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How Humans Found and Fought the Flu Virus for a Century

How did humans find and fight the flu virus for a century?

"atal Flu: A Hundred Years of Treatment: Influenza has always been one of humanity's strongest rivals, and one of the top ten deadly diseases in the world. Although modern medicine has shown various advantages, curing flu is still an unsolved problem.
"Fatal Flu" provides three main considerations: 

Human perception of the virus, how to deal with the flu, and are we ready for the next pandemic?

The 1918 influenza pandemic was the largest global plague with the highest number of deaths in history, killing 50 to 100 million people and infecting more than 500 million people. In the past 100 years, humans have had a deep understanding of the influenza virus, but there are still many unknowns that still cannot prevent and defeat this "serial killer".

Dr Jeremy Brown explored the history of humans finding and fighting the flu virus, examining several important issues related to the flu, such as why the flu is difficult to cure? Powerful reporting systems and data analysis are applied to the prediction of influenza trends. 


Predicting Epidemic

Can they accurately predict the arrival of the next pandemic?

Dr. Jeremy Brown, a veteran medic and emergency physician, received his Ph.D. from the University of London School of Medicine, and then went to Boston Medical Center for an emergency medical practice.
Formerly the research director of the Department of Emergency Medicine at the University of Washington, during which time he led the team to set up an HIV screening program, a new treatment for renal colic that received three licenses from the National Institutes of Health.

He currently heads the Emergency Nursing Research Office of the National Institutes of Health. He has published more than forty peer-reviewed papers and four monographs, including two first aid textbooks published by Harvard University Press.

Are we ready for the next pandemic like 1918? 

Most experts believe that the next outbreak is only a matter of time. Altum's story helps focus my thinking on the future on three things: our knowledge of the virus, our response to the virus, and our preparations for the next outbreak.

First of all, the greatest achievement we have achieved in the fight against the flu is to know the cause of the flu. In 1918, when millions of people were lying in bed and dying, we knew almost nothing about the culprits that caused the end of the world.

It may be bacteria, it may be the air we breathe, it may be due to a lack of sunlight, or it may be something mysterious like the arrangement of celestial bodies.
Within a century, we discovered the existence of viruses, classified and tracked them according to their structure and function, learned how they spread and mutated, and even took many photos.

In the Arctic, we dug out the corpses carrying the influenza virus in 1918 and pieced them together in the laboratory. 

We deciphered its genetic make-up and resurrected it in a voice of controversy. However, if we cannot eradicate the flu, the medical revolution that began in the mid-19th century, typified by the invention of antibiotics and vaccines, will not be completed.

Equally impressive is the way we deal with viruses. The most important new tool in our battle reserve is also useless against viruses. These tools include antibiotics for the treatment of possible complications after the flu, intensive care units, ventilators that patients with lung disease must use, and experts who understand emergency care and the ins and outs of infectious diseases.

The 1918 flu virus destroyed many cities and nearly paralyzed the city's economy. There were no effective treatments at the time, and the only thing people could do was provide verbal comfort while waiting for the patient to recover or die.

There are more and more medicines in the rivers and lakes, and even mainstream therapies such as bloodletting are more likely to kill patients than cure them.

Today things are quite different. But we still lack a drug that is effective against the flu virus. People can currently only respond with antiviral drugs.

However, for the better, the effects of these drugs are somewhat controversial. For the worse, these drugs have no effect at all. We urgently need to develop a safe and effective drug that can completely destroy the virus.

For decades, people have worked hard to achieve this goal. But we still have the heart and the power. We were able to respond to the flu, but still lacked a response and a medicine we really needed.

In 1918, we responded. We are not ready. Today, we are better at preventing problems before they occur. Each state has plans for a pandemic.

These plans cover all aspects, such as obtaining vaccines, coordinating hospitals to set up auxiliary treatment facilities in school gyms and nursing homes, and so on.

At the federal government level, the National Strategic Reserve Centre stores millions of doses of influenza vaccines and antivirals.

The U.S. Department of Health and Human Services updated the Influenza Pandemic Plan in 2017 with over 50 pages. "A pandemic influenza is not a theoretical threat. To be precise, it is a recurring threat."
The program's preface wrote, "Even so, we don't know when the next pandemic will happen. The outbreak does not know how serious its consequences will be. "

The annual flu vaccine is a key element in preparing people for outbreak prevention, but its effectiveness will hardly exceed 50%. This is despite the consensus that high-risk groups should be vaccinated.

But we still don't have enough reasons to force the government to make other decisions, such as whether healthy adults should receive regular vaccination.

Obtaining the necessary evidence is costly, but the cost of hoarding vaccines and medicines of questionable value is minimal.

Our current preparation is to assume another outbreak of a similar scale to the 1918 pandemic. Many experts worry that the outbreak will have a greater impact than other potential health crises.

So why haven't the tragedies of 1918 repeated in the past 100 years?

Now that modern medicine has made great progress, is it necessary for us to worry about an extremely unlikely situation because of the trauma of the past and anxiety about the future?

There are two attitudes towards this problem: pessimism and optimism. For pessimists, the next flu outbreak looks deadly and inevitable.

The news media is full of pessimists, because pessimism can easily make headlines. From magazines to cable news to almost every book.
Regarding flu there is a clear concern: A pandemic is inevitable. Here are some of the main reasons why pessimists can stand:

Experts warned. They understand the flu and have been working on the flu virus. We should value the words of experts because they take flu seriously.

The pandemic of 1918 and the flu outbreaks of 1957 and 1968 confirmed that the occurrence of the lethal flu wave did not stop theoretically.

We have every reason to assume that past outbreaks will really repeat themselves in the future. Other epidemic diseases have recently appeared, such as SARS, Ebola and Zika virus. These viruses give us a certain understanding of what may happen in the future.

These diseases know no borders. Influenza has no borders. Since 1918, the international travel industry has grown rapidly. It used to take days to sail from sea to the United States.

Today, the same trip takes only 6 hours by plane. We travel around the world at an alarming rate, as do the viruses we carry.

Although we know a lot about influenza, there is still much to be learned. For example, we don't know why the 1918 virus favored young people, or why it was a mild illness for some of us, but a fatal illness for others.

Without understanding these characteristics of the virus, we cannot be fully prepared for it. The number of poultry is increasing rapidly.

Although bird flu is more common in ducks and geese than in poultry, the vast majority of birds we raise and consume are more likely to transmit bird flu.

Coupled with the factors of international travel, it can have fatal consequences.

The flu spreads easily in densely populated areas. In 1918, family members who lived together in overcrowded houses or apartments quickly became infected with the virus.

Today, many residents of Africa, Asia and Latin America still live in crowded housing. The United States is not immune. About 3 million Americans live in a crowded environment. In New York, nearly 9% of households, more than 280,000 households are overcrowded.

In the United States, even if you live in a spacious house or apartment, you may take the subway or bus to work or school with dozens of people every morning.

These factors indicate that pandemic diseases cannot be avoided. But before reaching this conclusion, we might as well give the optimist a chance. We have every reason to believe that the disaster of 1918 will not repeat itself. Over time, the lethality of severe or pandemic diseases becomes less and less.

The 2009 swine flu outbreak suggests that we may have overestimated its severity. Regarding the severity of the disease, there will be a lot of hype in the past and the future. 

Every year, people die from the flu, but the number of excess deaths-especially those caused by the particularly nasty flu virus-has not increased. T

his phenomenon may not have much to do with our own interventions, but it has nothing to do with the evolutionary pressure of the virus itself. 

The virus spreads easily. A powerful virus can quickly kill the host or rest in bed, after which the virus is less likely to spread. From the perspective of an influenza virus, the best strategy for reproduction and transmission is to protect patients from serious illness. 
Newly infected patients continue to deal with healthy people.

In this way, the chances of the virus entering new hosts by coughing and sneezing are greatly increased. In this respect, evolutionary theory is on our side. The chances of the virus multiplying during a mild climate. Mild viruses do not cause an outbreak of a pandemic.

The 1918 influenza pandemic is thought to be very rare, and there is another reason that certain conditions must be completely coincident for the virus to be lethal.

The virus must be transmitted from birds to pig hosts and then to humans. This requires a specific set of gene exchanges and mutations. Without these conditions, the virus would not be so lethal. The virus must also be in good condition for transmission.

These conditions were provided during World War I by overcrowded military camps and warships, factories where workers worked, and low-cost apartments inhabited by the masses.

Jeremy Brown from NIH

Today, the problem of bacterial infections that cause most deaths has been addressed by antibiotics. After weighing the evidence, I'm not sure which party I should join.

Am I a pessimist or an optimist?

There are compelling reasons for all parties. To me, all parties seem to make sense. The year when the pandemic did not break out is one reason why optimists continue to be optimistic-but if it is a pessimist, in this case, we will feel that we are alive by chance.

Of course, we are more likely to hear pessimistic news. The voice of the pessimist is louder. Health officials make recommendations based on the worst case scenario.

News reports on the Internet and cable television always use intimidation tactics to attract our attention. Creating panic can cause anxiety. Don't look for good predictions about the flu based on your source. Don't be surprised if many outbreaks similar to the 2009 flu season occur in our lives, as the severity and speed of transmission of the flu in 2009 was overstated.

Optimists also face a serious problem. Americans are particularly optimistic. They like to read books about happiness, and away from troubles and negative emotions of the past. But disease has its own history, and if we don't study the past, we can easily be in danger. 1918 did qualify for an influenza pandemic. Since then, some of these conditions have changed radically. But it is also true that certain new and unforeseen circumstances may lead to outbreaks of other diseases.

Pessimists always complain about the past. Optimists always look forward to a different future; realists live in the present, they observe the facts and make corrections in the process. When it comes to the flu, most people join the realist camp.

People believe that we can reflect on the human pandemic experience, use existing knowledge and take practical action to prevent it before it happens. To do this, we need to consider a more critical issue. This issue does not involve medicine, science or policy. Instead, it involves our collective memory. 

Why don't we do more to understand the historical evolution of influenza?

Pessimists may indulge in the past; optimists tend to forget the past. Realists use the knowledge of the past to understand the present and the future.

As I have been working on this research for many years, I have come to a realistic conclusion: we have not done enough to keep the 1918 pandemic in our collective memory. 
Commemorating the centennial of the 1918 influenza pandemic is a step in the right direction, but it is only a small step. 
Changing our vigilance against disease requires the entire society to understand the impact of the disease, the consequences of the disease in the past, and the impact it now has on us. Of course, research funding can help change this outcome. But in the fight against disease, the most important thing is to discuss and understand it extensively outside university laboratories and academic seminars.

We commemorate the war, but other very destructive events should also remain in our collective memory. I hope to build a 1918 flu pandemic monument in the U.S. capital to commemorate our losses, reflect on what we have achieved, and remind us that there is still much to be done. This century is a century of disaster, natural disasters, world wars, disease and conflict. 

It is also a century of large-scale expansion, integration, global impact, technological breakthroughs, and medical success. The pandemic illustrates both of these issues. People's bodies are in danger, and their brains remain in comfort zones. 
This is human failure and human victory. Perhaps by the time the 1918 Influenza Pandemic Monument is completed, we are also celebrating that humans have found a cure for the flu.

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