Modern Epidemics. Salvador Macip

Modern Epidemics - Salvador Macip


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plague epidemic was the one in the midfourteenth century that raged across all of Europe, Asia and North Africa. Known as the Black Death or the Pestilence, it killed 25 million people, or half the population of the affected continents. The epidemic began in Asia and spread throughout Europe in just three years. The practice of quarantine (isolating a person who’s suspected of being infected) dates precisely from this period. There were several outbreaks of Black Death in Europe until it was seen for the last time in the seventeenth century in the north of the continent, and in the eighteenth century in the south.

      The bacterium responsible for plague wasn’t discovered until the nineteenth-century epidemic that hit China. In 1894, Alexandre Yersin and Shibasaburo Kitasato independently identified it in Hong Kong. The Swiss Yersin was having problems in studying the disease as he wasn’t permitted to examine the bodies of the victims, which were all being sent to Kitasato’s laboratory. At the time, the latter, an eminent microbiologist, especially well known for his work with Robert Koch on tuberculosis and tetanus, was the clear preference of the authorities. By contrast, Yersin received no support, but he wasn’t discouraged by that. He built a thatched hut, which became his laboratory, and started bribing morgue workers to give him access to the victims. Despite all the difficulties, Yersin ended up with the fame, partly because of errors in Kitasato’s work. Yersin decided to name the new microbe Pasteurella pestis in honour of Pasteur but, years after his death, the name was changed to Yersinia in recognition of his contribution.

      As I’ve said, plague is far from being a thing of the past. For example, there was an outbreak in China in early August 2009. It was a pneumonic plague and, by the time it was made public, ten people were infected and two had died. The authorities immediately quarantined 10,000 people to stop the contagion from spreading.

      The first known influenza pandemic is that of 1580 and, since then, there have been about thirty major outbreaks. In the twentieth century, for example, there were four: in 1900, 1918, 1957 and 1968. The pandemic of 1918 deserves special mention, as the last major health catastrophe of the twentieth century to affect the whole world – at least until the onset of AIDS. In terms of the number of victims, it’s considered to rank third among the pandemics (after the Black Death of the Middle Ages and the smallpox that exterminated most of America’s indigenous peoples).

      Although the 1918 pandemic is traditionally called ‘Spanish flu’, the part of the globe where it began isn’t known for sure. Spain was the first country to report cases – hence the name. In the debate about its origins, the main suspects are France, the United States, Spain itself and some countries of Asia. The final death toll isn’t clear either. The figures range from 20 to 100 million people, according to different studies or, in other words, up to ten times more than the number of people who died in the First World War. This could signify between 2 per cent and 5 per cent of the total population of the planet (of which possibly 50 per cent was infected), with particularly high rates among people aged between 25 and 45.

      Sometimes pandemics have sneaky beginnings. In this case, for example, the first flu outbreak in January 1918 was mild and nobody regarded it as being more serious than a normal flu. By spring that year, it was already crossing the United States, but still no one paid much attention. Meanwhile, in Europe, fully embroiled in the First World War, it was starting to be a more serious problem. That summer, a second outbreak, more serious than the first one, began in Switzerland and reached American shores in September that year. Most cases were clustered in October and November, but a third wave was to appear early in 1919, followed by a fourth and final minor one in the spring of 1920.

       We don’t learn from our errors

      The organizational problems that aggravate the effects of a pandemic today are less common, but they still exist. The dithering of many leaders in 2020 when faced with the beginnings of the COVID-19 pandemic would be an example of this. Nevertheless, it’s been worse on other occasions. With the onset of the 2003 SARS epidemic, the Chinese government concealed the outbreak, thus causing panic in the cities because of lack of information and feelings of mistrust. The same thing happened in the early days of the bird flu outbreak when the governments of Thailand and Indonesia concealed information. And during the 2009 swine flu outbreak, even though the data flowed fast and clearly in most parts of the world, in countries like Argentina, the attempts of politicians to cover up the gravity of the situation contributed towards increased levels of contagion.

      In 2005, a group of scientists, including Adolfo García-Sastre, a Spanish virologist working at the Mount Sinai Hospital, New York, managed to read the genome sequence of the virus that caused the 1918 flu pandemic. The biological material was taken from a well-conserved frozen corpse found in the glaciers of Alaska. The genetic information they obtained allowed them to re-create the virus in the laboratory and, with this synthetic virus, to reproduce the lethal effects of the infection in mice. The


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