Did the Spanish flu cause ME?

Thought this was an interesting question on Twitter:
https://twitter.com/user/status/1280915951387582465


So many people were infected back then by the Spanish flu. Even if only a small percentage went on to develop ME/CFS or a similar debilitating post-viral fatigue syndrome, that this would be more clearly described in the historic record.

From the Twitter discussion:

https://twitter.com/user/status/1280947366682660864


https://twitter.com/user/status/1280949182166155264


Interested in hearing S4ME forum members thoughts on this.

 

https://twitter.com/user/status/1280954917067210757

 

Interesting question. Could it have coincided with an increase of people diagnosed with "neurasthenia"?

A quick google search resulted into this article from May this year in Psychiatric Times
The Spanish Flu Pandemic and Mental Health: A Historical Perspective

In comparison to other aspects of the pandemic, little research has been done on the long-term impact of the Spanish flu on mental health. One of the few researchers to investigate the subject was historical demographer Svenn-Erik Mamelund, PhD. Looking at asylum hospitalizations in Norway from 1872 to 1929, Mamelund found that the number of first-time hospitalized patients with mental disorders attributed to influenza increased by an average annual factor of 7.2 in the 6 years following the pandemic.3 In addition, he pointed out that Spanish flu survivors reported sleep disturbances, depression, mental distraction, dizziness, and difficulties coping at work, and that influenza death rates in the United States during the years 1918-1920 significantly and positively related to suicide.4

Mamelund is among a number of scholars who have noted what many suspect to be a connection between the Spanish flu and a pronounced increase in neurological diseases. By 1919 and 1920, physicians and researchers in Great Britain were already reporting a marked rise in nervous symptoms and illnesses among some patients recovering from influenza infection; among other symptoms, depression, neuropathy, neurasthenia, meningitis, degenerative changes in nerve cells, and a decline in visual acuity were cited.5

 

Hard to say if there could have been some ME patients among here, but interesting interview from University of Colorado with history professor Susan Kingsley Kent from April this year.

Lessons from the 1918/1919 Influenza Pandemic

SKK: The flu left survivors with a variety of mental symptoms. British writer Caroline Playne noted “the plague of nervous character” following the onslaught of influenza. Pronounced fatigue, lassitude, depression, sleeplessness, hallucinations, emotional lability, and even dissociation accompanied the physical debilitation of the disease.

Dr. G. Holliday wrote to the British Medical Journal on August 17, 1918, that “mental symptoms were frequent” in the cases he saw; Samuel West informed readers of The Lancet in Feb. 1, 1919, that “the depression which follows influenza is so constant that it ought to be regarded as part of the disease.” The medical correspondent for The Times, having contracted the illness himself, advised readers that “the most distressing symptom was a swift loss of mental capacity and then inability to think coherently.” “All forms of hysteria have been observed after influenza,” reported Thomson and Thomson in 1919,” such as hysterical convulsions and the so-called hystero-epilectic attacks.” “Post-influenzal neurasthenia is very familiar,” they noted, “post-influenzal psychoses” “frequently observed and reported.” They cited a study that asserted that influenza, “of all the infectious diseases . . . is the most likely to be followed by mental disorder.”

The Lancet declared in December 1918 that “the ‘higher centres’ [of the nervous system] suffer chiefly. Marked depression is common, emotional instability is often seen, and suicide is by no means rare.”


This was interesting too:

the pandemic laid bare the inability of nations and peoples to prevent, control, or treat what had come to be regarded as an everyday illness. Science had failed; medicine had failed; governments had failed. Forgetting about the flu pandemic may just have appealed to publics too frightened and too freaked out to acknowledge so grand a failure on the art of institutions and agencies they had come to rely upon for protection and safety. Faced with such disturbing information, societies may have unconsciously determined that historical amnesia was the easier option.

 

Recently I posted elsewhere about a 3 part series (each episode 28 mins) on BBC Radio 4 'Pandemic 1918' about the Spanish Flu outbreak which is still available on BBC Sounds:

https://www.bbc.co.uk/programmes/m000j2ty

The 3rd episode was about the long-term impact. Unfortunately with my foggy memory I've forgotten the details, beyond finding the whole series really interesting.

 

Short article on the long-term effects of Spanish Flu on people who were in utero during the height of the pandemic. The effects of the Spanish Flu could be detected in health statistics decades later.

https://marginalrevolution.com/marg...g-effects-of-the-1918-influenza-pandemic.html

 

The 1990 Robert de Niro / Robin Williams film "Awakenings" was about the post-Spanish flu illness, they called it "encephalitis lethargica", where victims were like statues , but awake. Set in late 1920s/early 30s I think.

There was an intervention - L-dopa?- which worked, until the chemical "window" tragically shut. .....

The bit where Robert d N (a patient) brings down a "wrong-thinking" doctor in a meeting is priceless. I watched this film when i had my own illness (around 20 years ago) and found it made me cry. I've since been told that this illness was NOT actually an extreme form of ME/cfs (by someone off Twitter). https://en.wikipedia.org/wiki/Awakenings

 

In my opinion you can tell encephalitis letargica it's not like ME because the very ill patients seem comfortable sitting, don't seem to have problems with light or stimulation, and their movement is more stiff than weak. They also dramatically respond to L-dopa which I doubt has such effects on ME. Someone said it's more like Parkinson's disease.

 

Worth remembering that a century ago most families had someone who was chronically unwell as this was long before antibiotics and vaccines. So my guess is a lot of those who didn’t recover fully we’re just absorbed into the family care system, hidden away.

 

Yes, I think what you're saying here is an important aspect.

This is a bit off-thread but it was quite emotional to learn about my great grandmother who suffered from tuberculosis. She lived in a room in the attic to some relatives. They took care of her, but were of course scared of becoming infected themselves and kept their distance as well as they could while also raising her son. I don't think many people knew she was even there, as it wasn't talked about. I visited the house once. In an old wooden house, up in the attic, beyond a drying loft there was a tiny pink room with a bed and a desk. That's where she spent several years of her life.

No internet, no way of finding a community to belong to. Can you imagine the loneliness

 

Here are a series of articles lifted in their entirety from another site that I found interesting, both medically and in historical terms, as the poster noted.

How coronavirus affects the brain
https://www.yahoo.com/news/m/291ea7d7-e745-3513-b70c-44f2173ec704/how-coronavirus-affects-the.html
When it comes to the brain and nerves, the virus appears to have four main sets of effects:

1. A confused state (known as delirium or encephalopathy), sometimes with psychosis and memory disturbance.
2. Inflammation of the brain (known as encephalitis). This includes a form showing inflammatory lesions – acute disseminated encephalomyelitis (ADEM) – together with the effects of low oxygen in the brain.
3. Blood clots, leading to stroke (including in younger patients).
4. Potential damage to the nerves in the body, causing pain and numbness (for example in the form of post-infectious Guillain-Barre syndrome, in which your body’s immune system attacks your nerves).

Scientists warn of potential wave of COVID-linked brain damage
https://www.yahoo.com/news/scientists-warn-potential-wave-covid-230312538.html
LONDON (Reuters) - Scientists warned on Wednesday of a potential wave of coronavirus-related brain damage as new evidence suggested COVID-19 can lead to severe neurological complications, including inflammation, psychosis and delirium.
A study by researchers at University College London (UCL)described 43 cases of patients with COVID-19 who suffered either temporary brain dysfunction, strokes, nerve damage or other serious brain effects.
In the UCL study, published in the journal Brain, nine patients who had brain inflammation were diagnosed with a rare condition called acute disseminated encephalomyelitis (ADEM) which is more usually seen in children and can be triggered by viral infections

Remains to be seen’ if coronavirus causes same brain damage as Spanish flu
https://www.yahoo.com/lifestyle/coronavirus-covid19-spanish-flu-brain-damage-110114199.html
It is increasingly coming to light that a relatively small group of coronavirus patients endure neurological complications, like strokes or delirium.

 

Oh God, noooooooo. Unimaginable. And horrible . I'm convinced that I wouldn't still be here without the immense library of knowledge that can be called up with a few key strokes, and the massive comfort of finding others like ourselves.

But on a happier note, because they'd never had the undeniable brilliance of the multitudes of doors opened by the google machine and internet generally, the sense of loss would be absent, and possibly filled by books and actual windows opened onto the wider world outside.

But how indescribably lonely for all that .....

 

Michiel makes a valid point but.... looking at how medicine has performed with us and chronic illness in general in the last several decades... this is how things should work, clearly not how they actually do. I would pretty much actually expect medicine to be completely oblivious to such a thing besides a few passing observations, probably mostly by people angling for a psychosomatic boom time. These patients were likely to be discharged and rarely seen again, wasting away in their rooms, if they even had that "luxury". Lots probably ended up in psychiatric institutions or dying in the streets. This is how things still are today, to some degree.

Even today it's incredibly hard to account for long-term health consequences, how significant they are, how prevalent and especially in associating cause and effect. Back then? Forget about it. Even today with everything at their disposal someone screws it up every single time. Even if someone does it right, two more will screw up and then it becomes "this one said and those other two said otherwise".

It really should work like that. Somehow it doesn't. Maybe a retrospective analysis could make sense of things but judging by the state of my own medical file, I don't put much faith in the validity of those records or accounts from doctors who would choose to voice their opinion about a problem so vast it would have required massive systemic efforts to properly handle.