Are we reliving 1918?

I am a member of FluTrackers where my name is wotan. Several weeks ago I started this thread:

I have been reading John Barry's The Great Influenza, and have been struck by a few things. First, I was aware that the first wave in the spring of 1918 was considered mild, but I did not realize the following:

The first wave (assuming it started in Haskell County, KS, which Barry says is more or less impossible to determine) appeared to be slightly more severe in the very beginning, but it was a slightly less severe variant that got out. Compare with Mexico, although I am not entirely convinced that the increased mortality in Mexico was due to anything more than not knowing to use Tamiflu in the early days of the outbreak.

Symptoms from the first wave were so light (apparently less than seasonal flu) that the disease could be mistaken for something else entirely. We have seen anecdotal evidence of swine flu being mistaken for any number of other conditions.

The first wave persisted in the northern hemisphere into August. Obviously, we are still in it here at the end of May.

There were isolated incidences of more severe disease during the first wave. There is at least some anecdotal evidence to support this in the current outbreak as well.

I'm still fairly early into the second wave in the book, so I don't know what else I will find.

Sadly, the parallels continue. Consider for a moment the demographics attacked by the 1918 Spanish Flu:

The unusually severe disease killed between 2 and 20% of those infected, as opposed to the more usual flu epidemic mortality rate of 0.1%.[9][12] Another unusual feature of this pandemic was that it mostly killed young adults, with 99% of pandemic influenza deaths occurring in people under 65, and more than half in young adults 20 to 40 years old.[23] This is unusual since influenza is normally most deadly to the very young (under age 2) and the very old (over age 70), and may have been due to partial protection caused by exposure to a previous Russian flu pandemic of 1889.[24]

Source: Wikipedia

Now, consider the demographics for the 2009 pandemic so far:

57% of the cases that we're having reported to us occur in people 5 to 24 years of age, and 41% of the hospitalizations are in that same age group -- the older children and young adults. But I also want to tell you about the rates, the cases per 100,000 population, and let you know that the highest rates of hospitalization are actually in children under 5. And the next highest rates are in those people 5 to 24. So it looks like this is a virus that's disproportionately affecting younger people but there are still lots of infections and hospitalizations in older persons.

Source: Flutracker's post of CDC transcript.


Let's make this clear. Seasonal flu disproportionately attacks the elderly. The 2009 pandemic flu attacks the young! The 1918 pandemic flu attacks the young!

Will the 2009 pandemic grow as severe as 1918? Probably not, but that it might is the scary thought.