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It was the sickness to put an end to all the others, to infect a third of humanity, to kill tens of millions of people in their bed and to create panic over the end of days on continents still under the shock of war .
One hundred years after the Spanish flu epidemic known as the Spanish flu, scientists say that, while lessons have been drawn from the deadliest pandemic in history, the world is ill prepared for the next world murderer.
In particular, they warn that demographic changes, antibiotic resistance and climate change could all complicate any future epidemic.
"We are now facing new challenges, including the aging of the population, people suffering from underlying diseases such as obesity and diabetes," said Monday at AFP Dr. Carolien van Sandt of the University of Melbourne, member of the Peter Doherty Institute for Infection and Immunity.
Scientists predict that the next influenza pandemic – which will likely be a strain of bird flu that infects humans and spreads rapidly around the world through air travel – could kill up to 150 million people.
Van de Sandt and his team looked at a lot of data on the Spanish flu, which ravaged the planet in 1918.
They also studied three other pandemics: the "Asian" flu of 1957, the "Hong Kong" flu of 1968 and the outbreak of swine flu of 2009.
They found that although the Spanish flu infected one in three, many patients managed to survive a serious infection and others had only mild symptoms.
Unlike most countries that used wartime censorship to prevent the spread of the virus, Spain remained neutral during the First World War. Many reports of the disease in the Spanish media have led many to assume that the disease was native to this city and that his name was engraved.
It is now widely accepted that the 1918 influenza strain was in fact provoked by American soldiers and killed a disproportionate number of soldiers and young people, but researchers said the situation would be different this time around.
In 1918, in a world grappling with the economic consequences of the world war, the virus was made more deadly because of the high rate of malnutrition.
The team behind a new study, published in Frontiers in Microbiology's Cellular and Infection Microbiology, said the next epidemic would spread in the developed world within a population struggling with record rates of # 1. 39, obesity and diabetes.
– & # 39; Double burden & # 39; –
"What we know about the 2009 pandemic is that people with certain diseases (such as obesity and diabetes) were much more likely to be hospitalized because of influenza." said Kirsty Short, of the University's School of Chemistry and Biosciences. of Queensland, told AFP.
The team warned that the world was facing a "double burden" of serious diseases due to widespread malnutrition in poor countries – exacerbated by climate change – and over-nutrition in richer countries.
And global warming could have other consequences.
Van de Sandt said that, as many strains of influenza begin in birds, a heating planet could change the place where the next outbreak occurs.
"Climate change could alter bird migration patterns, bringing potentially pandemic viruses to new locations and potentially with more bird species," she said.
The 1918 survey found that older people behaved much better against the viral strain than younger adults.
The team speculated that this was partly due to the fact that the elderly had acquired some immunity in previous infections.
Most of those killed in 1918 – about 50 million people, or 2.5% of those infected – died as a result of secondary bacterial infections, which antibiotics helped relieve in subsequent pandemics.
But today, many bacteria are immune to antibiotics.
"This increases the risk that people will experience secondary bacterial infections and die in the next pandemic," said Katherine Kedzierska of the Doherty Institute in Melbourne.
The authors were particularly alarmed by the H7N9 avian virus, a virus that kills about 40% of the people it infects, even though it can not currently switch from human to human.
"At the moment, none of these viruses have acquired the ability to spread among humans, but we know that the virus needs only a few minor modifications to get there and could create a new pandemic of flu, "said van de Sandt.
– & # 39; Inform the public & # 39; –
While the world in 2018, with its more than seven billion people, its megacities and air travel around the world, is hardly recognizable for a century, the team insists that the Spanish flu can give many lessons to governments today.
By nature, strains of the pandemic virus are unpredictable – if the authorities knew for sure that the flu would spread, they could invest in a widely available vaccine.
While waiting for a universal vaccine to be created, "governments must inform the public what to expect and how to act in the event of a pandemic," van de Sandt said.
According to this study, governments could use the power of Internet communication to raise awareness and give instructions in case of a new pandemic.
"One of the important lessons learned from the 1918 influenza pandemic is that a well-prepared public response can save many lives," van de Sandt said.
Scientists have been particularly alarmed by the H7N9 avian virus – a virus that kills about 40% of the people it infects, even though it can not currently switch from human to human.
A century after the outbreak of influenza known as the Spanish flu, scientists say that, if the lessons were drawn from the deadliest pandemic in history, the world is poorly prepared for the next world murderer.
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