This image is from a ward in 1918, filled with patients with the same disease. This disease typically presents with abrupt onset of fever, headache, muscle ache, malaise, cough, sore throat, and rhinorrhea. Exam shows hyperemic mucosa and mild cervical lymphadenopathy, but little else. Complications include persistent high fever, dyspnea, bilateral reticular or reticulonodular opacities, secondary infection, rhabdomyolysis, encephalitis, transverse myelitis, aseptic meningitis, and Guillain-Barre syndrome.
Challenge: What is the molecular mechanism by which such pandemics occur?
Image is in the public domain.
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flu pandemic (the "Spanish" flu) was an influenza pandemic, and the first of the two pandemics involving H1N1 influenza virus, virus kills through a cytokine storm (overreaction of the body's immune system).
yes, a good history lesson :)
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Ancient History
This case, of course, refers to the 1918 influenza pandemic which occurred due to antigenic shift when high rates of viral reassortment occur among viruses infecting the same cell; this includes reassortment between animal and human viruses. For this particular pandemic, there were shifts in the hemagglutinin H1 and neuraminidase N1 envelope glycoproteins.
Sources: UpToDate; Wikipedia.
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