An invasion of a microscopic enemy called the influenza virus is marching into Central and Eastern Europe from the West. The disease can be as deadly as the plagues of old. But health officials say they met this year's version of the flu several years ago, and that it is following a normal course. RFE/RL correspondent Don Hill reports that there is more to be known about this unpleasant disease than you might think.
Prague, 13 January 2000 (RFE/RL) -- The virus that is spreading influenza's fever, coughing, and wheezing across the world this winter turns out to be an old acquaintance.
International news agencies are carrying reports this week of overloaded Israeli hospitals turning away patients, of stores in Britain during the normally popular after-Christmas sales standing deserted, and of one in five Dutch men and women stricken.
The epidemic, moving eastward across Europe, has just reached epidemic status in the Czech Republic's capital, Prague. Listen to Dr. Martina Havlickova, Czech National Institute of Public Health:
"Currently the incidence of flu, especially in Prague, has reached the dimensions of an epidemic, especially among those over 15 years old. The statistics say there are 2,000 cases for every 100,000 people. Various strains have been isolated that are derived from the Sydney A strain, which means that those people who took the precaution of being vaccinated should be fairly well protected."
The UN's World Health Organization -- known as WHO -- says the epidemic so far is within a normal range and has been both predictable and preventable.
Influenza is an inflammation of the respiratory tract, often accompanied by high fever, sore throat, severe aches and disabling fatigue. Epidemics usually occur in the winter, when sneezing and coughing sends moisture-borne viruses from infected persons into the air to be inhaled by new victims.
It is highly contagious, and can be deadly.
The ancient Greek physician Hippocrates described influenza 400 years before Christ. Records exist of influenza outbreaks since the 12th century. In this century, health officials have documented three pandemics, or global epidemics. They occurred in 1968, 1957 and 1918. The 1918 outbreak -- known as Spanish influenza -- caused more deaths than either the Black Plague or World War I. Soldiers on both sides in that war were among its hardest hit populations.
A doctor at the U.S. Armed Forces Institute of Pathology in Washington, Jeffrey K. Taubenberger, says the 1918 Spanish flu was remarkable for its peculiar ability to infect and kill otherwise healthy young adults.
Research by Taubenberger and other scientists supports the hypothesis that the most dangerous flu viruses migrate into humans from other animals -- especially birds and pigs. The Asian and Hong Kong viruses of recent years evidently began in fowl, moved to pigs -- whose respiratory and immune systems are similar to those of humans -- and then infected people.
Epidemiologists sort flu viruses into three types: Type A, which infects both humans and other animals, and Types B and C, which infect only humans. Type C is mild and does not cause epidemics.
The strain now toppling people in North America and Western and Central Europe is a Type A, first isolated almost four years ago in Sydney, Australia. Czech influenza watcher Havlickova says:
"Most of Europe has been hit. There are some differences. It seems the situation is fairly calm in Poland, and in Slovakia local cases have been recorded. Everywhere the strain that has been isolated seem to be similar --A-H-3-N-2."
The World Health Organization predicted last year that the Sydney strain would be common this year. Health authorities around the world heeded WHO's recommendation that flu vaccines distributed last fall include the Sydney strain.
Since the strain is at least four years old, many people already have developed some immunity to it. Those who received this season's influenza vaccinations also are likely to be immune. WHO says, however, that the use of influenza immunization is less widespread than it ought to be. Most likely to be stricken: the very young, and people over 50.
Prague's Dr. Havlickova says this year's epidemic still has teeth:
"We expect an increase in the cases of flu, at least in the next week. It is hard to say when the epidemic will reach its peak. On an average, such an epidemic usually lasts six weeks."
There are complex tests that can prove conclusively when one has the flu, but most doctors rely simply on observing symptoms.
For people who come down with the characteristic sore throats, fevers, aches and exhaustion, most doctors recommend a traditional response: take aspirin or other anti-inflammatory drugs, drink liquids, and get lots of rest. The disease can be dangerous, however. If it persists, doctors say, see a medical professional.
This common ailment may very well have affected history.
U.S. President Woodrow Wilson was severely ill, evidently with Spanish flu, at Versailles, when he was negotiating the treaty that ended World War I. Some historians speculate that -- had he been well -- he would have persuaded his allies to agree to a more benign treaty.
Public health officials urge people to avoid crowds in order to limit their exposure during influenza outbreaks. But that didn't help Greek Cypriot President Glafcos Clerides and Turkish Cypriot leader Rauf Denktash last month. When they were in New York trying to negotiate a settlement to the problem of divided Cyprus, they didn't even meet with each other. They conducted their exchanges, which UN officials called "proximity talks," through UN Secretary-General Kofi Annan and other officials who shuttled between their separate rooms.
When they got home to Cyprus, they both came down with the flu.