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According to John R. LaMontagne, chief of infectious diseases at the National Institute of Allergy and Infectious Diseases, the Spanish flu pandemic of 1918 was “the most devastating epidemic that we have ever had in history.” In fact, the Spanish Flu Pandemic is believed to have claimed approximately 22 million people all around the world, including Asia, Africa and Europe. An epidemic on such a large scale, that wreaked havoc in so many countries and pushed the health care system all around the globe to the brink of desperation, has to be looked into lest another flu outbreak occurs. And the possibility of such a recurrence is very high, considering the recent spate of events: Asian flu of 1957, Hong Kong flu of 1968, Severe Acute Respiratory Syndrome (SARS) crisis of 2003. Thus, our group decided on the Spanish Flu as our significant event as we realise that the battlefront against the influenza virus is not as impenetrable as we think it to be, considering recent outbreaks. We have to learn from the mistakes made in past epidemics and be sufficiently prepared for the next one, by examining the deficiencies in our international surveillance system and thus, further strengthening our defence against a future flu outbreak. ___________________________________________________Significance of Spanish Flu The Spanish Flu Pandemic of 1918 challenged the public health care systems of many countries, as the unknown nature of the virus and its mode of transmission was inhibiting the development of a suitable vaccine to combat it. Moreover, these public health care systems were lacking the organisation and infrastructure that was vital to dealing with this outbreak. Moreover, as the Spanish Flu occurred during the First World War, there weren’t enough resources that could have been used to implement suitable measures to contain the virus. Despite it being a pandemic i.e. spanning the entire world, countries did not see the importance of co-ordinating and co-operating with the rest of the world. This meant that even when measures taken in a particular country were effective, this was only so locally, and the virus would enter soon after from other neighbouring countries, where it was still virulent. Thus, the Spanish Flu stresses on the importance of a world body such as the World Health Organisation, that monitors the global threat of infections, that initiates and co-ordinates responses to such a threat, and that diffuses clear and consistent messages to the population that was “the biggest lack during the 1918 Spanish Flu outbreak” , according to C.E. Ammon. However, recently there has been growing disquiet about the capacity of the World Health Organisation to prevent and deal with an outbreak, especially in developing countries. “Influenza is a global threat,” says WHO’s Director General Dr Gro Harlem Brundtland. “It already kills up to a million people each year, and sooner or later it will ignite a pandemic. We can meet this challenge with a strong global surveillance system and a robust health infrastructure, or we will suffer the consequences. Today, we are not ready for the next influenza pandemic. Preparednes has to begin now. The situation is urgent.” Despite the presence of 112 Influenza Centres in 83 countries and four WHO Collaborating Centres for Reference and Research on Influenza as part of the WHO’s Global Influenza Surveillance Network, this surveillance network still has geographical gaps in the developing world as the recent outbreaks in Madagascar and The Democratic Republic of Congo illustrate. Developing world populations may be malnourished, live in areas with poor sanitation, encounter other diseases such as AIDS and may encounter inadequate public health care systems. In such conditions, influenza can be devastating. This was also the problem during the Spanish Flu, as it caused the largest number of deaths in the relatively underdeveloped continents like Asia and Africa, and the fact that this problem still persists despite the presence of the WHO, is disheartening. As seen from the consistent occurence of influenza outbreaks, there is much cause for concern that another outbreak might occur. Due to the ability of the influenza virus to adapt, mutate and re-emerge, as illustrated by the fact that the 1957 disease was similar to the 1889 disease, and the 1968 disease to that of 1900 , it is almost impossible to come up with a lasting solution to deal with the virus. Also, due to the huge volume of human traffic through international air flights that links the cities of the world in a close-knit matrix of vulnerability, the “entire world has become the hunger-gatherer’s home village, potentially one vast amplification factory for any such emerging epidemic virus.” In the Spanish Flu Pandemic, WW1 intensified the mortality figure through massive troop movements, the development of fronts and so on- these factors led to a homogenous mixing of the population unlike anything seen previously , but in fact occurs all the time today.
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