Subtitle: Why You Should Always Get Your Flu Shot

In the year 1918, the entire world caught influenza.  It was a particularly virulent strain, and thanks to troop movements in WWI it became the first recorded global pandemic.  A lot of people died.  And it wasn’t just children or the elderly; fully 8-10% of all people in their twenties and thirties died from it.  The world’s population was one-third of what it is now, and somewhere between 50 and 100 million died.  From the flu.

In modern days germs spread fast; just in the last decade we’ve had avian flu and H1N1 touch most of the globe.  If a virulent strain crops up, we could easily lose billions of people to it.

Flu is scary.

There was a second pandemic, too — encephalitis lethargica, known commonly as the “sleeping sickness”. It also moved with the troops, possibly piggybacking on the flu.  It causes the brain to swell, inducing a coma-like sleep for several days or weeks.  Some of the people who got it back never woke up, dying without ever having regained consciousness.  Those who did wake up frequently had changes in their personality.  Children in particular became entirely different people after the acute phase of the disease had passed.  Even worse, all sufferers tended to develop symptoms of Parkinson’s disease, spending the rest of their lives fully conscious in bodies unable to move or speak.  The last survivor of the pandemic died in 2002, trapped in his frozen body for 70 years.

Until the 1960s, it was thought that those with Parkinson’s weren’t aware of their surroundings. But a neurologist named Oliver Sacks, who wrote many fantastic books over the course of his career, tried giving the patients a drug call L-dopa.  Some of them temporarily regained movement and speech, and Sacks discovered that these people had been aware of everything to happen to them.  Terrifying.

Modern researchers aren’t sure if the 1918 flu and encephalitis lethargica were related.  One researcher pointed out that since pretty much everyone had the flu back then, it may have just been overlap.  Other theories are that it was caused by strep throat, which was also widespread at the time, or that everyone’s immune systems were already screwed up from the flu and encephalitis lethargica took advantage of that.

Encephalitis lethargica is treatable with steroids these days, if caught in time.  Cases still occur sometimes, from Texas to Madagascar.  But it hasn’t been an epidemic since the 1920’s.

Get your flu shots.

Random facts:

The reason why polio was mostly a 20th century disease is because sanitation had improved and people no longer had the immunity that came from drinking dirty water their whole lives.  Some modern doctors think the reason allergies are so prevalent these days, especially in children, is because of lack of exposure to germs in early life.  Don’t get me wrong, we don’t want to go back to drinking water laced with cholera or other diseases from dirty water, but there’s some evidence that childhood exposure to a few germs can actually make people healthier in the long run.

Until after WWII, most public health physicians were women.  The team of doctors to do the best work on encephalitis lethargica in the 1920s and 1930s was led by a Dr. Josephine Neal.  Her male co-workers disliked her for her gender, but she was the best in the field so she remained the boss for as long as the team lasted.

Early zombie movies may have been inspired by encephalitis lethargica.  Back then, everyone had heard of it.  It killed more than 5 million people in the US alone during the acute phase.  Why nobody remembers it any more is baffling.

Sources: Asleep: the forgotten epidemic that remains one of medicine’s greatest mysteries  by Molly Caldwell, and The great influenza: the epic story of the deadliest plague in history by John M. Barry.  Both books are excellent histories of how modern epidemiology began. Oliver Sacks wrote a book about his l-dopa experiments called Awakenings, but I haven’t read it yet.

Categories: History


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