In 1918, a pandemic raged that claimed an estimated 50 million lives worldwide. And stories from that time suggested again and again that mainly healthy young adults became ill and died. But that is not true, according to new research.
Scientists drew this conclusion after examining the skeletons of 369 people who died in the last century. The remains were divided into two groups for the study: one group consisted of the remains of people who had died before the pandemic and the other group consisted of remains of people who had died during the pandemic.
Lesions
The researchers then specifically looked for lesions in the tibia of the deceased. Lesions are damage or changes in the tissue caused, for example, by illness, an accident or malnutrition. Consider, for example, new bone formation in response to inflammation or bone fracture. By studying lesions, researchers can determine whether they were still active (i.e. not yet healing) at the time of death or whether they were healing or had even already healed. These three scenarios all hint at underlying suffering (at different stages). “By looking at who had lesions and whether those lesions were active or healing at the time of death, we get a picture of how vulnerable these people were, or who was more likely to die,” explains researcher Sharon DeWitte. “The results suggest that frail or unhealthy individuals were more likely to die during the pandemic than people who were not frail,” the researchers concluded in their study, published in the journal Proceedings of the National Academy of Sciences.
Not surprising
It is at odds with what stories and historical documents from that time would have us believe, namely that young, healthy people in particular fell prey to the Spanish Flu. It didn’t really surprise lead author Amanda Wissler, she says Scientias.nl. “’Healthy people’ shouldn’t die. Numerous studies have shown that certain people are more likely to die in all kinds of contexts, including in other pandemics such as the Black Death, but also during natural disasters, for example. It would only have surprised me if people who were healthy in 1918 had had a greater chance of dying.”
Young, but not healthy
The Spanish Flu therefore did not mainly target healthy young adults, scientists must conclude. It is true that a striking number of young people died during this pandemic. “Young adults between the ages of 20 and 40 had a much higher risk of dying during the 1918 pandemic than during the regular flu season or even compared to other flu epidemics,” says Wissler. And the new research does not change that. But what the study does suggest is that most young adults who died from the Spanish Flu were already vulnerable before the infection, or in other words, were not as healthy as tradition would have us believe.
Tuberculosis?
If particularly vulnerable people died during the Spanish Flu, the fact that a striking number of young adults died as a result of the Spanish Flu naturally raises an interesting question. Namely: why what made those young adults so vulnerable? Wissler can only speculate about that for now. “There are many theories about why young adults were more likely to die, including co-infection with tuberculosis.” Tuberculosis was common at that time, especially among young people, and may have weakened young adults just enough to make an infection with the Spanish Flu fatal.
Follow-up research
As with any epidemic, healthy young people died during the Spanish Flu. But, as this research suggests, in most cases there was still a (not yet further defined) vulnerability. However, more research is desperately needed. “There are many possible causes for vulnerability during the Spanish Flu: from malnutrition to low socio-economic status and from not being able to quarantine to having a poorer immune system. We can test some of these things using the skeletons that were also used in this study, but others cannot.” For now, however, Wissler first focuses on another interesting question. For example, she is currently investigating, using the same skeletons, whether men had a greater risk of death than women during the 1918 pandemic. “Men were more likely to develop severe COVID-19, so it will be interesting to find out if we will see something similar (among victims of the Spanish Flu, ed.).”
And so the last word about these skeletons and the Spanish Flu has not yet been said. It is easy to explain why scientists put so much time and energy into a pandemic that raged more than a century ago. Pandemics are timeless. And this makes research into what makes people particularly vulnerable during such a pandemic also very relevant. “We often see that the risk factors for diseases that occur today are the same as in the past,” notes Wissler. “I remember the news in the US during the corona pandemic reporting that people who belonged to minorities or had reduced access to social services were more likely to become seriously ill or die. It was presented in the news as if it were something new. But previous studies of the Spanish Flu have already shown that people with low socio-economic status were more likely to get sick and die. And even studies of the medieval Black Death have shown that people who were less healthy or more vulnerable had a greater risk of dying.” Here too, the following applies: nothing new under the sun. And we may be able to use this to our advantage in preparation for future pandemics.
2023-10-10 11:28:32
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