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H1N1 (Swine Flu) vs. Spanish Flu of 1918

By Julie Stachowiak, PhD
Multiple Sclerosis Guide; Guest blogger

We have all heard the comparisons between swine flu (H1N1) and the Spanish flu of 1918. Yes, there were some remarkable similarities: the Spanish flu started as a pretty mild disease in the spring and summer of 1917, but turned deadly in early fall and winter of 1918. In fact, it killed about 40 million people in less than a year, with about 750,000 Americans among them. The Spanish flu was also a specific H1N1 subtype of influenza A, like swine flu.

However, as pointed out in an article in Infection Control Today, swine flu is not Spanish flu and 2009 is not 1918. Many things are different today:

  • We now have two antiviral medications (Tamiflu and Relenza), which not only shorten the course of the illness in sick people who take it within 48 hours of symptom onset, they also limit the period during which people are contagious.
  • Public health authorities are taking measures to prevent the spread of swine flu, whereas very little was known about disease spread and transmission during the time of the Spanish flu, so very little was done to stop infections. The simple idea of handwashing to prevent infections was not even known or advocated until the 1840s. The most effective prevention measure that we (will) have is an effective vaccine against swine flu, which clearly was not the case with Spanish flu.
  • Antibiotics are now widely available. As many people know, antibiotics are not effective against viruses like influenza - however, many influenza-related deaths are caused by secondary bacterial infections, namely pneumonia. Antibiotics can effectively treat bacterial pneumonia.
  • We also now have great supportive care, such as ventilators. Some people who have respiratory failure can be kept alive on ventilators until they respond to treatment and can once again breathe on their own.

So, there you have it. We are in much better shape globally to deal with an influenza pandemic than we were in 1918. Of course, this does not mean that we will get out of this one without a huge number of people getting sick and many deaths, but we have many more weapons in our arsenal than we had in 1918.

September 15, 2009 at 4:15 pm
(1) Randy says:

Wasn’t there a smilar “pandimic” in 1976 under Ford’s watch. Didn’t he also try to “shove” down our throughts that everyone had to get shots?

September 16, 2009 at 5:46 pm
(2) Dreamer says:

I have been concerned about the potential for a ventilator shortage for more than 2 years now. The initial concern was if there was an outbreak of H5N1 or Avian Flu. It appears that the H1N1 Swine Flu pandemic could also be severe enough to cause ventilator shortages. There were calls for hospitals to double the number of ventilators that they have 2 years ago but this was not done. I started the Pandemic Ventilator Project as a way for concerned individuals to build ventilators from commercial grade equipment if the government did not heed the warnings to increase ventilator inventories. Individuals built ventilators to supply to hospitals during the polio epidemic when there were shortages. See the Pandemic Ventilator Project at http://www.panvent.blogspot.com There are ideas for basic ventilators, high frequency oscillatory ventilators and ECMO units.

November 5, 2009 at 9:16 pm
(3) janis maharaj says:

I had an H1N1 type flu in 1950 and almost died from it. If you are smart get your needle. How would you feel if your kid caught it from you and then dies from it because they don’t have any immunity? It is already happening – older adults have some immunity but kids don’t. Let’s see you sneer at the needle after that.

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