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Archives of Universal History / Getty Images
A warehouse used as a makeshift hospital for influenza patients in 1918
It has been 100 years since the influenza pandemic killed millions of people around the world, a much worse record than bubonic plague. But what is the probability that something similar will happen again? New strains of influenza continue to emerge and experts warn that another pandemic could occur despite a century of technological advances and health care.
During the outbreak of 1918-19, it was thought that the Spanish flu was caused by a bacterium rather than a virus. Viruses are now better understood, but scientists have also learned a lot from the study of the pandemic that raged a century ago.
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Scientific photo library
Color transmission electron micrograph of strain H5N1
They learned how it could behave differently from our usual experience with seasonal flu. It has proportionately affected more younger and healthier adults. Experts believe that older people infected with Spanish flu may have already encountered a similar strain and are therefore immune.
Dr. Niall Johnson, who published a study on the 1918-19 pandemic, said the medical profession knew infectious diseases a century ago, but not on this scale.
"A large number of medical memories mention the pandemic and often say that it was not the presentation of the disease that was unusual, but the huge volume of cases – and the little that they could offer people, "he said. -he declares.
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Wellcome Collection
Drawings of 1918 by John George Adami of (right) the trachea showing the earliest stage of the flu reaction and (left) the main bronchus of a set of lungs
Dr. Jonathan D Quick is an epidemic expert around the world and works to help nations better prepare themselves.
"With some influenza viruses – that was true in 1918 and 2009 – one of the things that's happening is that the way that flu kills, it's not the flu itself." ", did he declare. "That's what it does to your lungs, it kind of melts and then you have bacterial pneumonia … that will kill you.
"They did not have antibiotics so they died faster. But the other thing that happens, especially to young people who have a good immune system, is that your body reacts excessively. It ends up filling your lungs with fluid. Many of these deaths were not due to bacterial complications, but to an explosion of the immune system. "
Dr. Johnson says that the impact of the new viruses today will vary, for several reasons. These include vaccines that may confer some immunity, antiviral drugs, better hygiene, and antimicrobials that treat infections such as pneumonia, which contributed significantly to the 1918-19 mortality rate.
"So, yes, I think we're better off than in 1918, but the potential for a pandemic to become a global infection that sickens the majority of the world's population and kills a significant number is still the."
Dr. Quick thinks that such a scenario is not inevitable if we do more to make the world safer and more prepared.
"One of the most important things is to invest in the so-called universal flu vaccine," he said, a vaccine that works against all strains of the virus by targeting the part of the virus that does not do not change.
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The UK government establishes a national official risk register, which states that no country is immune to infectious diseases from another part of the world. He believes that in case of pandemic flu:
- Up to half of the British population might have symptoms
- This could potentially result in between 20,000 and 750,000 deaths and a high absence rate from work.
Mr Quick believes that the UK is the only country to report risks in this way.
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But overall, are we still complacent?
"Absolutely," he says. "I think we are just as vulnerable today to pandemic influenza as in 1918, but for different reasons – we are four times more populated today, we are twice as urbanized and this overpopulation has been a determining factor in recent Ebola outbreaks, and is a factor of influenza.
"We are 50 times more mobile – so we are in the air, crossing borders, there is no place on the planet more than 24 to 36 hours away from any big city."
He says the flu is delicate, a virus that continues to mutate and exchange genes.
"With all these risk factors at stake, we could have an epidemic with a new virus that has mutated and for which we do not have immunity," he says.
"We could have an epidemic that could kill between 200 and 400 m in a few years and hurt the global economy as badly as the Great Recession."
The experiment followed the movements and interactions of people to predict how a pandemic could spread
Predict the trajectory of a pandemic
The BBC Four Pandemic experiment, conducted with mathematicians from the University of Cambridge, involved nearly 29,000 people downloading an app to track their movements and social interactions and predict how a pandemic might spread.
Their modeling predicts that:
- In the United Kingdom, 43.3 million people could contract influenza in the event of a pandemic, in the worst case
- This worst case could mean 886,877 deaths in 248 days.
- The virus could spread more slowly and affect only three-quarters of the estimated population if a regular handwashing regime was used.
Dr. Meirion Evans, a recently retired consulting epidemiologist at Public Health Wales, says the key is vigilance and data sharing, underpinned by a global surveillance system coordinated by the World Health Organization (WHO).
"A global virology network is linked to this network … in the event of an incident, the local specialized laboratory will isolate, identify and type these viruses to determine whether it is an incident." novelty or not, to which virus is it linked? " he said.
Technology could also help. Mr. Quick mentions the Web Crawl created by Public Health Canada, which has collected news of the SARS outbreak as it has manifested itself in China.
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Wellcome Library
Archive advertisements associated with flu and cures
We have come a long way since the old newspaper ads, offering miracle cures, stories of old women and mere hope. But there are still lessons to be learned – and we underestimate the flu at our peril.
"If anyone doubts, humanity has not escaped infectious diseases," says Dr. Johnson. "In the mid-twentieth century, some people claimed in a rather Hebrew way that we had conquered infectious diseases. HIV, multidrug-resistant tuberculosis, influenza and Ebola all paid.
"The flu is particularly interesting because of its ability to change and our persistent inability to find vaccines that work against more than specific strains."
It is impossible to say when the next flu pandemic can occur – in 25 years or next year.
Although this is rare, Dr. Quick says that in the meantime, we must be ready at the highest level.
"Leaders need to be vigilant and be willing to open their eyes – because delays are fatal – we must react to the immediate outbreak, and then keep the promises of investing in the prevention of the next epidemic. That's what leadership is ".
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