Short abstract
BBC Radio 4, 2 February at 8 pm
Rating: ★★★
Aspate of high-profile infectious threats has gripped the public psyche over the past few years. Coming amid reports of a rise in avian flu and a year after the outbreak of severe acute respiratory syndrome (SARS), this programme, which looked at the influenza pandemic of 1918, was timely.
The 1918 flu was one of the most devastating disease outbreaks of all time, killing 50 million people worldwide Witnesses reported the effects on family and society, as well as providing descriptions of the signs and symptoms—including heliotrope cyanosis, a grey to lavender hue over patients' faces and ears. The ages of those affected—people in their 20s and 30s—made the accounts seem all the more chilling.
Rather remarkably this outbreak, which cost more lives than the first world war, has been largely ignored. Hence the programme dubbed it “the forgotten epidemic.” In the United Kingdom 250 000 people died from this strain in 1918, compared with a current figure of 4000 deaths a year from flu.
But why did this flu cause more deaths than any other? What were the origins of this particular pandemic? The virus is traced back to a military camp in France. It is likely that the mêlée of animals and, more importantly, birds, combined with the cramped conditions of the soldiers to foment a perfect breeding ground. As with SARS, it is believed that the virus originally came from a bird.
Figure 1.
The next pandemic?
Credit: EPA/AJAY/PA
Despite the huge death toll, most of the 70% of people affected recovered. So why did previously healthy young people die? Scientists have been attempting to isolate the virus and understand why some people died and others did not. By looking at archived specimens and exhuming bodies in Alaska (and elsewhere), a hypothesis has been developed. Maybe an exaggerated immune response, resulting in a cytokine storm, could have been responsible for the fluid that flooded the lungs of those afflicted. The work continues.
And what of the future? “Is there another virus out there somewhere that will one day mutate and take against us with drastic consequences?” asked the voice-over. The answer seemed to be yes. However, the scientists interviewed hoped that, by understanding past outbreaks, future epidemics might be prevented or contained.
This account of pestilence on a large scale retained a human dimension with witness accounts used to good effect. But the programme's focus on the future threat to mankind seemed somewhat scaremongering. While it is right to highlight the threat of pandemics, it is not right to exaggerate that threat.