1918 flu deaths - aspirin aggravated?

Aspirin May Have Had Role in 1918 Flu Epidemic

Excerpt:

Dr. Karen M. Starko, author of one of the earliest papers connecting aspirin use with Reye’s syndrome, has published an article suggesting that overdoses of the relatively new “wonder drug” could have been deadly.

What raised Dr. Starko’s suspicions is that high doses of aspirin, amounts considered unsafe today, were commonly used to treat the illness, and the symptoms of aspirin overdose may have been difficult to distinguish from those of the flu, especially among those who died soon after they became ill.

Some doubts were raised even at the time. At least one contemporary pathologist working for the Public Health Service thought that the amount of lung damage seen during autopsies in early deaths was too little to attribute to viral pneumonia, and that the large amounts of bloody, watery liquid in the lungs must have had some other cause.

Dr. Starko acknowledged that she did not have autopsy reports or other documents that could prove that aspirin was the problem. “There was a lot of chaos in these places,” she said, “and I’m not sure if there are good records anywhere.”

But of the many factors that might have influenced the outcome in any particular case, Dr. Starko wrote, aspirin overdose stands out for several reasons, including a confluence of historical events.

In February 1917, Bayer lost its American patent on aspirin, opening a lucrative drug market to many manufacturers. Bayer fought back with copious advertising, celebrating the brand’s purity just as the epidemic was reaching its peak.

Aspirin packages were produced containing no warnings about toxicity and few instructions about use. In the fall of 1918, facing a widespread deadly disease with no known cure, the surgeon general and the United States Navy recommended aspirin as a symptomatic treatment, and the military bought large quantities of the drug.

The Journal of the American Medical Association suggested a dose of 1,000 milligrams every three hours, the equivalent of almost 25 standard 325-milligram aspirin tablets in 24 hours. This is about twice the daily dosage generally considered safe today.

Comment: Interesting.