Monday, April 26, 2010

1889 Pandemic-from

1889 Pandemic Didn’t Need Planes to Circle Globe in 4 Months

The 1889 Russian flu pandemic circled the globe in just four months, captivating the world, despite the lack of airplanes or hyperventilating cable news stations.

If that was possible, closing down air traffic in the event of a new pandemic might not do much, argue the authors led by Alain-Jacques Valleron, an epidemiologist at the Institut National de la Santé et de la Recherche Médicale in Paris.

“The rapid progression of the 1889 pandemic demonstrates that slower surface travel, even with much smaller traveler flows, sufficed to spread the pandemic across all of Europe and the United States in ~4 months,” the researchers wrote in the Proceedings of the National Academy of Sciences on April 26. “This observation supports mathematical model results, which anticipated that restricting air transportation would have little, if any, effect. One possible hypothesis is that the important predictor of the speed of the pandemic is not the absolute numbers of passengers traveling between cities but the connectedness of the network of cities.”

The data on the disease were assembled for the first time from local records in 172 European and American cities. The Russian flu is particularly interesting because it was the first major epidemic to strike Europe after the laying down of dense railroad connections. In 1889, there were already more than 125,000 miles of rail lines connecting European cities. (That’s more mileage than exists today, the authors note).


The outbreak began in the spring of 1889. It peaked first in St. Petersburg, Russia, in December of that year. By then, it had spread all across Europe and North America and was front-page news in many places across the country. In papers like The Evening Bulletin in Maysville, Kentucky, the flu hit the front page in the days after Christmas. The paper printed dispatches from cities across the world. “It is safe to say that over one-tenth of the population is affected by it,” a Boston reporter wrote. Meanwhile, doctors in Pittsburgh “expected[ed] ‘la grippe’ to reach here in all its violence before another month has passed.”
Reports of royalty afflicted with influenza popped up in papers interspersed with bits of other news. The Salt Lake City Herald reported that the czar of Russia was “making favorable progress toward recovery from influenza.”

While popular culture was receiving its information through the papers and informal information networks, the new study shows that more detailed records exist that make detailed, quantitative epidemiology for 19th-century disease outbreaks possible. Local authorities in Germany were already conducting massive surveys of 16,000 physicians, of whom 21 percent actually responded.

Tracking the medical response to the outbreak is much harder. At the time, many different ideas for what caused the disease were floated, according to historian F.B. Smith.

“In keeping with traditional speculations about epidemics, some doctors invoked earthquakes and volcanic eruptions as material energizers, concentrators, and disseminators, but in mechanistic terms, not as mere erratic signs of Providential displeasure,” Smith wrote in a 1995 essay on the Russian flu. “Earthquakes had been reported in almost every month of 1889, in such disparate locations as the Isle of Wight and Portsmouth, Manchester, Sicily, Greece, Japan, Samoa, Alabama, and elsewhere round the world.”

One editorial in The Lancet argued that disease could travel around the world as easily as the dust from Krakatoa, which had exploded in 1883 and delivered brilliant sunsets in Europe.

“Why should not this troublesome complaint have been produced by injurious emanations from the earth? Mild at first . . . [influenza] gets worse as it goes on, apparently gathering up other morbific elements on its way,” he wrote. “There is no more difficulty in admitting an atmospheric pollution traveling across the Atlantic to New York than that the red sunsets . . . round the world were lately caused by the dust of a Java volcano.”

Other theories held that electrical and magnetic phenomenon were “likely agents,” Smith wrote, largely because some earlier epidemics had coincided with spectacular northern lights displays. It was hypothesized that electrical currents in the air could produce ozone, which intensified the illness.

In the end, what doctors did may not have mattered much. The French researchers found that the mortality of the 1889 pandemic was about the same as the flu outbreaks of 1947, 1957, 1968, and 1977-1978, and (so far) 2009-2010. Transportation, information and medical networks may have changed, but the virulence of the flu — with the huge exception of the 1918 pandemic — appears to have stayed roughly the same.

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