What they're not telling you about flu: Why war may be making us sick

Medicine, like weapons technology, seems to evolve the fastest when it is needed the most urgently, and such is the fascinating viral world of H1N1 - what we are learning this season will no doubt help to guard our well-being for years and years to come.

Health officials constantly refer to H1N1 as a new strain of flu, and it is - but we've been here before. In 1918, the Spanish flu, so-named for the mistaken belief that it originated in Spain, swept the world and killed 50 million people in a year - a medical holocaust. Spanish flu goes by another name, by the way - H1N1.

This is a fact that you won't be told, because the government doesn't want to stir up comparisons and fear. Of course, today's H1N1 to date is much more mild, and even if it does mutate, we have vaccinations, medication, nutrition and better understanding of prevention. We are far better suited to fight off a potentially-lethal cocktail of flu virus than our great-grandparents were. Yet six H1N1 deaths in Iowa with the 2009-10 flu season just beginning is - I apologize for this in advance - nothing to sneeze at.

Just a thought - the deadly Spanish flu pandemic came as the world was at war, in WWI. Isn't it interesting that today's H1N1 pandemic also comes as we are mired in war and have a large number of soldiers mobilized stateside and across the world?

War is a disruptive phenomenon, we know, bringing all kinds of different people and different germs together, in an environment that wouldn't happen otherwise - an ideal human petri dish for expanding illness.

Large numbers of soldiers in Iraq and Afghanistan have been stricken with swine flu, as have soldiers at home where many bases report over a hundred cases at a time. The Iraqi government hasn't missed this phenomenon, and is voicing concern that along with the seeds for peace, our troops may be bringing the germs to sow a pandemic.

There is a reason our medical center in Storm Lake has curtailed visitors' normal access to their units - they know that H1N1 thrives by sweeping through confined areas where many people breathe and touch surfaces in a small space - like a waiting room or an ER. Bringing that germ to people who are already weak with other health conditions - or exposing all the medical people we count on to care for our ill - could be disasterous.

Isolation isn't normally an option with the military.

The expert I quote at the start of this column has the best explanation of viral illness I've seen yet.

Upper-respiratory germs are like viruses on a wooden boat, Osterholm says. If they sink the ship, they drown too... unless they can survive in the water long enough for another boat to come along that they can climb aboard.

A virus, to be successful in spreading this fast in our local environment, can't generally be strong enough to kill its victims. The flu virus can live only up to eight hours outside a living human body (by comparison, smallpox, serious but rare, can live 24 hours outside the body; it can kill its host and have time to hitch another ride. The common cold survives just a couple hours outside the body must be mild but very easily spread).

One of the best ways to learn about the new H1N1 virus may be to study its 1918 predecessor, and scientists are rapidly doing this, though again, you're not likely to hear a lot about it.

Like today's flu, Spanish flu H1N1 mostly started mild, but later became so ferocious that some victims bled from the eyes and their skin turned so black that doctors couldn't identify their race. The worst victims would literally suffocate as their lungs filled with bloody, frothy liquid. About one in every four Americans caught the illness they knew as "Black Death."

Ironically, Woodrow Wilson, who called the troops into the war, was a victim of the flu they brought back, suffering while negotiating the Treaty of Versailles.

Experts now believe the "Spanish flu" originated in Haskall County, Kansas, where it first somehow made the pass from birds to humans. It quickly spread through an Army training camp there, and was passed from military camp to military came to front lines in Europe, and on around the world. The version of the virus they brought home was more deadly.

Similarly, today's H1N1 hit the military hard - over 200 cadets at the Air Force Academy had it at the same time way back in July.

Another reason to pray for peace perhaps - war is sick, quite literally.

Scientists have actually rebuilt the Spanish flu from pieces of genetic material retrieved from the lungs of people who died 87 years ago. Researchers writing in the journals Science and Nature say the tightly guarded replica is even more virulent than they expected, 100 times more potent than typical seasonal flu today.

The old flu bears an ominous likeness to H5N1, the "bird flu" which is now circulating in Asia, leading scientists to a disturbing conclusion.

What if the current rapid-spreading H1N1 virus attaches itself to the avian flu, which doesn't transmit readily between humans but has killed 60 percent of the people who have contracted it? Or what if avian flu mutates into a form passed human to human, as H1N1 has?

Superflu - fast and deadly. No one in the world will have had exposure, there is no immunity. The 1918 flu kills chicken eggs, which are used in the growth of modern vacccines.

Our expert, Osterholm, sounded the warning back in 2005. He was scoffed at back then, derided for doomsaying and nicknamed Chicken Little for suggesting flu could be a deadly threat in these times. Nobody is laughing any more.

Thankfully, this is not 1918. Thank goodness for medical advances, vaccines and antivirals, awareness and that wonderful antibacterial soap-in-a-bottle. With a little effort and luck, H1N1 will be a passing, mostly mild concern.

However, as we are learning, there is still much we don't know, and we will be wise to use this H1N1 outbreak to study and prepare for healthier future. You learn from the past, or repeat it in the future.