Mangalorean Recipes

1918 pandemic in human

The 1918 flu pandemic in humans was associated with H1N1 and influenza appearing in pigs;^[20] this may reflect a zoonosis either from swine to humans, or from humans to swine. Although it is not certain in which direction the virus was transferred, some evidence suggests, in this case, pigs caught the disease from humans.^[17] For instance, swine influenza was only noted as a new disease of pigs in 1918, after the first large outbreaks of influenza amongst people.^[17] Although a recent phylogenetic analysis of more recent strains of influenza in humans, birds, and swine suggests the 1918 outbreak in humans followed a reassortment event within a mammal,^[24] the exact origin of the 1918 strain remains elusive.^[25] It is estimated that anywhere from 50 to 100 million people were killed worldwide.^[20][26]

1976 U.S. outbreak

On February 5, 1976, a United States army recruit at Fort Dix said he felt tired and weak. He died the next day, and four of his fellow soldiers were later hospitalized. Two weeks after his death, health officials announced the cause of death was a new strain of swine flu. The strain, a variant of H1N1, is known as A/New Jersey/1976 (H1N1). It was detected only from January 19 to February 9 and did not spread beyond Fort Dix.^[27]

 

This new strain appeared to be closely related to the strain involved in the 1918 flu pandemic. Moreover, the ensuing increased surveillance uncovered another strain in circulation in the U.S.: A/Victoria/75 (H3N2) spread simultaneously, also caused illness, and persisted until March.^[27] Alarmed public health officials decided action must be taken to head off another major pandemic, and urged President Gerald Ford that every person in the U.S. be vaccinated for the disease.^[28]

The vaccination program was plagued by delays and public relations problems.^[29] On October 1, 1976, immunizations began, and three senior citizens died soon after receiving their injections. This resulted in a media outcry that linked these deaths to the immunizations, despite the lack of any proof the vaccine was the cause. According to science writer Patrick Di Justo, however, by the time the truth was known—that the deaths were not proven to be related to the vaccine—it was too late. "The government had long feared mass panic about swine flu—now they feared mass panic about the swine flu vaccinations." This became a strong setback to the program.^[30]

There were reports of Guillain-Barré syndrome, a paralyzing neuromuscular disorder, affecting some people who had received swine flu immunizations. Although if a link exists is still not clear, this syndrome may be a side effect of influenza vaccines. As a result, Di Justo writes, "the public refused to trust a government-operated health program that killed old people and crippled young people." In total, 48,161,019 Americans, or just over 22% of the population, had been immunized by the time the National Influenza Immunization Program was effectively halted on December 16, 1976.^{[31] [32]}

Overall, there were 1098 cases of Guillain-Barré Syndrome (GBS) recorded nationwide by CDC surveillance, 532 of which occurred after vaccination and 543 before vaccination.^[33] About one to two cases per 100,000 people of GBS occur every year, whether or not people have been vaccinated.^[34] The vaccination program seems to have increased this normal risk of developing GBS by about to one extra case per 100,000 vaccinations.^[34]

Recompensation charges were filed for over 4000 cases of severe vaccination damage, including 25 deaths, totalling US$3.5 billion, by 1979.^[35] The CDC stated most studies on modern influenza vaccines have seen no link with GBS,^[34][36][37] Although one review gives an incidence of about one case per million vaccinations,^[38] a large study in China, reported in the NEJM, covering close to 100 million doses of H1N1 flu vaccine, found only 11 cases of Guillain-Barre syndrome, which is lower than the normal rate of the disease in China; "The risk-benefit ratio, which is what vaccines and everything in medicine is about, is overwhelmingly in favor of vaccination."^[39]

1988 zoonosis

In September 1988, a swine flu virus killed one woman and infected others. A 32-year old woman, Barbara Ann Wieners, was eight months pregnant when she and her husband, Ed, became ill after visiting the hog barn at a county fair in Walworth County, Wisconsin. Barbara died eight days later, after developing pneumonia.^[40] The only pathogen identified was an H1N1 strain of swine influenza virus.^[41] Doctors were able to induce labor and deliver a healthy daughter before she died. Her husband recovered from his symptoms.

Influenza-like illness (ILI) was reportedly widespread among the pigs exhibited at the fair. Of the 25 swine exhibitors aged 9 to 19 at the fair, 19 tested positive for antibodies to SIV, but no serious illnesses were seen. The virus was able to spread between people, since one to three health care personnel who had cared for the pregnant woman developed mild, influenza-like illnesses, and antibody tests suggested they had been infected with swine flu, but there was no community outbreak.^[42][43]