At the Naito Museum of Pharmaceutical Science and Industry in Kakamigahara, Gifu Prefecture, a color print recalls a scourge that struck the country more than a century ago: “It is named ‘influenza’ which is originated from foreign goods imported . . . at first, there is a high fever . . . “

The print depicts a new flu strain that appeared in Japan in 1890 and spread the following year, infecting people in nearly every household. Doctors and drugstores were overwhelmed, and public bathhouses and other places were deserted, the print said.

People were urged to see a doctor immediately and told that heart disease patients would be in danger of dying.

Although the tone of the print would be rather alarmist today, its warning “never to invite great damage by blindly believing in rumors around town” should still be applied despite the comparatively vast knowledge of influenza that has been gathered since, one expert says.

“Considering the fatality rate of the new flu strain and its infectious capacity, countermeasures should be considered flexibly,” said Mitsuyoshi Urashima, an associate professor at Jikei University School of Medicine who is an expert on crisis management and infectious diseases.

Bird flu, for example, has a fatality rate of about 60 percent and has been cropping up from time to time in Southeast Asia. The World Health Organization has been pushing countries to prepare countermeasures for a potential bird flu pandemic.

But the fatality rate for H1N1 swine flu is just 0.4 percent in Mexico, where most of the deaths occurred. In advanced countries, the rate is close to seasonal flu, standing at less than 0.1 percent.

Since the virus could mutate into something more deadly, experts say there is a great need to stay flexible.

For example, the spread of severe acute respiratory syndrome (SARS) from China to other countries in 2003 killed about 800 people over several months. But since SARS only becomes infectious after symptoms appear, it can be contained by immediately isolating the patients.

H1N1, on the other hand, has the capacity to infect people the day before symptoms appear. This makes containment difficult because many people who catch it develop only mild symptoms, shrug it off, and continue with their daily activities.

But when the infections rise, they tend to flock to hospitals and clinics, Urashima said.

He also noted that deaths in the first wave of Spanish flu were low in Japan but soared in the second and third waves.

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