History of influenza

everyone knows about the 1917 influenza epidemic, but there were other influenza like epidemics before and after that. 

 So anyway, I was listening to this discussion about Jack the Ripper, and one person who was suspected by those who like conspiracy theories is a Royal son (at 22 minutes), and they mention that he was in Scotland during the time and he later died of influenza in the 1890s influenza epidemic.

there was a major flu epidemic in the 1890s? Sort of forgotten today that influenza is a recurring illness.

Hmm. sort of overlooked that lotss of influenza epidemics out there  

As for the 188990 epidemic here on Wikipedia, 

It was the last great pandemic of the 19th century, and is among the deadliest pandemics in history.[2][3] The pandemic killed about 1 million people out of a world population of about 1.5 billion (0.067% of population).[4][5] The most reported effects of the pandemic took place from October 1889 to December 1890, with recurrences in March to June 1891, November 1891 to June 1892, the northern winter of 1893–1894, and early 1895. According to researchers' estimates, excess mortality from Russian influenza in the Russian Empire for the period 1889–1890 could be from 60,000 to 90,000 people, with lethality from the virus, a little more than 0.2%.[6]

more here:

A partial listing of particularly violent outbreaks likely to have been influenza include one in 1510...In 1580, another pandemic started in Asia, then spread to Africa, Europe, and even America,,, 

In 1688, influenza struck England, Ireland, and Virginia; in all these places “the people dyed … as in a plague” (Duffy, 1953). A mutated or new virus continued to plague Europe and America again in 1693 and Massachusetts in 1699...

In London in 1847 and 1848, more people died from influenza than from the terrible cholera epidemic of 1832. In 1889 and 1890, a great and violent worldwide pandemic struck again ...

read the entire article for a background of repeated epidemics of influenza type epidemics.

there is a question in some of the articles I perused wondering if that the reason the 1918 influenza was weaker in China was that they had partial immunity from previous infections.

A similar idea could explain why in 1917 it killed the young adults not just the elderly was because the middle aged and elderly may have had partial immunity due to previous infection in this earlier epidemic.

One sometimes forgets about previous epidemics.

One of my earliest memories was the doctor making a house call for my mother who had Asian flu, which was a major epidemic of 1957

Sine things to remember when you read hysteria about the next swine flu or bird flu epidemics threatening the world.

Spanish Flu started in 1915?

UKMail article

A study has found there were investigations as early as 1915 into a mysterious illness which was killing World War I soldiers in France and England.  ,,,

A medical group in Etaples, northern France, reported treating hundreds of people with an 'unusually fatal disease' causing 'complex' breathing problems in 1917. And soldiers were being struck down with the virus across the Channel in Aldershot, England, in 1915 and 1916...

In a study of literature from the early 20th Century, Professor Oxford and his colleague Douglas Gill, a military historian, found records of the flu bubbling under the surface. Some 60,000 soldiers were being admitted to British and French army hospitals in 1915 and 1916 with flu-like symptoms – and around half of them were dying. But the virus quickly exploded and spread out of military bases and to people all over the world. 'In essence, the virus must have mutated,' said Professor Oxford. 'It lost a great deal of its virulence, but gained a marked ability to spread. In a study of literature from the early 20th Century, Professor Oxford and his colleague Douglas Gill, a military historian, found records of the flu bubbling under the surface.

Some 60,000 soldiers were being admitted to British and French army hospitals in 1915 and 1916 with flu-like symptoms – and around half of them were dying. But the virus quickly exploded and spread out of military bases and to people all over the world. 'In essence, the virus must have mutated,' said Professor Oxford. 'It lost a great deal of its virulence, but gained a marked ability to spread..

the black death: it decimated sub sahara Africa too

Science magazine:

"There was a deep, structural change in settlement patterns," Chouin says, just as the Black Death ravaged Eurasia and North Africa. With GLOBAFRICA funding, he has since documented a similar 14th century abandonment of Ife, Nigeria, the homeland of the Yoruba people, although that site was later reoccupied.

most of the literature on the black death is from England or western Europe, but it also decimated China, India and the Middle East.

I heard a lecture from somewhere that it was so bad in Egypt that they had a famine because there was not enough manpower to keep the irrigation systems unclogged.

One of these days I'll try to do this systemically, but alas I have so many interests that I doubt I will do it.

Ancient plauges

cross posted from my main blog


right now I'm listening to The-Fate-of-Rome-Climate-Disease-and-the-End-of-an-Empire on Scribd.

Scary.

The theory is that various plagues resulted in depopulation in the Roman empire, and the climate variations (volcanic?) caused famines.

Plagues that weakened Rome includes the Antonine plague (? Measles? Smallpox?) and the plague of Cyprian.(measles? Smallpox? a viral Hemorrhagic fever?)

Measles can be very serious in malnourished people and in adults, and can kill even today. But it may have mutated to be less severe with time. Measles was first described by a Persian physician in the 9th century, but some historians wonder if it mutated (from Rinderpest of cattle or distemper in dogs) long before then.

Ancient mummies howeveer do show evidence of smallpox scars, so we know that disease has been around for quite awhile.

Cyprian's plague was blamed on that diabolic sect the Christians (/s) but one wonders if the custom of Christians for careing for the poor and sick might have resulted in converts too. No data on this: Just wondering.

Wikipedia on the Diseases of Rome. Don't forget Malaria, which was more widespread in "temperate" climates than most moderns realize.

from the article: Mapping smallpox, malaria and Leprosy:

Malaria deaths in the United States, 1870 census.

But the really big plague that probably stopped the swift recovery of the western Roman empire was the plauge of Justinian.

Justinian's plague was probably Bubonic plague, and began in Egypt/Ethiopia, although the black death probably started in China.
The germ does hide in various little critters: Gerbils, rats, etc.
So IHS docs would see a couple cases a year in the Navajo reservation, and there are spotted reports about cases in Islamic terrorists catching it probably from living in dirty caves.

DNA studies suggest that it was around in the silk road area long before then,

from Nature

and SciAm wonders if this might have encouraged locals to migrate to safer pastures (i.e. to Europe and India). But DNA suggests that this strain was a lot less infectious.

But the analysis revealed that plague might have been less transmissible in the early Bronze Age. The six oldest Bronze Age strains lacked a gene called ymt that helps Y. pestis to colonize the guts of fleas, which serve as an important intermediary. In outbreaks of bubonic plague, infected fleas (often travelling on rodents) transmit the bacteria to humans living nearby. Without fleas as a go-between, Y. pestis spreads much less efficiently through blood (where it is known as septicaemic plague) or saliva droplets (pneumonic plague).

yet one does wonder what was behind a lot of bronze age plagues in the Middle East.


and one wonders if this is what hit the Philistines after they stole the Arc of the Covenant ("Hemorrhoids" is the usual translation.) and if this might have been the plague that devestated the Hittites after they went against Egypt in the Battle of Kadesh and took home some POWs as slave (and the plague followed them).

but this article claims it was the Hittites who spread Tularemia via infected sheep and they caught it too. UKTelegraph article:

The method of attack was simple. The Hittites would leave the sheep outside the targeted city. Locals would bring them in and either breed them or eat them, spreading the disease.

and this article suggests it was Tularemia that hit the Philistines too.

Global Security has a history of the use of Tularemia as biowarfare, and mentions the debate if the Tularemia in German troops at Stalingrad was biowarfare or just from normal infections. Discussion here.

Tularemia makes one sick for a couple of weeks, and has a low (under 20percent) mortality, and luckily for modern man, responds to antibiotics.

whereas Y.Pestic (black plague) works quite quickly to kill you.

more on Justinian plague here.

The Showman who saved 6500 lives

via Atlas Obscura: When Infants in Incubators were sideshow attractions:

The premise of the attraction was straightforward enough: pay an entrance fee to see something you wouldn’t usually be able to see.

What set Couney’s sideshow apart was that his subjects were premature babies in incubators, receiving care that hospitals did not provide.

The entrance fees he collected went toward his operating costs, including round-the-clock care and wet nurses. Couney did not charge the parents of his tiny patients.

Couney visited the Pan-American Exposition in Buffalo with his baby incubators, 1901. PUBLIC DOMAIN

Reporting in 1903, The Brooklyn Daily Eagle described the “seriousness and value of the system shown.” A visit to Couney’s showcase revealed rows of warmed, glass-fronted incubators supplied with filtered air, containing “little pitiful pinched looking waifs… the only things that indicate that they are alive are the healthy color of their little faces and the faint flutterings of movement which are perceptible on closer inspection.”

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NPR story of one of these children:

Lucille Horn was one of them. Born in 1920, she, too, ended up in an incubator on Coney Island.
"My father said I was so tiny, he could hold me in his hand," she tells her own daughter, Barbara, on a visit with StoryCorps in Long Island, N.Y. "I think I was only about 2 pounds, and I couldn't live on my own. I was too weak to survive."
She'd been born a twin, but her twin died at birth. And the hospital didn't show much hope for her, either: The staff said they didn't have a place for her; they told her father that there wasn't a chance in hell that she'd live.
"They didn't have any help for me at all," Horn says. "It was just: You die because you didn't belong in the world."
But her father refused to accept that for a final answer. He grabbed a blanket to wrap her in, hailed a taxicab and took her to Coney Island — and to Dr. Couney's infant exhibit.Dr. Martin Couney holds Beth Allen, one of his incubator babies, at Luna Park in Coney Island. This photo was taken in 1941.Courtesy of Beth Allen"How do you feel knowing that people paid to see you?" her daughter asks.
"It's strange, but as long as they saw me and I was alive, it was all right," Horn says. "I think it was definitely more of a freak show. Something that they ordinarily did not see."
Horn's healing was on display for paying customers for quite a while. It was only after six months that she finally left the incubators.
Years later, Horn decided to return to see the babies — this time as a visitor. When she stopped in, Couney happened to be there, and she took the opportunity to introduce herself.
"And there was a man standing in front of one of the incubators looking at his baby," Horn says, "and Dr. Couney went over to him and he tapped him on the shoulder."
"Look at this young lady," Couney told the man then. "She's one of our babies. And that's how your baby's gonna grow up."

Disease also kills: Civil war edition

StrategyPage has a review of a recent book about non combat deaths in the US Civil war....

Willis opens by pointing out that for both sides taken together, combat deaths amounted to perhaps a third of all deaths. He then sets out to explain how the other two-thirds perished.

Naturally disease was by far the biggest killer, causing most of the non-combat deaths, particularly early in the war as volunteers flocked to improvised training camps.

Mostly men of rural origins – even most Northerners – the recruits usually lacked immunity to many commonplace diseases, and died in droves. Dysentery was apparently the biggest killer, acquired from bad food or water, but malaria and pneumonia were up there as well.

Wills also looks at other causes, which seem to have accounted for about a tenth of all deaths. Accidents ranged from drowning to weapons malfunction or misuse, lightning strikes, sun stroke, falls, even snake bites. And there were also some murders, suicides, deaths in duels, executions, and others.

CSPAN has a discussion here. (R rated)






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related items:

The Swamp Doctor's adventures in the southwest ebook

Reminiscences of a Southern Hospital, by Its Matron

Rabies: Still a threat: 60 000 cases a year

This article from the CDC is about a few women in VietNam who didn't get anti rabies vaccine after being bitten because they were pregnant or breastfeeding and worried it would harm their fetus.

But the article includes this terrible fact:

Most of the world’s estimated 60,000 annual rabies deaths occur in countries where canine rabies is endemic and where PEP is often inaccessible to bite victims (4).

but cases have decreased in Vietnam thanks to the availability of the antirabies vaccine:

Vietnam has made progress in reducing human rabies deaths. The number of human rabies cases declined 82%, from 505 cases in 1994 to 91 in 2016 (3). The expansion of PEP centers in the country has played a critical role in this reduction by increasing access to PEP. 

this chart is from the Philippine health dept: we have about 200 cases a year here, and there is a push to eliminate cases by providing the shots, and also dog control.

our new mayor has started providing free post exposure rabies vaccine at the local health clinics.

Alas, they keep running out of the free vaccines, so I have provided money for two people in the last three months so their kids can finish the series of shots. (650 pesos a shot, four shots: that is 13 US dollars. But the minimum wage here is 300 pesos or six dollars a day, so you can see the problem).

Stray dogs are a problem: The authorities will pick them up (and kill them, infuriating PETA and their ilk). But stray dogs are miserable: Thin, mangy, and usually shy.

But most of the bites are from neighbor's dogs, who weren't vaccinated.

The government does have rabies shot clinics in our farm areas, for farm dogs to get shots, and you can get free shots here for the dogs if you know when they hold the clinic, but not everyone is doing it.

We usually pay to have the vet come here and give Rabies shots to all our dogs in May each year. It is cheaper than paying for vaccine when a visitor gets bitten. Not just by George, our killer lab (who used to bite anyone who got close to him even though he is chained at all times) but even Joy's masseuse was bitten by one of our small pet dogs who didn't recognize she was a friend.

and this audiobook tells the story of rabies:

Smallpox 1721

Is Smallpox a new disease?

tech times:

new analysis of smallpox DNA from the 17th century suggests smallpox might have recently evolved and does not date into prehistory as many had thought.

The disease had long been believed to have emerged among humans thousands of years ago, afflicting people in India, Egypt, and China. Some historical accounts even suggest the Egyptian pharaoh Ramses V, who passed away in 1145 B.C., had been struck by smallpox.

For the study that involved the genetic analysis of the viral DNA taken from the partially mummified remains of a child dating back from the 17th century, researchers found that the smallpox could be just some hundreds of years old.

measles is considered to be a "new" disease also, so questions if ancient plagues were measles are also at question. Measles evolved from the animal disease Rinerpest in the 11th century.

so what caused earlier plagues?

One problem is that diseases sort of change with time.

Often they are very virulent when they first hit humans, then because killing one's host is not very beneficial for your evolution, the variation of the germ that doesn't kill quickly (and hence, spreads to more people) wins the evolutionary battle.

DNA has helped to identify ancient diseases: there is some evidence that Justinian plague was actually Bubonic plague, and some studies of the plague of Athens suggest it might have been typhoid.

and they are still debating what caused the Antonine plague (which weakened the Roman Empire and killed Marcus Aurelius, the emperor in Gladiator). Since the soldiers caught it from "Parthia", a dry climate, one suspects it could be bubonic plague or a similar zoonosis.

but it also does mention the Chinese in 1000 AD devised innoculation with smallpox scabs to stop the disease from spreading (other stories insist it was Africans or the Arabs who did this. A lot of the Africans brought to the Americas were from Muslim areas and the Arabs were in touch with China so maybe the idea spread? The English started to use it from the Ottoman empire contacts.

on the other hand,

Until the 18th century, inoculation was a practice largely confined to China, India, Turkey, and other eastern countries. 

Lady Mary Montagu, an aristocrat and the wife of England’s ambassador to Turkey, is credited as being the first to bring attention to the practice in the Western world. In 1715, Montagu had gone through her own bout of smallpox, and had been disfigured as a result. After learning about inoculation during her time in Turkey, she was determined to protect her six-year-old son from the disease through inoculation.

One possible reason for the confusion is that there are two variations of smallpox: One with a very high mortality, and one with a lower mortality.

the latest case that suggested a recent evolution of the virus ignores non DNA evidence from the past

So is smallpox old or new, or something that just pops up now and then?  LINK and LINK (these are long MEGO type articles that I will have to read in detail later).

but this is one puzzle:

As variola virus lacks a known non-human animal reservoir, its origin as a human pathogen has been concealed under a veil of mystery. The evolutionary history of this virus can be dated based on either the assumed dates of variola virus subtypes diverging from the ancestors, or the dates of isolated samples that contain variola virus.

the problem with the smallpox family of viruses is that they mutate quickly, and humans can catch pox viruses from animals: The most famous example of this is Jenner's observation that milkmaids who caught cowpox never caught smallpox, and devised vaccination.

but other animal pox could cause problems: in recent years, there have been reported cases of monkeypox in humans.

and then there is camelpox:

Phylogenetic reconstructions suggest that camelpox virus, taterapox virus and variola virus emerged from a common progenitor almost simultaneously. Additionally, these viruses are strictly specific for their hosts, and both variola virus and camelpox virus cause diseases with high case fatality rates.

However, the real puzzle about human smallpox is that so far they haven't discovered an animal who carries it, i.e. a reservoir where it hides.

sow what does this mean?

It means a new outbreak could pop up from animals, mutate and kill thousands of people

Recent oubreaks of "new" diseases like SARS (in China), MERS (in the Middle East) and cases of avian flu in humans so far haven't killed millions mainly due to old fashioned ways of stopping the spread of the virus, e.g. washing hands, isolation, and stopping travelers.

 and of course outbreaks of known diseases like Zika and Ebola are also a worry.

But small pox? Spread via the air to people nearby, long incubatio perios, and no one except some of the military and first responders who have had immunity suggest a problem.

But at least with smallpox, there is a vaccine.

And the real worry: What if a newer variation, such as weaponized monkeypox or camelpox that evolves ?

again, the bad old days of quarrentine will return.

Disease and the silk road

Archeology.com reports that archeologists examining travelers' poop along the route of the Silk Road have found that Chinese parasites were spread by them.

Researchers excavated the 2,000-year-old excrement from a latrine at Xuanquanzhi, a major stopping point along the legendary trading route in northwestern China. The feces were found on “personal hygiene sticks,” rods wrapped with cloth at one end that travelers used to clean themselves after defecating. Microscopic examination revealed the eggs of four parasitic intestinal worms in the feces, including those of Chinese river fluke, which thrives in wet areas and could not have come from the area where the excavation took place—the arid Tamrin Basin. The worm is most common in Guangdong Province, around 1,240 miles from the site, suggesting that the traveler infected with it most likely journeyed a great distance.

and of course it was not just parasites:

Bipolar Mary Lincoln

I am always bemused when someone gets their two minute fame by deciding a famous person or epidemic is something different.

The latest: Mary Todd Lincoln, whose bouts of mania (hyperspending) and depression suggest a classic case of bipolar illness, instead is supposed to have suffered from B12 deficiency.

Uh no. B12 deficiency causes dementia, not mania.. and it was fatal back then, which is why they called it "pernicious anemia".

The article also says she had syphilis, a more common diagnosis that can cause mania, and would explain her walking difficulties at the end of her life.

However, her mood swings predated her marriage to Lincoln, which is more consistent with bipolar disease... or maybe a hysterical narcissitic personality. Maybe both: Her bouts of severe depression are well documented, but her buying sprees were what led to her son putting her in an asylum. She was released after a year, and lived several more years.

this would not happen with B12 deficiency

As for syphilis: It was a common diagnosis in those days since young men frequented the friendly ladies of the evening before marriage.

And Mary Lincoln might indeed have had tabes dorsalis.

more HERE.

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Neanderthal extinction: rewrite the books

There are various theories why the Neanderthals went extinct, most of them implying that aggressive newcomers pushed the off their hunting grounds to genocide.

But the latest theory wonders if the newcomers brought in new infectious disease did them in, in the same way that infectious disease caused millions of indigenous Amerindians to die after the Spanish arrived.

. “Humans migrating out of Africa would have been a significant reservoir of tropical diseases. For the Neanderthal population of Eurasia, adapted to that geographical infectious disease environment, exposure to new pathogens carried out of Africa may have been catastrophic,” Charlotte Houldcroft of the University of Cambridge told The Guardian. 

this was sort of ignored because "experts" insisted that cavemen didn't have infectious disease, and only after en settled down in houses with a pig in the parlor did disease become a problem.

Now there is a question if disease could have been there all along.

Archeology org link

UKGuardian has more details.

The DNA suggestion that sexual relationships might have occured also suggests STD's like herpes simplex might be behind the problem. But they also note TB in there.

the problem: This is only theory. Awaiting proof...

The STD syphillis came into Europe with Colombus' sailors (who when out of work went to Italy, had fun with the lovely ladies of Naples who then entertained the German mercenaries, if I remember the history correctly)

But what about those pre 1492 cases of syphillis found in a few skeletons?

I always assumed it was Yaws, a related disease, but now that DNA suggests some Norwegians and/or Icelanders have Amerindian female ancestry, the theory is that maybe the Vikings brought back not only Amerindian women but syphillis, and that was the source of why a few pre 1492 cases were found.

From Science Frontiers

Recently, however, several additional syphilitic skeletons were dug up at a medieval friary in northeastern Britain. The earliest of these bones date back to about 1300. In fact, the new evidence suggests that there was a geographically limited mini-epidemic of syphilis in Britain about this time. Columbus was now off the hook, but who should be hung on it instead? The Vikings, of course. Viking merchants began visiting this part of England about 1300. And it is now admitted that the Vikings had made it to the New World source of the disease circa 1000. Case closed!? (Malakoff, David; "Columbus, Syphilis, and English Monks," Science. 289:723, 2000.)

The DNA article LINK 

I like the part that she came "Voluntarily or non voluntarily": Both Indians and Vikings routinely captured women to use as slaves, a job that included sexual work. Some of course would later marry and be accepted into society, (hence the high amount of Celtic genes in Icelanders)