October 13, 2009

The 1918 Influenza pandemic

An interesting look at a potential killer during the 1918 Flu pandemic. From the New York Times:
In 1918 Pandemic, Another Possible Killer: Aspirin
The 1918 flu epidemic was probably the deadliest plague in human history, killing more than 50 million people worldwide. Now it appears that a small number of the deaths may have been caused not by the virus, but by a drug used to treat it: aspirin.

Dr. Karen M. Starko, author of one of the earliest papers connecting aspirin use with Reye�s syndrome, has published an article suggesting that overdoses of the relatively new �wonder drug� could have been deadly.

What raised Dr. Starko�s suspicions is that high doses of aspirin, amounts considered unsafe today, were commonly used to treat the illness, and the symptoms of aspirin overdose may have been difficult to distinguish from those of the flu, especially among those who died soon after they became ill.

Some doubts were raised even at the time. At least one contemporary pathologist working for the Public Health Service thought that the amount of lung damage seen during autopsies in early deaths was too little to attribute to viral pneumonia, and that the large amounts of bloody, watery liquid in the lungs must have had some other cause.
A bit on the dosage:
Aspirin packages were produced containing no warnings about toxicity and few instructions about use. In the fall of 1918, facing a widespread deadly disease with no known cure, the surgeon general and the United States Navy recommended aspirin as a symptomatic treatment, and the military bought large quantities of the drug.

The Journal of the American Medical Association suggested a dose of 1,000 milligrams every three hours, the equivalent of almost 25 standard 325-milligram aspirin tablets in 24 hours. This is about twice the daily dosage generally considered safe today.
A gram every three hours -- that is huge. I would be oozing blood from my pores at that level. Considering that this dosage would continue until the influenza symptoms abated, that is a dangerously high level in your body. More on Reye's Syndrome Hat tip to the puppy blender for the link. Posted by DaveH at October 13, 2009 9:17 PM
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