100 years ago this month - the start of the world's deadliest flu epidemic

In March 1918, a cook at Fort Riley in Kansas, USA reported to the infirmary with a 'bad cold'. By noon, 100 men were sick. More than 40 at the camp would die. With America and its allies caught up in the dreadful conflict of the Great War, the authorities tried to keep the news as quiet as possible from the enemy.

But it soon became impossible. For 12 days in May, the British fleet could not take to the sea because 10,000 sailors were ill. The disease appeared to strike with frightening speed. The Times wrote of people being 'perfectly well' at ten o' clock, but 'prostrate' by noon. 

Another odd thing was that unlike most flu epidemics, this one seemed to hit the young and fit harder than the old. More than 30,000 American soldiers would die of the disease, with a top doctor declaring at one point that it was more dangerous to be in a camp in the US than on the front line in France.

Across the world, what became known as 'Spanish flu' is estimated to have claimed about 70 million lives, while the First World War killed perhaps 17 million in all. Famous victims included the painter Egon Schiele, while King George V, the Kaiser, Woodrow Wilson and Walt Disney caught it, but survived.

For the full story, see A Disastrous History of the World.

Mosquitoes strike again - this time it's zika

First there was malaria, then yellow fever, then dengue (see my post of 31 July 2013), then it was chikungunya (see my post of 21 May 2014), now it is zika – all of them spread by mosquitoes. In the case of zika, now moving through Latin America and the Caribbean, it is the same mosquito (see picture) that spreads dengue and yellow fever.

If a pregnant woman is infected with zika, it is believed the virus can cause her baby to have an abnormally small head – a condition known as microcephaly, which is often caused by the failure of the brain to develop at its usual speed. Nearly 4,000 such babies have been born in Brazil since October, and 49 have died.

A number of countries including Colombia, Ecuador, El Salvador and Jamaica, have advised women to delay becoming pregnant until more is known about the disease, which was first identified in Africa in the 1940s. Some believe it was introduced to Brazil during the World Cup in 2014.

There is no known cure for zika, and the only way to prevent it is to avoid being bitten by the mosquitoes that carry it. In Brazil, they are working to clear stagnant water where the insects breed.

AIDS - are we winning the war?

Thirty years ago, I was one of the first foreign television reporters to report on AIDS in Africa. At that time, the disease was a death sentence. There was no effective treatment. But, at a speed that surprised quite a few in the medical profession, effective drugs began to appear, and, though still dangerous, the virus ceased to look all-conquering.

Now the United Nations says life expectancy of those with the HIV virus, which causes AIDS, has grown by 20 years since 2001, thanks to a sharp increase in access to effective drugs, the price of which have fallen dramatically. In 2000, the cost per year was $14,000. Now it is just $100.

In 2000, fewer than 700,000 of those with the virus were getting effective treatment. Now the figure is 15 million. The executive director of the UN’s AIDS programme, Michel Sidibé (pictured), describes this as ‘one of the greatest achievements in the history of global health.’

Not that everything in the garden is rosy. Up to 41.4 million are now infected by the virus, the majority of them in sub-Saharan Africa. So most are not getting access to treatment, and experts warn that if we do not invest more money, deaths will start increasing again. 

Where AIDS began

The origins of the AIDS pandemic have been traced back to 1920s Kinshasa in what is now the Democratic Republic of the Congo, 60 years before the disease first came to international attention. It has now infected nearly 75 million people.

Researchers from Oxford and Leuven used mutations in the virus’s genetic code to discover its roots. It is thought to have originated in chimpanzees before making the jump to humans.

When it arrived in Kinshasa, the city was growing rapidly. Thousands of male labourers had poured in, so that they outnumbered women by two to one. A thriving sex industry developed and medical records show that sexually transmitted disease was widespread.

It seems the virus then travelled via the railway network, and through vaccination campaigns where unsterilised needles were used. The researchers describe the conditions prevailing in 1920’s Kinshasa as a ‘perfect storm’.

Ebola spreads

Mali is the latest West African country to go on alert against the Ebola virus, after three cases were reported close to the border with Guinea where 86 people have died. Another six people have died in Liberia, while Sierra Leone has also reported cases.

Senegal has now closed its border with Guinea, and controls are being imposed on people entering Mali’s capital, Bamako.  The virus first appeared in Guinea's remote south-eastern region of Nzerekore, where most of the deaths have happened, but it was not confirmed as Ebola for six weeks, and it has now reached the capital, Conarky.

This is the first known outbreak of the disease in Guinea. Most recent cases have appeared in Uganda and the Democratic Republic of the Congo, and a sign of the alarm it is causing is that Saudi Arabia has suspended visas for Muslim pilgrims from Guinea and Liberia.

The virus is spread easily and kills 25-90% of those it infects. Just as with AIDS when it first appeared, there is no vaccine and no cure. The deadliest outbreak so far came in Congo (then Zaire) in 1976 (pictured), when 280 people died - about 88% of those infected.

Bird Flu bug spreads person to person

 

Worrying news from China that the new bird flu strain H7N9 has managed to pass from human to human. A 32 year old woman, who had had no contact with birds, died after nursing her father, who was also killed by the disease.

So far there have been 133 cases and 43 deaths from the strain.  Most victims had either had close contact with live poultry or had visited poultry markets. Researchers said there was no evidence of the virus being able to spread easily from person to person, but that there was ‘potential for pandemic spread’.

Dr James Rudge, of the London School of Hygiene and Tropical Medicine, said limited transmission of this kind was not surprising and that it had also been seen with the H5N1 strain which has killed more than 370 people since 2003.  There are worries that the world is due, indeed overdue, for a new pandemic.

The most devastating flu epidemic the world has ever seen came in 1918 when up to 70 million people died, while the ‘Asian flu’ outbreak of 1957 killed up to 4 million. (See also my blogs of 5 Feb; 14, 30 April; 13 May; 6, 11, July; 24 Oct, 13 Dec, 2009 and April 15, 2013.)

Swine flu emergency

The US government has declared swine flu a national emergency. This is essentially an administrative move designed to give the authorities a freer hand in dealing with the disease, but it also reflects the widespread worry that the virus could become a more formidable foe as winter approaches.

More than 1,000 deaths have been linked to the illness in America, while in Britain the figure is 122, with nearly 100 others currently critically ill. Over the last week, the number of cases in the UK almost doubled to 53,000, but earlier estimates that we might start seeing 100,000 new cases a day (see my blog of July 6) have been scaled back dramatically, and the UK authorities are predicting a total of perhaps 1,000 deaths.

The World Health Organisation says that nearly 5,000 people have died from swine flu across the globe, and that there have been more than 400,000 confirmed cases, though it says this is a very considerable underestimate as countries are no longer required to report individual cases.

See also my blogs of Feb 5, May 13, and July 11.

Measles

Measles is on the increase again in Britain – with the number of cases in England and Wales rising from 990 in 2007 to at least 1,348 last year. The Health Protection Agency says the reason is that fewer people had their children vaccinated because of a scare, which most doctors now discount, over the MMR vaccine.

In 2006, a 13 year old boy became the first person to die from the virus in the UK in 14 years, and he had been taking an immunosuppressive drug. Across the world, though, the disease can be deadly and in 2007, the World Health Organisation said it had killed nearly 200,000. That in itself was a huge decrease from the figure for the year 2000 of 750,000.

As Europeans took over the world from the fifteenth century onwards, the measles virus was one of the deadliest weapons they carried with them. It was estimated to have killed two million Mexican Indians in the 1600’s, and it also cut a swath through the North American Indians. In 1847, the victims were the Cayuse Indians who lived in Oregon and Washington, and soon after they were defeated in war and confined to a reservation.

Between 1875 and 1911 three epidemics hit Fiji, after the virus was thought to have been brought to the islands by a leading local dignitary who had been to Australia to discuss handing them over to the British. The first and deadliest outbreak killed perhaps 40,000 out of a population of 150,000. The two later epidemics tended to kill young people who had been born since the previous visitation, and so had not acquired immunity.