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1986-89 flu pandemic

The Hong Kong influenza, also known as the 1968 flu pandemic, was a flu pandemic whose outbreak in 1968 and 1969 killed between one and iv 1000000 people globally.[1] [two] [3] [4] [5] It is amidst the deadliest pandemics in history, and was acquired by an H3N2 strain of the flu A virus. The virus was descended from H2N2 (which caused the Asian influenza pandemic in 1957–1958) through antigenic shift—a genetic procedure in which genes from multiple subtypes are reassorted to form a new virus.[6] [seven] [8]

History [edit]

Origin and outbreak in Hong Kong and China [edit]

The first recorded instance of the outbreak appeared on 13 July 1968 in British Hong Kong.[8] [9] [10] [11] There is an unconfirmed possibility that the outbreak actually began in mainland China before it spread to Hong Kong.[x] On 11 July, before the outbreak in the colony was first noted, the Hong Kong paper Ming Pao reported an outbreak of respiratory illness in Guangdong Province,[12] and The Times the next day issued a similar report of an epidemic in southeastern Cathay.[13] Later reporting suggested that the flu had spread from the central provinces of Sichuan, Gansu, Shaanxi, and Shanxi, which had experienced epidemics in the bound.[xiv] However, due to a lack of etiological information on the outbreak and a strained relationship between Chinese health authorities and those in other countries at the time, information technology cannot be ascertained whether the Hong Kong virus was to blame.[13]

The outbreak in Hong Kong, where the population density was greater than vi,000 people per square kilometre (20,000 per sq. mi.), reached its maximum intensity in ii weeks.[10] [11] The outbreak lasted around six weeks, affecting nearly 15% of the population (some 500,000 people infected), but the mortality rate was low and the clinical symptoms were mild.[10] [11] [15] [16]

In that location were two waves of the flu in mainland People's republic of china, one betwixt July–September in 1968 and the other between June–December in 1970.[16] The reported data were very express due to the Cultural Revolution, simply retrospective assay of flu action between 1968 and 1992 shows that influenza infection was the most serious in 1968, implying that most areas in Mainland china were affected at the time.[sixteen]

Outbreaks in other areas [edit]

Despite the lethality of the 1957–1958 pandemic in China, footling improvement had been made regarding the handling of such epidemics.[11]

By 13 August, was clear to virologists that strains isolated from the outbreak in Hong Kong differed markedly from previous strains of flu.[17] However, they were non at the fourth dimension considered to be an entirely new subtype of influenza A, only a variant of older strains.[eighteen] Yet, the World Wellness Organisation warned of potential worldwide spread of the virus on sixteen August.[10] An outbreak of influenza-like illness in Singapore during the second week of August was the first indication of spread outside of Hong Kong.[eighteen] Around the same time, an outbreak became apparent in the Philippines[xix] and Malaysia,[20] and, before the stop of the month, an epidemic was underway in the Republic of Vietnam.[21]

The first known cases of the flu in the Great britain were identified in early Baronial in an infant and her female parent in London with no history of travel or known contact with anyone with a history of travel from the Far East. More than isolated cases soon followed, but it was non until September that larger outbreaks began occurring in school settings.[22]

In September 1968, the flu reached India,[23] northern Australia,[24] Thailand,[25] and Europe. The aforementioned month, the virus entered the United states of america and was carried by troops returning from the Vietnam War, simply it did non become widespread in the country until Dec 1968.

During the second week of September, nearly 2000 participants from 92 countries, including some in southeast Asia where the flu was epidemic, met in Tehran for the Eighth International Congresses on Tropical Medicine and Malaria.[26] An outbreak of influenza soon erupted amid the participants, afflicting at least a third of them.[27] The convention was the credible origin of a broader outbreak inside the uppercase city, which thereafter spread rapidly throughout Islamic republic of iran.[28] [21]

The virus entered Nihon repeatedly throughout August and September, but these introductions did not spark any larger outbreak. The outset "true epidemic" began in early October, almost entirely bars to school settings.[29]

In the USSR, the offset cases of the flu began to appear in mid-December.[30]

It reached Africa and South America by 1969.[31]

The development of the pandemic at offset resembled that of the 1957 pandemic, which had spread unencumbered throughout the jump and summertime and had go truly worldwide by October, by which betoken about all countries were experiencing their first or fifty-fifty second wave.[32] [33] However, the 2 experiences eventually diverged within a couple of months after their initial outbreaks. In 1968, many countries (eastward.g., the U.k., Japan) did not immediately run across outbreaks despite repeated introductions of the virus throughout August and September. Additionally, after September, there was little evidence of continued spread in new areas, despite similar importations of the virus into those areas. Epidemics did somewhen develop during the winter months, but these were often mild (especially when compared to the US experience).[13] In some countries (such as the UK and Nippon), it was not until the following wintertime of 1969–1970 that truly severe epidemics developed.[34]

At the time of the outbreak, the Hong Kong flu was likewise known as the "Mao flu" or "Mao Tse-tung flu".[35] [36] [37] [38] The name "Hong Kong flu" was not used within the colony, where the press dubbed it the "killer flu" afterward the start several deaths.[14] Before the end of July, the S China Morn Post predicted that "Fingers of scorn" would exist directed at Hong Kong in the coming weeks and stated that the colony had "acted, unwillingly, in our old role as an entrepot for a sneeze".[12] (An outbreak of influenza in Hong Kong had been the beginning ane to occur outside of mainland china during the 1957–1958 pandemic and had been what alerted the residual of the world to the developing situation, when international press began to report on it.)[39] [xl]

A city councilor later on decried the widespread adoption of the proper name "Hong Kong flu", challenge that information technology was "giving Hong Kong a bad proper noun". He asked why foreign press and health government did not refer to it by its "proper proper name—People's republic of china flu".[xiv] China certainly did not escape associations with the new virus, all the same, equally the name "Mao flu" suggests. It was speculated fifty-fifty at the time that the virus had originated from "Red China".[14] These differing names for the influenza resulted in some defoliation: In January 1969, a British member of parliament asked David Ennals, the Secretarial assistant of Country for Social Services, "in what manner the characteristics of Mao flu can exist distinguished from those of Hong Kong flu".[41] In addition to these names, the virus was also often referred to as "Asian flu" or "Asiatic flu",[42] [43] as it was not yet considered an entirely unlike subtype from the previously circulating influenza A.

Worldwide deaths from the virus peaked in December 1968 and January 1969, when public health warnings[44] and virus descriptions[45] had been widely issued in the scientific and medical journals. In Berlin, the excessive number of deaths led to corpses being stored in subway tunnels, and in West Germany, garbage collectors had to coffin the expressionless considering of a lack of undertakers. In total, East and West Germany registered 60,000 estimated deaths. In some areas of France, half of the workforce was bedridden, and manufacturing suffered large disruptions because of absenteeism. The UK postal and rail services were besides severely disrupted.[46]

United States [edit]

Afterward a major epidemic of H2N2 during the 1967–1968 flu flavor that resulted in outbreaks in all simply four states, the Communicable Disease Center (today the Centers for Illness Control and Prevention) in June 1968 forecasted little or no activeness in 1968–1969. The vaccines for the upcoming flavor would incorporate the and so-circulating seasonal influenza strains, and the CDC'south recommendations for their use extended mainly to individuals in older age groups (over the age of 45) and the chronically ill.[47]

Following the outbreak in Hong Kong and the recognition that it had been caused past a new variant of influenza, the CDC on 4 September revised its prediction for the 1968–1969 flavour. An extensive outbreak across the country was now more likely. It repeated more strongly its recommendation that existing vaccines go merely to those at highest chance and recommended vaccinating or revaccinating this group once the monovalent vaccine specific to the new variant became bachelor.[48]

The first cases of the virus were reported in Atlanta on 2 September.[49] The start was a Marine Corps major returning from Vietnam,[50] who fell ill four days later arriving back in the Us. Ii days later, his wife, who had not left the land, vicious ill as well.[49] The first outbreak occurred in a Marine Corps schoolhouse in San Diego that same calendar week. Before the end of the calendar week, influenza surveillance was heightened all across the country, and summaries of the information were thereafter reported regularly by the CDC each week in its Morbidity and Mortality Weekly Report. Farther outbreaks among military personnel with connections to southeast Asia were presently to follow during the eye of September.[50]

Isolated cases, mostly in those recently returning from the Far East, seeded the virus across the land throughout September. The first outbreaks in the civilian population occurred in belatedly September and in Oct, and activeness increased markedly throughout November, affecting 21 states by Thanksgiving.[l]

The epidemic became widespread in Dec, involving all 50 states before the finish of the yr.[l] Outbreaks occurred in colleges and hospitals, in some places the disease attacking upwards of 40% of their populations. Reports of absenteeism among students and nurses grew. Schools in Los Angeles, for example, reported rates ranging from ten to 25%, compared to a typical five or half-dozen%.[51] The Greater New York Hospital Association reported absenteeism of fifteen to 20% amid staff and urged its members to impose visitor restrictions to safeguard patients.[52]

Institutions in many states dismissed their students early for the holidays.[53] In New York and many other areas, holiday sales suffered mid-December, which affected retailers blamed on the flu epidemic (though aggrandizement could accept contributed to this likewise).[54] Economic activeness was also hampered by high levels of industrial absenteeism.[52] [50]

On 18 December, it was reported that President Johnson had been hospitalized at Bethesda Naval Hospital with flu-like symptoms,[55] only whether the new variant was the cause of his illness was not made clear. He returned to the White Business firm on 22 December.[56] Vice President Humphrey was also reported to be bilious from the flu on the twenty-four hour period Johnson's status was revealed.[55] Flu-like illness kept other senior governmental officials from their posts effectually this fourth dimension, such as National Security Advisor Walt Rostow, Deputy White House Printing Secretary Tom Johnson, and chairman of the Articulation Chiefs of Staff Full general Earle Wheeler.[57] On 23 December, information technology was reported that President-elect Nixon had been ill with the influenza at his daughter's hymeneals the day before.[58] Nixon later claimed that "the nuptials cured the flu."[59]

Top influenza activity for well-nigh states most likely occurred in the latter half of December or early Jan, but the verbal calendar week was impossible to decide due to the holiday flavour. Activity declined throughout January. Backlog pneumonia-influenza bloodshed passed the epidemic threshold during the kickoff week of Dec and increased apace over the next month, peaking in the showtime one-half of January. It took until late March for mortality to render to normal levels. There was no second wave during this season.[50]

Following the epidemic of influenza A, outbreaks of influenza B began in late January and connected until late March. Mostly elementary-school children were affected.[l] This influenza B activity fit within the design of epidemics every three to six years, only the 1968–1969 flu season became the first documented instance of ii major influenza A epidemics to occur in successive seasons.[60]

Given the widespread epidemic levels of influenza A activeness in 1968–1969, the CDC in June 1969 predicted piffling more than "sporadic cases" of flu A in the 1969–1970 flavour.[61] Influenza activeness was indeed less than the preceding flavor, just there was "considerably more" than expected. The flu affected 48 states the following season but was widespread in only six, compared to 44 out of the 50 states in which action was reported in 1968–1969.[62]

Vaccine [edit]

It became apparent once the extent of antigenic variation in the virus was recognized that a new vaccine would be needed to protect confronting information technology.[48] However, product of the previously recommended vaccines in the U.s.a. had concluded past July 1968, and supply of fertilized chicken eggs, in which flu vaccines are grown, was limited.[63] The start cultures of the virus were provided to manufacturers in August by the Division of Biologics of the National Institutes of Health for preliminary study. A strain isolated in Nihon was sent to the US and, after showing greater potential for vaccine product, was given to manufacturers on ix September.[64]

In 1968, American microbiologist Maurice Hilleman was caput of the virus and vaccination research programs at the pharmaceutical firm Merck & Co., one of the licensed vaccine manufacturers in the US. Hilleman, as the director of the Department of Respiratory Diseases at the Regular army Medical School (at present the Walter Reed Regular army Institute of Research), had foreseen the 1957 pandemic and kickstarted vaccine production then.[65] He was similarly instrumental in the development of the 1968 pandemic vaccine and, with the use of the Japanese strain, helped initiate early production.[65] [63] Merck would become on to produce over 9 million of the nearly 21 meg doses of vaccine produced.[66] [64] The other half was produced together by Eli Lilly & Co., Lederle Laboratories, Parke Davis & Co., the National Drug Company, and Wyeth Laboratories.[63] All of these except Wyeth had been involved in the production of the 1957 vaccine.[67]

On Nov xv, 66 days after the production strain became available, the first batch of 110,000 doses of vaccine was released, most of which went to the War machine.[68] [64] This represented a quicker turnaround than the release of the first doses of the 1957 vaccine, which took 3 months after its production strain became available. At this time, the flu was spreading fast effectually the country. There was much interest within the press and among public figures in the vaccine.[64] On xviii Nov, the Pharmaceutical Manufacturers Association announced that 17.5 million doses would be available for noncombatant use but said that "substantial quantities" would just come after the New year.[68] By the end of the yr, over 10 million doses had been released.[64] At this point, influenza was widespread in the country.

Notably, the coiffure of Apollo 8 received the vaccine on 3 December prior to their mission later in the month.[69] President Johnson received "two types" of vaccine prior to his tour of flu in Dec,[55] just it is not clear if one of these was the pandemic vaccine. Johnson, sixty at the time, was in poor wellness and had been hospitalized several times during his presidency.[55] He thus would accept been prioritized for vaccine given the CDC recommendations, even outside of existence the president.

Lots of vaccine connected to exist released throughout Jan 1969, with near 21 million doses bachelor by the end of the month. By this point, all the same, influenza activity and subsequent bloodshed had already peaked. Demand for the vaccine macerated and a considerable surplus remained. Given the fourth dimension it took to build upward antibodies, it is unlikely a significant number of people were finer immunized to change the course of the epidemic.[64] Hilleman himself would later on admit that the vaccine was "too niggling and also late" for most of the country.[lxx] However, it was later estimated that a "considerably higher" proportion of the recommended priority group of older and chronically ill persons received the pandemic vaccine than in 1957.[64]

Following the epidemic in the Us, leftover vaccine was made bachelor for the southern hemisphere and parts of Europe where the main outbreak had non yet happened.[seventy] The Japanese strain of the new variant was incorporated into the bivalent vaccines recommended for the 1969–1970 flu season in the US.[61]

Outside the US, vaccination efforts were undertaken in many countries in anticipation of an epidemic. In dissimilarity to The states policy, Japan had, since 1963, carried out mass vaccination campaigns against influenza every year regardless of whether an epidemic was expected. This began with the immunization of all children in kindergartens and primary and secondary schools followed past the vaccination of those working in crowded atmospheric condition. Enough vaccine was produced each twelvemonth to vaccinate about 24 1000000 people (nearly a quarter of Japan'south population at this time), and this became the goal in 1968, targeting the same priority groups as in a typical influenza season.[71]

The same Japanese strain used for vaccine production in the U.s. was immediately sent out to the seven manufacturing firms in Japan. It was soon decided a bivalent vaccine consisting of two parts the new variant and one part influenza B would be produced, in contrast to the U.s.'s apply of monovalent vaccine. The objective was also set that enough vaccine to immunize nigh 12 1000000 people would be produced by the finish of Oct, with the hope of at least vaccinating children to guard against an epidemic developing out of schools. Later some filibuster, the mass vaccination campaign was nearly completed earlier the finish of the year.[71]

Yugoslavia received the Japanese strain in mid-October and immediately began experimental trials prior to large-scale production. During this time before the new vaccine was gear up, one.5 meg doses of seasonal flu A vaccine were distributed for use. Ten one thousand thousand doses of the pandemic vaccine had been produced by mid-January 1969, and nearly 1 million people were immunized before the stop of Feb. About 100,000 doses were designated for the mass immunization of schoolchildren.[72]

In Denmark, the flu department at the governmental Statens Serum Institut produced about 200,000 doses of pandemic vaccine during the wintertime of 1968–1969, incorporating a strain isolated in Stockholm. In that location were no particular difficulties in production, only yield was poor.[73]

Millions of doses of vaccine were available in South Africa earlier its epidemic began at the terminate of March 1969, which afforded the opportunity to perform "limited studies" of its effectiveness.[74]

Past Jan 1969, vaccine product in Australia was underway at the Commonwealth Serum Laboratories (CSL), then a department of the federal regime. The trivalent pandemic vaccine, composed of two influenza A strains and a B strain, was anticipated for release in early March ahead of the winter flu flavor.[75] The inoculation consisted of a ii-dose series, each given four weeks apart.[75]

CSL was ambitious in its promotion of the vaccine, at to the lowest degree to doctors.[76] A spokesman for the laboratories described the new virus as "the worst flu nosotros accept had" and called an epidemic that yr "almost certain".[77] In light of the state of affairs, the Australian Pensioners Federation in early January wrote to Minister for Health Jim Forbes "demanding" that the vaccine be given free of accuse to pensioners.[78] In contrast to CSL's bolder predictions, Forbes described an outbreak that winter as "possible" merely did not call up it would "necessarily exist serious or extensive".[79] While the Department of Health reviewed the question of pandemic vaccine allocation in Australia, the government exported one 1000000 doses of its vaccine to Britain, already at the elevation of its epidemic.[lxxx]

In early February, the epidemiology committee of Commonwealth of australia's National Health and Medical Research Council met in Melbourne to discuss the influenza threat and the best use of vaccine the coming wintertime.[79] [81] A "serious epidemic" was considered the "strongest possibility", and it was recommended to Forbes that older people, children, and meaning women receive free immunization confronting the flu.[82] Notwithstanding, the quango brash confronting a mass vaccination campaign, citing the findings of its report which showed the unreliable protection against infection of the nowadays vaccines, and considered information technology unwise to vaccinate salubrious people while the limited supply could be amend used to mitigate severe outcomes in at-risk groups.[83]

On the last day of February, the Pharmaceutical Benefits Advisory Committee met to consider the question of making the pandemic vaccine a pharmaceutical benefit for pensioners.[83] Before the end of the week, Forbes announced that shots would be given for gratis to all pensioners and their dependents, representing near 2-thirds of the iii groups recommended for priority immunization. The policy would go into issue starting one April.[84]

Vaccination against the influenza was recommended beginning ane March,[85] but issues surrounding availability of vaccine shortly became credible throughout the calendar month.[86] In response to Representative Gordon Scholes of Victoria, who had heard complaints from chemists unable to acquire vaccine, Forbes clarified that bulk orders from larger establishments would be met showtime. He relayed the expectation of the managing director of CSL that the nowadays state of affairs would be met once quantities of unmarried doses became bachelor in early April.[85]

In the middle of March, Forbes assured that all medical practitioners would be able to learn the vaccine past the middle of April. He described the new type of influenza as milder than that which Australia had typically seen each year.[87]

Representative Charles Jones of Newcastle afterwards in the calendar month questioned Forbes why his home metropolis'due south order had non been filled. Forbes revealed the export of ane million doses to Britain earlier in the year but assured that the club "did not delay, or in any way hinder, [the Commonwealth Serum Laboratories'] capacity to fill Australian orders" and that there would be enough supply to meet expected demand.[80] Past this fourth dimension, 1,755,000 doses had been released, and production connected its step of 200,000 doses per week.[88]

Despite these assurances from Forbes, the Manager General of the Department of Health William Refshauge sent a letter on 9 April to all doctors in the state asking them non to vaccinate salubrious people until at-risk groups in the community have been inoculated. Forbes reported meeting with the Democracy Serum Laboratories commission to hash out how to speed up distribution of vaccine.[89] Two days later, the manager of CSL, Westward. R. Lane, dismissed criticism of the supply situation from the New Due south Wales branch of the Australian Medical Association as "a lot of nonsense". Contradicting the laboratories' more forceful marketing earlier in the year, he downplayed the likelihood of a serious epidemic but shared the expectation of 4 million doses distributed past the terminate of May, 8 times every bit much as the boilerplate annual total distribution of 500,000 vaccine doses.[90]

On 22 April, Forbes testified in the House of Representatives regarding the vaccine situation. He reported 2.5 million doses had been produced past this time since Feb. When asked by Representative Theo Nicholls of South Commonwealth of australia to consider importing vaccine to alleviate the present shortage, Forbes noted that the country had already imported the 150,000 doses available. He lamented CSL'southward contempo subjection to a "skillful deal of corruption" regarding the "temporary shortages" around the land, repeating the comparison between the present production attempt and the country's average almanac distribution of only 500,000 doses.[91] That aforementioned day, Northward. F. Keith, president of the Victorian branch of the Pharmacy Order, chosen on CSL to explicate the state of affairs surrounding vaccine supply to the public, which was putting pressure on chemists due to the lack of vaccines.[92]

On 25 April, it was reported that the Section of Health had reimported the remaining vaccine from the order of 1 one thousand thousand that the regime had exported to Britain in January. Subsequently being sent to United kingdom of great britain and northern ireland, packaged at that place, and then sent back to Australia, it was sold to doctors at a markup of nearly fifty percent. Doctors criticized the Department and CSL's poor planning with respect to vaccine supply and the conclusion to export vaccine to Uk when information technology had already reached the tiptop of its influenza flavour. They too blamed the shortage on an overreaction by the public, a response which they considered largely due to public statements made by CSL and health officials.[76] The Department later attributed the conclusion to reimport the vaccine to a want to ensure a reliable supply for pensioners.[93] Information technology also denied any involvement in the commercial sales of vaccine, in response to reporting on cost markups on the reimported vaccine,[94] saying that all it did was authorize the reimportation and list the product as a pharmaceutical benefit.[95] The government itself was paying the same for the reimported vaccine as information technology was for that being distributed past CSL.[94]

By the end of April, 2.eight meg doses of vaccine had been produced and distributed, with no signs of production slowing downward. 250,000 doses were now being produced each week, and well-nigh half a million more were anticipated for 2 May.[95]

Aftermath [edit]

The H3N2 virus displaced the previously circulating H2N2 virus, which get-go emerged in 1957, and returned during the following 1969–70 flu season, which resulted in a 2d, deadlier wave of deaths in Europe, Japan, and Australia.[34] It remains in circulation today as a strain of seasonal flu.[2]

Clinical data [edit]

Flu symptoms typically lasted four to v days, only some cases persisted for up to 2 weeks.[31]

Virology [edit]

The influenza viruses that caused the Hong Kong flu (magnified approximately 100,000 times)

The Hong Kong flu was the get-go known outbreak of the H3N2 strain, but there is serologic evidence of H3N1 infections in the late 19th century. The virus was isolated in Queen Mary Infirmary.[96]

Soon after the initial outbreak in Hong Kong, the virus responsible was recognized to be antigenically distinct from the current influenza A strain in circulation (which at the time was called "A2") but was generally non considered an entirely new subtype.[97] Analysis using the conventional techniques at the time revealed that it was indeed very different from older A2 viruses but as well, at the same time, seemingly related to them, depending on one'due south reading of the information. Experiments involving newer methods of analysis soon identified another surface antigen, neuraminidase, in add-on to hemagglutinin, which had already been recognized. It thus became clear that it was the hemagglutinin that had changed compared to older strains while the neuraminidase was identical.[98] These findings, in part, prompted the World Health Organization in 1971 to revise its system of classification for influenza viruses, taking into consideration both antigens. The novel virus was thereafter designated H3N2, indicating its partial similarity to H2N2 but also its antigenic distinction.[99]

The H3N2 pandemic flu strain contained genes from a low-pathogenicity avian flu virus.[eight] Specifically, it had acquired a new hemagglutinin gene and a new PB1 gene, while it preserved the neuraminidase and five other genes from the preexisting human H2N2 strain. The new hemagglutinin helped H3N2 evade preexisting immunity in humans. It is possible that the new PB1 facilitated viral replication and human-to-human transmission.[100]

The new subtype arose in pigs coinfected with avian and human viruses and was soon transferred to humans. Swine were considered the original "intermediate host" for influenza because they supported reassortment of divergent subtypes. Yet, other hosts appear capable of like coinfection (such as many poultry species), and direct transmission of avian viruses to humans is possible. H1N1, associated with the 1918 flu pandemic, may have been transmitted directly from birds to humans.[101]

Accumulated antibodies to the neuraminidase or internal proteins may accept resulted in many fewer casualties than nigh other pandemics. However, cross-immunity inside and between subtypes of influenza is poorly understood.[ citation needed ]

The basic reproduction number of the flu in this period was estimated at 1.80.[102]

Mortality [edit]

The estimates of the total death toll due to Hong Kong influenza (from its beginning in July 1968 until the outbreak faded during the winter of 1969–seventy[103]) vary:

  • The World Health Organization and Encyclopaedia Britannica estimated the number of deaths due to Hong Kong influenza to exist between 1 and 4 million globally.[1] [35]
  • The United states Centers for Illness Control and Prevention (CDC) estimated that, in total, the virus caused the deaths of i million people worldwide.[104]

However, the expiry charge per unit from the Hong Kong flu was lower than most other 20th-century pandemics.[31] The Earth Health Organization estimated the example fatality rate of Hong Kong flu to be lower than 0.2%.[ane] The affliction was allowed to spread through the population without restrictions on economical activity, and a vaccine created by American microbiologist Maurice Hilleman and his squad became available four months after information technology had started.[46] [66] [65] Fewer people died during this pandemic than in previous pandemics for several reasons:[104]

  1. Some amnesty confronting the N2 influenza virus may accept been retained in populations struck by the Asian Influenza strains that had been circulating since 1957.
  2. The pandemic did not gain momentum until near the winter school holidays in the Northern Hemisphere, thus limiting the infection's spread.
  3. Improved medical care gave vital back up to the very ill.
  4. The availability of antibiotics that were more than effective against secondary bacterial infections.

By region [edit]

For this pandemic, there were 2 geographically singled-out mortality patterns. In Due north America (the Us and Canada), the offset pandemic season (1968–69) was more severe than the second (1969–lxx). In the "smoldering" design seen in Europe and Asia (United Kingdom, France, Nihon, and Australia), the second pandemic season was ii to 5 times more severe than the first.[34] The Usa wellness authorities estimated that about 34,000[105] [106] to 100,000[104] people died in the U.S; almost backlog deaths were in those anile 65 and older.[107]

References [edit]

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External links [edit]

  • Flu Research Database – Database of influenza genomic sequences and related information.

braywhistre.blogspot.com

Source: https://en.wikipedia.org/wiki/Hong_Kong_flu

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