“Identical double-digit-year” pandemics: historical control measures

As the Covid-19 disease pandemic wreaks havoc across the globe, many people are anxious, as to how the virus will vanish.

Pandemics seemingly follow a particular trajectory.

The years 1717, 1818, 1919 and 2020 coincided with emergencies of global concern.

Surprisingly, “identical double-digit years” are synonymous with deadly pandemics. However, traditional pandemic control measures have withstood the test of time.

As smallpox pandemic was rampaging in 1717, Lady Mary Montagu, wife to the British Ambassador to Turkey, witnessed the ancient Turk practice of inoculating children with smallpox matter.

Lady Mary learnt that the practice protected children from smallpox.

She popularised the practice by having her six-year-old son inoculated while in Turkey.

In India, people slept next to those suffering from smallpox to “acquire protection” from the disease.

In Africa, pus taken from smallpox pustules (raised septic lesions on the skin) of mild cases was inoculated through a scratch in an arm.

Unfortunately, dosage was not fixed, some would get infection from the process, and fatalities were inevitable.

In 1796, physician Edward Jenner tested a theory learned from the milkmaids.

They argued that “after they contracted cowpox, they never got smallpox”.

He obtained his vaccine from the cow (vacca), so he named the virus vaccinia.

Jenner’s vaccination approach was widely adopted, reducing smallpox case morbidity and mortality.

Interestingly, traditional disease control knowledge was instrumental in developing the first vaccine.

And, Jenner ought to be recognised for commercialising the vaccination he borrowed from the ancient body of knowledge.

As the coronavirus continues, poor countries must stand up and be counted in the battle against the pandemic.

Madagascar tapped into the indigenous body of knowledge and launched an organic herbal product for prevention and treatment of Covid-19.

Surprisingly, many have prematurely dismissed such a milestone without rigorously testing the “primitive remedies”.

Yet Madagascar has 128 confirmed cases, 92 recoveries and no fatalities.

Currently, there are several multimillion-dollar clinical projects to find either a cure or a vaccine to the Covid-19 disease, with the first vaccine tentatively expected by September.

The 1818 pandemic – identical double-digit year – coincided with the Asiatic cholera pandemic, which ravaged human populations between 1817 and1824.

Cholera, a bacterial disease caused by vibrio cholerae, is transmitted through contaminated water or foods.

Vibrio cholerae release toxins that cause intestines to discharge increased amounts of water, leading to diarrhoea and rapid loss of fluids and electrolytes.

In 1854, British physician John Snow carefully studied cholera cases in the Soho area of London.

Snow identified contaminated water from the public well pump as the medium of transmission.

He convinced officials to remove the pump handle.

 And, immediately, cholera cases dropped in the area.

When the fifth cholera pandemic hit other countries, UK and USA were mostly safe, owing to improved water supplies and quarantine measures.

Apparently, indigenous agency effectively informed on pandemic control measures, without necessarily spending millions of dollars in some fancy laboratories.

Spanish physician Jaime Ferran in 1885 became the first to create a cholera vaccine from live germs by cultivating vibrio cholerae (Passport Health).

However, cholera outbreaks often wreck low middle-income countries owing to inadequate safe water supplies and poor sanitation.

Practising good hygiene and other disease control measures have always helped in mitigating impacts of contagion.

1919 presented the deadliest contagion in the history of humanity.

The Spanish flu pandemic (1918-1920) claimed 20-50 million lives worldwide.

Some scientists began to rule out bacterial infection as the cause of influenza disease.

English scientists Wilson Smith, Sir Patrick Laidlaw and Sir Christopher Andrewes were the first to isolate the influenza-A virus from nasal secretions of infected patients.

A few years later, in England, Thomas Francis Junior – the American virologist and epidemiologist – and Smith were able to transmit the virus to mice.

Eventually, it was demonstrated that influenza virus grew easily in fertilised hen eggs, a procedure being used today to manufacture most influenza vaccines.

According to Davenport F.M (1979), “The first clinical trials of influenza vaccines were conducted in the mid-1930s.”

In 1937, Smith, Andrewes and Stuart-Harris conducted a study among military forces in England.

They used a subcutaneous vaccination with an inactivated strain isolated from a mouse lung.

In 1938, Francis and Jonas Edward Salk used the approach to protect USA military forces from the contagion.

Subsequently, Salk would use the experience to develop an effective polio vaccine in 1952.

By December 1942, many studies officially proved that inactivated influenza vaccines could yield effective protection against flu outbreaks.

Although some diseases require sophisticated investigations, traditional measures such as improving safe water supplies, sanitation, hand washing and improving hygiene have helped in disease control.

In the wake of the current identical-double-digit-year pandemic, traditional health measures are the first line of defence in the absence of a vaccine.

The year 2020 has been characterised by unprecedented drastic measures. These include closing schools, placing restrictions on transportation and banning social gatherings.

Currently, Zimbabwe is in extended lockdown period, having recorded 34 cases, five recoveries, and four deaths.

Citizens are encouraged to religiously practice preventive and protective measures.

However, enforcing control measures is another story.

For instance, in 1918, a San Francisco health officer shot three people when one refused to wear a mandatory face mask.

In Arizona, police handed out fines for those caught without PPEs.

Eventually, the most drastic measures paid off.

As Zimbabweans anticipate the easing of lockdown rules, relaxing restrictions too early can cause the country to relapse.

Consequently, relapse will reverse all the notable gains and overwhelm health systems.

Henceforth, the Government must enact strict rules on mandatory preventive and protective measures.

And, health authorities must accelerate testing, tracing and treatment of Covid-19 cases to ensure control of the contagion.

As the world battles the “identical-double-digit-year pandemic”, stay at home, maintain social distancing, and practise hand hygiene.

Everisto Mapfidze is a registered general nurse who holds a Bsc Honours in Sociology (UZ). For feedback: [email protected]