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"Influenza cases are increasing." "The flu has made ten new victims since the last issue." "Teachers and students take their exams at the university hospital."
These are some of the titles published in the Daily Iowan, The journal led by the University of Iowa students in 1918, when the Spanish flu claimed the lives of 38 students and professors.
In the fall of 1918, when the first cases of influenza were confirmed on campus, the then president, Walter A. Jessup, wrote an editorial on the front page of the newspaper. DI Urge students and teachers to "cooperate to fight the flu". When a group of army trainees at the IU fell ill with the flu, the group was quarantined. "They will be confined to the campus and their barracks … to prevent any communicable disease," according to an article dated October 3, 1918. DI. "People with the epidemic are being treated in an isolated ward of the hospital."
Today, a century later, experts at the Public Health Laboratory at the University of Iowa are using advanced scientific technologies to quickly and accurately identify various infectious diseases, including influenza. Laboratory microbiologists and molecular scientists were among the first in the country to successfully detect the deadly H1N1 swine flu virus in 2009 and also created a new test to detect mumps in 2006, when this virus affected nearly 1,500 Iowans.
"The public health laboratory has a long tradition of service in Iowa," says Michael Pentella, clinical microbiologist and director of the Public Hygiene Laboratory. "Too often, because our work is largely outsourced to other government agencies, the public is unaware of the contribution of the University of Iowa. But our work involves an extraordinary level of expertise and innovation, a work that protects the health and well-being of Iowans every day of the year. "
An influenza epidemic unlike any other
While the flu was spreading to Iowa in 1918, health officials asked locals to stay away from large crowds and place water bins on radiators at the same time. house to keep the air moist inside. They could do nothing else to fight the disease; the influenza virus had not yet been identified and a vaccine against this virus would still be used in decades. By the end of the epidemic, in early 1919, more than 7,000 Iowans and about 20 million people died worldwide.
"The 1918 flu epidemic was interesting because it was an extremely pathogenic virus that had killed most young people while they were in the force of life," says Pentella. "Today, it is generally the elderly and very young people who we believe will die of the flu, but this epidemic strikes people aged 20 to 30 years and life expectancy is in free fall." worldwide, because of the number of deaths. "
The doctors were confused by the disease. City officials across the state have ordered the closure of theaters, cinemas, billiard halls and ice rinks. Outdoor sports facilities have been closed or completely closed, according to the article "Epidemic: Iowa Fights the Spanish Flu". by the Iowa State Historical Society in 1981. A football game between UI and Coe College in Cedar Rapids, Iowa, was closed to the public for fear of spreading the disease. It was played in an almost empty stadium where only the members of the Iowa School of Education present.
On the UI campus, students were encouraged to cover their mouths with a tissue when they sneeze or cough, and some faculty meetings were canceled, according to local newspapers. Blanket and bedding donations were requested by Army Quarantine students. Nursing students were invited to attend the University Hospital to care for the sick. the DI regularly reports on the deaths of students, alumni and teachers, often due to pneumonia caused by influenza.
Pentella has been appointed Director of the State's Laboratory of Hygiene in 2018, at the heart of one of the worst influenza seasons of recent history. During the 2017-2018 influenza season, 270 Iowans died, double the total of the previous year. In anticipation of the 2018-2019 influenza season, Pentella and her staff have recently issued guidelines on influenza surveillance testing and are encouraging Iowa residents to get vaccinated.
"The state's sanitation lab is working with the Iowa Department of Public Health to conduct surveillance activities," says Pentella. "Our specific role is laboratory surveillance, where we test the flu virus. If we detect it, we determine the subtype and influenza strain infecting the patient. "
Life Insurance Influenza Research Saves Lives
The association has several important links to the 1918 influenza epidemic. In 1931, Richard Shope, a native of Iowa and a graduate of Roy J. University, and Lucille A. Carver School of Medicine, discovered a swine flu very close to the human being. influenza virus. A few years later, in 1936, a group of British scientists, with the help of Shope, identified this virus as being remotely related to the one that caused the 1918 influenza epidemic.
Another UI graduate, Johan Hultin, studied the cause of the 1918 Spanish flu epidemic as a microbiology graduate student in the 1950s while attempting to isolate the virus from native Alaskan bodies. buried in the permafrost. Although initially unsuccessful, Hultin returned to Alaska four decades later and, using advanced scientific techniques, was able to characterize the genome of the influenza virus. As a result, scientists have since been able to develop vaccines in the event of another pandemic linked to the Spanish flu of 1918.
"If you look back in 1918, when they saw all these fatalities for the first time, they did not even know what the causal agent was, because microbiology was still in its infancy," says Pentella. "They were trying to figure out the cause, and to do that, they were taking samples from patients and then trying to grow the organism that was causing them. They developed a bacterium, and they thought it was the cause of the flu, but now we know that it was only a pathogen secondary to the flu that was suffering people. "
In addition to his work in the public health laboratory, Pentella also teaches the epidemiology of infectious diseases at the IU College of Public Health, where he brings his experience of managing viruses in the classroom. Pentella co-teaches the course with Christine Petersen, Associate Professor and Director of the UI's Center for Emerging Infectious Diseases. Petersen says he appreciates the close connection between the laboratory and the college, which promotes exciting research topics.
"Currently, researchers are studying the body's immune response to influenza, as well as the link between fever and the onset of the flu," she says. "There is even research on a possible link between floods and flu. It is essential that we better understand the flu virus, because the flu can be deadly. "
An influenza vaccine and peace of mind
Since the 1918 outbreak, the way in which microbiologists study the influenza virus and the way health professionals are fighting it has changed a lot, including the creation of an influenza vaccine in the early 1980s. 1940 and the use of extensive public health campaigns to encourage vaccination.
"The best way to avoid getting the flu is to get vaccinated," says Jorge Salinas, an epidemiologist for the Unemployment Insurance Hospitals. And Clinics and Assistant Professor of Internal Medicine and Infectious Diseases. "And you need to be vaccinated every year, because new research shows that receiving the vaccine every year gives you even more protection."
According to Salinas, influenza virus strains fought by influenza vaccines change from year to year. Some strains have been selected by experts from the Centers for Disease Control (CDC) and the World Health Organization (WHO). "They are assessing trends in viral infections in the US and around the world and are trying to predict the types of flu that are most likely to circulate during the next influenza season," says Salinas.
In 1918, without these surveillance capabilities, public health officials were at a disadvantage, says Salinas. In addition, the influenza virus that circulated in 1918 was probably a stump that most people had never encountered; their bodies were therefore less able to fight him.
"From time to time, a new type of flu emerges and these types of flu tend to have an even higher death rate, and they can sometimes lead to pandemics," says Salinas. The 2009 swine flu is one example, he added.
A laboratory dedicated to public safety
Today, the Public Health Laboratory collects and studies samples of the flu virus all year round, says Pentella. The laboratory uses a range of polymerase chain reaction (PCR) assays to identify infectious diseases. These tests detect selected regions of nucleic acids that are unique to specific pathogens. PCR tests are more reliable than traditional methods and much faster, providing results in just a few hours.
"When the first cases of flu appear, we ask doctors and labs to send us samples and we test them to determine what type of flu makes people sick," says Pentella. "Then the sample will be further characterized with respect to its similarity or difference to the strain contained in the current vaccine."
The state's health laboratory shares information on local flu cases with the CDC so that experts can continue to monitor mutations of the influenza virus around the world.
"We're dedicated to detection and surveillance, and I think it's important work because we find out what influenza viruses are spreading to communities," says Pentella. "Physicians and public health officials can inform the public about health risks. Surveillance is absolutely our first line of defense against an epidemic. "
Pentella says scientists are currently studying the immune response to the flu virus in an effort to develop a universal flu vaccine and that if they do, a better vaccine could be created.
"Some research is on a universal flu vaccine that could last several years," he says. "But it's innovative work, and sometimes we're lucky and it's going very fast, and other times it takes a lot of years."
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