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 Table of Contents  
Year : 2022  |  Volume : 3  |  Issue : 2  |  Page : 35-38

Does Current COVID-19 is first coronavirus-related global pandemic or history traced to 19th century as an unidentified COVID 1.0 disease “Russian Flu” apart from severe acute respiratory syndrome and Middle East respiratory syndrome?

1 Department of Pulmonary Medicine, MIMSR Medical College, Latur, Maharashtra, India
2 Department of Pathology, MIMSR Medical College, Latur, Maharashtra, India
3 Department of Internal Medicine, MIMSR Medical College, Latur, Maharashtra, India

Date of Submission23-Feb-2022
Date of Decision16-Mar-2022
Date of Acceptance24-Mar-2022
Date of Web Publication15-Jun-2022

Correspondence Address:
Shital Patil
Department of Pulmonary Medicine, MIMSR Medical College, Latur, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jascp.jascp_18_22

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How to cite this article:
Patil S, Acharya A, Gondhali G. Does Current COVID-19 is first coronavirus-related global pandemic or history traced to 19th century as an unidentified COVID 1.0 disease “Russian Flu” apart from severe acute respiratory syndrome and Middle East respiratory syndrome?. J Appl Sci Clin Pract 2022;3:35-8

How to cite this URL:
Patil S, Acharya A, Gondhali G. Does Current COVID-19 is first coronavirus-related global pandemic or history traced to 19th century as an unidentified COVID 1.0 disease “Russian Flu” apart from severe acute respiratory syndrome and Middle East respiratory syndrome?. J Appl Sci Clin Pract [serial online] 2022 [cited 2022 Jul 4];3:35-8. Available from: http://www.jascp.com/text.asp?2022/3/2/35/347593

COVID-19 has many myths and beliefs since its beginning and created havoc all over world including general community, medical experts and scientific community. Although origin of SARS-COV-2 is still unknown in spite of advanced medical technology of current era, lot of enthusiasm regarding last three to four waves and future is there and it has brought significant change towards life all over world. Still, as of today, we are not sure about the end of Covid-19 pandemic and many of us believe it could be of similar epidemiological trends of Spanish flu or Russian flu of 1890 and could it be a 'covid 1.0' disease.

COVID-19, Middle East respiratory syndrome, Russian flu, severe acute respiratory syndrome

  Introduction Top

COVID-19 is a coronavirus-related disease, its etiological agent was discovered in the middle of the 20th century, its epidemics-pandemics has created a health burden in the early 21st century, but evidence are coming up with its correlation with “Russian or Asiatic flu” of late 19th century. COVID-19 is the world's first known pandemic, etiologically related to coronavirus, and caused 400 million cases and 5.7 million deaths worldwide, and 42 million cases and 0.5 million deaths in India till 10 February 2022.[1] COVID-19 is a global pandemic with a significant impact on finance, economy, and health, resulting in accelerated health burden all over the world with a shortage of infrastructure required to tackle rapidly growing pandemic. COVID-19 pneumonia is a heterogeneous disease with a variable effect on lung parenchyma, airways, and vasculature, leading to long-term effects on lung functions, and proportionately large number of affected patients had “long COVID” manifestations documenting some systemic symptoms even after 18 months of COVID-19 infections. Many cases are lingering with long COVID manifestations ranging from minor to major illnesses affecting the quality of life, and its impact on morbidity and mortality later during the course of illness.

  Covid-19, Severe Acute Respiratory Syndrome, and Middle East Respiratory Syndrome Top

COVID-19 is the first coronavirus-related global pandemic documented in the history of medicine, and before these medical records documented the localized spread of coronavirus disease-causing epidemics in 2003 as severe acute respiratory syndrome (SARS) and in 2012 as the Middle East respiratory syndrome (MERS). SARS and MERS were controlled early and prevented spread to the entire world due to active measures taken by health-care system and curtailing the viral spread effectively with the help of measures taken by the rapid response team in segregating cases in time.[2] Many patients in COVID-19 disease were shown pulmonary and extrapulmonary manifestations variably during the first and second waves, which occurred as resultant pathophysiological effects of immune activation pathway and direct virus-induced lung damage. Contradictory to presently ongoing COVID-19, other known coronavirus-related pandemics MERS and SARS have documented predominant respiratory involvement as compared to extrapulmonary effects. Still, we do not know how coronavirus-related SARS, MERS, and COVID-19 diseases are having heterogeneous manifestations across the world ranging from isolated lung, lung and extrapulmonary involvement to minimal lung with predominant extrapulmonary involvement.[2]

The etiological agents of SARS and MERS as SARS-CoV and MERS-CoV, which were isolated from 'bat animal' which is a natural reservoir of most of the coronavirus family, and studies have documented bat-to-human transmission or zoonotic transmission. Epidemiological trends of SARS and MERS were similar, but mortality rate documented during MERS was higher than SARS. Till today, the origin of the causative agent of COVID-19, i.e., SARS-Cov-2 is not documented and various hypotheses came up with its spread started in wild animal see food market in Wuhan, China, with fading scientific evidence. Although case fatality documented in COVID-19 is less as compared to previously documented epidemics, various variants evolved during COVID-19 disease have different trends of mortality. Importantly why the Delta variant, a strain of the second wave of COVID-19 has the highest mortality as compared to the first wave Wuhan variant, and negligible in third-wave Omicron variant, is still unknown. Maybe, the genetic makeup of coronavirus was determining factor for overall outcome in the first and second waves, first was classical “Wuhan variant virus” and the second one was mutant “Delta variant” coronavirus; and as a mutant in the second wave was associated with increased morbidity and mortality and negligible mortality with Omicron variant.[3] Coronaviruses have a propensity to adapt to rapidly changing environmental conditions and very well adjust to it by having spontaneous mutations with interspecies and intraspecies mixtures by a genetic material exchange about 10 − 4 nucleotide substitution/site/year, resulting in high recombination frequencies. A plausible explanation for variants and waves in this ongoing pandemic is the persistence of asymptomatic or symptomatic infections for longer periods in individuals with or without viral shedding, underlying immune status of the host, and antigenic behavior of coronavirus with high mutation and recombination rate increases the probability, that a virus mutant with an extended host range might arise and this might be a reason for rapidly changing strains and variants that we have documented in the last two and half years.

  Covid-19 and Spanish Flu Top

Like the Influenza virus-related global pandemic in 1918 (early 20th century), a Spanish flu which has multiple waves in ongoing pandemic lasted for almost 5 years, currently ongoing COVID-19 pandemic has documented 3–5 waves globally lasted over a period of 2½ years. Virological isolation and genomic methods are well established and genotyping is available in current times. Due to advancements in rapid diagnostic modalities, the genetic makeup of coronavirus resulting into molecular change and cause of each wave as Wuhan, Delta, Omicron variants were documented in time including its epidemiological trends as virulence, infectivity, and mortality. As virological methods of isolation and genotyping were not very well-developed during the era of Spanish flu, genotyping was done, but strain mapping was not possible.[4] The Spanish flu involved 25%–30% of the world population with acute illness and resulted in 50 million deaths, while in COVID-19, 400 million infected population with 5.7 million deaths.[1],[4] More deaths during Spanish flu were due to lack of advanced medical facilities and intensive care units globally, and we have seen those benefits during COVID-19 and prevented millions of deaths due to advancement in intensive care, ventilatory facility, antiviral medicines, vaccination, and COVID appropriate behavior strategy such as social distancing, mask and hand hygiene, and finally community isolation by means of lockdown on large geographical areas were first documented in the history of mankind. In the Spanish flu also, an infection control policy was implemented and used the mask for the prevention of infection by control of aerosols, but social distancing and hand hygiene were underutilized, although it is highly effective during pandemics in controlling rapid spread and evolution.[4]

Mucormycosis, both pulmonary and extrapulmonary (eyes, nose, sinuses, and cerebral), fungal infection as a complication documented during the evolution of COVID-19 lung pneumonia predominantly in the second wave as compared to the first wave in India and documented in many parts of the world. Rational for documentation, especially in the second wave was unclear, may be related to more steroid use due to rapidly evolving ARDS (Acute Respiratory Distress Syndrome), more virulent nature of Delta variant, coronavirus-mucor fungus symbiosis which has increased localized and systemic access due mucosal inflammation and injury into the nose, sinuses and airways, and lastly, contamination of humidifier chamber of oxygen supplementation system with fungal spores, but the exact reason for occurrence was unknown.[3] Occurrence of Mucormycosis was never documented before with any respiratory virus-related pandemic as caused with influenza virus as in Spanish flu or coronavirus-related in SARS or MERS.

  History of Russian flu and Coronavirus-Related Diseases Top

The discovery of the human coronavirus and its association with respiratory illnesses was documented in the 1960s. Very little is known till 1967 when famous virologists Tyrrell and Bynoe discovered B814 virus which was isolated from tracheal samples of adults suffering from the common cold in human embryonic cell cultures. Then, Tyrrell and Bynoe's team of virologists documented its association and similarities with other groups of viruses causing bronchitis and gastroenteritis.[5] These new groups of viruses having a similar morphological pattern as “crown-shaped surface projections” were named as coronavirus, and accepted as a new genus of viruses.[6] Coronaviruses are enveloped, positive-stranded RNA viruses with a genome of approximately 30 kb and sharing many antigenic similarities between human and bovine coronavirus (BCoV) as human coronavirus OC43 (HCoV-OC43) and bovine coronavirus (BCoV).[7] Viral genome sequencing and molecular clock analysis of these two variants, HCoV-OC43 and BCoV have traced these to common ancestors around 1889–1890 and suggest a relatively recent zoonotic transmission event and dates around 1890.[7]

The first case of Russian flu was documented in St. Petersburg in 1889, after the outbreak of alarming cases with febrile respiratory illness were reported in Kazakhstan and Uzbekistan before to this cluster of cases. The Russian influenza, the first respiratory viral pandemic of unknown etiology in the history of mankind documented in late 1889 and fully evolved in 1890 and affected a major part of the world, including mortality and morbidity. Exact epidemiological patterns and trends of affection were not fully examined with the help of available history and records.[8] The majority of medical experts of that time believed it could be the influenza virus causing a pandemic. The evolution of Russian flu was very typical and described in currently ongoing COVID-19 pandemic, during the first 6 to 12 weeks only small geographical area was affected and behaving like epidemic, in the coming next 3 months majority of the world is affected with the involvement of population of all age groups with a predominance toward advanced age, irrespective of class and race and many cases had minimal symptoms and few had advanced disease without any danger signs of an illness called as “happy hypoxia” of the current time. This means that Russian flu evolved over a period of 3–6 months and occupied the entire globe, initially spread was documented across the railway lines and shipping lines and entered to Europe and then to the United Nations and other parts of the world. Although resources were limited including transportation, the wave of transmission and human transmission was as rapid as today's pandemics as recent past novel influenza and currently ongoing COVID-19. Medical experts believed trading industry has been resulted in rapid spread of Russian flu across the different continents, as in the USA after 70 days of first case and in 4 months it occupied entire world. Many medical experts were labeled Russian flu as influenza or plague of 1892, few of them as of coronavirus-related human pandemic although virological isolation and exact causative agent for Russian flu is not known. The pandemic was similar to COVID-19 in remarkable ways as it was an event intimately linked to modern transportation and global communications technologies.[8]

Medical experts also mentioned that around 1960s epidemic of febrile respiratory illness with a high mortality rate, bovine pleuropneumonia caused by (BCoV was documented and its transmission to humans has been documented in slaughterhouses by contact with these infected animals. Initially, bovine pleuropneumonia was thought to be caused by Mycoplasma mycoides and in 19th century due to similar clinical manifestations, scientific assumptions were coming up with its association with BCoV, and it can be hypothesized that the bovine respiratory disease in the second half of the 19th century might have been similar to the coronavirus-associated shipping fever disease.[8]

Similarities between Russian flu and coronavirus-related diseases

  1. The etiological agent is a respiratory virus in both pandemics, which has spread to humans from animals, and the pattern of evolution in both the pandemics is similar which has occupied the entire world in 3–4 months
  2. The rapid evolution of pandemic causing affection of all age groups people with more propensity to geriatric cases as compared to young population
  3. Infectivity and virulence of agents causing both the pandemics were similar and most of the affected cases become symptomatic and progress from 3 days to 2nd week of illness with similar mortality
  4. Epidemiological trends of different waves evolved over a period of 3–4 years as three to four waves have been documented in both the pandemics
  5. Pulmonary and extrapulmonary manifestations in cases were similar findings in both pandemics, as neurological manifestations were most common on both the pandemics
  6. Post pandemic systemic affections and longer symptomatic phases labeled as “Long COVID” is documented in currently ongoing pandemic, and it has been also described in Russian flu, where many affected patients had crippling and long manifestations
  7. Post illness immune suppression and reactivation of silent disease or new infection has been documented in both pandemics, mucormycosis and tuberculosis are documented with COVID-19 and later was documented with Russian flu.

[TAG:2]Molecular Clock Analysis between Covid-19 and Russian Flu or Covid 1.0[7][/TAG:2]

Russian flue was evolved during 1889–1890 and originated in central Asia and was having acute febrile respiratory manifestations as cough, malaise, fever, and neurological symptoms as headache and dizziness. All age groups were affected with more mortality in geriatric cases. Exact etiological documentation was not available as sampling and isolation were not done, and many scientific assumptions were leaning toward Influenza or coronavirus as a probable cause of the pandemic. Medical experts documented an epidemic of febrile respiratory illness with high mortality linked with BCoV, i.e., “shipping fever” occurred in the earlier decade of Russian flue predominantly in bovine slaughterhouses and infection got a transmission from infected animals to humans. The dating of the most recent common ancestor of BCoV and HCoV-OC43 to around 1890 is one argument. Another argument is the fact extrapulmonary manifestation, especially neurological symptoms were documented in 1889–1890 and then currently ongoing COVID-19 pandemic, and it was never documented in any influenza-related pandemic. This is the indirect evidence that “Russian or Asiatic flu” was an ongoing COVID 1.0 or first pandemic. In currently ongoing COVID-19 pandemic, many recovered cases from critical or advanced illness had “brain fog” presented as long COVID neurological manifestation similarly as observed with HCoV-OC43 associated Russian Flu with more neurological involvement. Furthermore, post-COVID manifestations or long-COVID symptoms documented in the currently ongoing pandemic has been described in the Russian Flu. Another important postpandemic issue is immunosuppression is very well described current pandemic and an increase in surge of mucormycosis and tuberculosis were documented. Similarly, medical experts of that time in Russian flu have mentioned that mortality and morbidity were similar to the currently ongoing pandemic, many peoples have killed due to larger geographical area affection despite low mortality, few cases had postpandemic manifestations and persisted for years, few cases were shown reactivation of chronic infections as tuberculosis/phthisis similarly in currently pandemic.[8]

  Conclusion Top

What we should learn from the Russian or Asiatic flu pandemic is that if it was related to coronavirus and trends were similar to the currently ongoing COVID-19 pandemic, still people have satisfactorily dealt with it irrespective of lack of modern medical treatment facilities such as ventilators, antiviral medicines, vaccinations, and intensive care units. Although medical science has learned many things from the currently ongoing pandemic, preparedness, and newer advancements as highly effective vaccines after analyzing global viral genomic data, potent antivirals are key step to save mankind from these smarter virions, and they will live with us and we should make adjustment according to changing patterns of these agents due to interspecies mixtures, as they were present before our presence on this planet.

  References Top

Available from: https://www.worldometers.info/coronavirus/. [Last accessed on 2022 Feb 10].  Back to cited text no. 1
de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: Recent insights into emerging coronaviruses. Nat Rev Microbiol 2016;14:523-34.  Back to cited text no. 2
Shital P, Gondhali G. Does genetic makeup of corona virus in COVID-19 disease is as predicted or is similar to other respiratory viruses like influenza? Still, we believe in covid appropriate behavior in spite of vaccination. Show must go on! Saudi J Med 2022;7:1-3.  Back to cited text no. 3
Liang ST, Liang LT, Rosen JM. COVID-19: A comparison to the 1918 influenza and how we can defeat it. Postgrad Med J 2021;97:273-4.  Back to cited text no. 4
Tyrrell DA, Bynoe ML. Cultivation of a novel type of common-cold virus in organ cultures. Br Med J 1965;1:1467-70.  Back to cited text no. 5
Kahn JS, McIntosh K. History and recent advances in coronavirus discovery. Pediatr Infect Dis J 2005;24:S223-7226.  Back to cited text no. 6
Vijgen L, Keyaerts E, Moës E, Thoelen I, Wollants E, Lemey P, et al. Complete genomic sequence of human coronavirus OC43: Molecular clock analysis suggests a relatively recent zoonotic coronavirus transmission event. J Virol 2005;79:1595-604.  Back to cited text no. 7
Ewing ET. La Grippe or Russian influenza: Mortality statistics during the 1890 Epidemic in Indiana. Influenza Other Respir Viruses 2019;13:279-87.  Back to cited text no. 8


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