1918 v. 1957 influenza
TRANSCRIPT
-
8/9/2019 1918 v. 1957 Influenza
1/16
1918 vs. 1957 : Spanish vs. AsianPreparedness and Vaccinations
Spread of Spanish Influenza 1918
-
8/9/2019 1918 v. 1957 Influenza
2/16
Spanish Influenza vs. Asian Influenza
In 1918, influenza is not a nationally
reportable disease (CDC).
February 1957 - the Asian influenza
emerged in China.
Scientific advancements make it easier to
identify than the 1918 influenza.
-
8/9/2019 1918 v. 1957 Influenza
3/16
Doctors in 1918Ignorance is Not Bliss
Warned Public Health Officialsof Dire Consequences
Urged Cities to PracticeIsolation and Quarantine
Patriotic War FervorA Nave Population Stubborn City Leaders
-
8/9/2019 1918 v. 1957 Influenza
4/16
Doctors and Hospitals in
1957
Influenza incidence
reaches high levels Physicians offices
crowded to overflowing Most patientsNot severely illDidnt need specialtreatment
-
8/9/2019 1918 v. 1957 Influenza
5/16
1918-Public
Health and Medi
cal Eff
orts
Hospitals 1918
Overflowed with
patients
Expanded treatment
centers
Intensified shortage ofmedical personnel
Overwork and
overexposure
Just not enough
Public Health Service - 1918
Struggles withorganization/lack of
leadership
Unprepared
Public Health Agencies
Theoretical Jobs Now a
Reality
-
8/9/2019 1918 v. 1957 Influenza
6/16
1957 Public
Health and Medi
cal Eff
orts
The CDC ASTHO
Intensively studied the
epidemic
Tried to predict
diseases course for
autumn
Looming pandemic
subject of special
meeting at the
Association of State and
Territorial Health
(ASTHO) Health officials met to
discuss strategy
-
8/9/2019 1918 v. 1957 Influenza
7/16
1918-1919 United States Public
Health Service Measures
A D i r e c t o r i n Ea c h S t a t e ! B o s t o n Wa n t s To o M a n y
N u r s e S h o r t a g e
N u r s e s N e c e s s a r y
-
8/9/2019 1918 v. 1957 Influenza
8/16
1957 US Public
Health Measu
res
June 1957 only weekly
telegraph reports from CDC
Influenza Surveillance Unit
National Health Survey
County Reports
Improvements ASTHO Recommendations
Home care
Safety Measures
Not many restrictions
Quarantine not considered
effective
no practical advantage
in the closing of schools
or the curtailment of
public gatherings as it
relates to the spread of
this disease.
-
8/9/2019 1918 v. 1957 Influenza
9/16
US Government Preparedness
1918
No problem finding the $$ 2 Hours for Congress to approve a
budget The problem?
No funds appropriated byCongress for prevention
-
8/9/2019 1918 v. 1957 Influenza
10/16
US Government Preparedness
1957
Armed Forces Epidemiological Board 1940 Commission on Influenza Studies of epidemiology and prevention
International Influenza Study
Program of the WHO 1948
-
8/9/2019 1918 v. 1957 Influenza
11/16
(Lackof) Treatment - 1918 No influenza vaccine
"Physicians triedeverything they
knew.
Only one therapeutic
measure shows
positive results
1931 Viral Growth
1940s First approvedinactivated vaccines for
influenza
Over time advances in
fields of immunologyand vaccinology enable
mass production
-
8/9/2019 1918 v. 1957 Influenza
12/16
(Presence of) Treatment 1957 To prevent illness and
death from epidemic
influenza within the limits ofavailable vaccine.
There was a shortage of
vaccine in August
Surgeon General Leroy
Burney makes an
announcement
Vaccine allocatedaccording to statespopulation
Distribution bymanufacturers throughcommercial networks
Recommended priority
be given to public healthworkers and communityservice providers, as wellas those with specialcircumstances.
-
8/9/2019 1918 v. 1957 Influenza
13/16
In his book,AmericasForgotten Pandemic, Alfred W.Crosby wrote, (the UnitedStates) "was not merelyunprepared to control thespread of influenza. It had
carefully, if unintentionally,prepared itself to expedite thecultivation and disseminationof the influenza virus of 1918."
Do You Agree? Why?
What would you change?
Were They
Ready???
-
8/9/2019 1918 v. 1957 Influenza
14/16
Ti
m
el
i
n
e
o
f
V
a
c
c
i
ne
P
r
o
d
u
c
ti
o
Ma
y
19
5
7
No
v
19
5
7
June July Aug. Sept. Oct.
May 13 USreceives first
influenzaspecimens fromHong Kong
May 22 Definitiveidentification of new
influenza strain
Vaccine trialsconducted
4 Million DosesReleased
9 Million DosesReleased
16 MillionDoses Released
-
8/9/2019 1918 v. 1957 Influenza
15/16
So
What
sthe P
roblem?
Only enough vaccine for 17% of Population
Vaccine only 60% effective
Epidemic peaked in late October, but rates sharply
declined in November
Have supply, but demand is gone
-
8/9/2019 1918 v. 1957 Influenza
16/16
Refe
ren
ces
Taubenberger JK, Morens DM. 1918 influenza: the mother of all pandemics. Emerg Infect
Dis [serial on the Internet]. 2006 Jan [date cited]. Available from
http://www.cdc.gov/ncidod/EID/vol12no01/05-0979.htm
D. A. Henderson, Brooke Courtney, Thomas V. Inglesby, Eric Toner, and Jennifer B. Nuzzo.Public health and medical responses to the 1957-58 influenza pandemic. Biosecurity and
Bioterrorism. Volume 7, Number 3, 2009. Mary Ann Liebert, Inc.
http://www.upmc-biosecurity.org/website/resources/publications/
2009/2009-08-05-public_health_medical_responses_1957.html
http://www.pandemicflu.gov/storybook/index.html
http://www.jhsph.edu/publichealthnews/articles/2005/great_influenza.html
Crosby, Alfred W. Jr., Epidemic and Peace 1918, Greenwood Press 1976. Updated
introduction and reprinted as, Americas Forgotten Pandemic, Cambridge Press 1989