Limits on Social Contact Helped Fight Flu Pandemic

Quarantines, school closings could be valuable in a future threat, study of 1918 influenza epidemic finds.

By Ed Edelson
HealthDay Reporter
Tuesday, August 7, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

TUESDAY, Aug. 7 (HealthDay News) -- In a finding that could save countless lives in the next flu pandemic, U.S. researchers have discovered that such public health measures as quarantines, school closings and bans on public gatherings reduced the death toll in the great influenza outbreak of 1918-19.

A pandemic is feared if a flu strain -- such as avian flu, which has killed some people in scattered outbreaks, primarily in Asia -- mutates so that it passes easily from person to person. Current vaccines and people's immune systems aren't prepared to protect against such a new infectious virus -- exactly the situation that occurred when a new strain called Spanish flu struck the world in 1918-19, killing 40 million people, 550,000 of them in the United States.

"Public health people have been talking about the risk of a flu pandemic for some time," said study lead author Dr. Howard Markel, director of the University of Michigan Center for the History of Medicine. "Even though it's now the 21st century, it would still take roughly six months once a pandemic starts to have enough vaccine manufactured and distributed."

Specialists at the University of Michigan worked with experts at the U.S. Centers for Disease Control and Prevention on non-medical protective measures taken in 43 cities. They studied public health records, newspaper reports and other chronicles of activity from Sept. 8, 1918, through Feb. 22, 1919.

"We paired with CDC to see whether things like quarantines and school closings could do anything to reduce the toll," Markel said. "We traveled through the country, looking at state archives, collecting two newspapers a day from each city and getting information from federal and state sources, combing all of this to create a database on incidence. Lo and behold, we found that those cities that responded earliest and sustained their response did best."

For example, St. Louis closed schools and canceled public gatherings early in the pandemic and maintained those measures for 10 weeks. Statistics showed that St. Louis had a markedly lower number of flu deaths than other cities.