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1918 vs. 1957 : Spanish vs. AsianPreparedness and Vaccinations

Spread of Spanish Influenza 1918

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Spanish Influenza vs. Asian Influenza

In 1918, influenza is not a nationally

reportable disease (CDC).

February 1957 - the Asian influenza

emerged in China.

Scientific advancements make it easier to

identify than the 1918 influenza.

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Doctors in 1918Ignorance is Not Bliss

Warned Public Health Officialsof Dire Consequences

Urged Cities to PracticeIsolation and Quarantine

Patriotic War FervorA Nave Population Stubborn City Leaders

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Doctors and Hospitals in

1957

Influenza incidence

reaches high levels Physicians offices

crowded to overflowing Most patientsNot severely illDidnt need specialtreatment

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1918-Public

Health and Medi

cal Eff

orts

Hospitals 1918

Overflowed with

patients

Expanded treatment

centers

Intensified shortage ofmedical personnel

Overwork and

overexposure

Just not enough

Public Health Service - 1918

Struggles withorganization/lack of

leadership

Unprepared

Public Health Agencies

Theoretical Jobs Now a

Reality

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1957 Public

Health and Medi

cal Eff

orts

The CDC ASTHO

Intensively studied the

epidemic

Tried to predict

diseases course for

autumn

Looming pandemic

subject of special

meeting at the

Association of State and

Territorial Health

(ASTHO) Health officials met to

discuss strategy

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1918-1919 United States Public

Health Service Measures

A D i r e c t o r i n Ea c h S t a t e ! B o s t o n Wa n t s To o M a n y

N u r s e S h o r t a g e

N u r s e s N e c e s s a r y

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1957 US Public

Health Measu

res

June 1957 only weekly

telegraph reports from CDC

Influenza Surveillance Unit

National Health Survey

County Reports

Improvements ASTHO Recommendations

Home care

Safety Measures

Not many restrictions

Quarantine not considered

effective

no practical advantage

in the closing of schools

or the curtailment of

public gatherings as it

relates to the spread of

this disease.

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US Government Preparedness

1918

No problem finding the $$ 2 Hours for Congress to approve a

budget The problem?

No funds appropriated byCongress for prevention

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US Government Preparedness

1957

Armed Forces Epidemiological Board 1940 Commission on Influenza Studies of epidemiology and prevention

International Influenza Study

Program of the WHO 1948

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(Lackof) Treatment - 1918 No influenza vaccine

"Physicians triedeverything they

knew.

Only one therapeutic

measure shows

positive results

1931 Viral Growth

1940s First approvedinactivated vaccines for

influenza

Over time advances in

fields of immunologyand vaccinology enable

mass production

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(Presence of) Treatment 1957 To prevent illness and

death from epidemic

influenza within the limits ofavailable vaccine.

There was a shortage of

vaccine in August

Surgeon General Leroy

Burney makes an

announcement

Vaccine allocatedaccording to statespopulation

Distribution bymanufacturers throughcommercial networks

Recommended priority

be given to public healthworkers and communityservice providers, as wellas those with specialcircumstances.

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In his book,AmericasForgotten Pandemic, Alfred W.Crosby wrote, (the UnitedStates) "was not merelyunprepared to control thespread of influenza. It had

carefully, if unintentionally,prepared itself to expedite thecultivation and disseminationof the influenza virus of 1918."

Do You Agree? Why?

What would you change?

Were They

Ready???

8/9/2019 1918 v. 1957 Influenza

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Ti

m

el

i

n

e

o

f

V

a

c

c

i

ne

P

r

o

d

u

c

ti

o

Ma

y

19

5

7

No

v

19

5

7

June July Aug. Sept. Oct.

May 13 USreceives first

influenzaspecimens fromHong Kong

May 22 Definitiveidentification of new

influenza strain

Vaccine trialsconducted

4 Million DosesReleased

9 Million DosesReleased

16 MillionDoses Released

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So

What

sthe P

roblem?

Only enough vaccine for 17% of Population

Vaccine only 60% effective

Epidemic peaked in late October, but rates sharply

declined in November

Have supply, but demand is gone

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Refe

ren

ces

Taubenberger JK, Morens DM. 1918 influenza: the mother of all pandemics. Emerg Infect

Dis [serial on the Internet]. 2006 Jan [date cited]. Available from

http://www.cdc.gov/ncidod/EID/vol12no01/05-0979.htm

D. A. Henderson, Brooke Courtney, Thomas V. Inglesby, Eric Toner, and Jennifer B. Nuzzo.Public health and medical responses to the 1957-58 influenza pandemic. Biosecurity and

Bioterrorism. Volume 7, Number 3, 2009. Mary Ann Liebert, Inc.

http://www.upmc-biosecurity.org/website/resources/publications/

2009/2009-08-05-public_health_medical_responses_1957.html

http://www.pandemicflu.gov/storybook/index.html

http://www.jhsph.edu/publichealthnews/articles/2005/great_influenza.html

Crosby, Alfred W. Jr., Epidemic and Peace 1918, Greenwood Press 1976. Updated

introduction and reprinted as, Americas Forgotten Pandemic, Cambridge Press 1989