The influenza pandemic of 1918-1919 killed somewhere between 20 and 40 million people, more than the total of those who died in World War I. It has been called the most devastating epidemic in recorded world history. More people died of influenza in a single year than in four-years of the Black Death Bubonic Plague. The 1918 influenza virus was a strain that is known today as H1N1. Interestingly, a variant of H1N1 is the “Swine Flu” strain circulating the globe today [Go to our website (www.biotechnews.com) to see an extract from a previous Report, “In Times Like These” where we provide extensive information on the subject of Influenza ─ Ed.].
The important thing to note about the 1918 flu pandemic is that it wasn’t the flu virus per se which caused so many deaths. Rather, most died of bacterial pneumonia. A recent paper on the 1918 flu pandemic in the CDC’s journal, Emerging Infectious Diseases states that the conventional wisdom underlying pandemic flu preparations is wrong. Medical and scientific experts now agree that bacteria, not influenza viruses, were the greatest cause of death during the 1918 flu pandemic.
“Government efforts to gird for the next influenza pandemic ought to take notice and stock up on antibiotics,” says John Brundage, a medical microbiologist at the Armed Forces Health Surveillance Center in Silver Spring, Maryland. Brundage’s team surveyed first-hand accounts, medical records and infection patterns from 1918-1919. Although a highly virulent strain of flu virus swept the world, Brundage’s team concluded that bacterial pneumonia, which came on the heels of what were mostly mild cases of flu, is what in fact killed the majority of the 20 to 40 million victims who died.
As a result of their study, Brundage, et al. conclude, “…deaths during the 1918-19 influenza pandemic are usually attributed to a hypervirulent influenza strain. As a result, preparations for the next pandemic focus almost exclusively on vaccine prevention and antiviral treatment for infections with a novel influenza strain. However, we hypothesize that infections with the pandemic strain generally caused self-limited (rarely fatal) illnesses that enabled colonizing strains of bacteria to produce highly lethal pneumonias. This sequential-infection hypothesis is consistent with characteristics of the 1918-19 pandemic, contemporaneous expert opinion, and current knowledge regarding the pathophysiologic effects of influenza viruses and their interactions with respiratory bacteria.” [Emphasis ours]
In a nutshell, what happens is that influenza, which is a virus, attacks your lung tissue and causes damage, but it doesn’t usually kill you. What kills you is the bacterial pneumonia that comes on afterwards and then causes the problems that result in death. Therefore, when you have influenza, or you get influenza, you not only need to be treated rapidly for the influenza, but also and most importantly for the bacterial infection that occurs afterward.
The first antibiotic to be used successfully in the treatment of human disease was tyrothricin, isolated from certain soil bacteria by American bacteriologist Rene Dubos in 1939. It was later, during World War II and shortly thereafter, that the “antibiotic era” began. In other words, in 1918, we did not have antibiotics. During the 1918 pandemic, it took only 7-10 days from the onset of flu symptoms to the time of death. The “modern medicine” of that day stood helplessly by as the secondary infection of bacterial pneumonia took the lives of millions upon millions.
Now, please don’t miss this: It is our considered opinion that the situation we are facing today is eerily similar. We have just spent quite a bit of time to demonstrate the fact that, even though we have lots of antibiotics at our disposal, the unyielding and relentless march of the growing army of multi drug-resistant Superbugs puts us very close to the place where we might as well have no antibiotics at all. In 1918, it was Streptococcus pneumoniae that was the culprit. Today, we not only have to worry about multi drug-resistant strains of this bug but as we’ve already mentioned, MDR Staphyloccus aureus (MRSA) is now turning up in both hospital-acquired and community-acquired cases of pneumonia. No doubt, other Superbugs will join the fray.
The exact “mechanism” of how the 1918 H1N1 virus was involved in preparing the way for the deadly pneumoccal pneumonia which followed is not known. However it happened, it decimated millions of young adults along with those who were weak and infirm. Whether it be the contemporary H1N1 (“Swine Flu”) virus, or the H5N1 (“Bird Flu”) virus which caused a scare in 2009, or the H7N9 virus of 2013, or some other strain of influenza which opens the door to MDR Superbugs, we can be almost certain that this will turn out to be one hellish nightmare.
But what about vaccines? At least two problems: First, in order to be really effective, a vaccine has to be “strain specific” matching the very same strain of virus which is causing the flu at any point in time. Matching the viral strain is an extremely difficult and complicated challenge which involves a bit of science and a whole heck of a lot of guessing. Often, the guess is wrong. And, should the virus mutate (which is likely), the vaccine would have little to confer in the way of immunity. What’s more, the World Health Organization (WHO) has admitted that H1N1 vaccines are “using new technologies…which have not yet been extensively evaluated for their safety in certain population groups.”
Secondly, even if we could perfectly match the viral strain and even if it did not mutate (highly unlikely), we don’t have the manufacturing capability to produce enough vaccines to take care of our population. Take the recent example of the scramble to stockpile vaccines for H1N1. The U.S. makes only 20 percent of the flu vaccine it requires. Great Britain has to import 100% of its vaccines. About 70 percent of the world’s existing flu vaccines are made in Europe, and only a handful of countries are self-sufficient in vaccines. Since the U.S. has limited flu vaccine facilities, and because factories can’t be built overnight, there is no quick fix to boost vaccine supplies. The WHO recently stated the production yields for pandemic vaccine viruses run 25-50 percent of those of normal seasonal flu viruses for some manufacturers. All of this boils down to shortages. Experts are now warning that during a global epidemic, governments may be under tremendous pressure to protect their own citizens first before allowing companies to ship doses of vaccine out of the country. Bottom line? We can’t bet our lives on either the effectiveness, safety or availability of flu vaccines.
Then what about antiviral drugs like Tamiflu (Oseltamivir) and Relenza (Zanamivir)? In 2005 circulating strains of influenza viruses began developing resistance to one or more of the four licensed antiviral agents (Oseltamivir, Zanamivir, Amantadine and Rimantadine). The CDC’s Advisory Committee on Immunization Practices recently stated this increasing resistance “has complicated antiviral treatment and chemoprophylaxis recommendations”. This is a tacit admission that we’ve got a serious problem here. In fact, rather than seeing the situation as “complicated”, other researchers have stated it more clearly, suggesting that “wide-scale use of antiviral agents in the event of an influenza pandemic is likely to promote the emergence of drug resistance, with potentially deleterious effects for outbreak control”. In other words, we will soon end up having to deal with multi drug-resistant viruses in addition to the MDR bacteria we have been discussing here. Now, in what we see as a signal of near desperation, instead of using just one antiviral, “cocktails” of two or more antivirals are being considered. This is nothing but a shot in the dark and we fully expect to see reports in the near future that this strategy will have proven itself useless and probably harmful and/or deadly in and of itself.
Tamiflu has a long record of failure and is worse than worthless. Viruses like H1N1 not only develop resistance to it, but the drug itself kills people. Japan has banned it. Even the FDA—after review of nearly 600 cases of neuropsychiatric events reported by patients on Tamiflu and 115 cases of neuropsychiatric events by patients taking Relenza—has warned that Tamiflu’s label be strengthened to note: “In some cases, these behaviors resulted in serious injuries, including death, in adult and pediatric patients.” FDA staff has been quoted as having said Relenza, a drug in the same class as Tamiflu, should have a warning label of “reports of hallucinations, delirium and abnormal behavior” observed in some patients taking the drug. Even if they were effective, antivirals must be taken within 48 hours of the onset of flu symptoms. Most people don’t recognize the symptoms and, if they do, many can’t get to their doctor fast enough. Bottom line? Reliance upon antivirals would more than likely be a foolish and deadly strategy.