linnugripiblog

Here are some of the most obvious changes regarding influenza from 1918 to today:
�� In 1918 there was a world war underway, which created higher-than-normal concentrations
of people in barracks and other assembly places, plus frequent and large-scale movement
of people to places where outbreaks had not occurred, facilitating the transmission of the
virus.
�� In 1918 a high proportion of U.S. medical resources were sent to Europe to serve the war
effort, further tilting the odds in favor of viral transmission in the United States because
medical resources here were unusually scarce.
�� The modern medical community now understands that influenza is a virus and has a better
understanding of how to constrain the spread of viruses.
�� Some of the deaths associated with the 1918 virus were due to bacterial pneumonia and
other conditions that “took advantage” of the weakened immune systems of those infected;
modern antibiotics can fight these secondary infections quite effectively.
�� Although there is no “cure” for influenza, some antiviral drugs (such as Relenza and
Tamiflu) and vaccines have been developed (although testing has not been completed)
that could mitigate the effect of the H5N1 strain; furthermore, the science and technology
necessary to develop vaccines is much more advanced.
�� Detection and confirmation of the presence of a virus is more rapid today; the World Health
Organization has 133 centers in 84 countries to collect and analyze viruses.
�� Through the Internet, television, cell phones and other means of communication, we can
disseminate information about the virus more quickly to more people in more places than
was possible in 1918.
�� We have better, and more specialized, health care facilities and equipment—emergency
rooms, intensive care units, mechanical ventilators, etc.—that can mitigate secondary
effects.
�� Countries are actively taking measures to prevent the virus from spreading, including
destroying diseased birds, vaccinating healthy birds,stockpiling antiviral medicines for
humans, planning quarantine scenarios, and conducting simulated outbreaks to train first
responders and medical professionals.

On the other hand, there are several reasons a new influenza pandemic could be as bad as, or
even worse, today than in 1918:
�� Widespread commercial air travel and extensive shipping of food (especially poultry
products) internationally create many more transmission opportunities and a means for
rapidly spreading contamination and infection.
�� The standard techniques for creating a vaccine for this virus might not work, or might not
work quickly enough (it takes roughly six months using current technology), to produce a
large enough supply early enough to inoculate even the highest risk groups, particularly if
two doses are required for the vaccine to be effective, (recognizing that for a vaccine to
work at all, it must be administered before a patient becomes ill from the virus).
�� The U.S. government’s recently issued pandemic response plan calls for states and
localities to be the main providers of health and other services and to pay for 75 percent of
the cost; many states will be hard pressed to come up with the money or the services
needed.
For antiviral medicines (as opposed to vaccines) to be effective, they must be administered
within 48 hours of exposure to the virus, and must be taken for five days or else they are
ineffective—those infected might not be able to get the medicine quickly enough or obtain
a sufficient supply to maintain the medicine’s effectiveness.
�� As noted earlier, some people in 1918 had a limited immunity to the virus because of
exposure to similar viruses in the several decades that preceded its arrival; that is not the
case today.
�� With the spread of HIV15 and the use of radiation and chemotherapy for cancer treatment,
many people today have compromised immune systems and may be less able to fight off a
virulent influenza strain.
�� The new virus could prove to be much more lethal than any previous virus.