Feb. 7, 2006

Previous pandemic in 1918 recalled as Cornell plans for possible avian flu threat

As avian flu spreads among bird populations throughout Asia and eastern Europe, accounting for close to 90 human deaths so far, health officials at Cornell University are working out details of an emergency plan for campus in the event of a pandemic.

Such a plan would be necessary only if the virus mutates to allow contagion between people. At present, almost all the human cases have originated from contact with birds, with the source of a few cases still unclear.

This would not be the first time for a flu pandemic to hit Cornell. In October 1918, the "Spanish influenza," now called the 1918 flu, overwhelmed campus and Ithaca for more than a month.

The first cases hit campus in the last week of September 1918, just prior to classes starting, and with the World War I armistice still nearly six weeks away. Within weeks, the number of cases skyrocketed. By Oct. 8, the day The Ithaca Journal ran the front-page headline "Anglo-American Troops Smash Hun Defenses," there were 300 reported cases of the flu, also called the grippe, in Ithaca that day.

Of the victims, 125 were in the Cornell infirmary and an untold number of ill women students were being housed in the annex of Sage College. To take the overflow, on the afternoon of Oct. 7, Cascadilla Hall was converted into a temporary hospital; by the next morning, 36 beds were filled, and the Cornell infirmary reported the first flu-related death for all of Ithaca: A male student in the vocational school had died from pneumonia. In the subsequent two weeks, many more died, often succumbing to pneumonia after contracting the flu.

C.D. Bostwick, the university treasurer at the time, wrote in a 1919 report to the university's president: "During October and November there were approximately 900 cases cared for, all being students in the university or in one of the government schools. There were 37 deaths." Although Buffalo and other cities shut down such public places as street cars, schools and saloons, The Ithaca Journal reported on Oct. 9 that the Ithaca health board felt such measures were ineffective, and public areas remained open.

At the time, most of the area's medical personnel had been called away to war. "There was a scarcity of doctors, nurses, and help of all kinds, and of equipment and supplies," Bostwick wrote.

The minutes of a Nov. 30, 1918, Cornell Board of Trustees meeting note that the university health facilities would have "been in serious plight" had it not been for "the unselfish labors" of volunteers from Ithaca and nearby towns. The minutes comment that the volunteers "devoted themselves for weeks, day or night, to any service ... however laborious or distasteful the service might be."

In addition, medical students were deputized to care for the sick in the wards. As a result, instruction at the Ithaca division of the medical college came to a halt that October. "For more than a month all of the seniors and juniors were devoting most of their time to the hospital," wrote Walter L. Niles, acting dean of the medical college in Ithaca, in a report to the president. The college's sole instructor in anatomy, Henry K. Davis (A.B. '12, A.M. '14), died in the pandemic.

Overall, there were 1,300 cases of grippe and almost 40 deaths in the Ithaca hospital system, in addition to the cases at Cornell.

The highly virulent strain of Spanish flu had a similar genetic structure to the current H5N1 avian flu strain, according to scientists who have recreated the 1918 virus' genome. That earlier strain jumped straight from birds to humans to kick off the pandemic that killed 50 million worldwide. In 2006, however, the H5N1 strain will need to mix genes with a human flu strain or undergo additional mutations to become transferable from human to human.

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