The year 1918 will be remembered in medical history as the year of the most deadly influenza pandemic the US and the world had yet seen. The influenza pandemic killed between 50 and 100 million people globally, with over 675,000 Americans dying. (This amount would equate to 2.15 million in the US today.) The most disturbing and scary fact is that evidence suggests that another pandemic, at least as severe, may occur one day.
Those patients dying from influenza in 1918 were many of the same type of patients that succumb today. Patients in the early and late stages of life are the most vulnerable. This remains true today, as well. The difference for many patients affected by the influenza virus today is that most patients dying in 1918 died from secondary bronchopneumonia caused by bacteria which today can be treated with antibiotics. The bacteria involved in the bronchopneumonia episodes of 1918 were common offenders for which today’s antibiotics are very effective. However, since 1918 many of the bacteria have become resistant to antibiotic treatment. This makes the possibility for effective treatment less certain and could lead to higher mortality.
Influenza vaccines developed as a result of this pandemic have been helpful in controlling the disease. The annual genetic drift of the virus makes vaccine construction more difficult, with less than 100% effectiveness as the outcome. New attempts at constructing a “universal” vaccine are in development. In the meantime, I encourage all patients to protect themselves at all times. Get a flu shot.