4 flu preparedness lessons from the 1918 pandemic

The 1918 flu pandemic offers several lessons on infection control and outbreak response efforts for health officials today, according to a study published Oct. 8 in Frontiers in Cellular and Infection Microbiology.

For the study, researchers analyzed numerous flu studies to identify the human, viral and societal factors that fueled the flu pandemic of 1918, in which 50 million people died.

"Like the 1918 pandemic, the severity of any future outbreak will result from a complex interplay between viral, host and societal factors," study author Carolien van de Sandt, PhD, a researcher at the Peter Doherty Institute for Infection and Immunity in Melbourne, Australia, told Science Daily. "Understanding these factors is vital for influenza pandemic preparedness."

Here are four lessons from the 1918 flu pandemic, as outlined by the researchers:

1. Conduct regular viral surveillance. The viral strain responsible for the 1918 pandemic could infect tissues outside of the respiratory tract and contained mutations making it more easily spread between humans. Today, scientists can analyze new viral strains for pandemic potential, a practice that proves more important than ever amid climate change, according to the researchers.

"Climate changes affect animal reservoirs of influenza viruses and bird migration patterns. This could spread viruses to new locations and across a wider range of bird species," Dr. van de Sandt told Science Daily.

2. Address public health issues. A century ago, malnourished individuals or those with underlying health issues were more likely to die from the flu. Current public health issues, such as obesity, could pose an issue for future pandemics and cause a higher death toll.

3. Consider population demographics. The 1918 pandemic had an outsized effect on young adults, not the elderly. Researchers suggest the older population had a greater immunity to the 1918 flu strain due to past virus exposure.

"Providing emergency vaccines during future pandemics should take in account different age groups, viral and host factors," Katherine Kedzierska, PhD, a study author and researcher at the Doherty Institute, told Science Daily.

4. Be proactive with infection control methods. Infection control measures such as prohibiting public gatherings and promoting hand-washing helped lower infection levels and death during the 1918 pandemic. However, the measures only proved successful if the interventions were implemented early and used throughout the entire pandemic.

"Until a broadly-protective vaccine is available, governments must inform the public on what to expect and how to act during a pandemic," Dr. van de Sandt told Science Daily. "An important lesson from the 1918 influenza pandemic is that a well-prepared public response can save many lives."

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