Re: BC - 18 new; 209 total; one school closed
This article brings up historical info of how the 1918 outbreak affected Vancouver. Vancouver's population is now over 2 million btw.
http://www2.canada.com/windsorstar/...l?id=e38d20e4-b0cc-4984-a6a1-47e71c45f2ef&p=1
Looking for flu clues
Almost half the world's countries now report outbreaks of the H1N1 viral infection commonly called swine flu. Laboratory-confirmed cases approached 28,000 this week. Canada now ranks third after Mexico and the U.S. for infections.
And, as the World Health Organization officially declared last week that the planet is finally in the throes of the influenza pandemic, comparisons to the Spanish flu of 1918 are naturally being made.
In Manitoba, judging from news reports, the province moved to begin mobilizing its own pandemic influenza plans as the number of patients developing severe symptoms continued to increase. At the time of writing, there were 56 confirmed cases with 27 patients requiring intensive care. Schools and day cares were closed in some communities and people presenting flu symptoms were being urged not to go to hospital emergency wards.
The Winnipeg Free Press quoted
Dr. Ethan Rubinstein, a professor of infectious diseases at the University of Manitoba. He said the outbreak is expected to follow the same pattern as in 1918.
We can hope those parallels don't track too closely. So far there's no cause for undue anxiety. Most cases appear relatively mild. However, prudence suggests revisiting the experience of 91 years ago. Knowledge gleaned from what happened then might help inform our reactions today.
Much of the 1918 pandemic remains a mystery. The flu wasn't a reportable illness then and communications were poor; health infrastructure was limited and local; diagnostic techniques and lab technology were primitive. Yet the Spanish flu may still teach useful things.
One troubling parallel springs right to the foreground. The impact upon aboriginal people in 1918 was disproportionately high.
In British Columbia, post-pandemic mortality estimates doubled when previously uncounted aboriginal deaths in remote communities were finally tabulated.
In Manitoba today, half the cases requiring intensive care are aboriginal, particularly worrying for public health authorities in B.C., which has one of Canada's largest aboriginal populations.
Another parallel that's worth thinking about is how the disease pulsed through the population. The 1918 outbreak occurred in three distinct phases. The Spanish flu first occurred in the early months of that year with a relatively mild wave of infections in the United States. It then appeared to abate during the summer months. That proved the lull before the storm. A second, much more virulent phase erupted in the fall.
The Spanish flu first arrived in B.C. at the small community of Corbin, just south of the Crowsnest Pass.
It reached Vancouver in October, subsided again and then returned for a third lethal phase in December and January 1919, before abruptly vanishing.
It's for just such a pattern of recurring waves of infection that today's public health and emergency measures planners will be watching closely as they prepare response strategies. Could this week's sudden heavy load of severe cases in Manitoba mark the beginning of a second, more dangerous phase? Let's hope not.
In 1918, Vancouver suffered among the highest urban mortality rates in North America. In late October, at the worst of the pandemic, 1,700 of the city's 109,000 inhabitants were in hospital. Yet that outcome represented a public health triumph. Deaths would have been more numerous had the city not been blessed with a far-sighted genius in its medical health officer.
Dr. Fred Underhill had carefully observed and planned during the early phases of the pandemic. He quelled anxiety, encouraged public engagement and deployed effective responses when the worst arrived. There's one more important lesson to learn from the Spanish flu.
Stephen Hume writes for the Vancouver Sun.
