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A mild first wave of flu pandemic could reduce deaths from a future outbreak of more severe infection, a new analysis suggests.

A review of the effects of the 1918 flu pandemic on American soldiers and British sailors and civilians found that people who were infected during the first, milder spring and summer wave had a 35 percent to 94 percent lower risk of catching the more severe strain than those who weren't infected earlier. The higher end of that continuum is similar to the 70 percent to 90 percent protection offered by vaccines.

Their risk of death also was 56 percent to 89 percent lower, according to an analysis published in the Journal of Infectious Diseases. Scientists from the National Institutes of Health, George Washington University and Tulane and Xavier Universities in Louisiana conducted the analysis.

"You wouldn’t want to eradicate this wave because it probably provided protection," says study author Lone Sinonsen, a visiting professor of global health at George Washington University School of Public Health and Health Services.

Still, it may be difficult to apply that conclusion in another pandemic, she says.

"You have to judge how severe [a disease outbreak] is before deciding whether to close schools and movie theaters and suffer the consequences of all that," Simonsen says. "It's going to be very hard to judge that in real time."

Richard Hatchett, associate director of emergency preparedness at the National Institute of Allergy and Infectious Diseases (NIAID), agreed.

"I'm not sure there is any direct application of the results of this paper to current pandemic planning," Hatchett told the University of Minnesota's CIDRAP News.

The Department of Health and Human Services calls for isolation of patients and voluntary quarantining of family members, as well as closing schools, depending on how severe a flu outbreak is. "I think their [the study authors'] recommendation of not implementing aggressive nonpharmaceutical interventions in a mild pandemic is in line with what the government is currently recommending," Hatchett told CIDRAP.

(CDC microbiologist Terrence Tumpey examines a reconstructed 1918 pandemic influenza virus/Public Health Image Library)

2 Comments

1. 1. Lisa P 01:03 AM 11/13/08

   Now that fall is here, let me remind that fall brings one of the most dangerous things you ever have heard of: flu season. The influenza virus is one of the most dangerous diseases that have ever plagued this earth, and the death toll from it has, according to most estimates, already eclipsed the Bubonic Plague. The death toll from the post World War 1 epidemic was over the dozens of millions. Yearly, the United States records almost a quarter of a million hospitalized from it, and over 36,000 deaths as a result of the influenza virus. The easiest way to prevent infection is to wash your hands. Doctors, experts and the CDC recommend getting an annual flu shot. Prevention and treatment can be expensive, especially for larger families. A vaccination for mom, dad, and three or more children at $20 - $30 per shot will get expensive, fast. A hospital visit could be even more expensive. If you dont think you can cover these sorts of things, a payday cash loan could be the best medicine. Remember to wash your hands, get yourself and your children vaccinated, and stay healthy.
   Click to read more on <a title="Personal Loans" href="http://personalmoneystore.com/moneyblog/what-are-personal-loans/i-rocked-out-with-a-payday-cash-loan/">Personal Loans</a>
   

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2. 2. debcamie 07:15 PM 11/28/08

   I agree that the flu virus severely affects some individuals; however, I repeatedly read information that it was the flu virus that killed millions of people during the 1918 pandemic. There is historic and current research to show that it was a secondary bacterial infection that usually claimed the lives of the victims. Autopsies completed on the bodies of soldiers by Dr. Victor Vaughn at Camp Devon revealed swollen and fluid filled lungs (Secrets of the Dead PBS). A report by Dr. S. W. Patterson in 1920 publication of the Medical Journal of Australia revealed hemorrhages, wide spread toxemia, evidence of tuberculosis, bronchial pneumonia, severe bronchitis, and emphysema. He isolated Pnuemococcus, Streptococcus, Staphylococcus, and B. Influenzae (Medical Front WWI). The article Predominant Role of Bacterial Pneumonia as a Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness, published in The Journal of Infectious Diseases, reported evidence of bacterial pneumonia cultured from preserved tissue samples of 1918 pandemic influenza victims (Morens, Taubenberger, and Fauci). A flu vaccination may have alleviated the severity of symptoms but would not have been able to prevent the bacterial infections. Voluntary quarantine along with hand washing, antibiotics and system supports such as oxygen all play roles in the reduction of high mortality rates such as seen during The Great Pandemic.
   
   Sources:
   
   Morens, M. David, Jeffery K. Taubenberger, and Anthony S. Fauci.
   Predominant Role of Bacterial Pneumonia as a Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness. The Journal of Infectious Diseases. 198 (2008): 962-970. 1 Nov. 2008
   <http://www.journals.uchicago.edu/doi/full/10.1086/591708?prevSearch=bacteria+and+t he+1918+pandemic>
   
   Patterson S. W., M.D. The Pathology of the Influenza in France.
   The Medical Journal of Australia 1 (1920) 10. Medical Front WW1. United States History. University of Kansas. 15 May 2006. 11 Oct. 2008
   < http://www.vlib.us/medical/mja.htm>
   
   Secrets of the Dead-Killer Flu. Background. PBS. Thirteen/WNET, New York. 3 March 2004. 30 Oct. 2008
   <http://www.pbs.org/wnet/secrets/previous_seasons/case_killerflu/index.html
   

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