32. Sticks & stones may break my bones but ....

Key words: Avian flu, epidemic, pandemic, Bukhara (Russia), Camp Funston (Kansas), flu nomenclature, nomenclature of syphilis.

No.32

Although the Avian flu outbreak on a certain well-known Norfolk turkey farm now seems to have disappeared from the British news headlines scientists are still expecting a flu epidemic or pandemic to affect the human population in due course. “It’s now a matter of when and where it will occur, not if,” they say.

Have noticed too that western governments have begun issuing guidelines to the public and to local authorities about how we should begin to prepare for any such outbreaks now in our country or locality?

“Make sure,” they advise, “that you have a two week supply of water and food at home. During a pandemic, if you cannot get to the shops, or if shops and supermarkets are out of supplies, it will be important for you to have extra supplies on hand. In order to limit the spread of germs and prevent infection teach your children to wash their hands frequently with soap and water and model the correct behaviour. Teach your children to cover coughs and sneezes with tissues, and be sure to model that behaviour. Make sure too that you have the following items on hand for use during what may become an extended period at home (the list includes: dried, canned and frozen foods but it also includes a torch and radio + batteries, a camping stove with bottled gas and a manual tin-opener)”.

Thus, although western governments are obviously trying to avoid causing panic amongst the general public they are nonetheless aware that large swathes of the population could soon become infected, or at least affected. The next influenza pandemic, it seems, is just the next communicable disease challenge that we are going to be faced with.

The first pandemic of 1510 apparently originated from Africa and then spread into Europe, after which the “Asiatic flu” epidemic of 1889-1890 began in Bukhara, Russia in May 1889. It west rapidly spread and hit North America in December 1889, South America in February-April 1890, India in February-March 1890, and Australia finally in the Spring of 1890. This latter pandemic was caused by the H2N8 type virus and it also had an extremely high mortality rate.

Next came the “Spanish flu” outbreak of 1918-1919. This was first identified in March 1918 amongst US troops training at Camp Funston, Kansas and by October 1918 it had spread to become a world-wide pandemic evident on each and every continent. This strain of flu” was particularly virulent and deadly. Fortunately it ended nearly as quickly as it began vanishing completely within 18 months; however within in six months at least 25 million people had died. An estimated 17 million died in India, 500,000 in the United States and 200,000 in the UK.

In passing - did you realise that this particular virus has recently been reconstructed by scientists at the main Centre for Disease Control in the USA who had been studying human remains preserved by the Alaskan permafrost. They identified it as a type of H1N1 virus.

After the Spanish flu tragedy the world health authorities were then faced with the “Asian flu” outbreak of 1957-58. This H2N2 sub-type was first identified in China in late February 1957 and by June 1957 it had spread to the United States, eventually causing about 70,000 deaths there.

Then, most recently the “Hong Kong flu” - so called because it was first detected in Hong Kong - threatened the world during 1968-69, causing approximately 34,000 deaths in the United States alone. This outbreak was caused by the “Influenza A” sub-strain, with these same H3N2 viruses still circulating today.

One further thing which I am sure that you must have noticed is the choice (and sometimes the range too) of names ascribed to these infections by different nations …. because influenza, has, like syphilis, had a good many different names in the past.

Did you know for example that following an outbreak of syphilis in the French army it became known as morbus gallicus (the French disease)? At the same time the Italian Girolamo Fracastoro named it the “Spanish disease” and in turn certain other French doctors called it either "la maladie anglaise" or “the English disease” and also the “Italian disease”. In turn the Russians called it the “Polish disease”, the Tahitians called it the “British disease” and the Turks called it the “Disease of the Christians”.

As far as naming these types of flu is been concerned when large numbers of French soldiers serving in the trenches France in 1918 became ill the soldiers called it the “Spanish flu”, despite the fact that there is no evidence that it originated there, whilst the Spanish called it the “French flu”.

For the moment though the latest strain of flu caused by this worrying new sub-strain, H5N2, is being referred to as Avian or bird flu … or is this just until such time as there is an epidemic in the human community in some very specific geographical location ?

However, one thing is certain. No matter how the crisis evolves neither patient admission numbers or staff sickness levels at Joyce Green Hospital will be at all affected, will they ?