Aspirin may be the enhancer of virulence in 1918 pandemic

BMJ ^

[GulfMan]

I would like to mention the possibility of aspirin as the enhancer of virulencein 1918 pandemic. During 18 months of so called "Spanish Flu pandemic" in 1918-19, 27 million people died world-wide. Mortality rate was the highest especially in the second wave of the pandemic: October 1918, especially in US.

The age-specific mortality curve did not trace the "U", but resembled a "W" with very high mortality rates in healthy young adults aged 20-40 years as well as in those less than 5 years of age and those aged 65 years and older. No adequate explanation of this mortality pattern has been presented. It was wartime and young men were crowded together in military camps, but the mortality was also high in men of the same age who remained at home.

September 13, 1918 US Surgeon General Rupert Blue of the U.S. Public Health Service, President of Medical Association (1916-17) dispatched advice to doctors ... aspirin success in the relief of the symptoms"[2]

In the first month after his advice, October 1918, the highest mortality was recorded.

Even five to ten grain (or about 324 to 648 mg) of aspirin tablets every three hours and more (up to 7 g within 24 hours) were prescribed to subdue fever ...

According to the reports by homeopathic medicine, under the non aspirin therapy the mortality rate was 1 percent or less, while more than five, even thirty percent of patients treated with aspirin in hospitals or in armed forces died.

Considering together with the significantly and very high pooled odds ratio of mortality in the meta-analysis of infected animal toxicity studies and the reanalysis of epidemiological studies in Japan reported by Hama, I believe that aspirin may be the enhancer of virulence also in 1918 pandemic.

[murron]

I was a frequent aspirin user for most of my 71 years of life. A few years ago I developed extreme shortness of breath after taking just a few steps. I thought it may be my heart. Had a routine blood test last summer and my hemoglobin showed a level 6. Should have been at least 10 or 11. I was so extremely anemic that it was affecting my breathing because I didn’t have enough oxygen in my blood. Had to have a blood transfusion. Dr. told me to immediately get off of aspirins and ibuprofen and take Tylenol only. He also put me on iron supplements.

Since that time, my breathing is back to normal, and when I had a recent blood test, my hemoglobin has jumped to 14. Feeling so much better now.

[MD Expat in PA]

I’ve read about the aspirin theory but I’m not convinced it accounts for a significant number of deaths.

For one thing, there was a high rate of death among Native American populations living in small isolated rural communities that probably had little access to doctors or aspirin as well as that death rates seem to have been equally high in other places in the world where aspirin was not so readily available.

From contemporary reports, people fell ill very suddenly, in some cases went to work in the morning and were dead either that night or the next morning so it is questionable how many even had a chance to go to a doctors or a pharmacy. Not to mention the fact that because of WWI, there was a shortage of doctors and nurses as so many had been sent to military installations or overseas.

https://www.smithsonianmag.com/history/ten-myths-about-1918-flu-pandemic-180967810/

This article says: “Blame it on aspirin. It says the Journal of the American Medical Association recommended “toxic” doses of aspirin: 1,000 mg every three hours, or 8,000 mg/day. That is not a toxic dose. Mild toxicity begins at a dose of 150mg/kg and serious toxicity begins at dose of 300 mg/kg. A toxic dose for an adult male would be more like 24,000 mg/day. A study by Karen Starko suggested that overdoses of aspirin might have contributed to a small number of deaths, but she acknowledged that she did not have autopsy reports or other documents to support her conjecture.

https://sciencebasedmedicine.org/fun-with-spanish-flu-myths/

[Ozark Tom]

Paracetamol (Tylenol) was first synthesized by an American chemist in 1877. Disputes about safety prevented it’s use for about eighty years, until a second look revealed that the accepted drugs of a similar chemical lineage actually served as precursors, which the body’s metabolism transformed into the active para-acetylaminophenol.

It was determined that contamination of materials used in testing the efficacy and safety of the then new painkiller, were most likely the culprit in painting a picture of side effects, toxicity, and carcinogenicity. If not for these missteps, the medication could have been made available nearly two decades before the introduction of aspirin to the market in the late 19th century.

[Ozark Tom]

As to aspirin’s safety, what of Reye’s Syndrome developed in connection with the treatment of symptoms, associated with viral infections? Children and young adults are the most frequently diagnosed with liver and brain injury in this case. Their immune response is different from the more mature adult exposed to health threats over a greater time period.

The body’s metabolism under viral attack perhaps is altered such that normally tolerated substances are treated in a different manner, and lead to a different outcome.

[trebb]

Maybe a certain degree of fever enhances the body’s ability to fight some things.