José Elías García Sánchez and Enrique García Sánchez
Departamento de Medicina Preventiva, Salud Pública y Microbiología Médica. Facultad de Medicina.
Universidad de Salamanca (Spain).
Correspondence: José Elías García Sánchez. Facultad de Medicina. Alfonso X El Sabio s/n. 37007 Salamanca (Spain).
Received 20 January 2006; accepted 30 January 2006
Each year, once winter has arrived in either hemisphere influenza begins to attack. In general, people believe 'flu is merely a fairly commonplace disease, although it causes a considerable number of deaths in some parts of the population, apart from the economic and social repercussions linked to its appearance. In part, this perception about the disease is due to the fact that within the term influenza other acute respiratory viral infections are included; for example, the common cold. Last winter (2005-2006), in the northern hemisphere alarms began to ring in the communications media because a new 'flu virus, H5N1, was producing cases at the very doors of Europe. The truth is that ever since 1997 this strain has been causing cases in humans, but only in the Far East. This virus is responsible for 'flu in birds and displays certain features that suggest it should be feared. Owing to their ability to fly and their migratory behaviour, its usual hosts (birds) spread it fast, easily, and over large geographic areas. It is an agent that has caused considerably mortality in humans, including children. The only positive aspect is that to date the spread of this strain to human beings has only occurred in people who have been in intimate contact with sick birds or who have eaten poorly cooked meat from these animals. Nevertheless, scientists fear that a mutation or recombination might occur that would allow not only an interspecies jump but also transmission among humans1. A 'flu virus that can lead to high mortality and that can be transmitted through the air to other human being is inevitably reminiscent of the great 1918 pandemic, known as the Spanish 'Flu.
However, the perspectives regarding 'flu today are not the same as those in play during the times of the Spanish 'Flu. The H5N1strain is known; there are laboratory techniques that allow not only its culture and identification but also its rapid detection. Efficient vaccines have been developed and we have advanced technologies for producing them and there are drugs that may prevent it or even cure it, such as the neuroaminidase inhibitors zanamivir and oseltamivir. Vaccines, however, are prepared with strains which circulated during the previous influenza season and some strains are resistant to zanamivir and oseltamivir.
The impact of 'flu on human health accounts for its appearance in the plots of some films portraying both its annual form to a certain extent considered commonplace- and its pandemic form, responsible for huge losses of life. However, the cinema has not only addressed the actual existence of 'flu but also its complications, its prevention and the possible use of 'flu viruses as biological weapons.
Many films portray acute respiratory syndromes that could correspond to the 'flu or a cold, as happens in reality. A good example is In the line of Fire (1993) by Wolfgang Petersen. In this film, the main character has fever, congestion, general malaise, difficulty in concentrating at work, and takes anti –influenza drugs. In The Taking of Pelham One Two Three (1974), by Joseph Sargent, the Mayor of New York has a similar condition but in this case receives intramuscular drugs, presumably antibiotics, which is something that should not be practised in cases of 'flu unless it courses with bacterial complications. In other films the directors have depicted certain conditions that could be 'flu [That`s Life! (1986), by Blake Edwards] and the illness is even used as an alibi for not carrying through with something or for justifying a certain indisposition [The Journey (1959) by Anatole Livtak].
The mortal nature of influenza viruses has been dealt with in several films not explicitly addressing the issue, such as It’s a Wonderful Life (1946), by Frank Capra, and even in musicals such as George Cukor’s My Fair Lady (1964). Pneumonia as a possible complication of flu is mentioned in the comedy Barefoot in the Park (1967), by Gene Saks, and confirmed as such in In Name Only (1939) by John Cromwell. In Awakenings (1990), by Penny Marshall, the director focuses on the encephalitis lethargica as a complication of 'flu.
Influenza epidemics that produce high mortality rates is a topic addressed in older films, such as Tundra (1936), by Norman Dawn, or Three Faces West (1949), by Bernard Vorhaus. The devastating effects 'flu viruses in indigenous populations who have never come into contact with them previously can be seen in Medicine Man (1992), by Hohn McTiernan, or in At Play in the Filed of the Lord (1991), by Hector Babenco.
As would be expected on the title, 1918 (1985), by Ken Harrison, portrays the pandemic of Spanish 'flu that occurred that year. The possibility of facing up to this virus strain again has been explored in two films produced for television: Runaway Virus (2000), by Jeff Bleckner , and Le neuvième Jour (1995), by David Delrieux. In both, the directors explore the possibility that the virus might have been frozen in the cadavers of people who died in the epidemic but were conserved in a polar environment. These films stress the development of a vaccine for the 'flu and they also portray virological investigations with influenza viruses.
The possibility of using a mutated influenza virus as a biological weapon is the core story around which Mission Impossible II (2000), by John Woo revolves. This agent was obtained during work aimed at developing a vaccine for 'flu.
As a conclusion, it may be affirmed that the impact that 'flu has and continues to have on human health does not correspond to that shown in the cinema, since only a limited number of films have afforded it much weight in their plots.