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Blog Image - 100 Years of Fighting Infectious Disease

A little more than one hundred years ago, an influenza pandemic swept the globe – infecting an estimated one-third of the world’s population and killing at least 50 million people.

Thankfully, much has changed in both science and public health since then. With each flu pandemic that has occurred in the past century, the most recent being 2009’s H1N1, we have become much better equipped to prevent and handle the spread of the disease. We spoke with laboratory professionals at the Department’s State Public Health Laboratory to learn how.

The flu virus spread quickly

The first reported flu cases in Massachusetts occurred on August 10,, 1918 among a handful of sailors at the Charlestown Navy Yard. Just six weeks later more than 85,000 people across the state had contracted the flu. And in just a single week that September, more than 700 Massachusetts residents died of flu or flu related illness.

By the time the pandemic was over, tens of thousands of Massachusetts residents would die. Nationwide, so many Americans died that the pandemic actually impacted average life expectancy rates – causing them to drop by about 12 years in its aftermath.

Limited prevention and treatment  

Why did the illness spread so quickly? In 1918, available tools to control the spread of flu were largely limited to things such as isolation (separating sick people from those who are healthy), quarantine (separating people who may have been exposed to a disease to see if they become sick), good personal hygiene, use of disinfectants, and limits on public gatherings. In fact, at the height of the epidemic, Boston Commissioner Dr. William Creighton Woodward imposed a “gathering ban” for several weeks closing theaters, cinemas, dance halls, saloons and other locations until deaths finally began to decline.

Overburdened health care system 

Another factor was a severe shortage of nurses during the pandemic. The U.S. had entered the First World War and many nurses had been deployed to military camps and abroad.

As a result, here in Massachusetts, Governor Samuel McCall asked every able-bodied person across the state with medical training to help fight the outbreak. In response, the Department of Health enrollment bureau deployed 1,003 volunteer nurses and nurse’s aides and 250 volunteer physicians and 4th year medical students.  Additionally, overloaded hospitals created some 50 “emergency hospitals” in places such as schools and private homes to temporarily house flu patients.

Major advancements

So how far has public health come in in 100 years? We now have vaccines to help prevent flu, antiviral drugs to treat flu illness, antibiotics to treat secondary bacterial infections such as pneumonia, and a global influenza surveillance system to help us spot the emergence of flu far earlier. There also is a much better understanding of non-pharmaceutical interventions–such as keeping away from friends and family when ill, practicing respiratory and cough etiquette and frequently washing one’s hands–and how these measures can help slow the spread of flu.

DPH is prepared

Today, DPH works day in and day out to protect residents from all manner of public health threats, such as the outbreak of measles now being seen in many parts of the U.S. The state’s laboratory performs testing for such threats all year round. And when it comes to flu season, laboratory staff are especially well prepared.

“Our testing provides a level of ‘granularity’ that allows us to characterize the flu virus circulating within our state,” said Massachusetts State Public Health Lab Director Sandra Smole.  “Because we share this data nationally with CDC, we are able to watch, on a weekly basis, how the local and national picture unfolds throughout flu season.  I still marvel at how different flu is each year. It underscores how important it is to get your annual flu shot.”

As part of the Lab’s system of identifying new flu strains, in 2012 the DPH team discovered a unique influenza B strain that had not been “seen” yet. It was given the strain name “B/Massachusetts/2/2012.”  Later that year, this particular flu strain became more prevalent- which meant that it could be a candidate for inclusion in the vaccine.  Eventually, this strain was used in the trivalent flu vaccine globally for two influenza seasons.

Flu Vax Image

Flu vaccine used globally during 2013-2014 flu season, based on discovery of new flu strain by DPH scientists

The DPH team was thrilled their discovery led to creation of a vaccine used around the word. Today, the Lab also works closely with partners across the state to prepare for the next flu pandemic.

“We work closely with our team of infectious disease epidemiologists to maintain a state of readiness,” says Smole. “Residents should rest assured that we’re able to respond to an influenza outbreak.  We are prepared for what’s coming.”

With thanks to former DPH Medical Director Dr. Al DeMaria and the Centers for Disease Control and Prevention for information used in this post.

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