Avian Flu - What we need to know

The politics of pandemics in history

Here is yesterday's feature article from The Boston Globe.  In the nineteenth century, the debate was between "miasmatism" and "contagionism."

How did communities fare in the 1918 pandemic?

"Most communities were woefully unprepared for the health crisis they faced," said Higgins, who is focusing his research efforts on the ability of Pennsylvania cities to respond. "Those cities that passed muster, relatively speaking, had been building a strong medical infrastructure for decades, and had sound public health policies based more upon science than politics.  I'm not sure that's the case today."

Wise words, read more here.

The 1918 pandemic was avian flu

Two teams of federal and university scientists announced today that they had resurrected the 1918 influenza virus, the cause of one of history's most deadly epidemics, and had found that unlike the viruses that caused more recent flu pandemics of 1957 and 1968, the 1918 virus was actually a bird flu that jumped directly to humans.

The work, being published in the journals Nature and Science, involved getting the complete genetic sequence of the 1918 virus, using techniques of molecular biology to synthesize it, and then using it to infect mice and human lung cells in a specially equipped, secure lab at the Centers for Disease Control and Prevention in Atlanta.

The findings, the scientists say, reveal a small number of genetic changes that may explain why the virus was so lethal. The work also confirms the legitimacy of worries about the bird flu viruses that are now emerging in Asia.

The new studies find that today's bird flu viruses share some of the crucial genetic changes that occurred in the 1918 flu. The scientists suspect that with the 1918 flu, changes in just 25 to 30 out of about 4,400 amino acids in the viral proteins turned the virus into a killer. The bird flus, known as H5N1 viruses, have a few, but not all of those changes.

Here is the full story, which contains many other points of interest.  Today I started writing my piece on what we should do about avian flu.

How long do the negative consequences of flu epidemics last?

There has been a recent study of the 1918-1919 flu.  It turns out that the pandemic affected health outcomes for many decades to follow.  Here is the abstract:

In the 1960-1980 Decennial U.S. Census data, cohorts in utero during the height of the Pandemic typically display reduced educational attainment, increased rates of physical disability, lower income, lower socioeconomic status, as well as accelerated adult mortality compared with other birth cohorts. In addition, persons born in states with more severe exposure to the Pandemic experienced worse outcomes than those born in states with less severe Pandemic exposures. These results demonstrate that investments aimed at improving fetal health can have substantial long-term effects on subsequent health and economic outcomes.

Thanks to Alex Tabarrok for the pointer, his post contains a lengthier and interesting discussion of the 1918-1919 pandemic.