A lot has changed since 1918 pandemic

May 09, 2006|by JEFF SEMLER

This year, there will be several recurring themes in my articles. One will be the 150th anniversary of the University of Maryland and the other will be avian influenza.

With the recent announcement by the federal government of its strategy to handle a potential outbreak, it seems appropriate to revisit the topic of avian influenza.

I want to make one thing perfectly clear: No outbreak of avian influenza should be taken lightly.

However, we need to remember the facts. To date, H5N1, the disease strain in question, has only been passed from birds to humans.

The fear is that the virus might mutate into a form that can be transmitted from human to human.

Influenza pandemics strike every few decades when a never-before-seen strain arises. Some of us can remember the Swine Flu threat of 1976, which confirms it is impossible to predict if and when the next will occur.


Frances Townsend, President Bush's White House homeland security adviser, said recently, "I should make clear from the outset that we do not know if the bird virus we are seeing overseas will ever become ... a pandemic."

The 1918 Spanish Flu pandemic is often pointed to as the harbinger of what the current strain could become.

There are a lot of differences between the world today and the world in 1918. World War I was ending and thousands of people were traveling the globe, returning home not knowing if they were infected.

Russia was in the throes of the Bolshevik Revolution.

It was described as, industry and agriculture was crippled, and the distribution of essentials was near breakdown. Famine was raging. Sanitation was nonexistent. Most of Europe and much of the world could be similarly described.

Medicine has also made great strides in the last century.

Just a few examples are vaccines for such diseases as yellow fever, typhus, tetanus, diphtheria, tuberculosis, whooping cough, polio, influenza, measles, chicken pox, mumps, meningitis, rubella and hepatitis. Additionally, antibiotics such as penicillin and streptomycin have been discovered.

Another change is the manner in which we raise poultry.

Birds today are raised in a controlled environment. These environments are well ventilated and exclude contact with wild migratory fowl that are suspected to be carriers of these viruses.

Human contact is also limited. Only the farmer interacts with birds on his farms. Any persons entering the farm wear protective clothing before entering the poultry houses.

So what should you do?

My best advice was summed up by Health and Human Services Secretary Michael Leavitt, who said, "We do not know if the H5N1 virus will be the spark of the next pandemic, we do know that it is spreading across the world on the backs of wild birds. And at some point in the near future we can expect it to come to the United States. That will not be a crisis. It will only become crisis if in fact it begins to transmit between people. Will that happen? We do not know but the warning signs are there and we need to be prepared."

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