'Dreaded disease’ likely to happen again

Published: Wednesday, September 12, 2018

By KIM HORTON
Times-News Columnist

On Oct. 10, 1918, Henderson County began to feel the seriousness of Spanish flu also called the “grippe.”

According to the French Broad Hustler, County Health Officer Dr. A. B. Drafts received an order from state authorities to limit public gatherings. The Board of Health further ordered schools, churches, shows, etc. to be closed through Oct. 19.

Later, the quarantine was extended to Nov. 2. Then on Nov. 22, the Board of Trustees of the City Schools opted not to re-open schools again until Dec. 30.

Never had anyone battled a flu strain as fatal as the Spanish flu. Because it could spread rapidly, people were asked to exercise precautions such as the following:

• Demand a paper cup even if it costs you more.
• Don’t associate with the impolite and careless, who spray your air with their spit.
• Don’t go to unnecessary public gatherings while the epidemic is on. Put your moving picture money in Thrift Stamps.

Naively perhaps, the State Board of Health pronounced that it was “firmly convinced that in the sunshine and climate of North Carolina, we have the most efficient possible method of combating the epidemic of influenza and influenza-pneumonia that is now costing the lives of so many of our citizens.”

The Spanish flu we now know as the 1918 influenza pandemic. A pandemic is a global outbreak of a new non-human flu virus, which would be very different from current and recent circulating seasonal influenza viruses, according to the Centers for Disease Control and Prevention.

Because these new influenza viruses can easily infect people and spread from person to person in an effective and continuous way, the CDC says it is a “dreaded disease, even in this area of advanced medical technology.” There have been four influenza pandemics in the last 100 years: 1918, 1957, 1968 and 2009.

The 1918 influenza pandemic was the most severe in recent history, according to the CDC. An H1N1 virus with genes of avian origin was the cause, and it hit in a series of three waves.

It is estimated that about 500 million people or one-third of the world’s population became infected. Deaths were estimated to be at least 50 million worldwide with about 675,000 occurring in the United States, including over 13,000 North Carolinians. This was about one-third of the world’s population.

The high mortality of healthy people, including those 20-40 years old, was a unique feature of this pandemic. The average age of death was 28 years old. The disease made people sick very quickly and often progressed to organ failure and pneumonia. There were reports of some people dying in 24 hours or less. Pneumonia was the cause of death for most.

In 1918, there was no vaccine to protect against the flu and no antibiotics to treat secondary bacterial infections. Although scientists had identified many bacteria that caused illness, they had not yet discovered viruses. There were no national systems to monitor influenza activity like there are today. Control efforts were limited to what are called non-pharmaceutical interventions or NPIs such as isolation, quarantine and good hygiene.

Compared to 1918, we are better at monitoring illnesses, deaths and the spread of diseases. We have tests to diagnose flu, vaccines to help prevent seasonal flu, drugs to treat it and antibiotics to treat secondary bacterial infections.

Yet flu viruses continue to be a challenge every year, and the risk of pandemic flu is always present. Flu viruses constantly change, making it possible on very rare occasions for animal viruses to change so that they infect and spread among people efficiently.

Other factors include population growth and increased international travel. With no immunity against pandemic flu, most people would be at high risk of infection.

Are we up to meeting a pandemic challenge? Every community in the United States should be ready to respond to an infectious disease outbreak, chemical or radiological release or natural disaster. Your Health Department and Preparedness Coordinator Anita Glance are responsible for community wide planning for an influenza pandemic.

If an outbreak should occur, we will work closely with Henderson County emergency agencies, regional partners and the state of North Carolina to respond and lend support through such an event.

But individuals bear responsibility to be prepared for emergencies, too. September is National Preparedness Month and a is perfect time for families to start or continue taking steps to be prepared. This NPM will focus on planning, with an overarching theme: Disasters Happen. Prepare Now. Learn How.

Where should you start? Consider learning lifesaving skills − such as CPR and first aid or checking your insurance policies and coverage for the hazards you may face, such as flood and earthquakes. Think about costs associated with disasters and save for an emergency.

Also, know how to take practical safety steps like shutting off water and gas. How would you handle worst case scenarios — schools closed, activities limited, inability to work, etc. How long would your supplies last?

This year marks the 100th anniversary of the 1918 influenza pandemic, which caused an estimated 50 million to 100 million deaths. It serves as a reminder that planning and preparedness for all types of public health emergencies are vital to keeping communities safe and resilient.

But even 100 years later, the best way to protect yourself and limit the spread of flu is still to stay home when you are sick, wash your hands, cover your cough and sneeze with a tissue or cough or sneeze into your upper sleeve or elbow, not your hands, and get your flu vaccine. Even though flu vaccine protection is not 100 percent, it is still the best tool we have.

The Department of Public Health will again offer flu vaccine to students and staff in all Henderson County schools this fall. Vaccine will also be available in our Immunization Clinic.

For more information about the 1918 Spanish Flu Pandemic, what you can do to prepare for emergencies and flu vaccine, visit hendersoncountync.gov/health.

Kim Horton is the communications manager for the Henderson County Department of Public Health. She can be reached at khorton@hendersoncountync.gov.

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