Hong kong flu

Hong Kong influenza is a new subtype of influenza A that emerged due to antigenic shift and occurred as a pandemic between 1968 and 1970 (Herold 2023). In Germany, the pandemic reached its peak in the winter of 1969 / 1970 (Müller 2020).

The first cases were reported in Germany at the beginning of 1969. The situation then escalated dramatically with the second wave in the winter of 1969/70. Hospitals were completely overwhelmed by the large number of people affected at the time, with patients sometimes lying in the corridors (Tenberg 2021).

The government relied on herd immunity at the time (Müller 2023). During the pandemic, the Honkong flu only led to the closure of schools, businesses and authorities in local hotspots. The pandemic hardly played a role in the radio and press (Thießen 2021). There was a serious funeral emergency in West Berlin, with 30% of nursing staff absent from local clinics (Müller 2023).

In the former GDR, the Hong Kong flu was initially denied, but then gave rise to the development of the first national pandemic plan (Müller 2020).

The viral disease is transmitted by droplet or smear infection. The incubation period is between 1 - 4 days (Herold 2023).

New subtypes of influenza A arise through antigenic shift. Antigenic shift involves the mixing of individual gene segments of a cell infected with two or more different influenza A viruses, also known as reassortment. Typically, the antigenic shift occurs in a pig, as it has a high susceptibility to avian, human and porcine influenza A viruses. The result of a reassortment is a new influenza A virus that triggers a pandemic in the human population (Herold 2023).

In the case of the Hong Kong flu, a reassortment occurred through the transmission of a human infected with influenza A virus and avian influenza of subtype H5N1 from infected chickens (Kirchner 2018).

The Hong Kong flu originated in China and spread worldwide between 1968 and 1970 (Thießen 2021). The increase in international air travel at the time played a central role in the spread of the virus for the first time during this pandemic (Tenberg 2021).

The Hong Kong flu is the A / H3N2 virus (Herold 2023).

In the case of Hong Kong flu, up to 44% of those infected had co-infections, most of which were caused by pneumococci (Kramer 2022).

At that time, the focus was on symptomatic treatment with antipyretics. Antibiotics were used for additional bacterial infections, amantadine to inhibit the release and replication of influenza viruses. Oxygen was administered if hypoxemia occurred (Tenberg 2021)

Course / prognosis

Until the emergence of the COVID-19 pandemic, influenza was the infectious disease with both the highest incidence and the highest mortality rate in Europe (Herold 2023).

According to WHO estimates, around 1.1 million people worldwide died from Hong Kong flu (Müller 2022). In West Germany alone, 50,000 people died (Thießen 2021).

The pandemic most likely came to an end in the spring of 1970 due to increasing herd immunity, but the virus still exists (Tenberg 2021).

Prophylaxis

Effective vaccinations against Hong Kong flu were available from mid-1969 (Witte 2011).

1. Herold G et al. (2023) Internal Medicine. Herold Publishing House 875
2. Kasper D L, Fauci A S, Hauser S L, Longo D L, Jameson J L, Loscalzo J et al. (2015) Harrison's Principles of Internal Medicine. Mc Graw Hill Education
3. Kirchner T, Müller- Hermelink, Roessner A (2018) Short textbook on pathology. Elsevier Urban and Fischer Publishers 176
4. Kramer A, Assadian O. Exner M, Hübner N O, Simon A, Scheithauer S (2022) Krankenahaus- und Praxishygiene: Hygienemanangement und Infektionsprävention in medizinischen und sozialen Einrichtungen. Elsevier Urban and Fischer Publishers 165
5. Müller S (2020) The Spanish flu: perception and interpretation of a pandemic of the century as reflected in the social democratic press. bub Bonner Universitätsdruckerei 11- 12, 69
6. Müller S (2022) From the Spanish flu to Corona: crisis interpretations in the 20th century. Economy, work and life with and after the Corona crisis. Nomos Verlagsgesellschaft mbH and Co. 17 - 34
7. Müller M (2023) Laboratory medicine, microbiology, clinical chemistry, infectiology, transfusion medicine in question and answer. Books on Demand. 1514
8. Tenberg L (2021) Every pandemic ends at some point. Hong Kong flu: The forgotten pandemic. WirtschaftsWoche doi: https://www.wiwo.de/politik/deutschland/hongkong-grippe-die-vergessene-pandemie-jede-pandemie-geht-irgendwann-zu-ende/27097334.html
9. Thießen M (2021) At a distance: A social history of the corona pandemic. Campus publishing house. Chapter 3
10. Witte W (2011) The influenza pandemic 1968- 1970: Strategies of crisis management in a separated Germany "Vodka and raspberry tea". Dtsch Med Wochenschr. (136) 2664 - 2668