State Fairs, Swine Flu, and the Next Flu Pandemic

November 9, 2016

Do you know how flu pandemics get their names? Find out here, as well as how the CDC is working hard to prevent the next one.

Charlotte's Web, as you probably know, is a delightful, but sad, story of a pig named Wilbur saved from the slaughterhouse by a resourceful spider named Charlotte. Wilbur eventually makes it to the state fair where Charlotte weaves several words into her web about Wilbur that ensures he will never be slaughtered. For the sad part, you need to read it again for yourself.

In reality, pigs at state fairs don’t always lead to good outcomes. The CDC in an October issue of the MMWRreported on 18 laboratory-confirmed human influenza infections acquired at agricultural fairs in two states this summer, Ohio and Michigan. One person required hospitalization and all recovered. All 18 reported exposure to swine. An H3N2 strain common to swine but not previously identified in humans was identified. No secondary human-to-human infections were seen.

Fortunately, this swine flu strain, like the avian flu strains now smoldering in southease Asia, hasn’t figured out how to go from human to human. If it does, then we may be in for another flu pandemic since nearly all humans lack immunity to this novel strain, up until now found only in pigs. Most pandemic flu outbreaks are thought to be the result of a cross species infection like this.

Up until our last flu pandemic in 2010 (the "swine" flu), influenza pandemics were named after the country or area of origin--but one of these naming schemes was inaccurate.

1. Which of our 20th-century pandemics did NOT start in the area for which it was named?

A. Spanish flu of 1918-1919

B. Asian flu of 1957-1958

C. Hong Kong flu of 1968-1969

Answer and discussion>>>

 

Answer: A. Spanish flu of 1918-1919

The exact origin of the Spanish flu is still debated, but none of the experts think Spain was the country of origin. Asia and the United States are the two leading “suspects.”  So, why or how did it get named “Spanish flu?” Unlike most flu epidemics, relatively healthy young adults died in droves during the Spanish flu outbreak. World War I army camps, with crowded sleeping quarters and mess halls, were hit particularly hard. The governments on both sides of the war tried to suppress this information, not wanting to interfere with recruiting and overall morale. Spain, as you may remember, was neutral and their newspapers were free to report on the illness sweeping their country. Thus it erroneously appeared to be the country hardest hit and so the outbreak was branded Spanish flu.

The flu strain that currently keeps CDC officials up at night is the H5N1avian flu mentioned above. About 650 human cases have been reported since 2003 from 15 countries. Avian flu has a mortality rate of 60%. Many of these are young, healthy adults. If that virus ever learns to spread from human to human, the world may end up looking a little like the one on the TV show Walking Dead, but without the zombies: empty streets, lack of food, looting.  What would things be like with 60% fewer police and firefighters, utility workers, nurses and doctors, truck drivers, and farmers?  On the other hand, it would also mean 60% fewer lawyers…

The FDA has approved a flu vaccine against this strain and it is being stockpiled by the US government. It is believed that it would be about 45% effective based on antibody responses in test patients.

Our last flu pandemic in 2009-2010 started in Mexico, but no one called it the “Mexican flu.” Instead, it became known as the “swine flu pandemic.”  Why did our way of naming pandemics change?  I honestly don’t know, but I have a theory. Some might consider having a pandemic named after your country as something pejorative. Our society is lot more “politically correct” than it used to be and perhaps the people who name these things decided that it is better to insult 968 million pigs worldwide rather than the 125 million people in Mexico.