Health24.com | Could the 1918 Spanish flu kill millions again?

In 1918, an influenza pandemic called the Spanish flu killed millions of people all over the world.

While flu normally targets the young and the elderly, this specific type of flu affected people of all ages – even strong, healthy people in their 20s and 30s.

The first reported case of Spanish flu occurred in March 1918 in Kansas, USA, when a soldier reported flu symptoms. By the end of the week, 500 more people had taken ill.

The flu spread rapidly throughout the rest of the world, including South Africa, where it killed almost half a million people – the fifth highest death toll in the world.

It was called the Spanish flu because of a misunderstanding. As Spain was largely neutral during World War I, they, unlike other war-struck countries, were free to report on the flu. Since other countries were informed about the flu by the Spanish media, they assumed that it had started in Spain.

Could the Spanish flu strike again?

According to Dr Tim Hinchey, a general practitioner and science communicator, influenza is mysterious and ever-changing. We can’t pinpoint how it will mutate. In fact, there are experts who agree that it’s only a matter of time before a flu pandemic strikes again, as the influenza virus constantly mutates and has the capacity to become resistant against antibiotics.

Other researchers say that an influenza outbreak as big as the Spanish flu will not necessarily happen again.

According to a study published in the journal Frontiers of Public Health, it is highly unlikely that an influenza outbreak of such an extent will happen again. The reason: significantly better technology, living conditions and medical facilities than in the 20th century.

Although there is not yet a universal vaccine to prevent all strains of influenza, we are capable of making effective vaccines for a specific influenza strain quite quickly. This factor, coupled with the fact that vaccinations can be distributed more rapidly and widely than 100 years ago, makes it unlikely that we will ever again experience an outbreak of such an extent.

But it doesn’t mean that it’s impossible. Cindy Weston, an assistant professor of nursing at Texas A&M University, says, “After sizable outbreaks, people will respond with large amounts of vaccinations, but they should be getting vaccinated every year to protect those most vulnerable, mainly children and the elderly.”

Annual vaccinations are important to contain future outbreaks. If vaccination rates are low, a potentially deadly flu outbreak could occur, Weston said. Millions of people get the flu every year, leading to hundreds of thousands of hospitalisations and thousands of deaths, according to a previous Health24 article.

What were the symptoms of this deadly flu?

This flu occurred in three waves. The first wave included normal flu-like symptoms such as a runny nose, fever and cough.

The second and third waves of the flu were worse – typical symptoms included a high fever and shivering, followed by often fatal lung complications. Sometimes septicaemia would also be a complication.

Why was this flu so deadly?

According to research conducted by professor Michael Worobey from the University of Arizona’s College of Science, one of the most pressing questions were why this specific strain of flu killed so many young, healthy adults when the young and old are mostly at risk.

They found that a strain of human influenza circulating since 1900 had mutated with a deadly strain of avian flu right before 1918. The human body couldn’t produce enough antibodies against this new, powerful strain, causing devastation and death.

And other flus?

Since 1918, there have been mutations of bird flu and swine flu but the numbers weren’t nearly as high as those of the Spanish flu.

The high pathogenic H5N1 bird flu first infected humans in 1997 in a poultry outbreak in Hong Kong. Since its re-emergence in 2003 and 2004, H5N1 has spread from Asia to Europe and Africa and has become entrenched in poultry in some countries, causing millions of avian infections, several hundred human cases and many human deaths.

H7N9 bird flu, a low pathogenic type, first infected three humans in China in March 2013. It has since infected more than 450 people and killed 175 of them, but no cases of H7N9 infection outside China have been reported to the World Health Organization.

In 2017 there were outbreaks of avian flu in parts of South Africa including Gauteng and Mpumalanga, but these cases were not transmitted to humans. 

Swine flu in humans occurred for the first time in 2009 in Mexico and has spread around the world since. The H1N1 strain is however no longer regarded as serious.

Safeguard yourself against flu 

Although we might not be dealing with a flu pandemic of massive proportion at the moment, it’s still important to protect yourself against the seasonal flu:

  • Get your yearly flu vaccination.
  • Boost your immune system by eating plenty of fruit and vegetables and getting enough sleep.
  • Wash your hands in shared environments such as office spaces.
  • Regularly sanitise your keyboard and cellphone.

Image credit: iStock

Health24.com | Is obesity contagious?

We all know that colds and flu are contagious, but is it possible that we can also “catch” lifestyle diseases like obesity from other people? 

It seems that living in a neighbourhood with a high rate of obesity might raise the odds that you and your children will become plus-sized, too.

Children affected as well

That’s according to a new study involving more than 1 500 US Army families. The researchers say their findings may help explain why high obesity rates in the United States tend to cluster in certain geographic areas.

This kind of problem is not exclusive to the US, and in South Africa excess body weight is an equally big problem. Not only adults are affected as 13% of children are overweight and obese – more than double the global average of 5%.

“Living in a community where obesity is more of the norm than not can influence what is socially acceptable in terms of eating and exercise behaviours and body size,” explained study author Ashlesha Datar.

The findings were published online in the Journal of the American Medical Association.

A phenomenon called “social contagion” may be at work, she said, though the study did not prove a cause-and-effect link. (According to Oxford Reference social contagion is the spread of ideas, attitudes, or behaviour patterns in a group through imitation and conformity.)

Countries with higher obesity rates

The bottom line: “If more people around you are obese, then that may increase your own chances of becoming obese,” said Datar, a senior economist at the University of Southern California Center for Economic and Social Research.

The researchers sifted through 2013–2014 data for about 1 300 parents and 1 100 children. The families were stationed at or near 38 military installations across the United States.

Datar wanted to see if families had higher odds for being overweight or obese when posted in counties with higher rates of obesity.

  • The team first reviewed body mass index (BMI) for family members. BMI is a measure of body fat based on height and weight.
  • They then assessed the “shared environment” in which service families lived, tallying up the number of grocery stores, sports and recreational facilities, etc.
  • The researchers also weighed each community’s overall obesity rate. These ranged from 21% to 38%.

Datar said the analysis confirmed that “military families assigned to installations in counties with higher obesity rates were more likely to be overweight or obese than military families assigned to installations in counties with lower rates of obesity.”

But the opposite also appears true: Relocating to a county with a lower obesity rate reduces a family’s odds of plumping up.

Health, eating and exercise

Datar said the study found no evidence to suggest that “neighbourhood shared environments” – such as access to the same eating and exercise options – were driving obesity rates.

Lona Sandon is an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas.

“It is well known in the behaviour and psychology literature that those around us influence behaviours, values and beliefs,” she said.

“That includes behaviours, values and beliefs related to health, eating and exercise,” Prof Sandon added. “Social acceptability and norms have a lot to do with food and exercise behaviour choices, whether we are aware of it or not.”

Prof Sandon’s advice: “If you want to change your weight, eating and exercise habits, get new friends who are already eating healthier and exercising.”

Image credit: iStock

NEXT ON HEALTH24X

The Real Trick To Aging May Just Be To Ignore It

Ann Brenoff’s “On The Fly” is a column about navigating growing older ― and a few other things.

I spent my 68th birthday on an exam table at the doctor’s office, squinting at my X-rays on the wall and listening to the man in the white jacket talk about why my left knee has betrayed me.

It buckles when I go up and down stairs, yelps loudly when I try to cross my legs, and jolts me awake from a deep sleep if I accidentally shift positions and bump it. The discomfort was enough for me to choose to spend my birthday in the company of the nice knee doctor.

Before my left knee started acting up, I spent a few weeks with my right thumb doing this weird snapping thing. Not really painful, more like a seriously major annoyance for someone who types for a living ― and yes, I still type for a living. And the snapping thumb came on the heels of my big toe joint aching in a way that WebMD was pretty sure could only be gout. It wasn’t. A few months before the non-gout episode, there was a flare-up of my plantar fasciitis ― a foot problem in which every step makes you wish you had a bullet stuffed in your mouth to bite. That one forced me to hang up my hiking boots until the prescription orthotics arrived. I may have proposed marriage to the physical therapist who saw me three times a week and rubbed my feet in all the right places. The man is gifted; I mean it.

So what does this all mean, all these aches and pains and weirdness affecting my body parts? It means that I am getting older. It also means that I might actually meet my medical plan’s deductible this year.

But mostly what it means is that if I want to avoid becoming someone who spends half her week seeing doctors and the other half waiting in line at the pharmacy, I need to get out in front of this. 

I understand that body parts wear out, and my superhero may be Bionic Woman, but that’s about as close as I’ll come to ever being one. I also know that pain is your body’s way of telling you something is wrong. But I’ve come around to believe that the key to successful aging rests in your ability to ignore the creaks in the floorboards.

If you run to the doctor for every twitch or tingle, you will spend (the rest of) your life there. Me? I’d rather keep company with folks less focused on growing old together and more into staying young together. 

So this is my plan: I’m going to will myself to rise above what hurts. I’m putting my mind over my matter. I won’t ignore serious pain ― nor am I suggesting that you do, either ― but I will raise the bar on what constitutes “serious.” 

My first line of defense will be my ice pack and my heating pad. I will continue to walk my dogs, hike my trails, and park the car in the spot farthest from the door to get my daily steps in. I will sing a song in my head to distract myself from any body parts that don’t feel like going along for the ride. I will take stairs, not elevators; I will stand, not sit; I will follow the “use it or lose it” rule whenever and for whatever possible.

It’s not greater longevity that I’m seeking. Frankly, I would rather die than live to be 100, which I suppose is actually what would happen. What I want, though, is to live as fully as I can for as long as I can. But when doing so requires a visit to the nice knee doctor who proclaims it is “time for surgery,” I may just reserve the right to take my ice pack and walk away singing “Have A Little Faith In Me”  on behalf of my knee.