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History of Influenza

History of Influenza. Etymology of “Influenza”. “Flow of liquid” or “influence” Used to express belief in the impact of the stars on appearance of epidemics. Greek “influentia”. Oxford-English Dictionary. Online Etymology Dictionary. www.fluvirustoday.info. Etymology of “Influenza”.

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History of Influenza

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  1. History of Influenza

  2. Etymology of “Influenza” • “Flow of liquid” or “influence” • Used to express belief in the impact of the stars on appearance of epidemics • Greek “influentia” Oxford-English Dictionary. Online Etymology Dictionary. www.fluvirustoday.info

  3. Etymology of “Influenza” • Adopted by England as common name “influenza” • After a 1743 flu outbreak which started in Italyand spread throughout Europe Oxford-English Dictionary. Online Etymology Dictionary. www.fluvirustoday.info

  4. Hippocrates’s “Epidemic” “Epidemios” – residing in a place 5th century BC Cough of Perinthus Cough, sore throat, muscle aches, voice problems, difficulty breathing Influenza? Martin P & Martin-Granel E. Emerg Infect Dis. 2006;12. http://www.cdc.gov/ncidod/EID/vol12no06/05-1263.htmRichards DW. J Am Med Assoc. 1968;204:1049-56.

  5. Epidemic vs. Pandemic • Epidemic • Sudden onset of infection • Large percentage of people • Disappears in approximately 3 months • Pandemic • Appear suddenly in an isolated area • Spread is worldwide and infects millions • Large number of deaths Potter CW. J Appl Microbiol. 2001;91:572–9.

  6. Epidemic Rates Over 7-Year Periods Influenza cases Deaths from influenza 8 7 6 5 4 3 2 1 0 Winter deaths in non-flu year Thousands x 103 Year 1 2 3 4 5 6 7 Virus Serotype A A B C D E Adapted from Potter CW. J Appl Microbiol. 2001;91:572–9.

  7. 1580 Influenza Pandemic • First record of influenza pandemic • Classified as pandemic by physicians and historians • Origins in Russia and crossed several major continents • Africa • Asia • Rome: Over 8,000 deaths • Spain: Several cities were depopulated Potter CW. J Appl Microbiol. 2001;91:572–9.

  8. 1830-1833 Influenza Pandemic • Widespread • Infected ¼ of those exposed • Began in China, to the Philippines, India, Russia, and then Europe 2 1.5 1 0.5 Deaths (Millions) 1700 1800 1900 2000 Year Adapted from Potter CW. J Appl Microbiol. 2001;91:572–9.

  9. Spanish Flu: Severity • “Greatest medical holocaust in history” (Waring, 1971) • “Deaths in the hospital exceeded 25% per night in the peak” (Starr, 1976) Potter CW. J Appl Microbiol. 2001;91:572–9.

  10. Spanish Flu: The Spread • First outbreaks in 1918 • Detroit • South Carolina • San Quentin Prison • Kansas • Infection spread seen normal in spring • American Expeditionary Force to British Expeditionary Force • War in Europe • Fall of 1918: more virulent form emerged • 10-fold increase in deaths • Estimated to have infected 50% of world’s population • Total mortality: 40-50 million from 1918-1920 Potter CW. J Appl Microbiol. 2001;91:572–9.

  11. Spanish Flu: Second Wave • Increase in virulence between first and second wave of Spanish Flu • Possible rapid mutation of proteins on virus surface • Possible mutation of viral RNA • Novel subtype with no previous immunity in humans under the age of 65 • Increased virulence correlated with ability to infect swine • Later became known as the “swine flu” Taubenberger JK. Proc Am Philos Soc. 2006;150:86-112.

  12. Spanish Flu: Outbreak Map First Wave (1918) Outbreak / Focal Point Second Wave (1920) Adapted from Potter CW. J Appl Microbiol. 2001;91:572–9.

  13. Asian Flu: Severity and Spread • Started in Yunnan Province, China • Disease then spread worldwide • New virus subtype • 1957-1958; 40-50% of population infected • Total mortality: 1 in 4,000 Potter CW. J Appl Microbiol. 2001;91:572–9.

  14. Asian Flu: Outbreak Map Adapted from Potter CW. J Appl Microbiol. 2001;91:572–9.

  15. 2009 Flu Pandemic • Not true “swine flu” • Did not transmit from pigs • Separate H1N1 strains common to humans, pigs, and birds Zampaglione M. WHO. April 2009.

  16. 5 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 Hospitalizations/100,000 in Age Group 0-4 5-24 25-49 50-64 ≥ 65 Age Group in 2009 (Years) “Swine” H1N1 Influenza Virus • United States: April 15, 2009 to July 24, 2009 • 43,771 confirmed and probable cases of novel Influenza A (H1N1) infection • 5,011 people were hospitalized • 302 deaths Adapted from Novel H1N1 Flu: Facts and Figures. CDC. 2009.

  17. “Swine” H1N1 Influenza Virus • 2009 flu has a target infection age similar to Spanish Flu 30 25 20 15 10 5 0 Rate/100,000 in Age Group 0-4 5-24 25-49 50-64 ≥ 65 Age Group in 2009 (Years) Adapted from Novel H1N1 Flu: Facts and Figures. CDC. 2009.

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