The Spanish Flu pandemic was exceptionally severe and had a fatality rate of approximately 2.5% with an estimated death toll of anywhere from 50 million to 100 million people. This extraordinary toll resulted from the extremely high illness rate and the extreme severity of the symptoms, suspected to be caused by cytokine storms (potentially fatal immune reaction consisting of a positive feedback loop between cytokines and immune cells, with highly elevated levels of various cytokines).

The Spanish Flu spread simultaneously in 3 distinct waves affecting North America, Asia and Europe during a period of 12 months between 1918 and 1919. This is part of the reason it is hard to pinpoint a point of original. Before and after the 1918 pandemic, most influenza pandemics developed in Asia and spread from there to the rest of the world. While influenza was not nationally reported in 1918, death rates from influenza and pneumonia had risen sharply in the United States in 1915 and 1916 due to a respiratory epidemic that began in December 1915. Death rates from this epidemic seemed to drop slightly during 1917. The United States experienced the first Spanish flu pandemic wave in the spring of 1918. The first wave began in March 1918 and spread unevenly through the United States, Europe, and possibly Asia during the next 6 months. Reported illness during this wave were high, but the death rate was not much higher than normal.

The first wave was quickly followed by a much more fatal second and third wave in the fall and winter of 1918–1919. The second wave began in September 1918 and lasted until November 1918 and proved to be highly fatal. A third wave followed in early 1919. Another unique aspect of the 1918 Spanish flu is that it nearly simultaneously infected humans and swine.

The pandemic took a huge toll on communities everywhere even in areas where the death rate was lower, there were many times so many people sickened by the virus that it brought every day life to a standstill. Some communities even went so far as to close all stores and would require customers to leave their orders otuside to be filled later. Health care workers with in high demand and short supply because they too were sick. There were even reports that mass graves had to be dub by steam shovel resulting in bodies buried without coffins in many places due to a lack of grave diggers.

Reading back through reports of the 1918 Spanish flu outbreak shows some similarities:

• It started in the spring, March to be precise.
• The spread was uneven at first and not much more deadly than normal flu
• It infected swine and humans
• There were reports that governments around the world downplayed the severity of the virus

Lets hope that those are the only similarities and the reports that the 2009 swine flu is waning are accurate and we don’t see a resurgence come fall and winter. I know one thing though. While I am not panicking, I am taking a lesson form the past and preparing for a potentially devastating flu season come fall and winter. I will be stocking up during summer on face masks, hand sanitizer and wipes, germ killers, disinfectants and the things my family will need to make it through a few weeks on our own. I think I will be watching for deals on chest freezers and vacuum sealers as well.

Mexican Health Secretary Jose Cordova described the outbreak as being in decline in Mexico and authorities there have stated that they believe the virus’s most active period in Mexico was between April 23 and April 28. Health officials in Mexico have reported 568 cases and 22 deaths related to swine flu in their country as of late Sunday. WHO has confirmed 506 of those cases and 19 deaths. There are 898 confirmed cases throughout the world in a total of 18 countries. The United Stated has 226 confirmed swine flu cases in 30 states, they include 1 death.

The following countries have swine flu cases that have been confirmed by the WHO:

• Canada has 70 confirmed cases
• United Kingdom has 15
• Spain has 13
• Germany has 6
• New Zealand has 4
• Israel has 3
• France has 2
• Austria, China, South Korea, Denmark, Netherlands, Switzerland, Costa Rica and Ireland each have one.

Officials in China have placed 68 people under quarantine, including 13 crew members of a Mexico City to Shanghai flight. The flight carried a passenger who tested positive for the 2009 H1N1 virus. A Chinese health official indicated that none of the other passengers has exhibited any flu-like symptoms. China’s state-run Xinhua news agency reported Sunday that approximately 110 other people on the Aeromexico plane went on to other destinations and may face quarantines elsewhere. Aeromexico planes have been barred from landing at Shanghai’s airport, as a result Aeromexico is suspending flights to Shanghai until May 15

New York has the highest number of confirmed cases, 63, within the United States. The Centers for Disease Control and Prevention (CDC) indicated that the following states also have confirmed cases:

• Texas has 40
• California has 26
• Arizona 18
• South Carolina 15
• Delaware 10
• Massachusetts and New Jersey each have 7
• Colorado has 4
• Florida, Illinois, Indiana, Ohio, Virginia, Wisconsin each have 3
• Connecticut, Kansas and Michigan each have 2
• Alabama, Iowa, Kentucky, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Mexico, Rhode Island, Tennessee and Utah each have 1

An inmate at Centinela State Prison in Imperial County in California with suspected swine flu prompted officials in that state to suspended visitation and other “nonessential activities”. They are still waiting for the case to be confirmed with lab testing. Health officials in three states announced additional confirmed cases that were not included in the CDC total listed about. North Carolina and Pennsylvania announced their first confirmed swine flu cases and Louisiana’s governor said his state had seven confirmed cases. U.S. Secretary of Health, Kathleen Sebelius warned Sunday that even if the flu outbreak slows, “it could come back with greater force in the winter and fall, when we get into flu season.” she went on to say “this is no time for complacency”.

The first outbreak occurred during 1918-1919. This was known as “Spanish flu” or A (H1N1). Spanish Flu caused the highest number of known influenza deaths. As a result of Spanish Flu More than 500,000 people died in the United States, and up to 50 million people may have died worldwide. Many people died within the first few days after infection, and others died of secondary complications. Nearly half of those who died from Spanish Flu were young, healthy adults. Influenza A (H1N1) viruses still circulate today after being introduced again into the human population in 1977.

The second occurred from 1957-1958 and was known as [A (H2N2)] or “Asian flu”. Asian Flu caused about 70,000 deaths in the United States. Asian Flu was first identified in China in late February 1957, Asian flu spread to the United States by June 1957.

During 1968-1969 [A (H3N2)] also known as ” Hong Kong flu” caused about 34,000 deaths in the United States. The Hong Kong flu virus was first detected in Hong Kong in early 1968 and spread to the United States later that year. Hong Kong flu or Influenza A (H3N2) viruses still circulate today.

Both the 1957-58 and 1968-69 pandemics were caused by viruses containing a combination of genes from a human influenza virus and an avian flu virus. The 1918-19 pandemic virus appears to have an avian origin.