Flu outbreaks dot Upper Peninsula past, present

by George Sedlacek

allergy-18656_640The National Center for Disease Control has reported an outbreak of influenza in humans similar to a virus found in swine—recalling the flu of a half-century ago that killed 500,000 Americans. Sound familiar? This was reported in the Marquette Mining Journal on February 20, 1976. A lot of information has been written about the swine flu vaccination program in that year, most of it negative. However, what gets lost is the fact that this particular virus had the potential of being a major killer, the same potential of the current H1N1 virus.
On February 4, 1976 the first reported fatality was at Fort Dix (New Jersey) in a nineteen-year-old recruit. The reports stated that four other young soldiers also were sick. Shortly after, more than 200 soldiers fell ill, quarantine measures were instituted quickly at the base and the disease did not spread. Health officials at the time feared this isolated outbreak could be the first ripple of a more deadly wave in the fall. It is common knowledge that these “novel” viruses can come back with a vengeance like the “Spanish Flu” epidemic of 1918-19.
Ironically, in Superiorland at nearly the same time, in 1976, there was an outbreak of the “seasonal flu.” The Mining Journal reported schools in southern Alger County were forced to close due to nearly half their students being out sick with the flu. Trenary had seventy-one out of 152 absent. In Negaunee, eighty-three students were sick on February 23 and more than 100 on the 24th. Seventy-two were reported sick in Ishpeming. The bug got to the NMU campus on March 9, with 261 students reporting illness. By March 17, health officials were able to isolate the virus as a Type A-Victoria virus. As is the case with seasonal flu, this epidemic died out as summer approached.
But the concerns remained about the potential of the novel new swine flu strain coming back in the fall of 1976. The CDC on April 10, 1976 announced a plan to immunize 213 million Americans for “swine flu.” They based this on concerns that the virus had “common characteristics” of the swine strain of 1918. For the first time, science had the capability of preventing a plague that could wipe out millions of people. Still, the CDC recognized that by making such an announcement, they would be put in a “no-win” situation. One doctor reporting in the book The Epidemic That Never Was stated that “As for ‘another 1918,’ I didn’t expect that…But who could be sure? It would wreck us if it came back as a major killer and we did not prepare. Yet, if there weren’t a pandemic, we’d be charged with wasting public money, crying wolf and causing all the inconvenience for nothing…It was a no-win situation.”
Back in Marquette County, the summer of 1976 was a busy one for the health department. Craig Remsburg, a young reporter for The Mining Journal, reported on local plans of Dr. Richard Potter, the health officer for the Marquette County Health Department. There were several articles explaining the plans of the Centers for Disease Control and how that related specifically to Marquette County residents.
“Some day late this Fall, 11,000 residents of Marquette County will be shot during a different kind of war,” Remsburg wrote.
Potter went on to explain that the availability of the vaccine gun would allow Marquette County Health Department staff to immunize up to 750 residents each hour at two county centers.
“The availability of the vaccine is holding up the determination of the vaccine clinic…Vaccines for high risk area residents—those sixty-five years of age or older or those with chronic disease—may be available as soon as next month from private physicians or at hospitals and nursing homes.”
There were numerous articles in the Mining Journal from September 29, 1976 to December 15, 1976. These articles chronicled the arrival of the new vaccine, policy changes identifying who should receive the vaccine first dictated to Potter at the last minute, controversy surrounding the vaccine as some individuals developed Guillaume-Barre Syndrome (none in the Upper Peninsula) and availability of the vaccine.
A tremendous amount of effort went into making this vaccine available to many people in a relatively short period of time. Creating a vaccine for a new or emerging virus is a complex process. There are many ways to create an effective vaccine, and the process depends on the type of virus or bacteria.
Vaccines are effective in preventing disease not only in individuals, but also in communities. This type of protection is called “herd immunity.” When a disease spreads from one human to another, it requires both an infected individual to spread it and a susceptible individual to catch it. Herd immunity works by decreasing the numbers of susceptible people. When the number of susceptible people drops low enough, the disease will disappear from the community because there are not enough people to carry on the catch-and-infect cycle. The greater the proportion of vaccinated members of the community, the more rapidly the disease will disappear.
This brings us back to the swine flu of 1976. The vaccine developed in 1976 was, in fact, effective against what was referred to as “the swine flu,” but also forever reduced confidence in public health pronouncements from the government and helped foster cynicism about federal policy makers that continues to this day due to potential links to some deaths in the elderly and some inoculation recipients who developed Guillaume-Barre Syndrome.
Did public officials overreact in 1976? As one CDC official said, “It could be said that this was public health’s greatest hour (since millions of people were vaccinated, potentially averting a return of the disease) or our worst disaster. We will never know.”

Hope for the best, prepare for the worst
Could this most recent outbreak of H1N1 (aka swine flu) be the first wave of a pandemic? Let’s say we do not plan for a second wave and one hits—one that has a lethal rate similar to the Avian Bird Flu (H5N1) in Asia. It’s an option public health cannot take.
In public health, we talk much about prevention of disease. This is why the staff of the Emergency Preparedness Team at the Marquette County Health Department views H1N1 as a potential major public health threat.
Jill Fries, emergency preparedness coordinator for the health department, and the rest of the team began holding daily meetings on April 27 the day the CDC declared us to be in a “Public Health Emergency.” It had only been one week since massive news reports began to tell of thousands of people getting the flu in Mexico and more than a hundred deaths. That this disease came on so quickly and with such communicability rightly caused concern. CDC as of May 18 has declared the virus to be in forty-eight states, causing five deaths with more than 5,000 cases. The illness appears to cause no more severe illness than the seasonal flu we experience, which causes, on average, more than 35,000 deaths each year.
Fries reports that it’s the goal of public health to provide the most accurate and up-to-date information to local physicians and labs; provide appropriate information to all media with the hope not to panic the general public, but to keep people aware of what is known, provide direction on ways to prevent transmission of the flu and lower a person’s risk of contracting influenza.
Equally important was to correct any rumors in the area such as: “I heard that the health department is shutting down all the businesses in Negaunee, because there are eighteen positive cases in Negaunee,” a local caller inquired a week into the H1N1 episode. The staff was able to assure the caller there were no confirmed cases of H1N1 in Marquette County, and at that time, there were no confirmed cases in the Upper Peninsula—no we were not shutting down any businesses.
Although the Emergency Preparedness Team is no longer meeting daily, we are monitoring the situation daily and strongly encouraging people to prepare their households for the potential second wave of H1N1 in the Fall 2009 or winter 2010. We do not at this point in time have any data that either states, “Yes, this is what is going to happen” or “No, this is not going to happen.” We only have historical data to guide us, and historically we are overdue for a major pandemic. Fries and the Emergency Preparedness Team at the Marquette County Health Department recommend:
• Practicing good health habits such as regularly washing hands, sneezing into tissue paper or sleeve, staying home when sick and being in the best physical condition as possible.
• Discussing with your family what your emergency plan is.
• If your place of employment shuts down or day care provider needs to close, what are your options?
• Does your place of employment have an emergency preparedness plan in place for a major influenza outbreak?
• If not, staff at the Marquette County Health Department can help with resources and suggestions for businesses both large and small to create a plan.
• There are also family plans available at the health department and online at www.mqthealth.org
For more information on the H1N1 virus, visit the Web site, or call Fries at 475-5649.
— George Sedlacek

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