What's New in Life Science Research

Ever since the first human deaths from avian influenza were reported in February 2003, in Hong Kong and mainland China, there has been enormous interest in tracking H5N1. Most of the public health efforts, increasing global in scale, have concentrated on epidemiological surveillance in poultry and humans, standardized and transparent case reporting, understanding the dynamics of bird-human and human-human transmission, and identifying the molecular structure of H5N1.

Emerging during the same six month period as the SARS epidemic (Severe Acute Respiratory Syndrome), H5N1 has inspired fear and fascination, as well as a steady stream of studies, papers, blogs, and commentaries.

A good place to start is Flu Wiki, which posts daily updates about H5N1 and is a veritable clearinghouse of information and links to almost everything flu-related on the web. A recent posts to scienceblogs describes the genesis of Flu-Wiki and demonstrates how its bloggers see the big picture, namely that flu needs to be understood in the larger public health infrastructure.

Even if avian influenza never arrives, a prospect that some scientists have come to believe, we'll be left with a wealth of information about about both this specific viral entity and much that is simply H5N1-related, including abundant research on H1N1 (which struck in 1918-1919), migratory bird paths, and how communities can prepare for a pandemic of any origin.

For the past few years the Center where I work at the University of Michigan has been involved in a big study of how 50 of the most populous cities in the United States responded during the 1918-1919 pandemic. We want to not only to better understand these city experiences in their historical context, but to determine what we can extrapolate from their public health measures -- what works and what doesn't work -- in the advent of another pandemic.

Our findings, published in JAMA, that cities that responded with public health measures (quarantine and isolation, school closure, and social distancing) in an early, sustained, and layered fashion generally fared better than those than responded late, haphazardly, and with one rather than several measures, has been incorporated into the U.S. Centers for Disease Control and Prevention's community mitigation guidelines.

Our continuing research is exploring additional aspects of the 1918-1919 influenza pandemic in urban America, such as how the organization of city government and the public health board affected outcomes, and the extent to which pre-existing health problems and profiles made certain communities more susceptible to high morbidity and mortality rates.

As with our earlier research on 1918 influenza "escape" communities, we eventually will make our voluminous research materials available online.

In the meantime, there's a lot out there for those who want to see what's been produced during this period of Flu-Mania about the 1918-1919 influenza pandemic.

Here are a few recommended sites related to U.S. history of the flu.

From the CDC
From the History Channel
The U.S. National Archives
The U.S. Navy
In North Carolina
The PBS site for the documentary Influenza 1918

I'm a historian so I think it's wonderful to have this wealth of information publicly available. It's being accessed by a wide range of people, from middle school students to researchers in social epidemiology and public health.

I see why some people might think it's overkill, especially since it's so hard to measure the extent to which this information has any contemporary public health value.

So even as I'm excited about the wealth of historical materials on the web, I see a few potential problems too, namely, fetishization, decontextualization, and sensationalization of the 1918 pandemic. It's quite similar -- just retrospectively applied -- to the tendency to focus overwhelmingly on blockbuster events and the threat of scary emerging infections, rather than invest seriously in the everyday, chronic ailments that kill millions by the day, such as TB and diarrheal diseases.