The Sick YearsThe Sick YearsExamining Examining the impact of the “Spanish Flu” Pandemic of the impact of the “Spanish Flu” Pandemic of

1918 to 19201918 to 1920

Teacher: Teacher:

Geographic focus:Geographic focus:Medical GeographyMedical Geography

How physical systems How physical systems affect human systems affect human systems

National & State StandardsNational & State Standards

National Geography StandardsNational Geography Standards

Physical SystemsPhysical Systems

7. The physical processes that shape the 7. The physical processes that shape the patterns of earth’s surface.patterns of earth’s surface.

Environment & SocietyEnvironment & Society

15. How physical systems affect human 15. How physical systems affect human systems. systems.

State Geography & other StandardsState Geography & other Standards

NM B.3NM B.3.: Analyze and evaluate .: Analyze and evaluate changes in regions and recognize the changes in regions and recognize the patterns and causes of those patterns and causes of those changes.changes.

NM D.1.: NM D.1.: Analyze how the Earth’s Analyze how the Earth’s physical processes are dynamic and physical processes are dynamic and interactive. interactive.

NM History Standard 4. NM History Standard 4.

Analyze the major political, economic, Analyze the major political, economic, and social developments that and social developments that occurred between WWI & WWII.occurred between WWI & WWII.

School AYP focus:School AYP focus: reading reading comprehension and writing skillscomprehension and writing skills

Objectives & MaterialsObjectives & Materials

ObjectivesObjectivesStudents will be able to:Students will be able to:1.1. Identify when & where the “Spanish Identify when & where the “Spanish

Flu” occurred.Flu” occurred.2.2. Analyze and discuss why the virus Analyze and discuss why the virus

was so deadly and how it spread was so deadly and how it spread so quickly. so quickly.

3.3. Discuss the differences between Discuss the differences between epidemic, endemic, and a epidemic, endemic, and a pandemic.pandemic.

4.4. Analyze and discuss the impact of Analyze and discuss the impact of the “Spanish Flu”, worldwide, from the “Spanish Flu”, worldwide, from 1918 to 1920. 1918 to 1920.

5.5. Analyze and discuss the dangers of Analyze and discuss the dangers of modern avian viruses, like the modern avian viruses, like the H5N1 virus, or “Avian Flu” and its H5N1 virus, or “Avian Flu” and its potential global impact. potential global impact.

MaterialsMaterialsStudents will need a:Students will need a:1.1. World MapWorld Map

Teacher will need:Teacher will need:1.1. Laptop ProjectorLaptop Projector2.2. Essay instructions (homework)Essay instructions (homework)Lesson Time: Two sessionsLesson Time: Two sessions

Session One: PresentationSession One: PresentationSession Two: Dr. Larry Brilliants “TED” Session Two: Dr. Larry Brilliants “TED”

video: Stop the next Pandemicvideo: Stop the next Pandemic& discussion& discussion

IntroductionIntroduction

““The most deadly disease The most deadly disease event in human history”event in human history”

WHOWHO

Who has heard of the Who has heard of the Spanish Flu? Spanish Flu?

When did it occur? When did it occur?

The World in 1918The World in 1918

In 1918, the deadliest war ever (to that In 1918, the deadliest war ever (to that point) known was coming to an end.point) known was coming to an end.

The dead you see are not flu victims, but The dead you see are not flu victims, but casualties of the western front of WWI.casualties of the western front of WWI.

By the end of the war, over 5.5 million By the end of the war, over 5.5 million allies and 4.8 million Germans lay dead. allies and 4.8 million Germans lay dead. Another 8 million (both sides) were missing Another 8 million (both sides) were missing and over 20 million were wounded. Most of and over 20 million were wounded. Most of these were men between 20 and 40. these were men between 20 and 40.

The entire European infrastructure was The entire European infrastructure was devastated by this war. devastated by this war.

The United States, however, were not only The United States, however, were not only credited as the victors, but were now credited as the victors, but were now officially becoming the most industrialized officially becoming the most industrialized nation in the world.nation in the world.

But there was another enemy lurking; one But there was another enemy lurking; one that was much smaller but would take 5 to that was much smaller but would take 5 to 10 times the number of casualties than the 10 times the number of casualties than the entire world war.entire world war.

The “Spanish Influenza”The “Spanish Influenza”“I had a little bird,“I had a little bird,it’s name was Enza,it’s name was Enza,I opened the window,I opened the window,and in-flew-Enza”and in-flew-Enza”

Between March, 1918 and June, 1920 it Between March, 1918 and June, 1920 it waswas estimated estimated that 25 to 50 million people died from this flu.that 25 to 50 million people died from this flu.

Current estimates indicate that the number was more Current estimates indicate that the number was more likely as high as 100 million people and that over 500 likely as high as 100 million people and that over 500 million people were infected. million people were infected.

This virus was so widespread that there were reported This virus was so widespread that there were reported cases as far as the Arctic and many remote South cases as far as the Arctic and many remote South Pacific islands. Pacific islands.

Hand out map of worldHand out map of world http://alliance.la.asu.edu/azga/http://alliance.la.asu.edu/azga/

Where it began?Where it began?

Identify Ft. Riley, KS and date it 03/04.1918Identify Ft. Riley, KS and date it 03/04.1918

Identify Queens, NY and date it 03/11/1918Identify Queens, NY and date it 03/11/1918

Identify Brest, France and mark it “H1N1” 06/1918Identify Brest, France and mark it “H1N1” 06/1918

Identify Sierra Leone, Africa and mark it “H1N1” 06/1918Identify Sierra Leone, Africa and mark it “H1N1” 06/1918

By the way… the virus did not originate in Spain, as the name suggests. It was first really By the way… the virus did not originate in Spain, as the name suggests. It was first really recognized in France, during the war. But because France was under wartime censorship, it recognized in France, during the war. But because France was under wartime censorship, it would be the outbreak in Spain (a neutral, free-press nation) that would massively advertise would be the outbreak in Spain (a neutral, free-press nation) that would massively advertise the virus. the virus.

The Dynamic VirusThe Dynamic Virus

H5N1, H1N1, H3N2... the flu virus H5N1, H1N1, H3N2... the flu virus designations are interesting and designations are interesting and puzzling. But how do scientists come up puzzling. But how do scientists come up with these strange names. According to with these strange names. According to experts, there are 15 different types of experts, there are 15 different types of hemagglutinin molecules and 9 different hemagglutinin molecules and 9 different types of neuraminidase molecules. types of neuraminidase molecules. Virologists identify Influenza A viruses by Virologists identify Influenza A viruses by their specific hemagglutinin and their specific hemagglutinin and neuraminidase molecules. In 1980, neuraminidase molecules. In 1980, scientists adopted a general formula for scientists adopted a general formula for naming Influenza A viruses, HxNy (x naming Influenza A viruses, HxNy (x represents the type of hemagglutinin represents the type of hemagglutinin molecule and y represents the type of molecule and y represents the type of neuraminidase molecule.)neuraminidase molecule.)

For example, an avian flu virus with For example, an avian flu virus with hemagglutinin molecule 3 and hemagglutinin molecule 3 and neuraminidase molecule 2, its name neuraminidase molecule 2, its name would be H3N2.would be H3N2.

Virus is believed to come from the wild Virus is believed to come from the wild birds of south Asia (who infect birds of south Asia (who infect domesticated birds). domesticated birds).

The Dynamic VirusThe Dynamic Virus

RNA is extremely error prone: on RNA is extremely error prone: on average, each new virus differs average, each new virus differs from its parent by at least one from its parent by at least one nucleotide. nucleotide.

Influenza is the only virus that Influenza is the only virus that undergoes true antigenic drift undergoes true antigenic drift (genetic changes in the virus that (genetic changes in the virus that occur because of errors in occur because of errors in replication.) replication.)

Two different viruses can infect a Two different viruses can infect a cell at the same time. For instance, cell at the same time. For instance, if human and an avian flu virus if human and an avian flu virus infect a pig cell, they can swap infect a pig cell, they can swap genes. This swap results in a new genes. This swap results in a new flu subtype that has both avian and flu subtype that has both avian and human flu characteristics. This human flu characteristics. This 'reassortment' is known as 'reassortment' is known as antigenic shift. antigenic shift.

How did it spread so fast?How did it spread so fast?

Wild birds are migratoryWild birds are migratory Domesticated birds are Domesticated birds are

everywhereeverywhere Humans are around Humans are around

domesticated birdsdomesticated birds HxNy viruses are HxNy viruses are

pathogenic and can pathogenic and can spread from a bird to spread from a bird to human host, quickly.human host, quickly.

Humans, then, pass it to Humans, then, pass it to each other.each other.

Non-vectored Disease: needs a Non-vectored Disease: needs a “middleman” or “middlepig”“middleman” or “middlepig”

Endemic, Epidemic, and PandemicEndemic, Epidemic, and Pandemic

Epidemic: Epidemic: An outbreak of a disease An outbreak of a disease spreading throughout a communityspreading throughout a community

Endemic: Endemic: Commonly found in a specific Commonly found in a specific geographical areageographical area

Pandemic: Pandemic: Occurring over a whole country Occurring over a whole country or the whole worldor the whole world

Impact of the “Spanish Flu”Impact of the “Spanish Flu”

In the US, the impact was In the US, the impact was severesevere

Look at the top chart. Look at the top chart. What do you see? What do you see?

The Spanish Flu killed The Spanish Flu killed young, healthy men more. young, healthy men more. Why?Why?

Look at the bottom chart. Look at the bottom chart. What do you see?What do you see?

Life expectancy dropped Life expectancy dropped significantly during the significantly during the Spanish Flu years.Spanish Flu years.

Share my grandma’s story Share my grandma’s story (optional)(optional)

Spanish Influenza ImpactSpanish Influenza Impact

City Estimated 1918 Population Total Deaths

Atlanta, GA 201,752 212

Boston, MA 785,245 6,225

Chicago, IL 2,596,681 14,014

Denver, CO 268,439 1,652

Los Angeles, CA 568,495 3,184

New York, NY 3,215,879 33,387

Philadelphia, PA 1,761,371 15,785

San Francisco, CA 478,530 3,755

Seattle, WA 366,445 1,441

Washington, DC 401,681 3,169

     

Impact on WWIImpact on WWI“Far from being mutually exclusive, the Great War and the “Far from being mutually exclusive, the Great War and the

1918-1919 flu worked in symbiotic and destructive 1918-1919 flu worked in symbiotic and destructive partnership” partnership”

The Great War created a perfect The Great War created a perfect breeding ground for the H1N1 virus.breeding ground for the H1N1 virus.

Soldiers, on both sides, were Soldiers, on both sides, were anxious, strained, depressed, anxious, strained, depressed, physically overtaxed, and physically overtaxed, and malnourished. malnourished.

Because so many were infected, the Because so many were infected, the over crowed factories, public offices, over crowed factories, public offices, and trenches made it easy to spread.and trenches made it easy to spread.

War efforts were hampered, as well. War efforts were hampered, as well. War ammunition factories reported up War ammunition factories reported up to 40% absenteeism.to 40% absenteeism.

The flu thwarted major attacks, on The flu thwarted major attacks, on both sides.both sides.

Result: over 225,000 civilians and Result: over 225,000 civilians and 30,000 soldiers died.30,000 soldiers died.

Class discussionClass discussion

If the war casualties exceeded 20 million If the war casualties exceeded 20 million and the flu took another 50 to 100 million, what and the flu took another 50 to 100 million, what kind of affect did the two have on society?kind of affect did the two have on society?

Remember: many of them were young menRemember: many of them were young men

Remember: European infrastructure collapsed, Remember: European infrastructure collapsed, sending them into a major depression.sending them into a major depression.

Today’s Dangers!Today’s Dangers!

H5N1, “Avian Flu”H5N1, “Avian Flu”

Like the Spanish Flu of 1918-Like the Spanish Flu of 1918-1920, the Avian Flu is highly 1920, the Avian Flu is highly pathogenic!pathogenic!

The countries shown on the right The countries shown on the right have all reported the presence of have all reported the presence of this deadly strain.this deadly strain.

Tens of millions of birds have Tens of millions of birds have been killed in an effort to prevent been killed in an effort to prevent the spread to a human host.the spread to a human host.

WHO has reported that up to 90 WHO has reported that up to 90 people have died from the H5N1 people have died from the H5N1 strain of influenzastrain of influenza

It is estimated that up to 1 billion It is estimated that up to 1 billion people may die, should this strain people may die, should this strain transmit beyond a locale.transmit beyond a locale.

Cases in AsiaCases in Asia

Migratory paths of Migratory paths of infected birds infected birds (potential)(potential)

Dr. Larry Brilliant: Help Dr. Larry Brilliant: Help Stop the next PandemicStop the next Pandemic

http://www.ted.com/talks/view/id/58http://www.ted.com/talks/view/id/58

26 minutes26 minutes

Watch and discuss:Watch and discuss:

Essay HomeworkEssay HomeworkAvailable as a handoutAvailable as a handout

Choose one of the following subjects and write a two page, Choose one of the following subjects and write a two page, double spaced reflective or research essay:double spaced reflective or research essay:

1.1. Reflect on Dr. Brilliant’s presentation and discuss his main Reflect on Dr. Brilliant’s presentation and discuss his main points and potential solutions. Discuss whether you agree or points and potential solutions. Discuss whether you agree or disagree and add any additional suggestions to help stop the disagree and add any additional suggestions to help stop the next pandemic.next pandemic.

2.2. Compare and contrast the Black Plague epidemic in 1347-1352 Compare and contrast the Black Plague epidemic in 1347-1352 in Europe and the Spanish Flu of 1918-1920. What similarities in Europe and the Spanish Flu of 1918-1920. What similarities and what differences did you find. Why did the Spanish Flu and what differences did you find. Why did the Spanish Flu spread faster? How were both pandemics stopped? spread faster? How were both pandemics stopped?

3.3. Choose a global disease (AIDS, small pox of the past, polio, Choose a global disease (AIDS, small pox of the past, polio, etc) and identify how many have perished, where they etc) and identify how many have perished, where they originated, who has been most affected, and what is being done originated, who has been most affected, and what is being done to eradicate these diseases? to eradicate these diseases?

Grading ChecklistGrading Checklist

Essay included all criteria identified in handout?Essay included all criteria identified in handout? 10 points10 points Essay sited sources used?Essay sited sources used? 2 points2 points Essay was 2 pages and double-spaced?Essay was 2 pages and double-spaced? 2 points2 points Writing followed standard rules and conventions?Writing followed standard rules and conventions? 6 points6 points

Each day late will produce a 3 point penaltyEach day late will produce a 3 point penalty

Total point value: 20 pointsTotal point value: 20 points

Due date: to be determinedDue date: to be determined

SourcesSources

www.wikipedia.comwww.wikipedia.com www.nationalgeographicsociety.comwww.nationalgeographicsociety.com World Health Organization websiteWorld Health Organization website