Pandemic Flu in the Kickapoo Valley--1918 and now

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PANDEMIC AVIAN INFLUENZA IN THE KICKAPOO REGION

By John H. Sime


Part One

There is quiet preparation being made for a cataclysm. Diseases are impersonal, anonymous forces in human history, but any number of times cities have collapsed, kingdoms have been rent asunder, and entire cultures have been ground to dust by sudden epidemics or pandemics (which is essentially a worldwide epidemic). Such a disease lurks on the horizon. It is called Bird Flu or Avian Flu. The virus that causes it is called H5N1. While it is not highly contagious, it does have a high mortality rate. So far, worldwide only about 300 people have caught the disease, but about half of those people have died. Most of those people died in Asia, but if the virus ever mutated enough to jump from human to human, instead from bird to human--the current preferred vector of transmission—the results could be a world wide calamity.
Hopefully, we will be well prepared. Wisconsin already is in the forefront of places from where the war on Bird Flu would be led. In 2006, the $9 million dollar Institute for Influenza Viral Research laboratory was established by the University of Wisconsin in Madison. It is headed by Dr. Yoshihiro Kawaoka and is one of the labs where new anti flu drugs will be tested. They hope to move beyond Tamiflu to more effective anti flu drugs.
Governor James Doyle hosted a pandemic readiness seminar in Madison in March 2006. Health officials, representatives from businesses, schools, and other sectors learned and shared information about preparing for a world wide outbreak. It was estimated at that seminar that in Wisconsin 8,000 people could die from such an outbreak. President Bush has budgeted 3.8 billion dollars for Bird Flu. Of that $350 million goes to state and local governments, with $1.5 million going to Wisconsin.
In western Wisconsin local coroners, police officials, health workers and rescue squad volunteers have been receiving training in this topic. Jerry Crotsenberg is a Crawford County employee who is program director of a six county western Wisconsin group that seeks to educate the public about bird flu. “We have a directive to educate the public about this.” He says. He has conducted training sessions for law enforcement and emergency professionals, health care workers, business people, educators, any group seeking information. Most recently he spoke to the Viroqua Ministerial Association.
His group—the Southwest Wisconsin Public Health Preparedness and Response Consortium—estimates that the death toll of a 1918 strength flu in Vernon County could range from 114 to 278, in Crawford County from 67 to 168, and Richland County from 74 to 178.



Part Two

Public health authorities are turning to the influenza pandemic of 1918—popularly known as “the Spanish Influenza”—as an historical precedent in dealing with a possible Bird Flu Pandemic. The virus which causes today’s Bird Flu is related to the virus which caused the Spanish Flu.
The disease is first identified in March, 1918 at Ft. Riley, Kansas, an Army training center. It is next seen in New York and Philadelphia where soldiers are shipped out to Europe. Soon it strikes soldiers in the trenches. Then in the fall it comes back to the U.S. for a second wave.
October, 1918 was the peak month of the Spanish Flu in the United States. That month over 200, 000 people died in the United States, more than had ever died before or ever would later die since in a single month. An estimated total of 675, 000 Americans died in the pandemic. The peak took a couple of months to reach western Wisconsin. December, 1918 was the peak month for Vernon County. In August of that year 16 death certificates were filed at the office of the Register of Deeds in Viroqua. By October the number was 32 deaths per month, in November—46, in December—49. January drops down to 28, with February down to 25, and in March things are back to normal with 21. Of course not all of these deaths were of Spanish Flu, but by comparison to previous and following years it is clear that the local death rate more than doubled during the period of the pandemic. More than once in December five deaths take place on a single day. This was and still is a very rare occurrence in Vernon County
The first death certificate filed in Vernon County which gives Spanish Influenza as the cause of death is that of a doctor in Viola. His name was Dr. Clyde Stormont and he died on October 5, 1918. He was thirty-two years old. Harley Henthorne of Viola was the funeral director. Dr. Stormont had just recently received his commission as a First Lieutenant in the U.S.Army. The next day, two more victims died—one in Genoa, the other in Hillsboro. Both were in their mid twenties. Both were recently discharged from the U.S. Army.
In fact, the conclusion of World War I is considered to be a factor in the rapid spread of the disease world wide. The disease was not war-caused, but the frequent movement and close living quarters of soldiers and sailors meant that once the military was exposed it could spread rapidly. The conclusion of the war in the fall of 1918 meant that hundreds of thousands of soldiers were returning from Europe, becoming a perfect vector to spread the disease world wide. Eventually, by the final conclusion of the pandemic, 2.5% to 5% of the world’s population died from the disease, with 20% having been infected
From the October 17, 1918 issue of the Viola News: “An order of the Wisconsin State Board of Health issued on October 10 closing for an indefinite period all schools, churches, Sunday Schools, theaters and other places of amusement and public gatherings as a measure for the control of influenza….As a consequence of this order the local Board of Health has acted promptly and…not only requests but insists that the order be strictly complied with…Let everyone avoid congregating at the post office, depot, or in the business places. Don’t loaf on street corners or help in forming a crowd. Don’t rush to the post office as soon as the mail arrives and loaf in the lobby, but wait until the mail is distributed, then go the office and get your mail and then leave immediately….This community has had enough experience with the disease.”
The terse lines on the Vernon County death certificates speak volumes. Numerous certificates give the cause of death as “gangrenous pneumonia”. One certificate merely says that the attending physician is unavailable due to his own illness, although the cause of death is given as influenza. Another certificate simply says: “influenza…could not get a doctor.” The normal functions of society were on the verge of breaking down. Schools, churches, theaters and most public gatherings were cancelled. Only funerals went on, with a time limit of fifteen minutes to prevent exposure. Stores went untended, cows went unmilked, babies went unfed. Indeed frequent victims of the flu were young healthy adults in their twenties and thirties. Scientists believe today that the cause of this phenomenon was a cytokine storm, in which a healthy immune system combats an unfamiliar disease by going into overdrive, producing gobs of immune cells, such as the fluid which filled the lungs rapidly, eventually suffocating victims. Doctors were helpless in the face of this rapid condition which could kill within hours.
Press coverage of the pandemic was minimal at best. The announcement of the state wide school closing in the Vernon County Censor was a short item far at the bottom of the large front page. The Viola News put it on page three. From then on, other than terse obituaries and references to people traveling out of town to help others stricken with the flu, little serious is written about it except for upbeat articles full of misinformation, usually ending with a pitch for Vick’s Vapo Rub. The press nationwide was under the clamp of wartime censorship, which regarded widespread discussion of the disease as helpful to the enemy.


Websites:
http://www.growingenius.com/UW/research.html University of Wisconsin website of Yoshiro Kawaoka, researcher in Avian Flu at UWMadison. ; with interesting graphics and animations.
http://www.pandemicflu.gov/ The Federal government website on Bird Flu.
http://dhfs.wisconsin.gov/preparedness/pdf_files/WIPandemicInfluenzaPlan.pdf The Official Wisconsin Pandemic Influenza Plan, a pdf file.