“Colds” of yesterday and today

What is commonly called “cold” is a rhinopharyngitis – that is to say an affection of the upper airways (nasal cavity and pharynx) – very often benign, mainly seasonal (winter) but not only, triggered in 40% of the cases by a specific virus (the rhinovirus) but also by other types of viruses known since “always”: the adenovirus, the respiratory syncytial virus, the influenza virus (the real flu), the para influenza and… the coronavirus ! The clinical symptoms, not univocal, remind us something..

• Fatigue more or less intense,
• Clear rhinorrhea (aqueous nasal discharge),
• Possible disturbance of smell and taste (consequence of the loss of smell),
• Possible headaches,
• Back pain, diffuse muscle and joint pain,
• Variable fever,
• Cough.

Complications of varying severity are possible, notably pulmonary, but also an attack on the central nervous system, or even death in exceptional cases, especially in frail, elderly subjects, sometimes with an associated comorbidity. Honoré Daumier, with his usual ferocity, sketched these “cold” epidemics in Paris at the end of the 19th century in Les gens de médecine. Even if viruses as entities in their own right had not yet been discovered, they already existed and, one suspects, always had. This is, of course, the case of our coronavirus.

The Spanish flu

One of the main characteristics of these viruses is their ability to mutate. We know it, it already concerns the seasonal flu, which imposes a vaccine always started again in autumn. It is also the case of the famous Spanish flu (Spanish because, in the middle of the world war, Spain, not being at war, was the only country to have described this pandemic). This Spanish flu started in China (Canton) from a duck attack (already), was brought in 1918 to the United States by immigrants, became very quickly of an extreme virulence, spread in all Europe and was responsible for a mortality that was estimated between 20 and 50 million deaths. For the African and Indian continents, the figure is even more imprecise. Some experts estimate that the number of victims of the Spanish flu could reach 100 million deaths in a few months.

At the same time, the First World War caused 19 million deaths in 4 years.
Over a period of 25 years, AIDS killed 25 million people.
The terrible Black Death in the 14th century was responsible for 25 million deaths in 7 years, on a population much smaller than today.

Fortunately, the mutations of SARS-CoV-2 are not very virulent. Today, in about one year, SARS-CoV-2 is responsible for 1.5 million deaths worldwide.

In comparison, tobacco kills 5 million people per year (1 death every 6 seconds) and 10 million are estimated at the dawn of the 2030s with exponential sales in emerging countries. After more than a century of tobacco consumption, the WHO speaks of 100 million deaths. Certainly much more. So… 200 million deaths, 300 million, more?
It seems useful to compare the number of deaths of past and present pandemics with those of tobacco and wars. They are obviously still too numerous and should be avoided as much as possible, but let’s put them into perspective.

Is the situation we are confronted with historically unprecedented, forcing our leaders to take elementary precautions in this world where any death is now one too many? The answer is no: the problems we face have been encountered and analyzed before. The 17th century was confronted with the problems of action under uncertainty. Thus in the Logic of Port-Royal, the logicians explicitly dealt with the notion of precaution before arguing thatit should not guide action in this world . We are in a world of responsible adults. When information, with its possible consequences, is clearly given, individuals must be able to act and decide freely. There is no need to infantilize and forbid, as the evil can be worse. These discussions of philosophers – who were once considered as our masters of thought – deserve to be updated.

The Russian Flu

An article written by Stéphane Korsia-Meffre and published by Vidal on November 26, 2020, concerning the Russian flu, deserves to be summarized here. The Russian flu, still called St Petersburg flu, is the first pandemic of the industrial era. It is well documented that it raged at the end of the 19th century throughout the world, beginning in the autumn of 1889 and ending in the spring of 1890, but that it would undergo waves during the following years : spring of 1891, winter of 1891-92, winter of 1892-93, winter of 1893-94 and even spring of 1895.

Recent studies of phylogenetics (study of the genetic modifications of the animal or vegetable species) evoke an astonishing hypothesis: would the coronavirus OC43 – one of the four benign human coronaviruses – be at the origin of the Russian flu pandemic which ravaged the world between 1889 and 1895? Before Covid 19, did the world know a pandemic at Covid 89 (1889)?

• Progression

The first outbreaks are described in Bukhara (now in Uzbekistan) but also, simultaneously, in western Canada and Greenland. The first major outbreak occurred in St. Petersburg in November 1889 and then spread throughout the world at a very rapid pace, with an outbreak in New York City causing 1,200 deaths in one week. Its particularity is its “bushfire” aspect: it explodes where it arrives and stops in a few weeks. Epidemic waves followed for 4 years, more severe in some countries (notably the United Kingdom) than in others, without any rational explanation. H. Franklin Parsons, of the medical department of the city of London, noted:

While the start of the first wave was sudden, with mortality peaking as early as the third week (January 18, 1890) of an epidemic that lasted six weeks, mortality then declined rapidly. In contrast, the start of the second wave, in May and June 1891, was more gradual, lasting 8 weeks in London, but this wave was ultimately more lethal.

Curious similarity !

In France, the Russian flu first affected the staff of the Louvre department stores (which became the Louvre des Antiquaires before closing) and spread like wildfire throughout the capital and the whole of France. Christmas 1989 was marked by the saturation of hospitals (construction of barracks in the courtyards of hospitals). There were 400 to 500 deaths per day in the capital. At the end of February 1890, calm suddenly returned to the capital.

• Clinical signs

The Russian influenza presents signs similar to the common influenza, but however the doctors note unusual and disconcerting particularities.

• The disease is more contagious than the flu,
• Swollen fingers at the beginning of the disease (vasculitis ? inflammation of the vessel walls),
• Severe attacks are more frequent in men,
• Kidney and digestive problems,
• Higher mortality in the elderly (unknown comorbidity?),
• Rapid recurrence in 15% of patients (which seems to be exceptional for Covid 19),
• Neurological manifestations abnormally high for a flu, making Professor Pierre Potain (known for his work on blood pressure) say that this flu is not the flu.

• Treatment

Different times, different treatments, from the most fanciful to the most dangerous, from castor oil, electric current, brandy… oysters… to strychnine, through Quinine!

1889, year of birth of Coronavirus OC43 ?

• Phylogenetic elements

To make it simple, a Belgian team, suspecting the phylogenetic proximity of OC43 with another beta-coronavirus, (BCoV) has, by a technique of molecular clock applied to the Spike protein (surface protein of the virus which allows the penetration of this last one in cells), allowed to estimate the most recent date of a common ancestor. It would be around 1890 and OC43 would be born from BCoV (responsible for Corona diarrhea in calves) because OC43 presents important deletions compared to BCoV.

• Epidemiological evidence

There is also epidemiological evidence to suggest that OC43 passed from cattle to humans during the Russian influenza pandemic. Between 1870 and 1890, the world’s cattle herd was decimated by a panzootic (animal pandemic) of contagious pneumonia that required massive stamping out to prevent the spread of the disease. This panzootic would be linked to the development of the cattle trade, made possible by the railways. The personnel in charge of the mass slaughter would have been contaminated by respiratory viruses of the slaughtered cattle and in particular a mutated strain of BCoV, i.e. OC43.

• Clinical elements

The neurological symptoms that marked the physicians of that time strongly evoke the neuroinvasive capabilities for which OC43 is known. Other clinical features of Russian influenza are reminiscent of symptomatology seen in March during the peak epidemic of Covid 19:

• Vasculitis of the fingertips,
• Severe forms in the elderly,
• Greater fragility in men, etc.

Conclusion

If OC43 is the ancestor of Covid 19, let us just note a few points.

The condition evolves in spontaneously resolving waves (no treatment given, relative isolation). The second wave, which was spread over a longer period (H. Franklin Parsons), proved to be more lethal. It can be seen that there were 5 to 6 successive waves, separated by a total lull. However, treatment was non-existent, as was isolation.

OC43 was responsible for one million deaths, which would correspond to 5 million deaths today, between autumn 1889 and spring 1895.

Certainly since the world is world, we are surrounded by viruses for which there are few curative treatments (the treatment remaining symptomatic). Their presence participates in the scourges that human beings have always faced. In 2013, in France, a pandemic was predicted, but we have to admit that we were ill-prepared for this certain eventuality. The vaccine, although surprisingly quickly found, will certainly be of indisputable help, at least for the most fragile individuals. It is certainly reasonable not to impose it, as vaccination is a free choice for individuals, especially if they are young and healthy, but the probable obligation to travel risks going against this free choice. Once again, there is a risk that clearly informed individuals will be infantilized rather than empowered.

Sources and bibliographical references :

• Article by Stéphane-Meffre for VIDAL, November 26, 2020-
Paul Molga, les Echos, July 30, 2015 with update of August 6, 2019

• Kempinska-Miroslawska B. and Wozniak-Kosek A.
“The influenza epidemic of 1889-90 in selected European cities – a picture based on the reports of two Poznan daily newspapers from the second half of the nineteenth century”
Med Sci Monit, 2013; 19: 1131-114

• Honigsbaum M.
The “Russian” influenza in the UK: Lessons learned, opportunities missed
Vaccine 29S B11-B15, 2011

• Valleron AJ, Meurisse S & Boelle PY
Historical Analysis of the 1889-1890 Pandemic in Europe
Inern J Infect Dis Volume 12, Suppl 1, e95, 1/12/2008

• André G.
Influenza or flu
Masson, 1908

• Knapp A.
The original plandemic: Unmasking the eerily familiar conspiracy theories behond the Russian flu of 1890
Forbes, 15 May 2020

• Mulder J & Masurel N.
Pre-epidemic antibody against 1957 strain of asiatic influenza in serum of older people living in the Netherlands
The Lancet, 1958, Apr. 19; 1(7025): 810-4

• Patrick DM, Petric M, Skoronski DS et al.
An outbreak of human coronavirus OC43 infection and serological cross-reactivity with SARS coronavirus
Can J Infect Dis Med Microbiol 2006; 17(6) 330 – 336

• Vijgen L, Keyaerts E, Moës E et al.
Complete Genomic Sequence of Human Coronavirus OC43: Molecular Clock Analysis Suggests a Relatively Recent Zoonotic Coronavirus Transmission
J. Virol. 79 : 1595 – 1604, 2005

• Vijgen L, Keyaerts E, Lemey P et al.
Evolutionary History of the Closely Related Group 2 Coronaviruses: Porcine Hemagglutinating Encephalomyelitis Virus, Bovine Coronavirus and Human Coronavirus OC43
J Virol (80)14: 7270-7274, 2006

• Knudsen JKOverraskende
opdagelse: Coronavirus har tidligere lagt verden ned (Surprising discovery: a coronavirus has blocked the world in the past)
DR (Danmarks radio), 13/08/2020

• Zhang XM, Herbst W, Koutsoulas KG & Storz J
Biological and genetic characterization of a hemagglutinating coronavirus isolated from a diarrheic child
J Med Virol 1994 Oct; 44(2): 152-61

• Arbour N, Day R, Newcombe J & Talbot PJ
Neuroinvasion by human respiratory coronaviruses
J Virol 74 : 8913 – 8921, 2000

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