1976 swine flu outbreak
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The 1976 swine flu outbreak, also known as the swine flu fiasco,[1] or the swine flu debacle, was a strain of H1N1 influenza virus that appeared in 1976. Infectious morbidity was only detected from January 19 to February 9, and were not found outside Fort Dix.[2] The outbreak is most remembered for the mass immunization that it prompted in the United States. The strain itself killed one person and hospitalized 13.[2] However, side-effects from the vaccine are thought to have caused five hundred cases of Guillain–Barré syndrome and 25 deaths.[3]
Outbreak
In late January 1976 a number of recruits at Fort Dix in New Jersey began to complain of respiratory illness, on February 5, 1976, David Lewis, an Army private said he felt tired and weak. Private Lewis then left his sick bed to go on a forced run, collapsed, was revived by his Sergeant only to die a few days later and four of his fellow soldiers were additionally hospitalized. Two weeks after his death, health officials announced that swine flu was the cause of death and that this strain of flu appeared to be closely related to the strain involved in the 1918 flu pandemic. Alarmed public-health officials decided that action must be taken to head off another major pandemic, and they urged President Gerald Ford that every person in the U.S. be vaccinated for the disease' despite prior knowledge that one version of the vaccine could cause neurological damage.[4]
The vaccination program, enacted at a cost of $135 million,[5] was plagued by delays and public relations problems. However, Centers for Disease Control vaccination efforts achieved unprecedented distribution results, with more than 40 million Americans immunized between October and December that year.[6] The first vaccinations were given on approximately October 1, the government suspended the immunization program on December 16 after reports of at least 54 cases of Guillain–Barré syndrome across ten states.[1] Approximately 24% of the population had been vaccinated by the time the program was canceled.[7] The suspected pandemic did not spread from Fort Dix and as a result only one person, an Army recruit, died from the flu in 1976.[8] A study in 2010 found a significantly enhanced immune response against the 2009 pandemic H1N1 in study participants who had received the 1976 swine flu vaccination.[9]
Reported vaccine side effects
There were multiple reports of Guillain–Barré syndrome (GBS), a paralyzing neuromuscular disorder, affecting some people who had received swine flu immunizations. One of the causes of this syndrome could be a rare side-effect of modern influenza vaccines, with an incidence of about one case per million vaccinations.[10] Guillain–Barré syndrome naturally occurs at a rate of 6-40 per million people per year,[11] implying an increased risk of between 2.5%-25% over the base rate.
Claims exist that about 500 cases of GBS were caused by the vaccine, and that these cases resulted in death from severe pulmonary complications for 25 people. These are claimed to have been caused by an immunopathological reaction to the 1976 vaccine.[citation needed][dubious – discuss] Other influenza vaccines have not been linked to GBS, though caution is advised for certain individuals, particularly those with a history of GBS.[12][13] According to Harvey Fineberg and Richard Neustadt, authors of The Swine Flu Affair, the risk of developing GBS was roughly 11 times greater with vaccination than without, though still a remote risk, affecting approximately 1 in 105,000 individuals.[1]
The CDC states that most studies on modern influenza vaccines (e.g., post 1976) have seen no link with GBS,[14][15][16] Although one review gives an incidence of about one case per million vaccinations,[17] a large study in China, reported in the NEJM covering close to 100 million doses of vaccine against the 2009 H1N1 "swine" flu found only eleven cases of Guillain–Barré syndrome, (0.1 event per million doses) total incidence in persons vaccinated, actually lower than the normal rate of the disease in China, and no other notable side effects.
Aftermath
The relatively benign disease outbreak and the subsequent vaccine reactions produced some political and sociological repercussions. In part, some of the political failures of the vaccination program have been attributed to the political climate associated with President Ford's re-election campaign in 1976.[5][6]
President Ford offered vaccine manufacturers indemnity,[5] and the United States Congress "rushed" indemnity legislation that has been characterized as "faulty" and "haphazard".[6]
See also
- 1918 flu pandemic
- 2009 flu pandemic
- 1976 Philadelphia Legionnaires' disease outbreak initiating in July, initially perceived to be a continuation of the swine flu outbreak
References
- ^ a b c Rita Rubin (May 5, 2009). "Lessons learned from the 1976 swine flu 'fiasco'". USA Today. Retrieved October 18, 2012.
- ^ a b Gaydos JC, Top FH, Hodder RA, Russell PK (January 2006). "Swine influenza a outbreak, Fort Dix, New Jersey, 1976". Emerging Infectious Diseases. 12 (1): 23–28. doi:10.3201/eid1201.050965. PMID 16494712. Archived from the original on 2009-07-21. Retrieved 2009-06-23.
{{cite journal}}: Unknown parameter|deadurl=ignored (|url-status=suggested) (help) - ^ Roan, Shari (April 27, 2009). "Swine flu debacle of 1976 is recalled". Los Angeles Times. Retrieved 27 April 2009.
- ^ "CBS 60 Minutes "Swine Flu"". Retrieved 28 October 2009.
- ^ a b c Eben Harrell (April 27, 2009). "How to Deal with Swine Flu: Heeding the Mistakes of 1976". TIME Magazine. Retrieved October 17, 2012.
- ^ a b c Stephanie Beck (April 30, 2009). "When politics and swine flu infect health". SF Gate. Retrieved October 17, 2012.
- ^ Pat Shellenbarger (April 28, 2009). "Local officials remember 1976 swine flu scare, President Ford's decision to order nationwide vaccinations". The Grand Rapids Press. Retrieved October 17, 2012.
- ^ Glenn Beck (April 27, 2009). "What Can We Learn From the 1976 Flu Debacle?". Fox News. Archived from the original on 2009-05-05. Retrieved 2009-04-29.
{{cite news}}: Unknown parameter|deadurl=ignored (|url-status=suggested) (help) - ^ Jonathan A. Mccullers; et al. (April 23, 2010). "Recipients of Vaccine against the 1976 'Swine Flu' Have Enhanced Neutralization Responses to the 2009 Novel H1N1 Influenza Virus". Clinical Infectious Diseases. 50 (11): 1487–92. doi:10.1086/652441. PMC 2946351. PMID 20415539.
- ^ Vellozzi C, Burwen DR, Dobardzic A, Ball R, Walton K, Haber P (March 2009). "Safety of trivalent inactivated influenza vaccines in adults: Background for pandemic influenza vaccine safety monitoring". Vaccine. 27 (15): 2114–2120. doi:10.1016/j.vaccine.2009.01.125. PMID 19356614.
- ^ Pithadia AB, Kakadia N (March–April 2010). "Guillain–Barré syndrome (GBS)" (PDF). Pharmacol Rep. 62 (2): 220–32. doi:10.1016/s1734-1140(10)70261-9. PMID 20508277.
- ^ Haber P, Sejvar J, Mikaeloff Y, Destefano F (2009). "Vaccines and Guillain–Barré syndrome". Drug Saf. 32 (4): 309–323. doi:10.2165/00002018-200932040-00005. PMID 19388722.
- ^ "Influenza / Flu Vaccine". University of Illinois at Springfield. Archived from the original on 29 April 2009. Retrieved 26 April 2009.
{{cite web}}: Unknown parameter|deadurl=ignored (|url-status=suggested) (help) - ^ "General Questions and Answers on Guillain–Barré syndrome". Centers for Disease Control and Prevention. September 14, 2009. Retrieved 12 February 2011.
- ^ Haber P, Sejvar J, Mikaeloff Y, DeStefano F (2009). "Vaccines and Guillain–Barré syndrome". Drug Safety. 32 (4): 309–323. doi:10.2165/00002018-200932040-00005. PMID 19388722.
- ^ Kaplan JE, Katona P, Hurwitz ES, Schonberger LB (August 1982). "Guillain–Barré syndrome in the United States, 1979-1980 and 1980-1981. Lack of an association with influenza Vaccination". JAMA. 248 (6): 698–700. doi:10.1001/jama.248.6.698. PMID 7097920.
- ^ Vellozzi C, Burwen DR, Dobardzic A, Ball R, Walton K, Haber P (March 2009). "Safety of trivalent inactivated influenza vaccines in adults: Background for pandemic influenza vaccine safety monitoring". Vaccine. 27 (15): 2114–2120. doi:10.1016/j.vaccine.2009.01.125. PMID 19356614.
Bibliography
- Dehner, George, Influenza: A Century of Science and Public Health Response, University of Pittsburgh Press, 2012. ISBN 978-0-8229-6189-5
- Sencer DJ, Millar JD (January 2006). "Reflections on the 1976 Swine Flu Vaccination Program". Emerging Infectious Diseases. Archived from the original on 28 April 2009. Retrieved 28 April 2009.
{{cite web}}: Unknown parameter|deadurl=ignored (|url-status=suggested) (help) - Pandemic Influenza: A Guide to Recent Institute of Medicine Studies and Workshops A collection of research papers and summaries of workshops by the Institute of Medicine on major policy issues related to pandemic influenza and other infectious disease threats.[dead link]
- The Swine Flu Affair: Decision-Making on a Slippery Disease Report commissioned by the Department of Health, Education and Welfare, written by Richard Neustadt and Harvey V. Fineberg. An examination of what happened during and after the 1976 swine flu outbreak and lessons to help cope with similar situations in the future.[dead link]
- Garrett, Laurie. "Chapter 6:The coming plague". The American Bicentennial. pp. 153–192. ISBN 1-85381-764-3.