| Influenza (Flu) |
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| Vaccines |
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| Pandemics |
| Outbreaks |
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The 1976 swine flu outbreak, also known as the swine flu fiasco,[1] or the swine flu debacle, was a strain of H1N1 influenza virus that appeared in 1976. Infections were only detected from January 19 to February 9, and were not found outside Fort Dix.[2] The outbreak is most remembered for the mass immunization that it prompted in the United States. The strain itself killed one person and hospitalized 13. However, side-effects from the vaccine caused five hundred cases of Guillain–Barré syndrome and 25 deaths.[3][4]
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In late January 1976 a number of recruits at Fort Dix in New Jersey began to complain of respiratory illness, on February 5, 1976, David Lewis, an Army private said he felt tired and weak. Private Lewis then left his sick bed to go on a forced run, collapsed, was revived by his Sergeant only to die a few days later and four of his fellow soldiers were additionally hospitalized. Two weeks after his death, health officials announced that swine flu was the cause of death and that this strain of flu appeared to be closely related to the strain involved in the 1918 flu pandemic. Alarmed public-health officials decided that action must be taken to head off another major pandemic, and they urged President Gerald Ford that every person in the U.S. be vaccinated for the disease' despite prior knowledge that one version of the vaccine could cause neurological damage.[5]
The vaccination program, enacted at a cost of $135 million,[6] was plagued by delays and public relations problems. However, Centers for Disease Control vaccination efforts achieved unprecedented distribution results, with more than 40 million Americans immunized between October and December that year.[7]
The first vaccinations were given on approximately October 1, the government suspended the immunization program on December 16 after reports of at least 54 cases of Guillain-Barré syndrome across ten states.[1] Approximately 24% of the population had been vaccinated by the time the program was canceled.[8] The budding pandemic was successfully confined to Fort Dix and as a result only one person, an Army recruit, died from the flu in 1976.[9] In the very long run, lives may have been saved -- a study in 2010 found a significantly enhanced immune response against the 2009 pandemic H1N1 in study participants who had received the 1976 swine flu vaccination.[10]
There were multiple reports of Guillain-Barré syndrome (GBS), a paralyzing neuromuscular disorder, affecting some people who had received swine flu immunizations. One of the causes of this syndrome could be a rare side-effect of modern influenza vaccines, with an incidence of about one case per million vaccinations.[11]
Overall, about 500 cases of GBS, resulting in death from severe pulmonary complications for 25 people, were probably caused by an immunopathological reaction to the 1976 vaccine. Other influenza vaccines have not been linked to GBS, though caution is advised for certain individuals, particularly those with a history of GBS.[12][13]
According to Harvey Fineberg and Richard Neustadt, authors of The Swine Flu Affair, the risk of developing GBS was roughly 11 times greater with vaccination than without, though still a remote risk, affecting approximately 1 in 105,000 individuals.[1]
The CDC states that most studies on modern influenza vaccines (e.g., post 1976) have seen no link with GBS,[14][15][16] Although one review gives an incidence of about one case per million vaccinations,[17] a large study in China, reported in the NEJM covering close to 100 million doses of vaccine against the 2009 H1N1 "swine" flu found only eleven cases of Guillain-Barre syndrome, (0.1%) total incidence in persons vaccinated, actually lower than the normal rate of the disease in China, and no other notable side effects; "The risk-benefit ratio, which is what vaccines and everything in medicine is about, is overwhelmingly in favor of vaccination."[18]
The relatively benign disease outbreak and the subsequent vaccine reactions produced some political and sociological repercussions. In part, some of the political failures of the vaccination program have been attributed to the political climate associated with President Ford's re-election campaign in 1976.[6][7]
President Ford offered vaccine manufacturers indemnity,[6] and the United States Congress "rushed" indemnity legislation that has been characterized as "faulty and "haphazard".[7]