod and we will delete it.

LOL

Tom DVM – at 13:14

gs Thanks.

annon 22. Would you by any chance, have the article of Dr. Osterholm’s from the May 2005 NEJM. If so, could you insert the quote. I might have it somewhere and will look for it also. Thanks.

anon_22 – at 13:20

“An influenza pandemic has always been a great global infectious-disease threat. There have been 10 pandemics of influenza A in the past 300 years. A recent analysis showed that the pandemic of 1918 and 1919 killed 50 million to 100 million people, 1 and although its severity is often considered anomalous, the pandemic of 1830 through 1832 was similarly severe — it simply occurred when the world’s population was smaller. Today, with a world population of 6.5 billion — more than three times that in 1918 — even a relatively “mild” pandemic could kill many millions of people.”

anon_22 – at 13:21

Was that fast enough service for you? LOL

Tom DVM – at 13:27

“An influenza pandemic has always been a great global infectious-disease threat. There have been 10 pandemics of influenza A in the past 300 years. A recent analysis showed that the pandemic of 1918 and 1919 killed 50 million to 100 million people,1 and although its severity is often considered anomalous, the pandemic of 1830 through 1832 was similarly severe — it simply occurred when the world’s population was smaller. Today, with a world population of 6.5 billion — more than three times that in 1918 — even a relatively “mild” pandemic could kill many millions of people.”

anon 22 I tip my crooked hat to you!! /:0) or is that hair…I’m not sure.

Tom DVM – at 13:28

OOPS!! /:0)

Northstar – at 14:19

Anon 451: Historically, it can be very difficult to determine what a plague actually was because from what I understand, when an illness enters a naive population, it can present with symptoms entirely different from what is usually seen. I belive when smallpox entered the Pacific Islands, it presented more as a tubercular illness — nothing like the skin leisons usually seen. I remember thinking how very strange that was. I checked a few indexes of the books on my shelf for that particular reference but couldn’t find it offhand. I’ll keep looking.

In addition, there are plagues that resemble no other illness - the “Picardy Sweats” is one example. It hit with its own set of distinctive symptoms but then vanished, never to be seen in history again. Nobody knows what it could have been.

I did think, in reading Defoe’s _Journal of a Plague Year_ that they were dealing with more than one illness. One, with the buboes, plainly plague — another with another set of symptoms, infectious from person to person while the first was asymptomatic, and without the typical buboes seen, only damage to internal organs. They also seemed to think that it infected chickens, (!) in fact, one of the tests to see if one had the infection before it became symptomatic was to breathe on a chicken to see if it became ill or died. This second version of “plague” was seen as the deadlier of the two, and death was very quick — people well in the morning dropping dead in the marketplace in the afternoon.

That to me sounded suspiciously like AI.

Another epidemic illness that is currently thought to have been infectious hepatitis is referenced in my old thread: _America’s 90% CFR_ (Or something like that.)

So the upshot is, yes, I think that previous flus could have been “plagues.”

09 November 2006

Closed - Bronco Bill – at 20:33

Closed to maintain Forum speed.

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