̽��ֱ�� of Cambridge - Mary Dobson

Spanish Flu: a warning from history

Anonymous — Fri, 30 Nov 2018 09:22:27 +0000

̽��ֱ��early origins and initial geographical starting point of the pandemic still remain a mystery but in the summer of 1918, there was a second wave of a far more virulent form of the influenza virus than anyone could have anticipated.

Soon dubbed ‘Spanish Flu’ after its effects were reported in the country’s newspapers, the virus rapidly spread across much of the globe to become one of the worst natural disasters in human history.

Doctors, nurses and volunteers were left helpless as their patients, the majority previously healthy young adults, languished and died from respiratory failure. There is now a broad consensus among experts that in just three years, Spanish Flu killed between fifty and one hundred million people. Despite this, public awareness of the disaster and the ongoing threat posed by influenza remains limited.

To mark the centenary and to highlight vital scientific research, the ̽��ֱ�� of Cambridge has made a new film exploring what we have learnt about Spanish Flu, the urgent threat posed by influenza today, and how scientists are preparing for future pandemics. ̽��ֱ��film presents original photographs from the 1918 outbreak and exclusive interviews with four leading experts:

Dr Mary Dobson, a historian of infectious diseases
Professor Derek Smith, Director of Cambridge’s Centre for Pathogen Evolution
Dr AJ te Velthuis, a virologist studying how RNA viruses amplify, mutate and cause disease
Professor Julia Gog, a mathematician of infectious diseases including influenza

One hundred years ago, celebrations marking the end of the First World War were cut short by the onslaught of a devastating disease: the 1918-19 influenza pandemic.

Spanish Flu: A Warning from History

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On the trail of history’s biggest killers

tdk25 — Fri, 06 Mar 2015 06:00:27 +0000

Diseases such as bubonic plague, smallpox, or scurvy, killed so many and caused such misery that they are still household names today, even if for most of us they are things of the past. From an historical perspective, they are also fascinating. By studying these illnesses and their impact, we can understand more about the people for whom such horrors were commonplace and real. Moreover, remarkable and inspiring tales of scientific endeavour are often part of the story of how they were controlled, treated, in some cases cured, and, in the case of smallpox, even eradicated from the globe.

Yet the study of these conditions is about more than simply gleaning historical information from a cabinet of increasingly distant medical curiosities. As time goes by, scientific knowledge is not just informing the work of historians; it is being informed by it. Many modern-day historians of medicine are operating more and more like pathologists and epidemiologists in their efforts to understand what caused the most disastrous pandemics of previous centuries, and how and why they spread. Their work is providing vital new information in the fight against modern-day “plagues”, such as cancer and dementia. More worryingly, it has started to highlight cases where millions died for medical reasons that remain obscure, raising some pressing “what-if” scenarios about our future.

In a new book published this week, Murderous Contagion, the historian of medicine Mary Dobson examines 30 of the biggest killers in the history of humankind, from scourges like the Black Death of the 14th century, to modern epidemics such as HIV/AIDS, and the still-developing Ebola crisis. Rather than simply focusing on the gruesome history of disease itself, however, or the often agonising treatments administered to earlier generations of patients, the study also shows how modern science and the history of medicine have come to depend on each other.

For one thing, historians are now able to take advantage of a growing body of scientific knowledge for their research. We know more than we ever have, for example, about how diseases “jumped” the barriers between species and spilled over from bats, birds, wild and domestic animals to humans, often adapting in their hosts as they spread. New techniques for recovering and analysing ancient DNA are also making it easier to identify past pathogens that were previously mysteries.

As we understand more about historical outbreaks, however, we are also learning more about human susceptibility to certain diseases, and how they might be prevented from recurring. History is increasingly capable of providing modern science not just with a record of what happened, but with information about why.

“Historians of medicine are moving closer to modern science as they come to understand more about the origins of disease,” Dobson, who is based at St John’s College, ̽��ֱ�� of Cambridge, explained. “It’s vitally important to get on top of where and how diseases originate before they have a chance to spread, and history can play an important role in this work. Understanding these stories is important for stopping diseases in their tracks, and fundamental to the goals of advancing global health in the present and future.”

Dobson’s book features striking examples of cases in which historical knowledge has, unexpectedly, become relevant to modern medical practice. In the 1950s, for example, two British epidemiologists decided to investigate the cause of a surge in cases of lung cancer that had become apparent during the previous decades. They predicted that this would most likely turn out to be exposure to car exhaust fumes, or possibly the tarring of roads.

As an outside possibility, they also considered smoking as another potential reason for the spike in cases. Some scientists thought this unlikely, but speculations about a link dated back as far as the 17th century, when James I himself had warned that tobacco was “hateful to the nose, harmful to the brain [and] dangerous to the lungs”. As we now know, smoking was indeed discovered to be the main cause of this emerging tragedy, and public health campaigns on the subject have become more plainspoken and forthright ever since.

̽��ֱ��potential for BSE, better known as “Mad Cow Disease”, to infect humans as variant Creutzfeldt-Jakob Disease (vCJD), might similarly never have become evident without historical knowledge of an obscure condition known as Kuru. This disease, characterised as “the trembling death”, had first been observed in the early 20th century among the indigenous population of Papua New Guinea. Symptoms included involuntary tremors, jerks, uncontrollable outbursts of laughter, loss of co-ordination, wasting and eventually death. ̽��ֱ��brains of people who had died from the disease were found to be riddled with holes. Extensive research eventually posited a link with ritualistic cannibalism, and thanks to the ending of such rites in the mid-20th century, Kuru all but disappeared, vindicating the theory.

These unusual symptoms were also apparent in some animal diseases, such as scrapie in sheep and in BSE in cows. In each case, the brain was found to have become “spongiform”, or Swiss-cheesed with holes. Scientists eventually linked these conditions to a new agent of infection; rather than a virus or bacterium, Kuru, scrapie and BSE were caused by an aberrant protein called a prion.

̽��ֱ��cannibalistic connection that had led to these symptoms emerging in Kuru opened up the disturbing possibility that BSE had emerged due to “high-tech” cannibalism, in the form of cattle feed made of proteins derived from sheep and cattle. By the 1980s, it was not just clear that this had happened, but that scrapie may have made an inter-species jump to become BSE in cows. If that was true, then it was equally possible that a similar leap could occur between cows and humans, particularly when cases of ‘new variant’ CJD started to emerge in young people.

This realisation formed the basis of the mid-1990s scare over BSE and vCJD in Britain. ̽��ֱ��feared large-scale epidemic of vCJD has not materialised, however, partly because offal had already been removed from cattle feed and tight controls put in place to keep infected meat out of the food chain. ̽��ֱ��link to Kuru, and subsequent discovery of prions, was critical: “What had begun as a mysterious disease in Papua New Guinea and an esoteric discussion in scientific circles about the cause of a rare class of animal and human neurological disorders has led to the revolutionary discovery of a new biological principle of infection in the form of prions,” Dobson writes.

In recent times, the story has taken a fascinating new twist as this research has begun to be linked to modern work on neurodegenerative disorders such as Alzheimer’s and Parkinson’s diseases. Although these diseases are not infectious, they are, it has emerged, like the Kuru-vCJD family, associated with the “misfolding” and malfunctioning of proteins. There is also growing evidence that the mechanisms by which these diseases progress could indeed be very similar. Even the recent upsurge in cases of type 2 diabetes appears to be linked to this “misfolding” phenomenon.

Elsewhere, the book highlights cases where the identity of the historical causes of a disease could prevent similar disasters occurring. Following the recent outbreaks of avian flu and swine flu, the mystery that surrounds historical pandemics of influenza is of especial concern. In particular, the cause of Spanish Influenza, which killed at least 50 million people between 1918 and 1920 – the highest death toll of any pandemic in human history – was unknown at the time.

Despite being one of the most deadly diseases of all time, Spanish Flu was until recently so little-studied it was sometimes characterised as a “forgotten” pandemic. Now scientists and historians are joining forces to understand how it began, how it spread, and why it was so lethal, especially in young adults. ̽��ֱ��traditional theory that it was disseminated by troop movements during and after World War I fails to explain why some of the worst-affected countries, such as India and Samoa, were far from the main theatres of conflict.

To date, there has been no subsequent global influenza pandemic of such lethality. H5N1 (bird flu), while potentially dangerous, has displayed limited capacity to “jump” the species barrier as initially feared, thereby, hopefully, eliminating any possibility of widespread human-to-human infection. H1N1 (swine flu) in 2009 was a more worrying example of “reassortment”, a process by which different types of flu combine into new strains, but was probably effectively contained through careful screening, quarantine programmes and efficient drug delivery – although not until it had claimed perhaps as many as 200,000 lives.

Both cases, however, demonstrate the urgency with which historians need to understand what caused the far more devastating Spanish flu pandemic. Researchers are now investigating the subject in the hope of finding more answers, and have even gone so far as to exhume the remains of victims from the permafrost to comprehend its cause, with the latest findings suggesting that it might, indeed, have been a novel form of bird flu.

Nonetheless, there are still questions to be asked and solved: “We still don’t know why and how Spanish Flu went global,” Dobson said. “But if we want to stop virulent flu pandemics from happening again, we really need to know more about why they happened in the past.”

Murderous Contagion: A Human History Of Disease by Mary Dobson is published by Quercus on March 6th, 2015.

Lower image shows soldiers from Fort Riley, Kansas, ill with Spanish influenza at a hospital ward at Camp Funston. Credit, Wikimedia Commons.

As well as telling us more about earlier societies, the study of diseases in the past is proving an invaluable tool for modern science, as a new book by the historian of medicine Mary Dobson reveals.

It’s vitally important to get on top of where and how diseases originate before they have a chance to spread. Understanding these stories is important for stopping diseases in their tracks.

Mary Dobson

Wikimedia Commons

Policemen in Seattle wearing masks made by the Red Cross, during the Spanish Influenza epidemic, December 1918.

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Cambridge heads for Hay

jfp40 — Thu, 10 Apr 2014 09:20:09 +0000

̽��ֱ��Cambridge Series has been running for six years at the prestigious Festival and is part of the ̽��ֱ��’s commitment to public engagement. ̽��ֱ��Festival runs from 22nd May to 1st June and is now open for bookings.

This year's line-up includes Sir John Gurdon who was jointly awarded the Nobel Prize for Physiology or Medicine for the discovery that mature cells can be converted to stem cells. He will talk about his pioneering work on cloning.

Other speakers include Dr Ha-Joon Chang on economics, classicist Professor Paul Cartledge on after Thermopylae, Dame Barbara Stocking, former chief executive of Oxfam GB and president of Murray Edwards College, on the challenges for women in the workplace, Professor Chris Dobson and Dr Mary Dobson on Alzheimer's and other plagues, economist Professor Noreena Hertz on smart thinking and Professor Robert Mair on tunnelling into the future of our cities.

Professor Richard Evans, president of Wolfson College, will talk about the history of conspiracy theories, Dr John Swenson-Wright from the Faculty of Asian and Middle Eastern Studies will ask if North Korea is the perennial crisis state and Dr Robin Hesketh from the Department of Biochemistry will attempt to demystify cancer.

Several of the talks will take the form of a conversation: Professor Simon Blackburn will debate the uses and abuses of self love with journalist Rosie Boycott; novelist and playwright Biyi Bandele, a former Judith E. Wilson Fellow at Churchill College, will be in conversation with Dr Malachi McIntosh from the Department of English about migrant writing; Professor Henrietta Moore, William Wyse Chair of Social Anthropology, will talk about the future of civil activism with Ricken Patel, founding President of Avaaz, the world's largest online activist community; and psychologist Dr Terri Apter will debate how women follow, resist and play with the stereotypes that define them with author and alumna Zoe Strimpel.

Other Cambridge academics speaking at Hay are Professor Stefan Collini discussing higher education’s two cultures - the humanities and science - and historian Professor David Reynolds.

Peter Florence, director of the Hay Festival, said: "Cambridge ̽��ֱ�� nurtures and challenges the world's greatest minds, and offers the deepest understanding of the most intractable problems and the most thrilling opportunities. And for one week a year they bring that thinking to a field in Wales and share it with everyone. That's a wonderful gift."

Nicola Buckley, head of public engagement at the ̽��ֱ�� of Cambridge, said: “ ̽��ֱ��Cambridge series is a wonderful way to share fascinating research from the ̽��ֱ�� with the public. ̽��ֱ��Hay Festival draws an international cross-section of people, from policy makers to prospective university students. We have found that Hay audiences are highly interested in the diversity of Cambridge speakers, and ask some great questions. We look forward to another fantastic series of speakers, with talks and debates covering so many areas of research and key ideas emerging from Cambridge, relevant to key issues faced globally today."

For tickets, go to: www.hayfestival.org

A host of Cambridge academics, including Nobel Laureate Sir John Gurdon, will be speaking on subjects ranging from stem cell technology and Alzheimer’s to the future of North Korea and the history of conspiracy theories at this year’s Hay Festival.

Cambridge ̽��ֱ�� nurtures and challenges the world's greatest minds, and offers the deepest understanding of the most intractable problems and the most thrilling opportunities

Peter Florence, Director of Hay Festival

Hay Festival

Night shot at Hay Festival

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