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For purchases where a shipping charge was paid, there will be no refund of the original shipping charge. Additional Questions If you have any questions please feel free to Contact Us. His sudden weakness and severe confusion halfway through that conference—widely commented upon—very possibly contributed to his abandoning his principles.
The result was the disastrous peace treaty, which would later contribute to the start of World War II. In fact, he had a degree temperature, intense coughing fits, diarrhea and other serious symptoms. A stroke explains none of the symptoms. Influenza, which was then widespread in Paris and killed a young aide to Wilson, explains all of them—including his confusion. Experts would later agree that many patients afflicted by the pandemic influenza had cognitive or psychological symptoms. After that third wave, the virus did not go away, but it did lose its extraordinary lethality, partly because many human immune systems now recognized it and partly because it lost the ability to easily invade the lungs.
No longer a bloodthirsty murderer, it evolved into a seasonal influenza. Scientists and other experts are still asking questions about the virus and the devastation it caused, including why the second wave was so much more lethal than the first.
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Another question concerns who died. Even though the death toll was historic, most people who were infected by the pandemic virus survived; in the developed world, the overall mortality was about 2 percent. In the less developed world, mortality was worse. In Mexico, estimates of the dead range from 2. Much of Russia and Iran saw 7 percent of the population die. In the Fiji Islands 14 percent of the population died—in 16 days. One-third of the population of Labrador died.
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In small native villages in Alaska and Gambia, everyone died, probably because all got sick simultaneously and no one could provide care, could not even give people water, and perhaps because, with so much death around them, those who might have survived did not fight. The age of the victims was also striking. Normally, elderly people account for the overwhelming number of influenza deaths; in , that was reversed, with young adults killed in the highest numbers.
This effect was heightened within certain subgroups.
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For instance, a Metropolitan Life Insurance Company study of people aged 25 to 45 found that 3. Other studies found that for pregnant women, fatality rates ranged from 23 percent to 71 percent. Why did so many young adults die? As it happens, young adults have the strongest immune systems, which attacked the virus with every weapon possible—including chemicals called cytokines and other microbe-fighting toxins—and the battlefield was the lung. The destruction, according to the noted influenza expert Edwin Kilbourne, resembled nothing so much as the lesions from breathing poison gas.
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Seasonal influenza is bad enough. Over the past four decades it has killed 3, to 48, Americans annually, depending on the dominant virus strains in circulation, among other things. And more deadly possibilities loom.
All told, these two avian influenza viruses had killed 1, out of the 2, people infected as of this past July—a staggering mortality rate. Scientists say that both virus strains, so far, bind only to cells deep in the lung and do not pass from person to person. If either one acquires the ability to infect the upper respiratory tract, through mutation or by swapping genes with an existing human virus, a deadly pandemic is possible.
Prompted by the re-emergence of avian influenza, governments, NGOs and major businesses around the world have poured resources into preparing for a pandemic. Because of my history of the pandemic, The Great Influenza , I was asked to participate in some of those efforts. Without such a vaccine, if a new pandemic virus surfaces, we will have to produce a vaccine specifically for it; doing so will take months and the vaccine may offer only marginal protection.
Another key step to improving pandemic readiness is to expand research on antiviral drugs; none is highly effective against influenza, and some strains have apparently acquired resistance to the antiviral drug Tamiflu. Magisterial in its breadth of perspective and depth of research and now revised to reflect the growing danger of the avian flu, "The Great Influenza" is ultimately a tale of triumph amid tragedy, which provides us with a precise and sobering model as we confront the epidemics looming on our own horizon.
Then there are the less glamorous measures, known as nonpharmaceutical interventions: hand-washing, telecommuting, covering coughs, staying home when sick instead of going to work and, if the pandemic is severe enough, widespread school closings and possibly more extreme controls.
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But the effectiveness of such interventions will depend on public compliance, and the public will have to trust what it is being told. That is why, in my view, the most important lesson from is to tell the truth. Though that idea is incorporated into every preparedness plan I know of, its actual implementation will depend on the character and leadership of the people in charge when a crisis erupts.
It had not officially reached California, but a suspected case—the severity of the symptoms made it seem so—had just surfaced in Los Angeles. The news media had learned of it and were demanding a press conference. The participant with the first move was a top-ranking public health official. What did he do? The patient might not have pandemic influenza. There is no reason for concern. I was stunned. This official had not actually told a lie, but he had deliberately minimized the danger; whether or not this particular patient had the disease, a pandemic was coming.
Instead of taking the lead in providing credible information he instantly fell behind the pace of events. He would find it almost impossible to get ahead of them again. He had, in short, shirked his duty to the public, risking countless lives. This article is a selection from the November issue of Smithsonian magazine.
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