swine flue, mexico city swine flu
Gregory Bull/AP
A couple wears surgical masks while riding
the subway in Mexico City, Mexico after an
outbreak of swine flu.

New Swine Flu Outbreak Recalls 1976 Crisis

April 26, 2009 05:18 PM
by Mark E. Moran
Swine flu, which caused panic and a national vaccination drive in 1976, has now been confirmed in New York and Kansas. Earlier outbreaks occurred in Mexico, Texas and California.

Swine Flu Outbreaks Worry Public Health Officials

The U.S. Centers for Disease Control and Prevention (CDC) has confirmed that eight students from St. Francis Prep High School in New York City have a Type A influenza virus that is Swine Flu.

More than 100 students at the school were sickened last week, although symptoms were mild in all cases. Some students at the high school recently traveled on Spring Break to Mexico, where there is a more prevalent and serious outbreak of Swine Flu. Health authorities in Kansas have also reported two cases in the state, again affecting people who recently returned from Mexico. The CDC now reports a total of 20 confirmed cases in the U.S. The World Health Organization, which is monitoring the situation, reports that the known cases in the United States are mild, with only one case requiring a brief hospitalization, and no deaths. The CDC has confirmed that the disease is spreading through human-to-human contact.

Swine flu is a respiratory disease of pigs caused by type A influenza viruses. Human infections are unusual, but do happen. Most commonly, human cases of swine flu happen in people who are around pigs. However, it is possible for swine flu viruses to spread from human to human, which appears to have occurred in the current outbreak.

Swine flu first became well-known to Americans in 1976 after an outbreak among 500 soldiers (one of whom died) at Fort Dix, N.J. Later that year, the federal government implemented a vaccination program against swine flu. The vaccine caused serious complications in hundreds of people, and was halted after a few months. The program was criticized by many as motivated by politicians eager to show they were taking action in the face of public concern.  However, in a joint article, the then-directors of the CDC and the immunization program defended the program, arguing that "Public health officials were concerned that if immunization was delayed until H1N1 was documented to have spread to other groups, the disease would spread faster than any ability to mobilize preventive vaccination efforts."

But in retrospect, they acknowledged that communication to the public should have come from scientifically qualified persons. Instead, President Ford convened a press conference, which included pictures of his being immunized.  The article acknowledges that "these instances seemed to underline the suspicion that the program was politically motivated, rather than a public health response to a possible catastrophe."

In response to the new outbreak, the CDC has begun to create a seed stock for a new vaccine that it would hope would be effective against the variant of the virus that is implicated in current cases.

The situation is more serious in Mexico. There, the World Health Organization (WHO) has reported nearly 900 serious cases of the flu in the last month, with 62 deaths. The flu in Mexico has not yet been confirmed to be swine flu, although it is believed to be associated with an animal virus. Symptoms in the Mexican cases have included fever, headache, eye pain, shortness of breath and extreme fatigue, leading to severe respiratory distress.

In a twist eerily reminiscent of the 1918 Spanish Flu pandemic, most cases in Mexico have been reported in healthy adults. The elderly and the very young, which usually are the hardest hit by the flu, have not been significantly affected. Some of the strains found in the United States are identical to some found in Mexico.

WHO advises that, with respect to the situation in Mexico, “Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern.” On Saturday, April 25, WHO formally declared the situation a “public health emergency of international concern.”
The viruses implicated in this outbreak have not been previously detected in pigs or humans. WHO reports that the viruses appear to respond to treatment with oseltamivir, but resist both amantadine and rimantadine.

William Schaffner, a flu expert at Vanderbilt University School of Medicine in Nashville, Tenn., told Bloomberg that the investigation of the outbreak “has a sense of urgency about it. They are asking us who work in hospitals to go to our emergency rooms and our pediatric wards to gather specimens and start testing them.”

Officials are concerned because of the apparent novel form of virus that is implicated in the outbreak. New influenza viruses have historically been dangerous for people. The “Spanish Flu” of 1918, for example, may have killed as many as 50 million people worldwide. Smaller, but very deadly, outbreaks of flu also occurred globally in 1957 and 1968.

However, Bloomberg reports that Anne Schuchat, director of respiratory diseases at the CDC, told reporters on a conference call on Friday that “We don’t think this is a time for major concern.”

Reference: Swine flu

Historical Context: The swine flu scare of 1976

The first major outbreak of Swine Flu occurred in February 1976 among 500 soldiers at Fort Dix. Time Magazine reported on the initial reactions to the outbreak, which included a federal vaccination program. That program eventually caused substantial problems to hundreds of recipients, and was finally halted after just three months; though it was reinstated, few Americans participated thereafter.

Haverford College biology student Joel Warner wrote “The Sky is Falling: An Analysis of the Swine Flu Affair of 1976,” in which he assessed the successes and failures of the National Influenza Immunization Program of 1976.

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