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Tracking the seasonal flu, The History of the Flu Vaccine and The Flu Vaccine of 2011


The seasonal flu of 2011 arrived with the first confirmed case in Arkansas (Read more). The vaccination of the public swung into action with the seasonal flu vaccine components of 2011, which were exactly the same as the vaccine components of 2010, and described in my previous article, entitled, “Should I get the flu vaccine this year?”. The 2011 – 2012 flu season is going to be an ordinary one, unlike the one in 2009 and the far deadlier one in 2018, all of them caused by the same deadly swine flu H1N1 strain of the flu virus. First reported death from swine flu in 2009 was a 23 month old boy in Texas (Read more). The vaccination of the public swung into action in 2009. Why was 2018 the deadliest flu season in America with over 40 million estimated to be killed world-wide, far more than by the war?  Why was the 2009 flu season pandemic by the same flu virus strain  far less deadlier? The answer is the flu vaccine, the story of which I will tell you here.

A Flu Virus

The Story of The Flu Vaccine:
This year quite different from other years in the story of the Flu Vaccine and that is because Prof. Edwin Kilbourne passed away very quietly in 2011. He had devoted his entire life to the study of the flu virus and played a leadership role in the history of the development of the flu vaccine. I could tell you about Dr Kilbourne but to tell you why he is important, I would need to tell you about the 2018 flu pandemic.

Many have wondered why the Flu pandemic of 1918 is not mentioned as a turning point in American lifestyles in the History books. The fall of 2018 began just like another fall in the middle of a chaos of a country in the midst of the a world war. Stealthier than any human enemy, arrived a tiny microbe, the flu virus strain H1N1 on a crisp New England fall day in a Boston sea port. It must have arrived with some sailors. The September of 1918, the Boston Port was busy with war shipments of machinery. The war efforts allowed the virus to spread and diffuse. It was named the “Spanish Flu” or the “La Grippe”.

The flu pandemic of 1918 devastated many towns and military cantonments by acting very strangely. It wiped out America’s young and healthy, particularly those aged 20-35 years of age. There was no cure. The ill were advised to rest lying down, get fresh air, and to take plenty of fluids. The healthy were advised to avoid crowded, public places. Many wore masks to protect themselves or to prevent infecting others.

The Contagious First Wave of the 1918 Flu Pandemic
The best recorded first case was in Fort Riley, USA. On March 11, 1918, Private Albert Gitchell, a cook at Fort Riley, came down with a cold that required isolation. Within 5 weeks, 1,127 soldiers came down with the same symptoms and 46 of them died. Soldiers trained at Fort Riley before being deployed for the war effort in Europe and unintentionally spread the flu to Europe. When the flu began to ravage the people of Spain, the Spaniards publicly announced the disease. Spain was not in World War 1 and was not censoring its news and the world first heard of the deadly flu from Spain. Hence, the name, the “Spanish Flu”. By July 1918, the “Spanish Flu” had visited Russia, India, China and Africa and appeared to be dying out. Nobody guessed that this was only the first wave of the deadly flu pandemic about to be unleashed upon an unsuspecting world of humans by a microscopic, indestructible microbe.

The Contagious and Deadly Second Wave of the 1918 Flu Pandemic
Towards the end of August, a more deadly flu struck three world cities simultaneously. Boston, USA; Brest, France; and Freeport, Sierra Leone. The overwhelmed hospitals asked for volunteers to take care of their sick, who had to be housed in tents because of their sheer numbers.

Nurses care for the sick in tents

Some died within two days of first symptoms which included coughing violently, bleeding from their ears or turning blue in color and of course, extreme fatigue, fever and headache. The Spanish flu in its second wave struck suddenly and severely, killing some within several hours or a few days, while sparing others. Not surprisingly, panic ensued. Public events were canceled. Schools and theaters closed. Masks were required by many communities. Popular homemade remedies of the past did nothing to prevent or cure this disease. The dead piled up and mass graves had to deal with the bodies. There were not enough people to dig individual graves.

The Third Wave of the 1918 Pandemic
On November 11, 1918, an Armistice brought an end to World War 1. The hugging and kissing of the returning soldiers, some carrying the flu virus helped to create yet another epidemic wave, spreading a weaker version of the “Spanish Flu”. This wave was largely ignored because people had to concentrate on rebuilding their lives, while the pandemic lingered alongside and slowly petered away. Some say the flu lingered until next year but nothing as deadly as the early fall of 1918.

Preventing Another Deadly Pandemic
In an effort to prevent another deadly pandemic in the future, the USA government allocated 1 million dollars to learn more about the “Spanish Flu”. Among many recruited towards the laboratory war against the “Spanish Flu” was a young and eager Dr Edwin Kilbourne, a medical school graduate who was well-trained in virology laboratory research.

Dr Edwin D Kilbourne and Dr D E Rogers testing the Asian Flu virus

It was particularly hard for the Alaskan Indians for whom the death rate was elevated beyond that of the non-Indians. In one Inuit village in Alaska 72 of its 80 residents  died within 5 days in November 1918. Years later in 1997, a researcher dug up remains in the permafrost to isolate the flu virus and reconstructed the fatal strain H1N1. The Spanish Flu had traveled from Boston to Alaska in 2 months, killing many in it’s path.

In 1918 children would skip to the rhyme (Source: Crawford)
I had a little bird, Its name was Enza. I opened the window, And in-flu-enza.

The “Spanish Flu” of 1918 killed over 40 million people worldwide that flu season, while the World War 1 claimed about 16 million. Archives of photos here describe how the public and the government reacted to a situation of panic in the midst of a world war. These archives will help guide future leaders when faced with a similar crisis in the future. The Flu virus mutates over the years and has a habit of returning every few decades to cause epidemics or pandemics, that kill many. A cryptic, well-researched PBS movie (click here to watch) entitled, “1918 Spanish Influenza”, follows the story of the 1918 flu virus pandemic.

Native American death rate from the flu

on
swine flu death rates elevated for alaska natives and american indians

http://www.washingtonpost.com/wp-dyn/content/article/2009/12/10/AR2009121003937.html

The “Spanish flu” of 1918-19 devastated Inuit villages in Alaska. In one, Brevig Mission, 72 out of 80 residents died over five days in November 1918. A researcher extracted tissue samples in 1997 from a body buried there in a mass grave in the permafrost, allowing scientists to reconstruct that fatal strain of influenza.

CDC brochure advising that antibiotics will not work against the flu

http://www.cdc.gov/getsmart/campaign-materials/print-materials/Brochure-NativeAmerican.html

Arkansas has confirmed the first case of seasonal flu for 2011 in America   http://nwahomepage.com/fulltext-news/?nxd_id=276457

First reported death from swine flu in 2009 was a 23 month old boy in Texas    http://www.chron.com/news/health/article/Swine-flu-s-spread-pushes-Texas-to-cut-high-1744879.php

Tracking swine flu worldwide   http://www.nytimes.com/interactive/2009/04/27/us/20090427-flu-update-graphic.html

The United States Department of Health and Human Services  – a one stop to flu   http://1918.pandemicflu.gov/

The flu season that should be in history books    http://virus.stanford.edu/uda/   http://virus.stanford.edu/uda/

In 1918 children would skip to the rhyme (Crawford)  (source  http://virus.stanford.edu/uda/  )     I had a little bird,Its name was Enza.I opened the window,And in-flu-enza.     It first arrived in Boston in September of 1918 through the port busy with war shipments of machinery and supplies. The war also enabled the virus to spread and diffuse.  

Watch the PBS movie on the 1918 Spanish Influenza  http://www.pbs.org/wgbh/americanexperience/films/influenza/

Watch an archive of photos of the 1918 flu that killed an estimated excess of 40 million people worldwide while the world war 1 during the same time claimed an estimated 16 million lives  http://www.archives.gov/exhibits/influenza-epidemic/

For the federal government answers to frequent questions go to   http://www.flu.gov/general/

For a brief history of the Flu vaccine in The Times in 2008   http://www.time.com/time/nation/article/0,8599,1864920,00.html

The CBS documentary by Norman Gorin on the 1976 flu vaccine that caused 4000 people to claim damages, two thirds of them neurological   http://www.dailymotion.com/video/x9nnh6_swine-flu-1976-propaganda_news#rel-page-1

Natural questions followed on how to deal with the 2009 flu pandemic heeding the lessons of the 1976 mass flu vaccination  http://www.time.com/time/health/article/0,8599,1894129,00.html

Looking back it is not difficult to see why the 1976 flu vaccination decisions were taken.  http://www.haverford.edu/biology/edwards/disease/viral_essays/warnervirus.htm  but with the knowledge now, that the 1976 vaccine had the trigger that could make 8.3 per million people with most likely no prior illness sick from GBS versus 0.7 per million people with most likely a prior illness sick from GBS. Rationale for future vaccination programs.

Dr Edwin Kilbourne was the virologist who convinced the US Public Health Service to mass vaccinate. His was a stellar career, devoted to outwitting the Flu Virus. 1920 – 2011.  http://www.virology.ws/2011/02/25/edwin-d-kilbourne-md-1920-2011/    The New York Times only featured a miniscule portion of his career and his role in the 1976 flu vaccine fiasco and ignored his tremendous contribution to the modern flu vaccine.

Palese and Garcia-Sastra continue the search for a diagnostic, preventive and curative agent for all strains of Influenza. http://www.freepatentsonline.com/y2011/0027270.html  and http://en.wikipedia.org/wiki/Peter_Palese  and the team at Mt Sinai

Towards a broadly protective flu vaccine  http://www.jci.org/articles/view/37232  The team at St Judes Medical center  with the goal to define the role of cross reactive lymphocytes. Webster’s article on flu history with photo of little girls skip roping to the poem above  http://people.scs.carleton.ca/~soma/biosec/readings/influenza/influenza.html   Also has great related internet sources.

Egg free vaccine – my earlier article

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Should I get the flu vaccine this year?


Although, the 2011-2012 combination in the flu vaccine, is the same as the 2010-2011, an effective way you can protect yourself against a flu virus infection is through vaccination.

The Flu Virus

However, current vaccination approaches rely on achieving a good match between circulating flu virus strains and the isolates included in the vaccine formulation.  The recommendation is made by the World Health Organization  collaborating centers. Such a match is often difficult due to a combination of factors, one being that the recommendations are made six months prior to the initiation of the flu season, and the flu viruses are constantly undergoing change.

What if the formulation of the vaccine this year is the same as the previous year? The US Centers for Disease Control (CDC) advice that for optimal protection it is safest to get vaccinated against the flu every year. The CDC recommends all people above six months get vaccinated annually; especially the young and the elderly and gives information specific to the 2011-2012 season, including the vaccine formulation, which is exactly the same as the 2010-2011 combination, but is different from the 2009-2010 and earlier combinations. Some non-vaccinated people got quite ill and weak for a very long time in the fall of 2009 from what could have been the H1N1 flu. The vaccinated people apparently were protected or only had mild flu-like symptoms and lost little productive time.

Get vaccinated annually: A Boston.com article by a Globe staff, Deborah Kotz, gives a simple explanation why one needs to get immunized annually in spite of the same combination of strains in the vaccine. If you are naturally infected by the flu virus, your body can retain that immune memory for a life-time. On the other hand, when you are vaccinated by the same flu virus, your body’s immune memory becomes weaker over time, and we do not know currently whether you will have an appropriate immune response if infected next year.

According the CDC, certain people should get advice on whether they should get vaccinated; especially those with egg allergy or latex allergy.

If you have an egg allergy:

A Scientist Cultivating the Flu vaccine in Live Eggs - A labor intensive effort

When you have to make a decision about getting a flu vaccine, which is the vaccine currently grown only in egg in most countries, then you should seriously consider medical supervision because you may have options. They are rather limited in the USA versus Europe and I have detailed current strategies in a previous article on flu vaccination and egg allergy.  The options in Europe are quite different from those currently available in the USA. You may also read “Next generation of flu vaccines coming of age: Cell – based technology may replace egg – based flu vaccines“, by Teddi Dineley Johnson.

What is the combination in the 2011-2012 flu Vaccine? There is an international effort to create that single, life-time flu vaccine, but until then the vaccine combination will need to be reassessed every year. The 2011-2012 combination in the flu vaccine, which is the same as the 2010-2011,  is:

A/Cal/7/2009 (H1N1) – like

A/Perth/16/2009 (H3N2) – like

B/Brisbane/60/2008 – like antigens

If you have a latex allergy: There is both the traditional injection version and a new, intradermal version vaccine available this year.  If you have a latex allergy you may want to take advice and choose a latex free version. The package insert says that the dermal version prefilled syringe tip caps (Fluzone) may contain natural rubber latex to which you may have an allergic reaction if you are allergic to latex. The intradermal version is specially designed to not hurt at all, unlike a needle in the arm version, which many find painful. Either way, your choice of vaccination this year will have the same combination of flu virus.

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