Flu in the East

Back in balmy July, when most people were concentrating on keeping cool rather than keeping well, Surgeon General William H. Stewart of the Public Health Service predicted that winter would bring a heavy wave of flu to the eastern half of the nation. He was right, and then some. Last week an influenza-like ailment had thousands of people moaning, barking, wheezing and groaning in at least 30 states east of the Rockies. Health officials in New York and at the National Communicable Disease Center in Atlanta conceded, after weeks of hedging, that the outbreak had reached epidemic proportion.

Month Early. Surgeon General Stewart's predictions of a major outbreak of the Asian (A2) strain of flu virus were based on the cyclical and somewhat self-defeating nature of the disease--those infected one year are usually immune to the virus the next. The more infected, the more who become immune. Last winter the flu was strongest in the Western states, while the East, which went through its last major outbreak two winters ago, suffered relatively little. Immunity to influenza viruses built up west of the Rockies and dwindled elsewhere.

Even so, the current outbreak began in October--a month ahead of schedule--in Michigan. In the weeks preceding Christmas, it spread to eight other states, creeping as far south as Florida. In one Alabama county, 7,000 persons went to their doctors with flulike symptoms. In Ohio, 40% of the students at one school were absent. Still, U.S. health officials refused to blame the wave of illness specifically on Asian flu. Weeks of lab testing are necessary before flu viruses can be isolated and identified. And the symptoms of Asian flu--three to four days of fever, coughing, sore throat, aches and pains--are also indicative of any number of respiratory infections.

Drift Capability. By last week, however, laboratories had confirmed A-2 as the cause of illness in at least 15 states. Similar evidence mounted in 15 other states and Washington, D.C. In New York City, deaths due to pneumonia, often flu-related, rose to 109 during the last week in December--a rise of 65% over the same week in 1966. Bedded down with the flu himself, the city's health commissioner, Dr. Edward O'Rourke, had expected the death toll to reach only 91 for the week. From London last week came reports that an A-2 epidemic had spread from Liverpool to London, playing havoc with Great Britain's labor force and trebling the number of flu and pneumonia deaths during three weeks in December.

The big question facing health officials now: how effective will available vaccines be against this year's A2? Flu viruses have the exasperating capability to "drift" each year, changing characteristics to varying degrees and accreting new "armor" against existing vaccines. So far, the virus "drift" does not appear significant. "Present influenza vaccines," says the Communicable Disease Center's Dr. Stephen Schoenbaum, "should afford adequate protection since they contain A-2 strains similar to the ones we have isolated."

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