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Current outbreak raises fears of 1918 repeat

By: Jen Skerritt

Posted: 06/11/2009 1:00 AM | Comments: 0 (including replies)

Influenza victims crowd into an emergency hospital near Fort Riley, Kansas in this 1918 photo. (NATIONAL MUSEUM OF HEALTH AND MEDICINE, ARMED FORCES INSTITUTE OF PATHOLOGY, WASHINGTON, D.C.)

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CHILLING parallels between the spread of H1N1 and the 1918 Spanish flu that killed millions have disease experts bracing for an onslaught of new infections and a possible second wave of illness.

Dr. Ethan Rubinstein, head of infectious diseases at the University of Manitoba, said experts now believe the H1N1 influenza will follow the same pattern as the 1918 pandemic as the virus continues to spread in more countries worldwide and cause a disproportionate amount of severe illness in First Nations communities.

In the last week, the H1N1 virus, also known as swine flu, has erupted in St. Theresa Point and Garden Hill -- neighbouring remote First Nations with poor access to health care, overcrowded homes and lack of running water.

Similarly, impoverished aboriginal communities and North End immigrants were hit hard by the 1918 outbreak. In Norway House Cree Nation, nearly one in five people died from Spanish flu.

Although public health is better-equipped to deal with a widespread outbreak, Rubinstein said there's no vaccine to protect against the first wave of the virus and antiviral drugs like Tamiflu don't stop the spread of influenza. He said no one knows whether the latest cluster of flu cases is the end of the first wave, or beginning of a second wave of illness.

The 1918 pandemic started with a mild wave of flu in spring that fizzled out and resurfaced in fall. Historians say the flu killed at least 1,200 Winnipeggers, and hit hard in November 1918.

"The working hypothesis now is that this pandemic will follow the 1918 (pattern)," Rubinstein said, following a lecture on tuberculosis among First Nations at the University of Winnipeg Wednesday.

"I think we have many more means today to stop the devastation than before. So I don't expect the death rate to be even close to 1918, but the spread of the disease may still be like that."

The heightened concern over a repeat of the 1918 pandemic comes as the World Health Organization is on the brink of raising the pandemic alert to Level 6 -- which indicates a full-blown pandemic. More than 26,500 cases of swine flu and 140 deaths have been reported worldwide.

Esyllt Jones, associate professor in the U of M's history department, said airborne diseases like influenza and tuberculosis have thrived for the better part of a century in overcrowded and poorly ventilated homes, where people can easily spread viruses to one another.

In a three-month period during the 1918 outbreak, about 450 people died in Winnipeg's North End, compared to 103 deaths reported in prosperous Crescentwood.

Jones said public health experts have long known that influenza viruses tend to strike impoverished people living in crowded homes and that addressing the inequities may help prevent the spread of disease.

jen.skerritt@freepress.mb.ca

Republished from the Winnipeg Free Press print edition June 11, 2009 A3

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